MatExp and Me

Women’s Voices in #MatExp – Your Midwife

25 January 2016 by Helen Calvert / #MatExp Actions, Environment and Facilities, MatExp and Me, The #MatExp Journey / 13 Comments

I was asked to do a talk to student midwives at Salford University last week on the topic of “Women’s Voices” in maternity care. As part of my presentation I included the voices of the midwives who work in maternity care, and a reminder that there are many other women for whom maternity care is their professional, as well as perhaps their personal, experience. “Women’s Voices” in maternity care should cover the midwives, obstetricians, health visitors, doulas who care for us, as well as the women giving birth.

So I decided to start a series of blog posts on “Women’s Voices in #MatExp” from the point of view of those working in maternity, and this is the first of those. This is Dawn Stone’s experience of being a midwife in the NHS. Thank you so much to Dawn for agreeing to write for us.

And yes, I will be doing a “Men’s Voices in #MatExp” series too. Because this campaign is about all voices.

Helen.x

*********************

Dawn Stone is a 27 year old midwife living and working in central London. Dawn qualified as a midwife in 2014, and is passionate about improving experiences for students, midwives and women.

It’s an insignificant Monday afternoon in SE London to many. It’s beautifully warm, people are rejoicing in beer gardens as they finish work, I hear the giggles and shrieks of laughter from a nearby park as I walk home. It’s an idyllic summers day; and yet somehow it feels cold to me.

I’m on my way to see my GP. I made the appointment last week, but it feels fortuitous to have this lifeline today. Because today, of all the 303 days I’ve been a midwife, it feels way too much to bear. And I need some help.

I’ve been here before. A few months ago the feelings on inadequacy, frustration and disappointment reared their ugly heads and I made the same journey to my GP, begging for help. She, to her credit, was wonderful but the medication she prescribed was not. I went back to work but felt like I was going through the motions. My appetite was reduced, I hadn’t slept a whole night in months, and I constantly had a knot of tension in my stomach whenever I thought about work.

What do I do? I’m a midwife. And it nearly knocked me off my feet completely.

I trained as a midwife in a busy central London hospital, which often felt like a baptism of fire and was definitely not what I was expecting. I was lucky to witness amazing births, incredible women, and unfortunately, at times, disappointing midwives. It seemed as though some had lost the ability to care about the women as well as for them; and so I qualified with a goal. Be the best midwife I can be, and never forget the power and importance of being kind. It sounds so simple when you write it down!

Upon qualifying, I moved to another busy central London hospital, and began working as a bona fide midwife, alongside a group of also newly qualified midwives who would become my lifeline. Together we jumped into this chaotic and intense career, and discovered that being a student midwife does NOT prepare you for being a midwife. Not at all. You have no idea as a student the enormity of every decision you make – that lochia is normal, that baby is not jaundiced, that baby is unwell and needs an urgent review. And on and on it goes; a hundred different decisions, all before lunchtime and all before you’ve had a drink or something to eat. And if you’re lucky, you’re figuring this all out in an environment which is supportive and conducive to learning, where you know you have more experienced midwives to lean on and ask ‘Does it get better?’

If you’re unlucky, you’re essentially told to suck it up and keep going. Never mind that you’re awake at 4am going over and over the shift from yesterday, thinking about each woman and baby, and what you handed over – did you forget something? You definitely did. Shut up mind, go to sleep. Except you definitely did forget something because you did a blood sugar on the baby in bed 9 before you left and you forgot to write it down. It was normal, thankfully, but should I ring? No. It’s 4am and it’s your day off. Go back to sleep.

Working on a busy 50 bed AN/PN ward can feel like being on a carousel that’s spinning and spinning; there is no slowing down, only jumping on, and trying to stay upright and facing the right way.

When I arrive for my night shift, I look at my workload and I hope for an okay night. I have a mixture of 2 high risk AN women (for close monitoring of their severe PET), an IOL for post dates and 4 PN mums & babies – all of them are on obs overnight, 1 mum is also on IVABX for sepsis, and my colleague has just handed over that one of the babies hasn’t fed for 6 hours. I take a deep breath, try to quell the tide of worry that’s swirling in my stomach, and do the only thing I can do. I make a plan. I read the notes, I look at the blood results, and I try to prioritise what needs doing and when. I say hello to all 7 women, some of whom I know, and I begin to do what needs to be done.

And I’m sorry if I couldn’t sit with you longer during your breastfeed. I can see your baby is feeding well but as a first time Mum you need some support and guidance as you learn this new skill. I want to sit with you, and gently reassure and reaffirm you as you confidently latch your baby to your breast. But I can’t. Because I have 6 other women, and 3 other babies who need me. So I do what I can, and then ask a maternity support worker to step in, and do what I cannot.

I’m sorry my checking on you and baby felt like a list of questions, one after the other, relentlessly. I know this isn’t the best way to elicit how you feel about this huge shift to parenthood, and I may not ask the question you need me to, and so your niggling worries remain unchecked.

I’m sorry I have to wake you at 2am, and 6am, to check your blood pressure. The medication you’re on to manage it is very good but we need to ensure its effective, and the middle of the night BP is actually one of the most useful. I hate waking people up, and I know you don’t mean to swear at me as you grumble and sigh, before brandishing me your arm, but it still hurts to hear. Thankfully your blood pressure is normal, and I can tiptoe out & leave you to rest.

As I walk past the desk, I see my bottle of water, next to my colleagues. All untouched.

I’m sorry you’re in a mixed bay of women, and you can hear babies crying as your labour is starting, and it’s not dark or quiet as you need it to be. I’m sorry you’re quietly sobbing on the edge of the bed as you try to get through this contraction without making too much noise and waking the sleeping bay. I’m sorry I can’t be with you, talking you through your contractions and helping you to relax and reduce the fear/tension/pain cycle. I know that you need me, but I have obs to do on 2 of the babies in this bay, and I need to check on one of women with raised BP as she’s on the monitor and I hope it’s ok as I had to dash out of the room once it was on. I’m sorry I’m only half with you as I rub your back, as I’m juggling my outstanding jobs in my head. Thankfully, some codeine and a warm baths eases some of your pain, and you spend a few hours soaking in there, feeling much more relaxed.

I’m so relieved.

I’m so relieved that your labour didn’t progress rapidly, and your baby wasn’t born on the ward.

I’m so relieved all of your babies obs were normal, and they didn’t show signs of an infection.

I’m so relieved that the heavy bleeding you complained of turned out to be normal blood loss, and you’re not having a haemorrhage.

I’m so relieved your blood pressure was normal, and you’re not feeling any symptoms of pre eclampsia.

I’m so relieved when you come to me at 4am, as I sit at the desk gratefully drinking a coffee as I relish the middle of the night peace that’s descended, and tell me you latched your baby on yourself & it felt like a good feed.

