Will I poo when I give birth?

poo

Will I poo when I give birth? is a question that worries a lot of women.  And possibly their men folk, although men tend to be lot more relaxed about poo than us!

The short answer is no, not necessarily.  Often in early labour you have a bit of a dodgy tummy and any poo is kindly cleared out by your body. Especially with first babies, when labour is often longer.

As the baby comes around the curve of the birth canal then pressure is caused to the rectum.  If there is a little bit of poo there it will be pushed out.  And you get an uncontrollable urge to bear down.  If you are with a woman in labour you will hear the noise she is making change to a more ‘pushy’ sound.

In fact if there is any poo there it is best got rid of!  Years ago women were routinely given enemas to clear their bowels and we thankfully no longer do that.  If women are very constipated then it can hold the baby back. Seriously!  I have looked after women when the labour was taking a long time, they were constipated, had a poo, suddenly more space for baby and the baby was born shortly after.  Brilliant.

Sometimes people attempt to get labour going by stimulating the bowel by having a spicy curry or taking castor oil.  I wouldn’t recommend the castor oil route.

Talking about poo from a midwives perspective we are very discreet.  If there is some poo during the birth then we will cover it and deal with it ASAP with minimal fuss. If you are in a birthing pool then we have a sieve that we use!

And we honestly don’t mind at all.  Everybody poos it is perfectly natural.  As a matter of fact; midwives get excited if we see poo!- it means that the baby is coming!

The feeling of the baby’s head coming down often feels that you need a poo/ are pooing and most times you really aren’t; it is just the baby’s head pushing down. It can feel like the baby is coming out of your bottom.  It is helpful to know that this a completely normal sensation and a really positive sign in late labour.  We would encourage you to just follow the lead of your body.  It knows what to do.

Many women feel more comfortable sitting on a toilet and pushing/ bearing down in the second stage for this very reason. It is a trick we often use to encourage the baby to descend.  Lots and lots of babies (my own son included!) are born on or near a toilet. Us midwives are very skilled at ensuring that the baby doesn’t fall down the loo!

If you are in labour and start feeling like you need to poo then please don’t worry.  In fact it’s fantastic – your baby should be born really soon. Trust your body.

Katheryn x

This post originally appeared on my blog The Vintage Midwife

Advertisements

For the student midwife who is thinking of quitting

Screenshot_2015-08-16-16-39-15-20150816-164230580_1
Third baby (of 40) caught as a student midwife

I qualified as a midwife ten years ago and I have never felt more passionate about my job. But it hasn’t always been like this. There have been several times that I have seriously thought about giving it all up.

When I was a student midwife I came really, really close to leaving the course.   Just so you don’t think I am a quitter; I am not alone in my feelings.  Midwifery training has never been more popular, in part thanks to ‘Call the Midwife’ and ‘One Born Every Minute’,  but up to fifty percent of student midwives will drop out of their course.  The reasons for this are multitude.  Basically the academic side and going to placements and working shifts as well is tough.  Many students are doing this whilst looking after families.   People come into their midwifery training with a real passion and the reality of midwifery in the NHS today is often very different to what we hope it to be, see here, and here.

The first year of qualifying was tough.  The difference between being a student and the awesome responsibility I now had.  The peace I had to make with myself between what I knew was best for the woman and what the hospital guidelines and procedures dictated I do.  I like to call this ‘selling my soul’, something I still struggle with now at times.

I am really, really glad that when the going got tough I stuck it out and I wanted to offer some words of ‘wisdom’ to all the wonderful people who are going off to start their midwifery training now, who are just qualifying or who are struggling;

