Tea & Knitting

This week there has been a lot of poor journalism around a maternal death following a home birth.  There have also been a lot of opinions about where women 'should' give birth, safety of birth, midwives and so forth.  It tires me; the questions we should be asking are how can we best support women who do not wish to give birth a clinical environment, and how can we best support midwives to enable this.

However, I fear these debates will just go on and on, so for now, I have decided to focus on something a little more positive; the art of knitting......

I have (slowly) been catching up with some of my midwifery reading; I subscribe to various journals, and one of my favourites is the ARM 'Midwifery Matters' journal.

In the Summer 2012 issue, there was a synopsis of the on-line debate on the ARM forum regarding Knitting, and whether is was acceptable for midwives to knit at births.  Sadly, some HoM's did not feel it appropriate for midwives to knit at births, and midwives have been informed that it is 'unprofessional'.

The late and very gifted Tricia Anderson spoke and wrote about the art of 'drinking tea intelligently', a phrase which highlights how midwives may appear to be doing very little, but are in fact intuitively, patiently, quietly, observing and listening to the mother as her labour unfolds.

Midwifery is an 'art and a science': one midwifery skill that is undervalued (I feel) is the art of recognising where a women may be in her labour from her body language, the sounds she makes and  the positions she adopts - not from a vaginal examination to asses what her cervix is doing.  When a midwife is quietly present in the back ground, she sends a strong message to the mother: "I am here, you are safe, all is well."  The quiet midwife can recognise when a little more support might be needed and welcomed; gentle massage on the mothers back or on her sacrum, a calmly spoken word of encouragement, the passing of a cold flannel to cool her face.  Sometimes, these actions need to be directed to the father, who is doing a wonderful job, but who may also need reassurance and encouragement.

I recall visiting a labour ward not too long ago to drop some samples; I was welcomed by a young, newly qualified midwife who was sat at the reception desk.  From one of the labour rooms, I heard the distinct sounds of a women who was labouring strongly, who was working beautifully with her body, and who was clearly pushing spontaneously as the strong surges urged her to bare down.  The midwife, in her smart crisp uniform and shiney bright name badge called to her colleague; "do you think that women is fully?  maybe we should go in and check (VE) her."  Slowly, another midwife took it on herself to see to the woman, who was alone with her partner.  At that moment, I feel such a deep sadness: I felt sad that this midwife could not clearly recognise the sounds of labour, that the woman did not have a midwife by her side, and that our 'professionalism' was represented by a uniform sat at a desk.

So back to knitting; I loved the response in the forum from Linda Wylie, a Midwifery Lecturer in Paisley who posted:

"I take a session with my student midwives in which my opening gambit is - today we are going to learn to knit.  I then go on to talk about masterly inactivity as described my Mary Cronk."

Perhaps, if this was a compulsory part of midwifery training for all students, we would have more midwives qualifying who were confident to keep their hands busy and off the woman; who were tuned into the sounds of women and their labour, who felt content to sit quietly in the back ground (and not the midwives station?) and who understood the significance of 'drinking tea intelligently'.

I decided a couple of years ago that I needed to learn to knit.  I was content to sit in the background at a birth, but knitting engages the mind in a gentle repetitive activity.  Knitting is easily transferable.  You can pick it up.  Put it down.  Stop if its annoying the woman.  Start if you need to keep your hands busy.  And all the great midwives knit (in my romantic mind anyway).  Knitting reminds me of the wise women, the elders of the community sharing their skills and knowledge with the younger women; it reminds me of a time when we slowed a little, and it reminds me of my time at The Farm (with other amazing midwives and Ina May Gaskin) where we spent time together creating crafts and remembering the ways of women.

So I knit; I've knitted bags, flowers, tea cosies, scarf's, animals to name a few.  But mostly, I knit baby hats; these are simple, require no pattern, and are a gorgeous gift to give to the new mother for her new baby who has arrived earth-side.

Hats!

Tomato Hat

So I urge you fellow midwives, student midwives and aspiring midwives to take up your needles and start a (quiet) revolution.

Knitting is very conducive to thought.  It is nice to knit a while, put down the needles, write a while, then take up the sock again.  ~Dorothy Day

Happy knitting!

Midwife angela 

What we do.....

I was thinking about the question "what do you do then?" in response to IM's not reflecting some of the midwives seen on current TV programmes.  Taking time to reflect on that question, I realised its more what we DON'T do.....

