Articles by Month: June 2004

Birmingham maternity hospitals

The group I am working with in Birmingham are from two hospitals - Solihull and Heartlands. I was aware of this in advance, so to try and find out what experience the group had from working in other hospitals, I asked each person to tell us where they trained and had worked as a midwife. It is often useful when group members have worked in a variety of units, because they bring perspectives and experience from different service providers.

As the group members introduced each other it became clear that this was a very stable workforce. All but a very few had trained in these hospitals and then worked in one or other. This is unusual, and whilst it can mean a very tightly knit, cohesive group of midwives who share common philosophies and practice habits that may not necessarily be the reality.

I then told them that I would try to push their boundaries beyond what they knew from working in this small geographical area because I felt they needed to know of other ways of working. When midwives want to introduce a new service, try a new technique or change a policy, they need to find other units that have travelled that road before. I have never encountered two hospitals who work the same with identical policies, protocols and management strategies, and this diversity (whilst challenging the claim that may be made that “our hospital has the best way of providing service”) can offer valuable feedback to others who want to learn from their experience.

These two hospital in Birmingham, despite being somewhat of a “closed shop” within the Trust, are very different. Both serve a different demographic group, with one having much higher rates of epidural use (the affluent Solihull clientele) and the other a much lower caesarean birth rate. Neither have a midwifery led unit or a birth centre, although they are hopeful one can be established.

I am looking forward to exposing them to other ideas about birth today..... and leaving them with much food for thought.

Posted by andrea at 05:30 PM | Comments (2)

Unexpected birth outcomes

The necessity for including the topic of “unexpected outcomes” in prenatal programs for parents was explored in the London workshop over the weekend. It is an issue that is often difficult to raise and hard to present in a positive way, yet it is a worry that will concern almost every woman at some point in her pregnancy and to ignore it would be to send a message that this topic is not important.

Labour and birth is an unpredictable event in every respect. Coming to terms with this uncertainty is often difficult for parents, especially in today’s society where organisation, predictability and forward planning are such hallmarks of modern life. Many women, used to carefully constructed diaries and routine appointments with friends, family and the gym can find the chaos of trying to meet the needs of a new baby completely overwhelming. If there are other surprises, such as a sick child or perhaps the death of the baby to factor in (with all the resultant emotional turmoil), depression and anxiety can be major outcomes for both parents.

These topics must be included in the prenatal education program, not necessarily with a heavy emphasis on detail, but with at least enough time to enable reflection and acknowledge the reality of these tragic events. I have written about how this can be achieved with sensitivity and realism in my article “Mentioning the unmentionable”.

It was an interesting weekend and the diversity of the group provided some useful perspectives as we shared ideas and developed plans for improving the variety of prenatal programs currently on offer. For the next two days I will be in Birmingham (Solihull), presenting my last Active Birth workshop for this current tour.

Posted by andrea at 06:18 PM | Comments (0)

More on midwifery in Spain

This weekend I am presenting a “Teaching Skills” workshop in London. It is the usual interesting mix of participants - midwives, National Childbirth Trust educators, students and some Yoga teachers.

One of the group members is a midwife who is from Spain, whom I met before in an Active Birth workshop. I shared my experiences of my last week in Spain with her and she agreed that the basic problem in Spain is that the “midwives” that work in many hospitals there see themselves as technicians with skills that give them sought after status within the medical model. They see themselves as specialist nurses, focusing on tasks rather than the needs of the women in their care.

In other western countries, especially those with a strong history of midwifery, there a completely different concept of midwifery. The total care of the pregnant woman, including her spiritual, emotional, psychological and physical health are considered part of their scope of practice and midwives aim to care for the woman through her whole episode of childbearing. This doesn’t always happen, of course, because the maternity services are not always geared to provide these level of personalised service, but the education midwives nevertheless receive enables them to undertake this kind of total care whenever possible.