  • Write- Write down why you want to be a midwife and keep it somewhere-  when the going gets tough (and it will sometimes) it can really help to refer to this. Write down when you have a difficult day and want to offload or reflect.  (Bearing in mind confidentiality.)  Keep all the thank you cards you get- also really helpful to look at.
  • Read, read, read – not the just the stuff they tell you, but Ina May Gaskin, Michelle Odent etc.  My favourite birth books are here
  • Observe – The role of the midwife is really one of watching more than doing.  You can learn so much just by watching a woman in labour.  Notice the sounds, often this alone will give a really good indication of what stage of labour a woman is at.  The smells (yes really!)  The distinctive smell of amniotic fluid, so you can tell if waters have broken and notice the smell of birth.  Look at the woman’s skin; how her legs become more mottled, how her sacrum may move and lift up, the purple line in her bottom.  You don’t need to just rely on vaginal examinations to know what stage of labour a woman is at.  Watch what other midwives do (good and bad) Do you want to be like them?  Or not?
  • Give yourself time – you are not going to master all the skills straight away.  They take years to learn.  For example vaginal examinations (VE), where you asses progress in labour by how thin and open the cervix is, how many centimetres dilated, baby’s position etc.  When I first did them it felt like a lucky dip in a bowl of jelly! It honestly wasn’t until I qualified that I properly felt a cervix (god knows what I was feeling before!)  and couldn’t believe that it actually felt like a circle.  When doing a VE give yourself time and remember that the woman will have a cervix in there! She got pregnant after all.  Just finding a cervix is sufficient in the early days.  Remember that very experienced midwives sometimes get it wrong.  I know of a Band 7 (top dog) on Delivery Suite who told a woman she was fully dilated and she was only 1 cm!
  • Find like minded people – they are out there and can be a great support.  Other students, midwives, doulas.  In person or online.
  • Trust – trust yourself.  Time and time again I have found that a gut feeling was right; ignore those feelings at your peril. Even as a student, or newly qualified when more experienced people may tell you that you are wrong. And trust in women’s bodies and their ability to give birth.
  • Be kind – to the women, their partners, their babies.  Remember their names, hold their hand, make them a cup of tea.  You may not feel like you can do a lot to start with but these kindnesses matter more than anything and will be remembered.  (Unkindness likewise).  Be kind to yourself – it is hard doing the job you are doing.  You need some time and support for yourself in order to support other people well. Yoga, swimming, mindfulness, massage, good food.

There is an amazing quote by Aristotle that I love on the qualities a good midwife should have

“A ladies’ hand, a hawk’s eye and a lion’s heart.”

Best of luck on your path, I promise you it gets easier. Remember just as you say to the women “you can do it!”

Katheryn x

This post originally appeared in a slightly different form on my blog the vintage midwife

Compu’er says no!

computer says no

I had a slight meltdown on labour ward the other day, a meltdown that resulted in an argument between me and….. a computer system. Yea we’ve all been there, I’m sure many of you can relate to this.

There seems to be more and more machines and computer systems on labour ward these days, all designed to ‘help’ us do our jobs more safely and more efficiently (that’s if you can remember all your passwords!) Number one is the maternity computer system, that holds all the patient details, and where we record everything about a woman’s labour. You need your username and password to use this system. Then you need a different username and password on a different computer system to request blood tests and check results. Another username and password to use the fetal blood sample machine, another to use the glucometer machine, another for the urinalysis machine… the list goes on and on. Hang on a minute, all this technology just to have a baby??!!! Really??

My meltdown with the computer began when I entered a request for a blood test on the computer system for a woman I was looking after, and the compu’er said no! So not only did I need to ask permission from the computer to do the blood test in the first place, it then told me NO! It told me I had already requested this test today on this patient and was I really sure that I wanted to repeat this test again. Now hang on a minute, I’ve got a computer questioning my decision to do a blood test, surely this can’t be right, what’s next? The computer telling me that the woman’s labour is taking too long and she should be given drugs to speed it up? This will probably happen in the future, I kid you not (shudders). So after muttering ‘bloody computers’ under my breath I stomped off to the staff room for a cuppa and a Jaffa cake and had a flick through my iPhone whilst continuing to moan about computers taking over the world (oh the irony!)

But let’s face it; women did manage years ago to give birth without all of this. Please take me back to ‘call the midwife days’ when all midwives needed were a pair of gloves, clamps and scissors to cut the cord and a pen and paper to jot down the crucial details – time of birth, weight, sex of the baby. Job done. I’m pretty sure that in the not too distant future, as well as carrying a pair of gloves in their pockets, all midwives will be carrying ipads to input everything they say and do as they go. Oh well, that’ll be one more thing that’ll get dropped in the birth pool no doubt (along with the pagers, drug cupboard keys, and the fetal heart monitors!)