I’m so relieved. I’m also hungry, and tired, and the water has remained untouched although I have slurped a coffee my colleague made for me.

This shift has been busy, and stressful, and required me to constantly assess, juggle and prioritise. But it’s not extraordinary. It’s a typical shift in a typical London hospital on any given day. The women are grateful, and I leave with a small sense of doing a good job.

Until I return the following night to be told I didn’t do a VTE risk assessment. And the dyad I helped with breastfeeding are now mixed feeding as she felt her baby wasn’t getting enough. And the mum who labour began during the night is still on the ward, awaiting a doctors review to formulate an ongoing plan. And we’re short staffed. And I can feel a headache coming on as I didn’t sleep well, worrying and replaying the previous shift over and over.

With such unrelenting pressure, is it any wonder I’m crying to my GP, telling her how unhappy I am, how tired, how morose? And is it any wonder she doesn’t bat an eyelid when I ask for antidepressants, and a sick note?

*********************

#MatExp is a campaign about ACTION! So what can be done? We have already written about how it is Time to Act for Midwives, but as this recent post on Sheena Byrom’s blog demonstrates, these issues are not isolated and they are not yet being taken seriously.

Sheena kindly commented on what Dawn had to say:

“Dawn’s reflection of her experience trying to do her work as a midwife is distressing, and tragically, Dawn is by no means alone. I receive regular emails from midwives and student midwives who feel desperate, unable to go on, and ready to leave our profession.

I sincerely hope the National Maternity Review report will kick start the much needed radical reform of maternity services. If we can’t support, care for and nurture maternity workers to provide safe, effective high quality maternity care, we have an unsustainable situation.”

A mile in my shoes

Community Outreach Midwife Wendy Warrington also commented on Dawn’s experiences:

“This could have been written by me and the majority of my midwifery colleagues as accurate, and to be honest been there themselves me included! I came back to work after nearly 3 weeks off and Monday morning I had a knot in my stomach when I turned on my work phone and strolled into the community office. Fortunately all was well, but that was due to in the run up to Christmas ny starting early working at home, finishing late and putting written plans in place. Four women on my caseload delivered and I have high risk caseload due to safeguarding concerns.

In terms of improving the situation there needs to be a shift from the blame and bullying culture that seems to be prevalent within the midwifery profession and the NHS as a whole. Senior management with their expectations bully staff below them and this continues down the pecking order. Midwifery sadly is still very hierarchical. Also the public perception and expectation has shifted from when I first started. There does not seem to be the respect from the public as in days gone by . The “where there’s a blame there’s a claim” culture. Cuts to funding, staff shortages and the media have not helped.

Sadly I am counting down the days until retirement as are many of my colleagues.

So how to improve the situation? As colleagues we should nurture and support one another, and small pockets of us do. I personally have found my escape using Twitter and Facebook groups. Realising there were others out there who felt and thought like me and had not had the passion snuffed out of them really helped me, and gave me the courage to continue and believe that I can make a difference as a midwife. But than in itself can cause problems: cyber bullying, we have seen that. The more your profile is raised the more you expose yourself to scrutiny. I was seconded to Project Manager for Early Years agenda for Greater Manchester and the knives were out . I was devastated when my Head of Midwifery said that this was par for the course: try to better yourself and jealousy kicks in.

There are health and well-being initiatives in some trusts which need promoting. While we are there to do our work the public should remember we have children, elderly parents and our own problems like them, and sometimes we can’t leave it at the door as much as we try to, so compassion and understanding comes from both sides. I do not know of any midwife who comes to work to upset, harm or distress any woman or her family.”

So what do we need to do? What are you doing? What is happening in your Trust that is helping? Please share best practice and ideas – we are stronger when we work together.

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Top Ten Things NOT To Say To A Preemie Parent

21 January 2016 by Helen Calvert / Language, MatExp and Me, Postnatal Care, Pregnancy Complications / 2 Comments

Language is a huge theme for #MatExp, and one of our six Heart Values. Francesca Tucker kindly agreed to write this post for us looking at people’s inadvertent language trip ups when talking to parents of premature babies. Francesca is a part-time working Mum, who lives in the New Forest with her husband Murray, baby Harry and their three cats. Harry was born at 28 weeks, whilst his parents were on holiday in France. He’s now a happy, healthy 18 month old!

As I sit and write this now, I can do it with a smile on my face. But 18 months ago, if you’d said any of the following “Top 10” to me, my reaction would have been vastly different. Depending on how my day had gone / how many Brady’s baby Harry had decided to scare us with / how much milk I’d managed to express etc., you may have had a response of tears, anger or stony silence. Because, quite frankly, there are just some things you don’t say to the parent of a premature baby!

Speaking on behalf of “The Premature Club” which no-one wants membership to, we understand that it’s difficult to know what to say. The pure joy of the newborn news is tinged by the elephant in the room- “what if they don’t make it”? We know that as our family, friends and loved ones you are thinking of us (we do appreciate it!) and you want to say the right thing, but we’re not expecting you to – there are no magic words that will break the spell and make everything better. Just being there for us, letting us cry, shout, or just sit in silence helps. And that silence can be golden – far better than the following “Top 10 Things not to say to a Preemie Parent”! (As compiled by myself and another Prem-Mum whilst we were in neonatal, both with boobs out, trying to get our babies to practice their breastfeeding!)…..

1. You’re lucky! You got to meet your baby early!

Yep, at this time, we’re feeling really lucky-said no-one EVER! Last time I checked, there was no calendar hung in my uterus, so I’m pretty sure the baby had no concept of ETAs.

2. Your baby was just keen to meet you.

I was creating quite a nice little home in my womb which I was quite proud of- food on demand, good thermostat, nice sounds, and a lovely landlady who was providing everything. I think my baby was quite happy to stay put for a while longer, and wasn’t that eager to meet me. He/she had heard me chatting enough already, so I’m pretty sure the baby knew me already!

3. Oooh, having such a small baby must have made labour easy!

Putting aside the obvious fact that childbirth is painful, what a lot of people forget is that Prems often arrive in emergency situations. This may involve tearing, C-sections, episiotomies as well as the wider delivery tool-kit of forceps, ventouse etc. This is NOT easy! (And don’t even get me started on the emotional aspects of labour)

4. Lucky you! You’ve got less baby weight to lose!

Why is it that when someone has a baby, everyone feels it’s acceptable to start commenting on your weight?! It’s no-one else’s business that you weigh, it’s the last thing on your mind whilst listening to the endless beeping in neonatal. And chances are that with the stress of the situation, you’ll be losing weight anyway

5. Well, at least with the baby in hospital, you get a good night’s sleep!

Erm, no!! At night, most Prem parents are trying to cram in a day’s work of general life into a couple of hours (unfortunately bills still need to be paid, housework done etc.), prepare supplies that need to go to the hospital the next day, express milk through the night to keep supply up, and are generally stressing. A good night sleep is not anticipated for months!