Although maternity care in Spain leaves much to be desired, this midwife commented that she felt women were starting to demand better services and alternatives to the medicalised, hospital based birth that is currently the norm. She is one of the new generation of midwives, many of whom have sought their education in England. There was a period in Spain when there were no courses in midwifery available at all, and now they are currently only training about 100 midwives a year. The workforce is rapidly ageing because of this gap of about 15 years when no courses were available. There is a looming crisis in maternity care and many of the midwives who have been waiting in the wings in England may well return to Spain. If this happens, the returning midwives will bring with them a different concept of midwifery care. Many women in Spain (according to my informant today) are looking for alternatives, and these midwives may well be able to do this.

There could be exciting changes in the wind in Spain, of these predictions are fulfilled!

Posted by andrea at 07:04 AM | Comments (1)

Workshop feedback

I had some lovely feedback today. When I arrived into the office after my trip to Spain, there was a letter waiting for me from a midwife who was at the Burton Active Birth workshop last week. She wrote:

”Just a quick note to say thank you for such an enjoyable weekend. I learnt such a lot and it was great to meet other midwives and share experiences.

I went to work Sunday night, so enthusiastic, and cared for a woman who had the most wonderful birth “drug free”. I felt so proud of us all - mum, dad, baby and me. The following shift, armed with my new lease of life, I cared for a woman who wanted to get on the bed. I worked so hard to keep her off the bed and didn’t rush to do an internal (much to my colleague’s dismay). She did all the things we talked about on your course, all went well. She pushed spontaneously, in a darkened quiet room with “no doubt” a rush of endorphins (me and her!) Until I looked down and saw - not only her bottom, but the baby’s!! She was on all fours, and sadly a very senior person put her in lithotomy. Nevertheless, she had a wonderful birth, she was delighted, as was the dad. Unfortunately I was greeted with a variety of comments from my colleagues “I’d have examined her on admission”, “I’d have had her on a CTG” (would that have told us it was a breech?, I asked). Still it was a great experience and although I have been a bit tense about other people’s views, my care was woman centred and she was delighted (said she was turned over because she said it only got painful then!) but what a miracle she had a vaginal birth. If she’d have had an internal she’d have had a section and it was a huge 8 ½ lb baby. Goes to show you!”

As you can imagine I was thrilled that this midwife had taken the plunge and tried some of the ideas we explored during the workshop. It can be hard to ignore the comments of doubting colleagues, but in the end it is the woman having the baby who counts.

I hope that other midwives will take heart from this feedback. I am always thrilled to know that my work is proving useful and even more excited to hear of midwives really embracing their role and discovering the pleasures for themselves and parents of enabling natural births to occur. Congratulations to this midwife and thank you for the wonderful birth story.

Posted by andrea at 02:01 AM | Comments (0)

Homebirth transfers

I am back in Spain, presenting another program at the Acuario Birth Centre. This small private clinic is about an hour’s drive south of Valencia and as I was driven down by Rachel Macleod, the program facilitator, we got talking about women’s motivation for home births. Rachel works at Acuario and also offers a home birth service, using the Centre as a back up in case of transfer.

One recent transfer involved a woman who was following a strict macrobiotic diet during her pregnancy. She was of slight build and in good general health, although her baby was not growing as well as Rachel anticipated. She had booked for a home birth, and when labour began, it was clear it would be a long, drawn out event, as the baby was in a posterior position. The mother was well supported by her family and everything seemed to be on track. After a day of regular contractions, the membranes finally broke about 9.30 p.m., hopefully signalling the start of a more active phase of labour. Rachel visited her and found her to be 3 cms dilated with contractions every 3 minutes. Six hours later she was still 3 cms and making no progress at all. The decision was made to transfer to Acuario as the woman was exhausted and wanted help. An epidural was organised and a syntocinon drip, but the baby didn’t react well to the stronger contractions and a caesarean was the eventual outcome at 9.00 a.m.