Of course there’s no stopping progress and I know we need to embrace these changes, but we’re talking about birth here not a bank transaction. Birth is a spiritual moment that brings people together. Birth brings everyone in its presence into the ‘present’ and reminds you of what’s really important in life. The definition of the word midwife is ‘with woman’ not ‘with computer’. If the midwife is interacting with the computers and all the other machines around her then she’s not interacting with the woman, and us midwives know that a woman in labour needs continual emotional support more than anything else, and that’s something a machine cannot provide.

So is all this technology in the birth room actually more of a hindrance than a help? Well maybe one day there won’t be any need for us midwives at all cos maybe there will be another machine designed to catch all the babies too!

Sharon x

http://www.bumpsnbabies.org

Midwife approved list of what to pack in your hospital bag

hospital bag

Giving birth is an unpredictable event; usually you don’t know when it’ll happen, or how long it’ll take. You might get lucky and have a super speedy labour and not need much from the list we’ve compiled below, but our motto is that of the Girl Guides – ‘Always be prepared!’

For you

Your iPod/pad/phone AND CHARGER!!! With the hypnobirthing tracks on them of course!!! Also make your own playlist in case you fancy something a bit more energetic, something by the prodigy maybe??!!

Fresh water in a sports bottle Don’t bother faffing around with a plastic cup and straw or you’ll likely end up with the straw rammed up your nostril and a face full of water mid contraction!

Jelly babies The instant pick me up when your energy levels are flagging, midwives love a jelly baby on a night shift too! 🙂

Food for him You never know how long your labour will take and a hungry birth partner = a grumpy birth partner, so pack some of his favourite snacks to keep him going otherwise he’ll be ringing his mum to drop by with some sandwiches

Isotonic drinks Just in case the vending machine is out of order, pack a few bottles

Bikini for the birth pool Us midwives have seen it all before but this whole  ‘getting your kit off’ in front of strangers is probably a new thing for you (probably), so just wear whatever is most comfortable for you, bikini, bathing suit, birthday suit, whatever.

Yoga mat A tad controversial this one, it’s for the men to have a snooze on if they’re super tired and the only option is the floor.  No he won’t be snoozing at that crucial moment when you’re birthing his baby, but he might just need 40 winks before the drive home maybe?

Hair band The good ol’ 90’s scrunchy is the best otherwise your other half is rummaging around in your make bag looking for your hair bobble for an eternity.

Change for the car park  Yes you need to take out a small mortgage these days for hospital parking but if you ask nicely you might be entitled to a free pass, worth a go!

Your birth plan.  Laminated, with key points highlighted (only joking) make sure you give it to the midwife looking after you.

Lip balm Gas and air = dry lips, nuff said

Flannel Yes it’s not just something we midwives suggested in the good old days, women in labour these days still need their brows mopped with a cool damp flannel!

Warm socks We’ve lost count of the number of women we’ve looked after in labour that have stripped off completely bar their socks! Must be something to do with blood flow going to the uterus leaving the extremities cold maybe?

Hot water bottle Great to put on your lower back or under the bump to ease any cramping. Be warned the midwives might not be able to re-fill it (due to elf ‘n’ safety) but if that’s the case ask if they have any heat packs you can use instead.

Big pants and proper brick like sanitary pads. Panty liners just won’t cut it if your waters have gone nor will they just after you’ve had the bubba – think 9 months of periods all in one go, gross but true. You could also try the TENA lady incontinence pants (we won’t judge you honest!) Oh and leave those lacy thongs at home, only big, baggy dark pants will do, yes motherhood is sexy!

Tracky bottoms (dark ones obvs.) and a zip up hoody for after the birth. Much comfier than jeans and teamed with a zip up top = easy access for breastfeeding and you’ll be looking bang on trend on the postnatal ward!