6. With those nurses around, you’re getting far more support than most Mums.

Yes, the nurses are a fantastic support (they become your extended family!), and it’s a hard job to do, but they are by no means doing it single-handedly. They encourage the parents to get involved wherever and whenever possible. I can’t think of many parents that have a baby just to hand them over to someone else to look after – you are the parents, and you want the job! But also remember, the medical team is desperately needed- many Prems need a lot of medical support…surely no-one can begrudge a baby that?!

7. But tiny babies are so cute!

True, but would you swap your baby being dangerously small for “cute”? I thought not. And trying to find the “adorably small” premature outfits is tricky…and very expensive!

8. When will the baby be coming home?

We don’t know, and if we do, we often won’t want to say. It is upsetting thinking you’re about to take your baby home, only for your child to take a downturn and your excitement turns to disappointment and fear. Sometimes it’s easier for the parents to say nothing, rather than having to explain why the baby is remaining in hospital. And when we finally take our little family home, we may well want a day or two to take it all in-it’s a long journey to get home!

9. How are you doing?

Mmmm, a tricky one. Some days will be good, some days will be bad. With 1001 thoughts and emotions running through a Prem parents head, it’ll probably take too long for them to give an honest answer- default option is option to be “Okay, thanks. You?” A better thing to say if the offering of help for a specific thing e.g. “Would you like me to bring you a meal around, so you don’t need to cook?”

10 Will he/she be okay?

A very personal question, and again one that is completely dependent on individual circumstances. Define “okay”? The baby may have long-term health issues, but with the prospect of excellent quality of life, the outlook is overall positive. Or the baby may be going through a serious complication, where the outcome is an unknown. No-one wants to answer “No, he/she is not okay”, as it’s upsetting for all concerned. I personally think such questions are best avoided, and simply substituted by as much love and support as you can provide.

These are some of the favourite options I had for you from our early days of the neonatal journey. Now, a favourite is “Isn’t he walking yet?” – nope! But bear in mind, his peers have a 3month developmental head-start! Maybe I should do a Top 10 comments for the “Advancing Prem Baby”?!……….

But to anyone reading this, currently supporting a neonatal family – thank you. Even though the family may not show it (they are probably too overwhelmed presently), having you present in their lives is helping them more than you’ll know. And if you’re the parents of the little baby/babies lying in hospital- I welcome you to “The Premature Club”- it’s tough, and at times you may feel so wholly overwhelmed it can engulf you. But remember, you are doing a great job and making the best of your situation. I send my love and support to you.

By Rosiepics — Francesca and Harry by Rosiepics

Francesca Tucker

2016

For more “What Not To Say” and other Preemie Top Tens please visit The Smallest Things website.

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WhoseShoes Confirmed That My Shoes Have Climbed A Mountain

19 January 2016 by Helen Calvert / About MatExp, Caesarean Sections, Environment and Facilities, Informed Choice, Language, MatExp and Me, The #MatExp Journey / Comments Off

This post is from Michelle Quashie, and originally appeared on her blog site Strong Since Birth. Our thanks to Michelle for agreeing for it to be reposted here.

The day had finally arrived! After contributing to #MatExp and interacting with many conversations surrounding ‘WhoseShoes’ throughout the year, I was finally going to experience the magic in real life.

Laura, the chair of our MSLC has written a fantastic post that captures the excitement of the day perfectly, you can read it here: When WhoseShoes Came To The PRUH

I was not disappointed, the day was everything I had dreamed of, but for me it was so much more.

I was asked to open the event by sharing my Maternity Experience. I have spoke at several maternity training events in the past but my audience has always been Midwives. I was aware that this was a multi discipline training event and it was to be the first time I would share my story in such detail with Obstetricians and everyone else involved in Maternity. The thought made me feel anxious but I knew how important this opportunity was.

I had planned to stay in control and not let the emotions attached to my experience be displayed in the form of tears. It was so important to me to remain composed and in control.

My heart pounded through the showing of the MatExp film, this film moves me every time. It is so powerful and very thought provoking. Sadly I can resonate with many of the situations displayed in the film. I knew I was about to be discussing some of those memories any minute with all those surrounding me.

My name was called and I made my way to the front with my heart pounding. I decided to be honest and share how I was feeling with the room.

‘Please bare with me, I am feeling very nervous. I’m sure once I start talking I will warm up and I will be fine!’

Automatically I felt more relaxed and felt more able to share my story without the anxiety overruling my thoughts.

It’s amazing how every time I share my experience it comes out slightly different, or I find myself saying things that I hadn’t thought of before? I had missed a couple of important bits out but neither the less I was very happy with the way I had presented and gauging by the feeling of emotion in the room I had touched the hearts of nearly everyone around me. For the first time I was able to keep my tears to myself even though I had noted that tears were shed by many in response. The room fell silent but the atmosphere spoke volumes.

I wasn’t aware of the tweets that were being circulated on social media but looking at them them later along with the emails I had received It confirmed that my talk was a positive part of the day.

“Also a massive well done to Michelle for her heartfelt and emotional story, I could see it touched many people as there were certainly a few tears in the room. That took huge courage to stand there in front of so many people and share such a personal experience and to tell it so well. Huge WELL DONE Michelle.”

We began to play the the game and interesting discussions were had in response to the thought provoking questions that are key to the WhoseShoes success.

Some of the discussions that stick in my mind were:

A woman wanted a home birth but her husband wasn’t convinced. We had discussed that there wasn’t enough support or information given during antenatal care to ensure that the couple felt safe,supported and empowered to fulfil the woman’s birth choice.
Consultant Obstetricians are normally addressed by other members of their team using their title i.e., Sir, Mr, Mrs or Miss as a mark of respect. I may be wrong but it feels hierarchical, unlike the power slogan and barrier breaker behind WhoseShoes and #MatExp ‘No Hierarchy, just ordinary people’.
It was also discussed that consultants were on site until 9 pm, after that they are on call for emergency situations only. Now I understand why during my appointment to discuss my VBAC, the registrar said ‘ I mean, we don’t know when you will go into labour or who will be on duty should you rupture’. I now understand that my birth choices were influenced by staffing levels at the hospital.
Other key themes were Empathy, Language, supporting and facilitating informed decision making and just how important it was for everyone to be cared for individually based on their individual situation and needs.
Midwives are able to have time to build a relationship with women whereas doctors are often called for the emergency situation and do their best to resolve the medical issue as it arises. This can sometimes make it hard for them to be able to connect with the woman that they are caring for and are not always able to fully appreciate the long lasting effects the experience can have on a woman.