In discussing this case, Rachel noted that this was not a strong, robust woman, with good reserves that she could draw on in the event of a long labour. When the baby is positioned like this, movement, walking, rocking etc will be important to get the baby to position itself and to move down. This woman was unable to keep this up, and it was clear she didn’t have the required stamina. The size of the baby was of concern as well. The question was whether the macrobiotic labour was a factor - this diet can be low in protein unless care is taken and whilst the woman was apparently well, the effect of such a diet on her baby was less clear. The baby was 2.8 kilos, small, but otherwise healthy, but one wonders if it too was unable to find the reserves it needed to weather a long slow labour. Of course, the longer labour may have been protective of such a tiny infant, and it may have done well if the epidural and syntocinon had not become necessary.

There was also the question of her motivation for a homebirth. Many women see a home birth as a “good idea”, without any real understanding of the benefits of labouring at home or any real commitment to the basic principles. It can also be seen as “appropriate” for a particular lifestyle”. In the event, sometimes these labours just don’t proceed until a transfer to hospital is made and the woman is at last able to let go and get on with the necessary work. The emotional and psychological state of a woman is a key factor in any birth, perhaps especially for those planning birth at home.

Much of this is speculation, but talking these events over and observing labours closely is how we learn more about birth and its many variations. There are always so many strories to tell!

Posted by andrea at 06:02 PM | Comments (0)

Promoting midwifery in Spain

This afternoon I head to Spain again, to present a workshop for the Acuario Birth Centre in Beniarberg, near Valencia. This will be my third visit to this wonderful centre and I am again looking forward to catching up with my friends there.

This time I am hoping to talk to the people who come to the workshop, and the organisers, about setting up a network of like-minded midwives etc in Spain. From the feedback I have had from midwives in workshops (both in Spain and from Spanish midwives in Britain) and the numerous enquiries that my previous Diary entries, there seems to be a need for a support network to keep moral high and lead a process of change.

There are a number of Spanish people who would like to see more options for birth, fewer interventions, a more holistic and humanised approach to maternity care and better outcomes for mothers ans babies. In short, a midwifery alternative to the current obstetrically dominated services. Changing entrenched programs is hard and difficult, but not impossible and it will take commitment and effort to get such a process moving. A network, probably based around an email discussion list, would be a good place to start. I’ll be talking to everyone that I can during this trip about this possibility and if we can geta group established I will put the details into a future Diary entry.

In the meantime, if you would like to join such a group, please put a comment on this Diary entry and we can be in touch with you.

Sometimes when I am in Spain it can be difficult for me to access my emails regularly and to write my Diary entries as often as I would like. It may be a few days before you receive the next installment, but I will have several days to report on by that time and will post these entries at the same time, as soon as I can.

Posted by andrea at 08:24 PM | Comments (2)

Feedback on workshops

This workshop in Burton on Trent (yesterday and today) is on the theme of “Teaching Skills for Educators” and it makes a good change of pace from the Active Birth workshops I have been presenting over these past weeks.

Several group members are from Goodhope Hospital in Sutton Coldfield near Birmingham and I was delighted to hear of the progress they are making in their efforts to keep birth normal and to incorporate the ideas we had explored in the workshops I have presented there in the past. They are running their own Active Birth programs now for parents and also for staff - which is a wonderful development. It is so encouraging to have this feedback and to know that what I am offering is having some impact.

We cover a lot in this Teaching Skills program - starting with some of the foundations for developing parent education (working with adults, aims and objectives, teaching and learning styles etc), program planning and of course, lots of different presentation ideas. My main goal is to shift thinking from the emphasis that is usually placed on cramming in information and facts, towards enabling parents to gain skills they will need to manage their changed lives during pregnancy, birth and parenting. Many programs are so short these days (often only 3 or 4 sessions) that attempting to make sure parents “know everything” is clearly futile. It makes more sense to help parents feel confident solving problems, learning how to use the health care system effectively and to evaluate the options and choices they will be offered. A good dose of consumer rights and negotiation skills are also useful.

The activities I include are all designed to enable these skills to be developed by group members, whilst they have fun, get to know each other and build their confidence. When I present these workshops I realise how much I miss being able to work with expectant parents. One day when I am unable/unwilling to continue with all the travel, I will again be able to offer programs for parents on a regular basis. It is such fun and so rewarding - a real community service.