• We don't tell women what they should or should not do; we explore, discuss, share and come to a (mutually made) 'trusting' decision.
• We don't subject women to unnecessary intervention such as routine VE's, ARM's, directive pushing or managed 3rd stage.
• We don't assume we know best simply because we are the 'professional'; women know their minds, bodies and babies.  We learn as much from them as they from us.
• We don't apply time frames to labour and birth; we wait respectfully, 'drink tea intelligently' (Anderson) and gently support birth as it unfolds.  We do not (on the whole) need to hasten this process.
• We don't  'normalise the abnormal'; we approach every woman, every pregnancy and every birth as an event that is 'uniquely normal', working with evidence based practice, within our midwives rules and code of conduct, and in the woman's best interest

Angela xx

Celebrating Normal Birth

I am off-call!  After attending and supporting 8 beautiful, strong, wonderful mothers since April, I am now due a short break.  I have learnt so much and had the immense honour of attending:

• a home 'land' birth
• a home VBAC in water
• a breech hospital birth
• a caesarean birth
• 4 home water births

I am taking my short sabbatical from being on-call in order to rest, reflect and regather my energy.  

In the mean-time, I am planning a workshop for Student midwives and doulas on Physiological Birth: birth is a normal process, a part of life and something that women should be well supported through.  Marsden Wagner writes eloquently and honestly about the dehumanisation of birth here - food for thought indeed. 

Mothers and midwives we need to reclaim birth, we need to honour the strength and courage of all women and we need to do it now.  A fantastic new website has been created for women to share their experiences of birth and midwifery - and to campaign to improve the care that women receive.  Take the time to visit the site and make your own entry....   birth is 'uniquely normal' and we need to celebrate this!

'Holding the space' & emotional strength

When you are invited to attend a birth, you are honoured to be supporting a woman at an immensely important time in her life.  As a midwife, the energy that you bring into the room during the labour and birth is really important, as you need to be able to 'hold' the space around the woman so that she can labour with minimum disruption and in her own time.  This ability to 'hold a space' requires a great deal of emotional strength; trust; patience and the ability to sit on one's hands.  This is being 'with woman'.

In March, my mother died, and the recent months have been difficult for me.  Aside to the loss of my mother, I am learning to support my daughter who is Aspergers, learning 'how' to home educate two of my children (!), dealing with a teenage daughter...... and still wanting to be the absolute best midwife I can be.

Something has to give, and for a little while that will be my midwifery.  I am taking a short 6-month sabbatical so that I can grieve, heal, rest, learn, and support my family.  Only then, when I have taken care of myself, can I return to supporting women as they journey to meeting their baby and be the midwife I aspire to be.

Angela x

Parents and Students

Last night I worked at a Mother Care 'baby&me' event; I was the 'guest' professional, on hand to offer information and advice to expectant parents.  I was feeling a bit nervous before hand, but I actually really enjoyed the event.  I chatted to lots of parents about home-birth; water-birth and choice of care.  Many parents had not had any options explored or suggested to them - and this is sadly because the brilliant NHS midwives just don't have the time!

I have been invited to come back next time (the staff were really excited I attended, and I gather that they struggle getting health professionals sometimes); I will of course attend and feel better prepared on what to take for next time.

This week I also met with my SoM for my annual supervision, and have some targets for the next year.  I really appreciate talking to other midwives - there is so much to learn and absorb (we never stop learning) and getting thoughts and ideas from another perspective is very enriching; hence my love for working with students!  I get lots of applications from students to work with me and I have my own rule of only taking 3rd year students out with me, as I physically could not accommodate more.  To make up for this I am starting to develop workshops for aspiring students and current students.  I have run two aspiring student workshops and received excellent feedback so am now keen to run more!

Angela x

First 2012 Baby....

Last week saw the arrival of my first baby of the year!  A bouncing baby boy arrived on Thursday morning after a very long labour.  Fantastically proud parents and a new mummy who was so amazing in labour and made it look easy for most of the time.

I did (of course) cry when he was born; we had transferred in from a planned home water birth as contractions were quite spaced out and mum was getting quite tired, despite all her best efforts to get energy on board and to rest where possible, it felt like the right decision to visit our local unit.  We had good care and baby arrived a few hours later.  Getting home again was more tricky; I am puzzled with my NHS colleagues obsession with testing blood sugars on a baby.  Really?  A well, term baby with quite a lot of fat to spare (did I mention he was a 'bouncing' boy), who had a good birth really should not need to have so many holes in his feet.  Poor thing resembled a pin cushion once they had finished with him and by all accounts this would have continued until a strong-minded midwife realised it was nonsense and they stopped.

Hurrah for stroppy midwives.

Loss

T'is the silence that's deafening

when the baby is born

into the midwives arms.

Warm, but still. No breath.

The mourning begins, as

the tears flow

for this sweet, sweet child

who is born into this world.

But not unto this life. This time.

T'is the silence that's deafening

as the bitter sweet tears roll down

the mothers cheeks.

And the fathers eyes; so empty, so sad. So sad.

The babe, swaddled and caressed. Perfect.

So real, yet so out of reach.

Not to be part of this world. This time.

T'is the silence that hurts

and the empty arms that ache.

Along with a heart - breaking.

Grieving

For a son, a daughter

A child

A life

A love.

Not this time.

Not yet.

Angela.

For Vincent. Born 28 December 2011.

For River. Born 20 July 2011.

For all the babies born as angels.