The day was coming to an end and Anna gave us fabulous evaluation of our morning using the comments that came from the discussion at each table. It was fabulous to visualise the discussion using the graphic that Anna had been working on through out the morning.

We each made an individual pledges. Here is my pledge:

“To provide a platform for women to share their Maternity experience. I would like to ensure that women’s voices are heard as part of training and development.”

I am currently planning a conference called ‘Women’s Voices’. More details will be available soon.

As the morning came to an end and people were leaving someone tapped me on my shoulder. I turned round and my tummy flipped. The face before me took me straight to a place of feeling vulnerable, feeling panicky.

‘Michelle it was me wasn’t it?’

Stood before me was the registrar that I had my consultation for my vba2c with. Unbeknown to my self and the organisers we had shared the morning. I had shared an experience that changed my life but had also been a time that left me feeling scared, vulnerable, isolated and questioning my mental health. The person that was responsible for those feelings was standing here in front of me, for a moment the feelings came flooding back, I battled to keep them contained.

She apologised for the way she had cared for me. She admitted that she had been wrong and has since ensured that she was fully aware of her professional guidance. She was now fully supportive of women’s choice regarding their birth and ensured me that since having to write a statement in response to my complaint, she is fully aware of the impact of the care she provides a woman.

She actually thanked me for highlighting the error of her ways promising me it had changed her attitudes. I could see that she was overwhelmed with emotion and had spoke to me honestly. She asked if she could hug me and we both held each other for comfort.

I told her that I admired her for taking the time to come a talk to me and for apologising. I also explained that I was aware that she was not entirely to blame for the care I had received and I now understood that her response to me wanting a vaginal birth after two caesareans was due to the cultural belief of the trust she worked in.

It was clear that my birth wishes would not be supported and neither would anyone wanting to support me at that time. I know this because many attempts were made to provide me with the support I needed and no one stepped out of their comfort zone to provide me with the support I needed with regards me birth choices. As a result I had no choice but to transfer my care.

She empathised and promised me that as a result of my experience things were changing.

We said our goodbyes and I was trying very hard to contain my emotion that the meeting had evoked.

A consultant midwife that has walked by my side through this maternity experience and others and who has been a pillar of support to me came to see me. ‘Are you OK Michelle?’

The flood gates open and I broke down. I couldn’t talk at that moment. I was just overwhelmed with emotion. I couldn’t make sense of it at the time but now I think I can.

That meeting with the registrar brought some closure. I admire her ability to acknowledge the error of her ways.

The meeting took me back and reminded me of the scared women I once was sitting in her office, trying to persuade her that I could give birth, pleading with them to allow me. Feeling so horrible when it was highlighted that I had never given birth and they wasn’t sure if I could. I was subjected to a number of negative comments that effected my mental well being and left me questioning my sanity. Comments that left my family feeling unable to support my decisions in fear of my safety. it was a meeting that left me feeling isolated.

Here I sat after coming full circle with the same women but this time I was a different woman. I am a now a woman who has had the most amazing journey and have achieved some incredible things;

I gave birth, not only did I give birth but I bloody rocked that labour ward!

I came back and I told the story, I sang it from the rooftops!

I learnt to believe in me and my abilities.

I joined their MSLC and contributed to so many fantastic improvements within the Maternity service.

I have spoke at training events within maternity with an aim to improve maternity care for women.

I have written and had my views published here and in The Practising Midwife .

I have contributed to #MatExp campaign and connected with some fantastic people as a result.

I have met, received support and been inspired by many fantastic people. too many to mention.

The realisation that my shoes have climbed a mountain has happened!

I received the following email from a Consultant Obstetrician following the Whose Shoes event. It confirmed that this journey has been worth every little step:

“Dear Michelle,

I just wanted to reiterate how touched I was by your story and how impressed I was by the way you delivered it. You will be responsible for improving the practise of every obstetrician in that room today which in the end will improve the care of tens of thousands of women.

If anyone is amazing it is you!”

This is one of many mountains.

I hope to be climbing a mountain near you soon.

Michelle Quashie

2016

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Induction – Cascade – Caesarean Section?

8 December 2015 by Helen Calvert / Caesarean Sections, Informed Choice, MatExp and Me, Pregnancy Complications / Comments Off

I have great pleasure in introducing a guest blog from Kirsty Sharrock, a.k.a. SouthwarkBelle. Kirsty is mum to two girls and lives in London. Her other day job involves biological samples, powerful lasers and badly fitting lab coats. When her first child was born in 2009 she became fascinated, and often infuriated, by the amount of misleading information aimed at new parents. Her response was the SouthwarkBelle blog where she tries to make sense of some of the dubious science or at least have a good rant about it.

Thank you so much to Kirsty for writing for us on the topic of Induction of Labour.

It’s a well known fact of modern childbirth: Inducing labour sets off a chain of other interventions which often result in an emergency caesarean.

But is this actually true?

Would you be surprised if I said it’s not? I certainly was. The idea goes against so much that I had heard from other women and from midwives, my antenatal teacher and of course the internet.

When I went overdue with my first baby I dreaded being induced. I’d heard nothing but horror stories saying it was entirely awful and unnecessary, it would almost certainly make the birth more painful and complicated and would probably set off a “cascade of interventions” leading, with grim inevitability, to the one thing I was most afraid off – an emergency Caesarean. It would also completely scupper my plans for a natural birth in a midwife led unit. But at the same time I was MASSIVE, it was August, and hot, I was desperate to meet my baby and had had quite enough of being pregnant. So I agreed to book an induction, then did everything I could think of to make that booking unnecessary. In the event I got my wish, sort of.

So was I right to fear the induction?

It seems the answer to that is no.

A 2014 study showed that being induced doesn’t increase the likelihood of having a caesarean. In fact women who were induced at term or when overdue were 12% LESS likely to have a C section than those who hung on for nature to do her thing. Their babies were also less likely to be stillborn or admitted to the NICU.

But can we believe this study?

We often see piles of scientific “evidence” that contradict each other. One minute coffee causes cancer the next it cures it etc. etc. so how reliable is this publication, given that it goes so strongly against the generally accepted view?

In this case the authors of the paper didn’t set up their own experiment or trial. Instead they did what is known as a meta-analysis. This is important because a meta-analysis is far more reliable than most of the scientific studies that make it into the media. The authors took the data from 157 different trials and did some serious number crunching. Looking not just at the results of those trials but at their weaknesses too. For example, many of the individual trials were pretty small, meaning their results are less reliable than bigger studies. Others were quite old or asked slightly different questions to the rest. But this variation is the whole point of a meta-analysis. By putting it all together it’s possible to overcome many of the errors and biases that inevitably influence the results of individual studies and to find a more reliable consensus.