Posted by andrea at 06:13 PM | Comments (0)

The "What will people think?" syndrome

The “what will people think” syndrome popped up yesterday, during the second day of the Nottingham workshop. In a punitive environment, or one where there is very little mutual support from colleagues or management, midwives will no doubt worry about what will happen if they step outside the accepted practices or try something different. This kind of climate saps confidence and undermines autonomy and should be stamped out by midwifery managers, who are responsible for the overall philosophy of a maternity unit.

The only real barriers for trying new approaches, using innovative ideas and experimenting, are in people’s minds. In maternity care, where meeting the needs of pregnant and labouring women should be the central aim, midwives have the opportunity to work with a degree of freedom that offers excitement and enviable possibilities for professional development. As long as a midwife practices with good intent, safely and with the full permission of the woman, she is protected by law and should receive the support of her superiors. She must be able to justify what she does and provide evidence for her actions, but at the end of the day, she is primarily responsible to the women for whom she is caring.

Midwives gain valuable experience when women ask for something different, or labour in ways that appear to step outside the boundaries of current practice. This is the way to learn about the many variations ion the birth theme, and to discover the mysteries and strengths of women’s bodies.

When midwives shy away from supporting women, when they back the protocols and policies at the expense of women’s needs, they not only let the women down but they undermine their own positions and professionalism. Who cares “what others think”? It is the woman who matters most, and keeping her birth normal and supporting her physiological needs is a midwife’s primary goal. When colleagues snigger and finger point, when others make snide remarks and sarcastic comments, it is their inflexibility, lack of imagination and basic humanity that is being exposed. Women will support a midwife’s efforts in improving her birth experience, and this is the place to look for the most valuable rewards.

Posted by andrea at 06:43 PM | Comments (0)

Accepting the risks of hospital birth

The issue of risk assessment came up in the Nottingham workshop yesterday. Many midwives in the UK believe that they are required to follow protocols and policies closely or else they will be at legal risk, resulting in women being subjected to unnecessary procedures and risky interventions, just because the policies state that these must be routinely carried out. Inductions, rupturing membranes, applying electronic fetal monitoring routinely and giving syntometrine for third stage as standard procedure are a few examples that spring to mind.

In contrast, women are told that having a home birth is decidedly risky and many are being denied this option for very spurious reasons. This issue was canvassed in a wonderful article in the June issue of MIDIRS, and drew on responses from the ukmidwifery email list to compile a list of “excuses” for denying women their rights to a home birth.

The article also included a list of criteria for accepting a hospital birth that women might want to consider. It was produced by Laura Abbott, a British independent midwife and makes interesting reading. Here is the list - you might want to include this in your prenatal program, so that women can make a truly informed choice about a birth place:

Criteria for eligibility for hospital birth

Must not be scared of needles

Must not be claustrophobic or uncomfortable in confined spaces

Must be able to fast for long periods of time

Must be happy to share one toilet with 30 others

Must accept that said toilet may be a considerable distance from the bed area

Must enjoy sleeping on a mattress covered in plastic

Must not have rebellious or questioning nature

Must fully accept that may contract MRSA [a serious hospital acquired bacterial infection resistant to all antibiotics]

Must fully accept that may contract any infection: uterine or perineal

Must be happy to share one midwife with three other labouring women at the same time

Must also be happy that said midwife has been fasted for many hours

Must like and trust in electric equipment

Must be happy that has a 1:4 chance of having major surgery for no good reason.

This non exhaustive list has been included in your medical records and must be discussed and signed by you (the mother), a registered midwife and a supervisor of midwives. If this has not been discussed or signed by all of the above staff you will not be allowed to have a hospital birth and will unfortunately have to stay at home to have your baby.

Posted by andrea at 05:33 PM | Comments (0)

Prize winners in Hemel Hempstead

The 500th baby was born at the Hemel Birth Centre yesterday, while we were workshopping away in another part of the hospital. The unit has only been open for around 18 months, and has proven very popular - the number of women choosing it has exceeded expectations.