Flip flops  There’s just something a bit grannyish about plodding around a hospital in your slippers don’t you think? Flip flops can also be worn in the shower.

Lansinoh nipple cream Pricey but so worth it, put a smidge on after every feed keeps ‘em super soft and keeps the cracks at bay

Pillows.  There’s either a tone of pillows on labour ward or none at all, so to be sure best to bring your own, maybe sprinkle a few drops of lavender oil on them for added relaxation.

Nursing bras, and maybe a few breast pads too in case you’re ‘that woman’ with an abundance of breast milk and could easily nurse all the babies on the ward and still have some left over.

Toiletry bag with  shower gel, deodorant, shampoo & conditioner (do they still make wash and go??) and BB cream, well you wanna be looking glam for those post birth photos don’t you?!

 

For baby

Disposable nappies Even if you’ve invested in the washable ones, for infection control reasons just use disposable nappies whilst in hospital.

Cotton wool For cleaning baby’s bottom, wipes can be a tad harsh on their peachy cheeks initially, so best to save the wipes for a few days down the line if you can.

Vests, sleep suits, and a hat. Yes the pink frilly Dior dress is adorable but trust us, for those first few days it’s all about being practical and although the poppers will drive you a bit insane at 3am the sleep suit is the way to go for practicality.

 A nice warm blanket Yes the knitted ones are very classy but the warmest are those cheap fleece ones from Matalan, honest!

 

  • Top Tips – Make full use of the NHS linen, i.e. towels, cot sheets and baby blankets. It’ll save you the hassle of packing and washing your own!
  • Pack a little treat for yourself, maybe a mini bottle of prosecco??, or a scrumptious bar of chocolate?? after all you’re the one that’s done all the hard work, congratulations, you rock!!

Sharon , Katheryn & Jade xxx

Guest Blog Post! The Life Of A Student Midwife

student midwifeGuest blog post from Jess a student midwife in her 2nd year of training giving us a little insight into the life of a ‘student baby catcher’.

Being asked what career pathway you want to follow when you are only 16 seems like a massive request, but for me I always knew that someday I wanted to become a midwife. I could see myself caring for women throughout their pregnancy, labour and postnatal period and having great honour in sharing these times with women. I have always been a people person (or so my mum says!) and love chatting to a variety of different individuals. Here I am following my dream! Half way through my second year of midwifery training and loving every single moment, each day I learn something new and life couldn’t be better! So I thought I would give you an insight on what it’s like to be a student midwife in 2015, with the three best and worst things about being a student midwife. Three not so great things:

1. As an undergraduate student midwife, you are required to attend for 45 weeks of each year for three years. Meaning that we aren’t your typical party animal university students (or so I think?) … placements, lectures and essays take up the majority of your time and balancing a social life can be difficult!

2. So each placement is 6 weeks, and in each placement you get allocated a mentor who is a fully qualified midwife. Each midwife practices slightly differently and by the time you’ve got used to how one midwife practices it’s time to move on! Just when you start to feel like you are getting into the swing of things.

3. After 6 weeks out on placement going back to university must be one of the hardest tasks (well for me anyway!) … It feels strange being sat in a lecture theatre for hours at a time when on placement you were normally non-stop for the majority of the shift. Saying that I do love catching up with the rest of my cohort’s midwifery journeys!

Three fabulous things:
1. When they say that midwifery is the best job in the world … they sure didn’t underestimate that one! As a student we are supernumerary which is great because it means that we get to spend more time with you, and that’s where we learn so much as believe it or not no two women are the same! It’s great knowing that just chatting to you can put you at ease and make such a difference to your experience.

2. As a student, we are made to feel a part of the team … before you ask that does mean partaking in drinking cups of tea and eating cake, which, of course, is a very important part of the job! Your mentor becomes your personal guru of midwifery knowledge and wisdom, and by the end of your 6 weeks you feel slightly sad about moving on.

3. ‘Catching’ or delivering a baby must be the greatest feeling in the world! It is such a magical and honourable experience to welcome a new life into the world, the pride and love that a mother and her partner have at that moment is something that can never be replicated. I am extremely thankful that as a student midwife I am able to share such an amazing moment with mothers from all walks of life.