We rarely get perfect answers in anything associated with biology. For obvious ethical and practical reasons we can’t do loads of enormous, randomly controlled trials to answer questions about human childbirth. So a meta-analysis, although still imperfect, is about as good as it gets.

But how can it be true when it contradicts so many people’s experiences?

This is the really tricky part. These results fly in the face of something many of us have learned to be true: In the experience of many women, midwives, etc. inductions tend to end in C sections. As yet I don’t know of any scientific studies to explain this difference, but if we step away from numbers and statistics for a moment, there are a few, very human, possibilities:

Relying on personal experiences is tricky. We’re all inclined to notice and trust things that confirm our existing beliefs. That’s just human nature, and it happens to everyone (I’ve known a few, usually logical, scientists get carried away over flimsy results that fit their current theory). In this case perhaps midwives and doctors who expect inductions to end in c sections are just a little more likely to remember the ones that do. Those births may also stick in the mind more than the less eventful, straight forward ones.

A similar thing can also happen with women’s own experiences. Even with everything seemingly perfect, births don’t always go to plan. Difficult births happen and sometimes they happen after an induction. If a woman has heard many times that inductions cause c sections, then it’s only natural to assume the induction was to blame if she does end up in theatre. Maybe that was the cause, but there is no way to be completely sure that the same things wouldn’t have happened with a spontaneous labour.

There is also the risk of self-fulfilling prophecies. It’s possible that some women are ending up in theatre just a little earlier than they need to because they, or those caring for them, suspected it was inevitable. Perhaps most importantly, there is the issue of fear. It is thought that fear can be a big cause of problems in childbirth. If a women is induced, and terrified of the procedure and what she’s been told it will lead to, then it could be the fear itself which causes the problems.

So should every woman be induced at full term?

What this study doesn’t do is prove that all women should be induced the second they hit 40 weeks.

There are many reasons why a woman may decide to delay or refuse an induction. I went into labour naturally but still ended up having some of the interventions that can be used in an induction and I found them pretty unpleasant. Every woman and every birth is different and each comes with a unique set of considerations. Meta-analysis and big data sets give us a clearer and more objective view of the big picture but they can’t say what is right or wrong for any individual mother. That choice must be hers and to make it women need good, evidence based information and often help from skilled, knowledgeable, health care professionals.

This paper also doesn’t give us is a very clear picture of just how likely it is that an individual induction will prevent a c section, still birth or NICU admission. What I hope we will see in the future is more user friendly data. Every women will have their own tipping point for where the numbers add up to choosing induction.

P1010492 — Looking pretty rough after a labour that started naturally, but still ended in an emergency caesarean

So what now?

Like many pregnant women I was taught to fear induction of labour and the cascade of interventions it would cause. Now it seems that fear was based on a myth. So it’s important that the evidence, challenging though it may feel, gets out to pregnant women and to those giving them advice. Unnecessary fear in childbirth is potentially harmful and certainly unfair. All the more so for those women who feel they have little choice but to be induced for urgent medical reasons.

This study also has implication beyond individual decisions. There is often a binary division of births. On one side the “low risk”, “normal” births that can be handled entirely by midwives and on the other “high risk” births, which are, effectively, everything else. Being induced can push an otherwise low risk woman over that line.

In the hospital where I gave birth this made a big difference. The Midwife led unit didn’t just have lower all round intervention rates, it also housed built in birthing pools and lovely en-suite rooms where mum, dad and baby could recover together after the birth. If I’d been induced I wouldn’t have been allowed on this unit. So, in choosing weather to be induced or not, I wasn’t just weighing up the risks of induction v continued pregnancy. I was also deciding if I should risk higher intervention rates, sacrifice the more welcoming facilities and deny my husband the opportunity to share the first precious hours of his child’s life. Now we have strong evidence that induction can reduce C section rates and in some cases save lives, should it really be the determining factor in where some women can give birth? Or in the standard of care they receive?

For me, spontaneous labour didn’t prevent an emergency C section. Perhaps I’d have stayed out of surgery if I had been induced? I doubt it, although I’ll never know for sure. But I can be glad that when other new mums are overdue, concerned about their baby’s health or just hot, heavy and sick of being pregnant, the myth of induction-cascade-caesarean section will be one less thing to fear.

Kirsty Sharrock / SouthwarkBelle

2015

Kirsty MatExp pals — Kirsty with #MatExp pals Leigh, Louise and Jen

A version of this blog first appeared on the SouthwarkBelle website: http://www.southwarkbelle.blogspot.co.uk/2014/09/induction-cascade-caesarean-section.html

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BECAUSE OF YOU I DIDN’T GIVE UP: +ve #MatExp

7 December 2015 by aNoviceMum / MatExp and Me / Comments Off

Welcome to the start of ‘A Catalogue of Maternity Experiences’. Rachel @enduringdelight from This Woman’s Work Blog gets us started with her positive maternity experiences and how they inspired her. We hope this motivates you to share your story too.

Read “An Important Catalogue of Your Maternity Experiences” to find out more about this #MatExp action, and submit your story.

I am by no means as eloquent when writing as some of the other members of the #MatExp community, but after seeing this tweet from the inspirational Sheena Byrom and following a suggestion from the lovely Helen Calvert I felt it really important to write this post. As Fab Obs Flo once told me, outside of my comfort zone is where the magic happens (thanks Flo!).

“I’ve learned that people will forget what you said, forget what you did, but people will never forget how you made them feel.” – Maya Angelou

This quote pretty much sums up the story of our children’s births. I will never forget how the people who cared for us made me feel and how they changed my life.

I’m Rachel, mama to (almost) 7 year old boy/girl twins and our youngest little boy who is 3½ years old. I’m also now an NHS Breastfeeding Peer Supporter, MSLC Vice Chair and birth junkie with a particular interest in improving birth experiences for families and the relationship between attachment and neuroscience.

I can’t even remember how I stumbled across #MatExp , but it is an amazing movement; it excites me to know that there are many other people out there as passionate as I am about supporting families to have the maternity experience they crave. For a long time I thought that my passion for positive birth and all of the issues surrounding it might just be a bit odd!! I don’t contribute to #MatExp as much as many or as much as I would like, but it is a privilege to be part of that community and so I am very grateful to some of #MatExp’s lovely ladies for encouraging me to persevere with writing this when I was struggling.

If you follow #MatExp you will know that, sadly, for a lot of the amazing people contributing to this grass roots movement inadequate care or a negative experience was their catalyst for getting involved. For me the complete opposite is true, but sometimes that makes things difficult for me because in certain circumstances it’s really hard to talk about having had positive birth experiences as I feel like somehow people may interpret that as me being critical of theirs.