The midwives had organised a raffle to be drawn when this milestone was reached, so yesterday, after we finished the program, I was invited to draw the winning ticket. There were 16 prizes in all, so I took turns with Caroline Duncombe (on the left) and Nicky Wilkins (on the right) to choose the winners. The photo was taken by Jenni Farrell, the workshop organiser.

This Birth Centre is a lovely unit - as a stand alone centre it is 20 minutes from the nearest referral centre and the autonomy of practice that it offers midwives is excellent. They have a “snoozle room” too - a lovely dark room, with soft beanbags, a mattress and floor cushions, lava lamps, other mood lighting and peaceful music. Anyone in the unit is able to use it, to chill out, relax, recover or rest. Women often use it in early labour and midwives can also take time out to restore energy after a busy shift. There have been a few babies born there as well - it is a very comfy and inviting intimate space.

The statistics for the first year of operation of the Unit are being compiled now, and I have encouraged them to publish them in an appropriate midwifery journal. Successes such as these need publicity, so that others can learn how it can be done, and to strengthen the case for more of these kinds of services.

It was a terrific weekend, and a pleasure to be among a group of dedicated and enthusiastic midwives. This afternoon I am off to Nottingham for another in an ongoing series of programs fot the midwives in that area.

Posted by andrea at 09:44 PM | Comments (0)

Learning about birth in Sri Lanka

I’ve learned about birth in Sri Lanka today. One of this group (in Hemel Hempstead) has extended a holiday in Britain so she could attend this program and it has given us all a chance to find out about birth in her country.

Sri Lanka was a British colony (Ceylon) for many years and their culture still contains echos of this background. Their maternity services are based on the English system and the obstetricians have their education primarily in the UK, rather than the US. There is a flourishing private obstetric system, especially in the cities, well supported by Sri Lankan women, who are highly literate. In rural areas, as part of the public system, midwives supervise traditional birth attendants, and many women give birth at home. Conditions are often far from ideal, and efforts are bing made to provide alternative services based in clinics and hospitals.

This is what I have discovered so far - I hope to learn more tomorrow.

Meanwhile, I have been able to catch up with Jenni Farrell, an Australian midwife, now living in Hemel Hempsted with her family. I had met Jenni some years ago when she was working in Toowoomba, Queensland, so it was good to hear about her experiences in Britain. She also talked about the cultural differences, in this case between birth and maternity care in Australia and the situation she discovered in Britain. Anyone who moves from one country and works in another will find there are many differences in the ways things are done and it takes time to adjust and adapt.

Australians have tended to regard Britain as a bastion of great midwifery, leaders and innovators, and staunch protectors of the midwifery model of care. I have often found the reality somewhat different. It seems that Jenni has had some similar experiences, although working now in the Hemel Birth Centre has at last given her the opportunity to practice the midwifery she expected.

More on the Hemel Birth Centre tomorrow as well.

Posted by andrea at 04:52 AM | Comments (0)

Big event for next year

Next year, Birth International is hosting a two-day Conference on the theme of “Preparing for Birth”. It will be geared around the needs of childbirth and parenting educators and will offer a number of well known speakers, and a series of hands-on workshops.

The dates are Friday April 8 and Saturday April 9, and the venue will the Reading University. This location is very central in the UK, only 23 minutes by train from London and on almost all the major train routes. It is close to Heathrow and Gatwick airports, with direct bus connections. It is easy to get to by car and there will be free parking.

The facilities will suit our needs very well. The auditorium and break out rooms are conveniently grouped around a central foyer area and the dining room is across a leafy courtyard. The on-site accommodation is very inexpensive, and we hope that most of the participants will choose to stay; to network, enjoy the evening video program and catch up with friends.

The program will be finalised in the coming weeks and will be included in our next printed catalogue and also on our Web site. Those who send us an “Expression of Interest” will be sent the full program and registration details early, enabling them to take advantage of the early booking discounts etc. The numbers will be capped, so early registration will be essential.