There you have it, three of the best and worst things about being a student midwife. I wouldn’t change this career choice for the world and I am so thankful for all of the marvellous experiences that I have shared with women so far which have helped shape my midwifery pathway!

Jess x

An English Midwife in Spain

a brit abroadHow did this happen? This was not the plan. The plan was to work in a bar, pull a few pints and take it easy. I’d only been qualified and working as a midwife for just 18 months in the U.K when I decided I’d had enough. After three years of intense training, being skint and then the dreaded first year as a newly qualified midwife I just couldn’t be arsed with it anymore. Sod it I thought, sod the student loan repayments I’m off to Spain to live with my parents. The Costa Blanca, now we’re talking! Sun, sea, sand, and not a labouring woman in sight – bliss! In hindsight I was probably burnt out but didn’t realise at the time.

After a few months of winding down and working on the tan the plan changed… There was a new hospital being built in the area. Would they need midwives I wondered? Turns out they did, and the fact that I spoke English was a bonus due to the large number of English speaking Europeans living in the area. So there I was being interviewed for a job as a midwife through a translator because did I mention that I couldn’t speak Spanish? Yeah that’s right, not a word, nada!

So lucky me was offered a job and told to learn as much Spanish as possible over the next six months before the hospital opened. Yeah no probs I can do that I thought. Now I did my best in those six months trying to learn the lingo, swotting up all day everyday but there was no getting away from the fact that my Spanish was crap, I mean really crap. And now here I was on my first day having my photo taken for my ID badge. They say every picture tells a story, that photo says it all, the look of terror on my face! How was I gonna pull this off?

Fortunately there were others there in the same boat as me – mostly doctors, from all over Europe. Clinging to our translation dictionaries somehow we all got by and made ourselves understood one way or another and thankfully there wasn’t reams of paperwork to fill out like there is in the U.K. Our Spanish colleagues were lovely people with a lot of patience; I’ll never forget how kind they were towards me cos no doubt I drove them up the bloody wall most days.

Of course over time things got easier, I even became useful and was called upon as a translator if an English speaking patient was on the unit. Usually the classic English tourist – sunburnt, and shouting loudly in English hoping that the Spanish doctor would suddenly understand them if they shouted the same sentence several times, each time a bit louder. I could probably write a whole book about my time as a midwife in Spain, (no plans to) but there was one particular night shift on labour ward that comes to me now and again, along with the realisation that no matter what language is spoken words are just that – words, and actually maybe we all talk way too much. Talk is cheap, actions speak louder than words, you get the gist.

So I worked mostly day shifts but was asked if I could cover a night shift for a midwife who was off sick. It was a quiet evening, there were two of us midwives and two maternity assistants lounging in the staff room, nibbling on pipas whilst watching the Spanish version of ‘wheel of fortune’ (crap TV game shows in every country!) The only obstetrician on that night arrived to announce that the last patient on her list that she had seen in antenatal clinic needed her labour inducing. She was off to the doctors’ rest room to be called only if there was problem.

It was my turn to do some work. Within the hour the woman was in a hospital gown, on the monitor, with a hormone drip flowing through her veins to get her contractions going. No husband or birth partner with her, so it was just me and her and here’s the thing – she was Moroccan. She couldn’t speak Spanish or English and I couldn’t speak Arabic, so we communicated with the odd hand gesture and the occasional smile or nod.

With the lights off I curled up on a chair next to the bed near to the monitor. In the dark all you could hear was the baby’s heart beat, and the woman quietly chanting what I guessed was a prayer? An affirmation? Something from the Quran? Whatever it was it sent me into a chilled out trance. I gave her the occasional smile, offered her some water now and again and squeezed her hand to hopefully reassure her all was well. No words. After a few hours things hotted up, her contractions got stronger, she rolled from side to side and her chanting got loader. Then suddenly she looked me right in the eye and said something to me in Arabic which I guessed was ‘it’s coming?’ I lifted up her sheet and there were signs that she was ready to give birth so I called the maternity assistants and we moved her into the ‘birthing room’. This wasn’t her first baby, she started pushing, she knew instinctively what to do. Just the odd smile and nod from me. I caught the baby and put him in her arms. All straight forward, no problems and within half an hour the maternity assistants had cleaned her up, the baby was feeding at the breast, and she was ready for the ward. As she was wheeled passed me on her bed she leaned out and grabbed my arm, she looked me intensely in the eye and held my gaze for a moment. She smiled and said something in Arabic which I guessed was ‘thank you’ and then she was gone.