A positive birth experience for me was always going to be a physiological one, but I am not militant about it and I don’t believe that’s what everybody should have. Moreover I believe that a birth that deviates from a woman’s ideal can still be positive if that woman is consulted, supported and given options rather than dictated to.

Having beautiful birth experiences and successful breastfeeding journeys are what drove me to become involved in movements like #MatExp and peer support. I’m all too aware that sadly not everybody is as blessed as I am to have had experiences like mine, but I really feel like they should be. It shouldn’t be a lottery that thankfully I won. Every woman should be listened to, respected and involved every step of the way in her own and her baby’s care.

“Do the best you can until you know better and when you know better, do better.” –Maya Angelou

My maternity experiences were very different, but positive in their own right. In hindsight there are things I would change if I could go back and there are things that weren’t ideal and that health care professionals should and could have dealt with differently, but that doesn’t make them a negative experience. In fact the only reason I know that there are some things I would change and things that could have been done better is because of all of the things I have learned since, but if my birth experiences hadn’t been positive to begin with I wouldn’t have been propelled into the world of positive birth and maternity experience and so would have been none the wiser.

The birth of our twins involved an induction at 38 weeks and 4 days gestation. I see so many negative things written about induction that it is important to me to write about this. I’m not writing about the process of induction and how good/bad this is for women and their babies. What I want to write about is the fact that, if you have knowledgeable and respectful people caring for you it can be a positive birth experience even if it is not your ideal. I am so grateful to the midwife who cared for us when our twins were born. To be honest I think she was the catalyst for my passion for birth and the person who gave me the confidence to decide on a home birth for our youngest son.

I’d had a very straightforward multiple pregnancy and so despite being classed as “high risk” (a label I despise) I hadn’t needed much care at the hospital other than routine appointments and so was quite nervous about how I would gel with midwives caring for me when the time came for our babies to be born in hospital. I need not have worried; as soon as Carmen walked in the room she came across as so knowledgeable and this gave me complete faith in her from the outset. It was clear that she had every confidence in my body’s ability to do its job which in turn gave me that very same confidence. After all, if she thought I could do it then why wouldn’t I?

Something that particularly stays in my mind is her supporting my decision to not have an epidural. I had never wanted one, but the anaesthetist was fairly insistent on me having one almost as soon as the drip was in my arm and I think I would have given in were it not for Carmen; instead when she could see the conversation was becoming too much for me she delicately stepped in and dealt with it whilst remaining respectful and professional towards her colleague. I remember feeling so grateful to her for that and so relieved to not have to fight for what I wanted.

“Drinking tea intelligently.” –Tricia Anderson

Our twins were born about 8½ hours after my syntocinon drip was started. I remember Carmen talking me through each stage of the induction; she read my birth plan and made sure that I didn’t remain on the bed and that I got breaks from the CTG trace, she got a rocking chair to allow me to be more upright and off the bed, dimmed the lights and left us to it as much as possible, but without ever being more than a stone’s throw away. She really did drink tea intelligently!! Even when she was drinking tea for real on her break I was her priority and she came back when I begged for her to.

Three years later I found myself excitedly planning a homebirth for our third child in our teeny terrace house. There were a couple of little administrative hiccups, but each midwife I came into contact with was positive and enthusiastic about our plans which made me feel really confident about our decision.

When the day came for our little boy’s birth I was blessed to have the support of another intelligent tea drinker; familiarizing herself with my birth preferences and facilitating them; Lorraine was a quiet, reassuring and confident companion and exactly what I needed. Although she hadn’t been my named midwife I had met her at a routine appointment and as soon as she arrived at our home on my son’s birthday I remembered how enthusiastic she had been about my plans for a homebirth when I had seen her all of those weeks before so I immediately felt calmed by her presence.

It was a very straightforward, if a little speedy, birth and with the aid of a tens machine, some hypnotherapy and a little gas and air our son was born in water less then two hours after Lorraine arrived and probably only about 20 minutes after the arrival of the second midwife. They stayed with us for a couple of hours or so after the birth; helping my husband to tidy up and ensuring we got breastfeeding off to a good start, being attentive, but respectful of what was an important time for us.

The midwifery team’s apparent confidence from the outset in the decision we had made to have our son at home as well as Lorraine’s confidence in her own ability as a midwife and my body’s ability to deliver our baby served to make me more determined to support other women and help them to achieve a birth experience that they were happy with. This is how I came to become involved in our local MSLC just a few months later; I wanted so much to make a difference.

It goes without saying that when mistakes are made we need to learn from them and make sure that those mistakes never ever happen again; I’ve worked for solicitors on birth injury cases and am all too aware of the devastation that can result from human error.

In addition though it is vitally important that we learn from the positive.

There are many midwives (and other healthcare professionals) who are wonderful at their jobs and passionate about the care they provide. These people have life changing positive impacts on families every single day and I feel so strongly about the fact that best practice should be shared and celebrated so that it can be replicated by others and that’s what I wanted to do today and to achieve in writing this. I wanted to share my positive experiences and celebrate the midwives who made a difference to me and to my family; I will forever be eternally grateful to you.

“We are like a snowflake; all different in our own beautiful way.” – Unknown

Most of the world faith traditions have stories of the birth of special people. There are signs accompanying the birth. Stars, wise men and phenomena announcing the arrival on earth of someone wonderful. Perhaps these stories are signs of what we should celebrate with each birth. The birth of every single child and every new parent is special.

As we welcome these little ones into our world let us think deeply. What physical environment is most fitting? What psychological and emotional factors should be named and made present? What people and attitudes will build that loving cradle of experience to welcome the newest member of the human race – our race? Every child and every mother are unique – like every snowflake.

Maternity experience is about creating the best for the newest.

I am fortunate that my experiences have been positive. Let’s always put women, children, families at the centre of our care and create experiences that reflect how special birth is.

Rachel xx

(The content of this post is my story, but a special thank you to John Walsh not only for taking the time to proof read and make some suggestions as to the finer detail, but also for his encouragement. You can read more of John’s wonderful musings here.)

~ How has your maternity experience influenced you? ~

Look out for @HeartMummy Helen’s story next month.

You can submit your story too; see the second paragraph for more information.

Like what you’ve read? Share far and wide 🙂

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Health Visiting & Midwifery – A Partnership

23 November 2015 by Helen Calvert / Continuity of Care, MatExp and Me, Postnatal Care / 8 Comments

I have great pleasure in sharing with you a guest blog from Health Visiting Lecturer Charlotte Smith and Midwifery Lecturer Neesha Ridley – a great team from UCLan.

Following our wonderfully informative Twitter chat last week, we were asked to contribute to the MatExp blog – what an honour, thank you!

We are writing as a partnership, because this is what we believe health visiting and midwifery should be. To explain, “We” are Neesha and Charlotte, a midwife and health visitor (in that order!) who recently found ourselves united in a number of ways.

