Back To Sleep

I don’t know about you, but when my children were born, I felt over whelmed with the advice available to me as a new Mum about how to do everything right.  It made no difference that I was a midwife; I had sailed through the pregnancies and births but now was presented with a newborn baby.

Sleep was a key theme in those first few weeks (or the lack of) and I was never sure whether my babies slept too much or too little or in my case, I definitely was NOT getting enough of the stuff.  But there was one area of the sleep subject I knew was really important, vital in fact for peace of mind.  How to make sure my baby was asleep safely by reducing the risk of Cot Death.  A horrible subject for any new Mum to have to think about but 300 babies a year are still dying unexpectedly and I wanted to find out why?  Judith Howard who works for the Foundation for the Study of Infant Death (FSID) tells me more about Cot Death and what advice pregnant women and new parents need to know about how to reduce the risks.

1.What is Sudden Infant Death Syndrome? (SIDS)

SIDS or cot death is the sudden and unexpected death of a healthy baby for no obvious reasons. Numbers (which stood at 2000 a year ) have dropped by 65% since the successful back to sleep campaign in 1991. It is now extremely rare compared with live births but still claims 300 deaths every year which is shocking when we at FSID know that those numbers could be reduced by at least 100 if mothers did not smoke and even more so if all parents and full time carers followed the Reduce the Risk advice.

2.What us your role at FSID?

My role at FSID is actually 2 fold. I am a Helpline advisor one day a week, based at Head Office in London, speaking to both bereaved families and professionals as well as answering calls from anyone who wants advice on how to reduce the risks of SIDs. I also train professionals in the whole of the SE of the UK on the latest research backed advice. A vast region covering Kent, Sussex, Surrey. Berkshire, Hampshire and the Channel Islands!

3.What is the advice to pregnant Mums or new parents about reducing the risk?

The current reduce the risk advice is the following:

  • Cut out smoking in pregnancy
  • Place the baby back to sleep feet to foot of crib (with bedding tucked in firmly)
  • Don’t let the baby get too hot or allow their head to be covered ( also no hats to be worn indoors )
  • NEVER sleep with a baby at any time on a sofa or in an armchair
  • Breastfeed your baby
  • The safest place for a baby to sleep is in the same ROOM as the the parent for the first 6 months
  • Using a dummy at all sleep times in 24 hours reduces the risk of SIDS
4.What is the current advice about using dummies?

Published research papers around the world all show that a baby who is offered a dummy (once breast feeding is established) at all points of sleep in 24 hours more than halves the risk of SIDS.  Do not replace a dummy in a sleeping baby’s mouth if it has been spat out. Remove the dummy completely from 6 months and by 12 months.

5.What risks are associated with bed sharing?

The risks of SIDS are particularly increased if either parent:

  • Smokes ( wherever that may be even outdoors)
  • Has recently drunk alcohol
  • Taken prescribed or recreational drugs
  • If the baby was born pre 35 weeks and or weighs less than 2.5kg
  • If the parent is very tired ( particularly the mother! )
Top 3 tips for safe sleeping
  1. Sleep a baby on it’s back feet to foot
  2. Do not smoke anywhere if you have a baby
  3. Share a room but not a bed with your baby for the first 6 month
Where can people get more information and advice?
At our website www.fsid.org.uk or call our helpline on 0808 802 6868 or alternatively email us at helpline@fsid.org.uk 
Click here to see Judith demonstrating putting baby Bruno back to sleep.

The Birth I Want

With my new job as a case loading midwife looming, I came across this campaign via Facebook which really struck a cord with me.  It’s been set up by Vicky Garner, a busy Mum to 3 boys who strongly believes that all pregnant women deserved one-to-one midwifery care throughout their pregnancy, birth and postnatal period.  I was lucky enough to speak to Vicky and find out more about the campaign.

Tell me about the campaign

It’s a campaign for mums, by mums.  We’ve set up now because for years successive governments have promised changes in maternity services – changes that would put the wants and needs of the mother-to-be at the centre of care, where she should be.  Yet we are still not at that point.  Back in May 2012 the current government pledged to reform maternity services and we want to encourage them to deliver on those pledges – to ensure that every mother is given one-to-one care with a midwife/midwives they know through pregnancy, birth and beyond and also given the option of having their baby in a hospital, a birth centre or at home.  Since maternity services should reflect what mums want and need, our campaign is based on the thoughts and experiences mums have of birth and maternity care.  We aim to take the collective voice of mums to policy makers.

What made you want to start it?