You know where I’m going with all this…… a woman in labour with a midwife by her side. They barely spoke yet a baby was born. All was well, the woman seemed happy with her care. Maybe the fact that we couldn’t speak to each other meant that she could focus more on herself, and switch off the thinking part of her brain which allowed her to labour better? (AKA Hypnobirthing). Some of you reading this will probably think, Yeah but what if something had gone wrong? Where was her informed consent? What about the lengthy discussions about the pros and cons of induction and what research backs up the evidence and the guidelines? What about litigation??? blah blah blah! I don’t know. Everyone will have their opinions on what’s right and wrong, but what I do know is that I remember that night shift, I remember the whole ‘not talking thing’ and it felt right, it felt peaceful, and sometimes I wish there could be more days when there is just less talk.

Sharon x

Here’s me and the only other English midwife with our lovely boss. Looking more tanned and healthy than your average NHS midwife in the UK!

midwives in spain

So you want to be a midwife?

wanna be midwifeI was recently contacted by someone who wants to be a midwife and I have been wondering what to say to her. Midwifery training is incredibly popular at the moment, no doubt thanks in part to Call The Midwife and One Born Every Minute.  I have lost count of the number of people who have said to me ‘I would love to do your job…’ with a wistful look in their eye.  At our local university over 1,000 people applied for the 70 spaces available on the next Midwifery course.

But I wonder if there is any other job that is so romanticized and where the harsh reality of life on the shop floor is so different to what we hope for?

I don’t think people always fully appreciate the enormous RESPONSIBILITY that you have as a midwife.  At times it can feel overwhelming.  You are responsible not only for the health and safety of that woman but also for her baby.  You may be responsible for a baby dying or being severely disabled.  Just let that sink in for a moment, it’s quite a big deal huh?

Sometimes, despite the best care babies can be born in an unexpectedly poor condition and I know of several very good midwives that have been involved in these tragic cases. This involves investigations, court cases, a very hard and long process before their name is cleared.

Childbirth is a natural, normal function that is a momentous event for a woman and her family.  But in the litigation fearing, policy following, hugely overworked, overstretched and understaffed NHS then this can often feel lost.

The heartbreaking fact for midwives is that if you have only 15 mins per antenatal appointment, have to do 13 postnatal visits in a morning, look after 10 women and babies on a postnatal ward, catch 3 babies on a night shift then you just simply can not give the care that you know these women and babies deserve. Meanwhile you are answering endless phone calls, buzzers, doorbells, doing reams of paperwork, hunting for missing equipment, mopping blood up, chasing social workers, teaching students…

All of this in a twelve hour shift without time even for a wee and only a handful of Quality Street to eat all day.  Working loads of weekends, night shifts, Christmas Day, New Years Eve.  Still want to do it?  Have I put you off yet?

I decided I wanted to be a midwife when I saw a baby being born whilst training as a student nurse, fresh out of school. I was just 18 and it was the most amazing thing I had ever seen.  Like a magic trick, a baby appearing out of a woman’s body.  I have lost count of the number of babies I have seen born since then, it must be several hundred.  And do you know what?  I still find it as exciting as that first time I saw it.  When you see that tiny scrap of hair, that new life emerging, knowing that you are the first person to see this new person, it never loses its thrill.

Yes it’s hard work and nothing like the ‘lovely’ job people often imagine it to be but I still want to be a midwife.

If you think you’d like to be a midwife click to find out more about our aspiring midwife study day.

Also check out this great website for aspiring midwives and student midwives www.studentmidwife.net

Katheryn x

http://www.bumpsnbabies.org