First, we are new to our roles as lecturers at the University of Central Lancashire. We enrolled on our teaching course together, thus embarking on our new career journey together – joint working together is enjoyable, time saving, cost effective and efficient, and our shared “newbie” status allows us to express our vulnerabilities and successes openly with each other. (Also, we discover we have a similar sense of humour which is always a bonus!)

Second, our passion for joint working was discovered when Neesha asked Charlotte to come and speak to midwifery students about the role of the health visitor. Neesha had been aware of the importance of MDT working in the childbearing continuum and had organised a succession of guest speakers, designed to give Midwifery students the knowledge and experience of the services they will work alongside in the “real world”. Charlotte leaped at the chance, and went along to the session prepared to outline the role of the health visitor.

What neither of us had been prepared for was the response. Armed with insightful questions and an obvious desire to learn more about their health visiting colleagues, the midwifery students described the need for closer relationships between the two disciplines, and the lack of opportunity in practice to facilitate this.

On feeding this back to the health visiting students, Charlotte had exactly the same response. Why aren’t we being taught with midwives? Why do we not have relationships with our colleagues if we are to work in partnership with them? Why is it that the first time we “properly” meet a midwife is when our training is over? How are we supposed to understand each other’s roles if we learn completely separately?

Our engagement in the Twitter chat around this issue last week confirmed that parents themselves value consistent, seamless support from services in the perinatal period. It also confirmed that at best this experience was inconsistent across the UK.

Just as it is a privilege to be involved in the journey of new parents and the arrival of their baby in the world, so it is equally a privilege to be part of the journey of a new midwife and health visitor into qualification. As we reflected on and evaluated these sessions together, it occurred to us that there were synergies between the two experiences – and it made sense to us that like in every issue in the 1001 critical days, the answer lies in early intervention.

As lecturers, that means introducing the two disciplines in a more facilitative, educational experience during education. In practice, this could be mirrored by a home or clinic joint contact between health visitor, midwife and the family during the antenatal period.

It is well documented that antenatal contacts are significant in improving the health outcomes of women, children and families – we are currently collating the evidence in a paper on exactly this subject. We are very aware that there are organisational and strategic challenges to this proposal, having worked at the coal face for some time and recently, and from listening to our students, and to the views of parents and commissioners. However our third area of unity is this – we have a duty to our professions and to our students, and above all to the children and families who experience our services. We have the privilege of being on a journey with inspirational, committed and dedicated students and we owe it to them to provide the experiences that they identify as facilitating best practice. As a result we are working together not only to influence the curriculum to include structured facilitative relationship building and education between our two professions, but to encourage students to take responsibility for ensuring they maintain this out in the real world.

Not every family would appreciate a joint visit from services – nor might it be economically or organisationally feasible in some cases. But if we educate and practice ourselves as separate, uncommunicative services, families will continue to see us as such. With more conjoined education and more solid relationships from the outset, at least families will have the choice.

Charlotte Smith, RN, HV

Neesha Ridley, RM

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Ready, Set, Go! #MatExpOnTour

1 November 2015 by Helen Calvert / MatExp and Me, The #MatExp Journey / Comments Off

Where are you off to this month? Where will you be discussing maternity services? With whom will you be meeting? How will you be travelling?

Following the success of #OxyOct we want to focus on the #MatExp journey in November with #MatExpOnTour. Every connection counts – whether you are speaking at a conference or having a cuppa with a friend. If it involves ideas for improving maternity services then we want to hear about it.

Please tweet us your pics and post updates to our Facebook group of your meetings, conferences, tweet ups and events. Will you and your colleagues be discussing the #MatExp Heart Values? Will you be spreading the word about #MatExp on your travels? Will you and your friends be talking about change over tea and a slice of cake? As always, everyone counts, all voices matter, all connections matter big or small – we are stronger together.

Let’s get on the road. All aboard!

P.S. Click here to order #MatExp materials to help you to spread the word!

See where we have been on tour in the map below. Want to add something? Just get in touch.

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Dads Matter

12 October 2015 by Helen Calvert / #MatExp Actions, MatExp and Me, Postnatal Care / 1 Comment

As part of Oxytocin October (#OxyOct) I have been revisiting the first set of blog posts we put up calling for people to ACT in certain areas of maternity care. One of these was Time to Act for Dads & Partners, which included a mention of Mark Williams‘ work in this area.

Mark Williams is the founder of a new organisation called Dads Matter UK (Perinatal Mental Health for Fathers). He also founded Fathers Reaching Out, Youngness and Independent Mental Health Campaigners.

Father’s Reaching Out was set up in 2011 to raise awareness surrounding the detrimental impact that postnatal depression (PND) has on both fathers and equally families as a whole. Dads Matters UK aims to raise awareness of perinatal mental health, and educate every dad before the birth about birth trauma and PTSD for men.

We are delighted that Mark has written this blog post for #MatExp as part of #OxyOct.

______________________________________________

Depression can hit up to around one in five fathers by the time the child reaches adolescence. In a published report in 2015, it states that at least 10% of fathers will suffer with postnatal depression, which can include the birth itself and up to a year after. Fathers can develop lots of complications in this period, and this can influence their daily lives as well as affect their role within their family unit. It can impact heavily on their relationships, financial stability alongside lifestyle and emotional states. Emotional problems and psychological health needs are crucial elements to postnatal depression in fathers and need to be addressed. Fathers tend to get forgotten at this important and life changing event of having a baby, with mother and child being the centre of care delivery and rightly so, but we must remember there is a father there too. Fathers often get pushed aside which can result in feelings of isolation, anxiety and confusion at a time when they to need help.

Dads Matter UK is suggesting that the health service needs to develop a process for the screening and detecting of postnatal depression in fathers. As many fathers, the figures suggest, suffer with anxiety post birth of the child. The birth of a new baby can cause problems such as poor sleep, anxiety and stress. This can lead to problems within the relationship and fundamental communication processes within that relationship. After speaking to hundreds of fathers we are primarily concerned with the health of the father and their families. We feel that postnatal depression in fathers is equally significant and requires important consideration when implementing strategies and screening tools for postnatal depression. Fathers suffering with depression can feel increasingly pushed out and unsure of their role within the family thus affecting the bonding and attachment process between father and child.

Screening is important for men, as they are less likely to seek help and support. Particularly, in relation to their health problems. Due to the associated stigma towards mental health and its associated issues, young fathers are even more likely to be at risk and not seek the help they need. Men are often reluctant to admit that they may have an emotional problem or are unlikely to admit to feeling out of control. If this area of health is not addressed adequately this could lead to further breakdowns in the family structure and have long lasting devastating outcomes for our children.