After my second baby was born at home under the care of community midwives I was surprised when pregnant with my third to be told that there was a possibility that the same group of midwives might not be able to send out a midwife to my home(if the birth centre was busy) and should that happen, I would have to go into the birth centre to have my baby.  I knew that I wanted a home birth and I also knew that I didn’t want to be worried about whether or not I had to go into the birth centre, so we took on an Independent Midwife.  This brought two things to my attention.  One, that independent midwifery is under threat and we need to do something about it and two, that women across the country are not being given choice over where they have their baby and many are also not getting continuity of care from midwives that they know.  I decided to put my experience as an environmental campaigner to use and set up The Birth I Want.

How important do you think one-to-one midwifery care is for women?

One-to-one midwifery care, before, during and after birth is, in my mind the single most important factor in a positive birth experience for mum, baby and family.  It makes complete sense to me that getting to know your midwife and your midwife getting to know you is an essential ingredient in having the birth you want (even if things don’t go to plan).   And of course, the benefits of one to one care in terms of reducing interventions, reducing c-sections and increasing breastfeeding rates are well known.   And I don’t think one to one care should just be for those mums who are having babies at home or in a birth centre. Mums who chose to birth in hospital or who are high risk so have no choice should be able to be accompanied by their midwife.  It may sound like pie in the sky but it would make such a difference to the birth experiences of so many women.  That’s what mums are telling us too, so we want to try and make it happen.

Do you think the lack of case loading midwifery encourages women to choose an independent midwife?

I think the lack of case loading midwifery certainly does drive those women who understand the importance of a close relationship with their midwives, to Independent Midwifery.  I also think that not being given choice of place of birth is doing that too.  What those women will do come Sept 2013 if the insurance issue hasn’t been sorted I don’t know.  The fact is that we could deliver a case loading system far more widely without many more than the promised 3500 more midwives if those in the driving seats were able to think in new ways.  I’m pretty sure too that if we went down the route of more case loading, we would see less Postnatal Depression and Post Traumatic Stress Disorder, because mothers-to-be who feel supported throughout their pregnancy and birth experience are less likely to have an experience that leaves them feeling out of control and disempowered.

What can be done?

We need to let policy makers know that mothers (and their families) want change. We are the ones who have the experience of maternity services, we need to have a say about the shape of them. We have various ways that you can take action via our website and there has never been a better time!  www.thebirthiwant.org.uk 

Catching Babies

(A beautiful BAFTA animation created by Emma Lazenby, the daughter of a midwife)

My 2 year old has just learnt this phrase when asked at nursery ‘Where is Mummy today?’ Unfortunately her response to ‘Where is Daddy today?’ doesn’t quite gain the same reaction.   It is a sweet way to describe what I actually do for a job.   When my elder daughter was asked to draw a picture of what her Mummy did for a job, I had images of her drawing babies falling from the sky with me holding out a pair or humongous arms attempting to catch them all.

That’s me apparently, bottom right

I’ve always been very open with my elder daughter about why I have to get up whilst she is still asleep to go to hospital for a 12 hour shift and return when she’s in bed.  She knows that midwives look after pregnant women and help them to deliver their babies.  She also knows how babies come out of Mummies.  There are no babies left under gooseberry bushes in my stories!

When I was pregnant with my second daughter, someone gave me a wonderful book called ‘Hello Baby’ which tells the story of a baby being born at home whilst the three elder siblings watch.  The illustrations are beautiful and show the baby being born, the placenta and the cord being cut.  I was never planning on having my daughter present at the birth of her new sibling but I wanted her to be aware of how birth is meant to be, and this is how she came into this world.  It raised lots of questions which I answered with honestly and integrity and I even showed her the photos from her own birth, which she loved.  She was especially interested in the cord clamp on her sister’s belly button and when helping with nappy changes she would inspect it making sure it was kept dry and tucked into the nappy.  The other day she declared she wanted to be a midwife ‘just like Mummy’ so we threw together a few bits in her dressing up box and some various props from around the house.  It was wonderful watching her create an imaginary game from the stories she had heard from me.  I felt extremely proud of what I do, even if it means I don’t see the children as much as I would like to.  But I think it’s so important for them to see their Mother go to work each day to do a job she loves.

Cough cough cough

Birth never fails to amaze me.  Last week whilst I was on nights is a classics example of this.

I was assessing a women who had only been in the premises of labour ward for 6 minutes before she delivered a baby boy.  Shocked? She certainly was.  Especially as 4 minutes prior to her waters breaking and baby Noah arriving in a huge flood of amniotic fluid, she was telling me what she had been doing earlier that day.  She had been to Sainsburys, taken her toddler to a play group and popped into her doctors surgery where she received her free Whooping Cough vaccination.  She still had the little round plaster on her arm where she had been jabbed.

As of the first week of this month, all pregnant women will be offered a vaccination against whooping cough in an urgent effort by the government to reduce the surge in deaths of small babies.  Tragically ten children from across the UK have died from whooping cough in the first eight months of this year – up from seven in the whole of 2011.  At present, babies are given a whooping cough jab when they are eight weeks old, followed by boosters at three and four months.  They cannot have their vaccine any sooner as their immune systems are not developed enough for it to be effective.  All nine babies who died from whooping cough this year have been under the age of eight weeks.