I love organising Conferences and have done many in the past. They are always a buzz, and with my great team of staff to assist, I know we can make this a very memorable event. April is a lovely time in England - the daffodils are everywhere, the trees are in new leaf and the air is full of promise. Next year, this promise will include the opportunity to update and gain new skills for parent education!

Posted by andrea at 04:37 AM | Comments (0)

Silly rules and regulations

Once again, during my travels in Ireland these past few days, the ridiculous rules imposed by the Occupational Health and Safety police surfaced. No-one disputes the necessity for making workplaces safe, but their over enthusiastic approach has, in some instances, become absurd.

There was the story of one hospital where someone had an accident with the kettle, resulting in a blanket ban on the use of electric jugs by visitors (read: fathers) to the labour ward. In another unit, a hot pack was overheated by someone unfamiliar with the microwave, so all hot packs were banned forthwith.

I have heard of midwives being told that if they don’t wear uniforms, they will not have any insurance (unbelievable!) and long hair and false fingernails being outlawed because of concerns about possible infection.

All of these measures and wonderful examples of the “nanny state” where people are not expected to take any responsibility for themselves and instead and shepherded from cradle to grave by “caring” authorities. Rules like these almost encourage dissent, because they are so patently over the top. If we treat adults like children then they will behave that way.....

If fathers can’t be trusted to boil a kettle then what is the world coming to? If the microwave is some fancy model that needs instruction in its use, then why not provide some basic hints and then let then get on with it?

I am going to start making a list of all the silly rules and regulations being imposed on midwives and expectant parents in an effort to keep them in line. They will make good reading in a future Diary entry. Let me know of you have some good example to share.

Posted by andrea at 06:57 PM | Comments (1)

The importance of companions for labour and birth

I am often surprised that here in the UK, many hospitals still have very restrictive policies about who can accompany a labouring woman into the hospital for the birth. Many maternity units still routinely insist that she can have only one support person at a time, which will usually be the baby’s father. If she wants others to be involved, they must take turns.

When challenged to explain these draconian measures, the reason frequently quoted is “lack of space”, yet I know that it will be quite possible to squeeze in a number of midwifery or medical staff if needed or desired and that the room will accommodate much unnecessary medical equipment, such a monitors and resuscitaires.

Here in Ireland, I discovered that if a woman comes into the labour ward during the evening, the father will often be sent home, with the instruction to come back in the morning. I was astounded to hear of this antiquated rule - no wonder women go out of labour, require drugs for sedation and then are induced for “failure to progress” - they must feel frightened and abandoned when forcefully separately from their loved ones. I even heard one midwife state (with a small laugh) that she thought the men should always be excluded, as they were a nuisance!

These kinds of attitudes show how little thought has gone into supporting normal physiology and facilitating the central event of family life - the birth of a child. Birth has always been socially important in a community, creating bonds between adults and babies, cementing relationships and ensuring that the baby has caring adults committed to its needs. Fracturing these ties, through enforced limitations on who can be present at birth is a social injustice that could have deep implications for families and community stability.

I hope that this weekend, if nothing else, I have bene able to jolt this group into realising the implications of these kinds of outdated policies and that they will make swift changes to embrace and support labouring women and their companions in more caring and inclusive ways

Posted by andrea at 04:13 PM | Comments (0)

Cord complications

This weekend I am in Londonderry, Northern Ireland. It is a full workshop, and everyone is from the main hospital here - either working in the hospital itself or connected through the community midwifery program. We even have one of the local obstetricians, who is very supportive of midwifery and of keeping birth normal.

At one point, we were talking about dealing with the minor complications that can occur during labour. The baby whose cord is tightly around its neck, delaying the birth, was one such example. This is the first group I have encountered where they all stated that leaving the cord intact was standard procedure.

Usually I hear that midwives routinely clamp and cut when they can’t slip the cord over the baby’s head. Once cut, the race is on to get the baby born and it is hoped that no further delay, for example from impacted shoulders, occurs because the baby is without an oxygen supply until it can breathe on its own.