We must remember that fathers can also suffer from PTSD at the birth. Post-traumatic Stress Disorder can occur following a life-threatening event like military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. Most survivors of trauma return to normal given a little time. However, some people have stress reactions that don’t go away on their own, or may even get worse over time. These individuals may develop PTSD.

People who suffer from PTSD often suffer from nightmares, flashbacks, difficulty sleeping, and feeling emotionally numb. These symptoms can significantly impair a person’s daily life. As we know many suffer in silence and let post traumatic stress disorder effect all parts of their daily living. My own nightmares were what if my son had died and the thought of my wife being pregnant in the past did give me so much anxiety that at the time I didn’t know why.

PTSD is marked by clear physical and psychological symptoms. It often has symptoms like depression, substance abuse, problems of memory and cognition, and other physical and mental health problems. The disorder is also associated with difficulties in social or family life, including occupational instability, marital problems, family discord, and difficulties in parenting.

The “invisible wounds” of birth trauma-related PTSD affect not only the father or the family member, but also those around him or her. We must remember it effects everyone and education is needed to prepare the family for what may happen during and after the labour.

We run the risk of letting our fathers down at a time when we need to build strong families and communities for our future generations. Identifying the right support and providing improved health care in relation to Perinatal Mental Health is a top priority, so let’s ensure our health services have the right tools and services available to help and support fathers in relation to their partners’ postnatal depression. When screening fathers we must be mindful to remember that individuals are unique and have developed different styles of coping. It is important to respect the individual, involve them in their care and offer support to them as a person rather than just treat the illness.

Mark Williams, 2015.

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National Maternity Review – National Drop-In Listening Events

30 July 2015 by Leigh Kendall / MatExp and Me, The #MatExp Journey / Comments Off

The National Maternity Review held its first listening event on July 23. #MatExp was represented by Flo, Gill, and Leigh. If you were unable to attend, you can read more about what happened in Gill’s fab, visual Steller story and Leigh’s blog.

The NHS Maternity Review wants to hear from everyone!

You are invited to come and share your views and experiences of maternity services and care.

The NHS Maternity Review will be hosting a number of events around the country as part of its national tour to hear how women, their families and advocates, provider organisations and the professional bodies involved in maternity care feel about the current services. We also want to know what you would like the Review Panel to bear in mind as our members go about their work. These events are an opportunity to share your experiences, contribute to the work of the Review, and have your voice heard.

The feedback from these events will contribute directly to the work of the Review and we are keen to hear from women, their families, those who work in maternity services and other professional bodies. All are welcome to come and share your views.

The Review will be visiting the following locations on the dates below. Final details for some of these events will be circulated in due course.

Tuesday 4^th August, 10am-7pm – The Lancaster Suite, Preston Guildhall & Conference Centre, Preston
Friday 7^th August, 9am-4.30pm – Morton Park Family & Community Centre, Carlisle
Thursday 13^th August, 10am-8pm – Holyfields Centre, Birmingham
Tuesday 25^th August, 10am-7pm – Acorn Children’s Centre, Taunton
Wednesday 26^th August, 9am-7pm – venue tbc, Plymouth
Tuesday 1^st September, 9am-7pm – St Nicolas Centre, Ipswich
Wednesday 2^nd September, 9am-7pm – The Kings Centre, Norwich
Friday 4^th September, 9am-7pm – venue tbc, St. Albans
Thursday 17^th September, 10am-7pm – venue tbc, Sheffield
Friday 18^th September, 10am-7pm – venue tbc, Manchester
Monday 21^st September, 10am-7pm – venue tbc, East London
Wednesday 7^th October, 10am-7pm – venue tbc, Newcastle

For more information, please contact [email protected] (who are organising the events for the Review).

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#MatExp Book Club

22 June 2015 by Florence Wilcock / About MatExp, MatExp and Me, The #MatExp Journey / Comments Off

One of the beauties of #MatExp and our ‘Whose shoes’ maternity workshops is to start to see each other as equals and as people , breaking down assumptions about roles and views. Last week I got into an exchange on Twitter that I believe exemplified this. Catherine @BerksMaternity suggested that those involved in #MatExp might like to read ‘Birth: A History’ by Tina Cassidy. I think she was surprised when replied that I had read it twice over its a brilliant book that my mum gave me. It’s a fascinating history of birth through the ages. In fact it’s there on our Pinterest maternity whose shoes board as I tweeted about it last August. We then started an exchange of other books and a comment about the importance of reading & reflection.

This Twitter exchange made me think about the idea of a #MatExp book group idea. We all share a common interest of improving maternity experience and with it the desire to break down barriers between people so we can work constructively together. There maybe other books that we share a love for, there may be books or extracts that are useful in prompting reflection and thought about how we perceive others. I can immediately think of all sorts of books that influence my thinking that I could share & I’m sure others can too. There are some obvious books to share an comment on those directly about maternity such as Sheena’s @SagefemmeSB wonderful collaborative book ROAR. There are books that fact or fiction that have nothing directly to do with maternity but that influence the way we think. To use a quote from one of my all time favourite books:

“All this she must possess,” added Darcy, “and to all this she must yet add something more substantial, in the improvement of her mind by extensive reading.” Mr. Darcy

So I would like to suggest that together we ‘improve our minds’ by sharing some of those books some may be books we recommend are worth reading others may be about sharing the impact they have had on us. To kick us off I will share two.

A Glasgow Manual of Obstetrics Edited by SJ Cameron 1936

I found this in a second hand book shop many years ago & I love to dip in and out of its pages. It has some fascinating diagrams , horrific descriptions of destructive procedures and is like a window into the past. It shows some things never change like the mechanisms of labour and others have changed completely. One of my favourite paragraphs describes not getting out of bed until ten days postnatal and not going outside until week four. This book is the reason why one of my favourite cards in ‘whose shoes’ MatExp workshop asks ‘what do you think we do now that we will look back on and wonder why’ a question promoted by Gill’s mum recounting use of castor oil in her time!

The Hand that First Held Mine by Maggie O’Farrell

I love many of Maggie O’Farrell’s books my favourite is actually ‘The vanishing act of Esme Lennox’ more of which another time. In The hand that first held mine she writes a very powerful description in the first few chapters of a woman’s experience of a massive obstetric haemorrhage and the immediate postnatal period afterwards. It is an incredibly terrifying description both of the events but also her confusion with the well meaning midwife, health visitors etc who come and do her home visits afterwards. I highly recommend dipping into it and have sometimes read excerpts as part of training sessions.

So there are two books to get people thinking, I’ve picked at random there are many more I can and will suggest. So calling all #MatExp friends what books do you recommend or what do you get out of them that you could add to the #MatExp book group conversation ?

Florence Wilcock
Divisional Director Specialist Services
Kingston Hospital NHS Foundation Trust

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