As a pregnant woman given the jab, your body will make antibodies (proteins that fight infections) that are passed on to your baby via the placenta.  This will give your baby protection for the first few weeks of life.  Invaluable right? Even if you have previously been immunised, it’s still encouraged to be vaccinated again to boost your immunity, as it helps protect your baby before he or she can start their own immunisations. The vaccine will be offered during your routine antenatal appointments with your midwife or GP.

For more information click here or speak to your midwife.  Oh and in case you were wondering, Noah was a name on their list but due to the circumstances in which he was born, they thought it was rather apt.

Pre-Eclampsia

Lady Sybil

How tragic to see the lovely Lady Sybil lose her life to such a treatable illness, eclampsia in last nights episode of Downton Abbey. I’m sure for those who watched it found it just as difficult to see her family witness her having an eclamptic fit whilst the family doctor watched on in horror as there was nothing he could do to save her. Luckily in this day and age, pre-eclampsia is a managable condition and with the right detection and diagnosis situations such as these are extremely rare.

Pre-eclampsia is a condition that only occurs during pregnancy. It causes high blood pressure and it also causes protein to leak from your kidneys into your urine. This can be detected by testing your urine for protein. Pre-eclampsia usually comes on sometime after the 20th week of your pregnancy and gets better within six weeks of you giving birth. The severity can vary. Pre-eclampsia can cause complications for you as the mother, for your baby, or for both of you. The more severe the condition becomes, the greater the risk that complications will develop. Somewhere between 2 and 8 in 100 pregnant women develop pre-eclampsia.

Eclampsia is a type of seizure (a fit or convulsion) which is a life-threatening complication of pregnancy. Less than 1 in 100 women with pre-eclampsia develop eclampsia. So, most women with pre-eclampsia do not progress to have eclampsia. However, a main aim of treatment and care of women with pre-eclampsia is to prevent eclampsia and other possible complications.

Your midwife will want you to produce a urine sample at every antenatal appointment

She will also check your blood pressure

And measure the fundal height of your bump

The severity of pre-eclampsia is usually (but not always) related to your blood pressure level. You may have no symptoms at first, or if you only have mildly raised blood pressure and a small amount of protein in your urine. If pre-eclampsia becomes worse, one or more of the following symptoms may develop. Contact your midwife urgently if any of these occur:

  • Severe headaches that do not go away.
  • Problems with your vision, such as blurred vision, flashing lights or spots in front of your eyes.
  • Abdominal (tummy) pain. The pain that occurs with pre-eclampsia tends to be mainly in the upper part of your abdomen, just below your ribs, especially on your right side.
  • Vomiting later in your pregnancy (not the morning sickness of early pregnancy).
  • Sudden swelling or puffiness of your hands, face or feet.
  • Not being able to feel your baby move as much.
  • Just not feeling right.

In the case of Lady Sybil, many opportunities were missed by the family doctor, Dr Clarkson to detect pre-eclampsia. She was heard complaining of abdominal pain, swollen ankles and a serve headache despite her doctor quoting ‘Lady Sybil is just a healthy young woman going through a very natural process.’ However medicine has moved on from the post Edwardian era and pre-eclampsia is much more widely known and understood. for more information click here.

P.s did anyone notice the nurse present at the birth as the doctors aid and not a midwife?! Shame on you ITV, bring on Series 2 of Call the Midwife!

Call the Community Midwife

 

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It’s been a while, I’m really sorry.  I’m not really sure what happened during the summer, I just didn’t have anything to blog about.  Ok that’s not actually true, I think looking back I wasn’t enjoying work.  And that gives me the fear.  A very wise midwife once said to me during my training ‘The day you stop getting that feeling in your stomach when a baby is born, is the day it’s time to hang up your midwifery hat.’ 

Well that feeling has never left my stomach but I knew I needed a change.  I wanted to know the women I cared for, not just who I was assigned to on my 12 hour shifts on labour ward.  I wanted to provide continuity of care from the very first booking appointment right up to the birth and postnatal period.

So as of next month I’m joining a very well established group of community midwives.  It’s called case loading midwifery and it’s exactly what Midwife Jenny Lee and her colleagues portrayed in the BBC series Call the Midwife (minus the veil and crucifix).  Watching each episode avidly, highlighted what kind of midwife I really wanted to be.  It was a time when pregnant women could rely on continuity of care from midwives they knew, when home births were the norm and when midwives were able to practise their skills independently and with confidence.

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So there are a lot of changes happening in our household.  My husband is going to have to tolerate my pager going off at all hours as I wobble off on my bicycle to attend a beautiful home birth.

I can’t wait.