Midwifery students are being taught not to ever cut the cord, but they often say that when they are doing their practical work in hospitals they are told otherwise. It was therefore refreshing to hear that here, at least, the baby is encouraged to birth itself, as usually happens, in a tumbling action that speedily produces the rest of the body and enables to cord to unwrap itself from above.

Not everything they do here is as non-interventionist as this, but it was encouraging to hear that in this instance at least, they trust the baby, and Nature, to solve the problem without further ado. We’ll work on some of the other issues they may like to consider in the same vein tomorrow.

Posted by andrea at 04:49 AM | Comments (0)

"Pelvic arthropathy"

Here in Belfast I have come across a new reason for performing caesarean surgery on pregnant women: “pelvic arthropathy”. Several of the midwives in this group mentioned that this “condition” was being given as a reason for women to request a caesarean and for doctors to offer it as an alternative to labour.

Having never heard of this condition, I asked for details. Some genius has invented the term to cover the softening of the joints that naturally occurs during pregnancy. For a small minority of women this can become rather disabling, making it difficult for them to walk as the laxity in their hip joints develops and some instability occurs. However, in true obstetric style, a term has been invented for this normal loosening of the joints that occurs as a result of the hormone relaxin combining with the increasing body weight of pregnancy, giving it the status of a “medical problem”.

Once again, a useful attribute of pregnancy - this time, the softening of the joints that enables the pelvis to become stretchy and capacious - is being labelled as a major problem, one that requires caesarean surgery to correct! Women who have excessively loose joints may find weightbearing and walking difficult, but they can count on plenty of space for the baby to move through during the birth and this bonus can compensate for the inconvenience felt during the last months of pregnancy. It is a situation that often gets worse with each pregnancy, but then, babies tend to be bigger with each pregnancy as well. Nature has thought of a woman’s need for extra space for each baby and made this possible.

Trust medicine to take a perfectly normal, adaptive process designed to assist women birth bigger babies and turn it into a “complication” that requires a surgical solution. It is ironic that I have discovered this new condition here in Ireland, the home of the “active management of labour protocol”, another invention designed to rescue women from “long labours”. I can only think that Irish women need to wake up and see they are being manipulated by a greedy and grasping group of medical professionals who are using pseudo-science to hoodwink them into succumbing to unnecessary, expensive surgery.

Now that you have read about “pelvic arthropathy” here, please don’t tell anyone - I wouldn’t want this new “condition” to spread like a plague beyond Ireland! The rest of us will stick to celebrating the hormonal advantages of relaxin and rejoice in our newfound pelvic flexibility, knowing that we’ll have easier births, especially for our bigger babies.

Posted by andrea at 04:00 PM | Comments (5)

A brilliant read

The journey to the UK was made much more bearable because I had packed a copy of “The Baby Catcher” to read during the trip. This book, by midwife Peggy Vincent, describes her journey through midwifery, from her beginnings as a nurse back in the early 70s through midwifery school in the 80s, the setting up of the first Birth Centre in Berkeley, California and her thousands of home births.

It is one of the best books I have read - and one I would like all midwives to read, for inspiration, insight and just plain enjoyment. As the stories of the births rolled off the pages, Peggy’s beautifully written accounts brought every scene to life, and I feel as if I have witnessed a vast variety of women’s labours, some long and hard, others easy, many with special twists and turns and lots of humourous touches. I won’t easily forget Zelda, tramping up and down on a hospital bed, or Rosie the tarantula, or the birth in a leaky yacht as the seven year drought in California broke with tumultuous storms. It is full of vivid tales and is a real treat!

Many pregnant women would also find comfort from reading about birth from this midwife’s perspective - it would increase their confidence, provide insight and perhaps put many of their fears into perspective. If some of these women could give birth, then women everywhere can do it too.

Put this one on your “must read” list and think about giving it to your pregnant friend/midwife colleague or even the local obstetrician. Insights like these are special and need sharing. I am sure you will find is as rivetting and entertaining as I did on the long flight over.

You can order it here:

http://www.birthinternational.com/product/book/bk788.html

Posted by andrea at 10:01 PM | Comments (0)