Perceptions and Birth Stories

perception

There is no truth, there is only perception……… Gustave Flaubert

Yes it’s another one of those irritating quotes that pops up as you scroll through your instagram account. But before you roll your eyes and groan, think about it, it’s true – There is no truth only perception.  When it comes to a birth story how much is truth and how much is perception? Us midwives love a birth story. Sometimes we hear the story from several people that were there at the birth, all chipping in with their own version of events and that’s when this quote really hits home, because one person can perceive an experience way differently to another.  A woman who has laboured high on a dose of birth hormones, adrenaline and some gas and air thrown in the mix will tell you her version of events, but then so too will her mother and her partner that were there with her and they all tell the story slightly differently. Confusing? Yes! So what is the truth? What really did happen during that birth? Who knows.  Let’s not forget there was another person in that room too with her version / perception of events …the midwife!   Us midwives know we have a massive role to play in a woman’s birth experience, but probably only to a degree, the rest is down to her and the way she perceive the event.

Let’s go back to the gas and air for a minute. Gas and air is fantastic stuff. It’s a mind bending, thought altering, wonder drug. It takes you to another planet where you just don’t give a toss about anything. Many women get right off their faces on it in labour. ‘This stuff is bloody amazing!’ they say as they cling onto the mouth piece for dear life. The gas is seen as her new BFF and she aint givin’ it up for no one. You know when a woman is in ‘gas land’ when she comes out with random things in-between contractions with a strange smile on her face. “Everyone just seems so far away man…just totally thought I was Barry White”. Yep, she’s in gas land. So if she thinks she’s Barry White what else does she perceive about this momentous moment in her life that will shape her version of her ‘birth story’.

Likewise another biggy when it comes to altering perceptions during birth is the beast that is adrenaline. Adrenaline flowing through a woman’s body in labour will trigger the flight or fight response within her. She becomes stressed, perceives she is in danger, fearful thoughts run through her mind. She leaps off the bed mid contraction yelling “that’s it, no more, I’m going home”.   She wants to flee the danger that she perceives, but of course she doesn’t get very far, she’s in rip roaring labour and about to have a baby. All that adrenalin surging through her body isn’t particularly helpful during labour and is likely to influence her perception of the birth in a negative way.

And why is it that one woman in labour can perceive the physical sensations of her contractions so differently to another? Some women describe their contractions as agonizingly painful; others report feelings of euphoria with no mention of pain at all. Perception has a part to play here too. In our hypnobirthing classes we demonstrate this idea by bringing the couples into a relaxed state and encouraging them to image that their right hand is in a bucket of cold icy water. We suggest that they perceive their hand becoming cold and then numb. We encourage them to bring their numb hand to their face and feel the numbing sensation transfer to their cheek and mouth. At the end of this hypnosis script the couples themselves seem pretty baffled at what they’ve just experienced. There is no bucket of icy water, that’s the truth, so how come they genuinely felt that their hand was icy cold and numb? What the mind of man can conceive and believe, it can achieve” ( Naploean Hill ). Clever stuff eh!

So can us midwives really influence a woman’s birth story in a positive way? Well yes, obviously it goes without saying, being kind, showing compassion etc. but it’s not always that simple thanks to good ol’ perception. The calm voice and those reassuring words that you used worked a treat as you supported a woman through her labour last week. The encouragement you gave to spur her on through her labour was spot on. She sent you a lovely thank you card and a cracking box of chocolates. In the card she wrote “Your kind but strong words helped me avoid the epidural that I considered having, I had a fantastic birth experience, thank you”.  But beware, woe betide the midwife that thinks she’s cracked it and becomes smug, thinking she’s worthy of a midwife of the year award, because tomorrow you might find yourself in a similar situation; you care for another woman in the same way, yet she perceives your encouragement as patronising and insensitive. She perceives that you prevented her from having her happydural and her birth story is far from positive. No thank you card or box of choccies from her. You feel deflated, cussing yourself that you got it so wrong this time, you bad midwife you.

Most women will have some recollection of the day they gave birth, but it seems time also has a part to play. A woman’s birth story can alter over time, cleverly edited by her mind with key events highlighted that she remembers forever, others becoming foggy and maybe less relevant to her. We shouldn’t dismiss a woman’s perception of events during her labour as irrelevant because it’s not. A woman’s birth story is exactly that – her birth story and that’s fine. Life is based on perception. Perception is based on opinion. Opinion is based on thought. Thought comes from the mind. So as midwives whilst we have some control over certain factors that influence a woman’s birth story, whether positively or negatively, we cannot fully control her perceptions.

Sharon x

http://www.bumpsnbabies.org

 

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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

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

Opinions are like arseholes – everyone’s got one!

bartMidwives have plenty opinions about the business of giving birth. In the same way that blokes seem to have plenty of opinions when it comes to football. Check out what’s trending on twitter on a Saturday afternoon and you’ll get the jist. Nothing like a penalty to get a man ranting on about their opinions of the refs opinion of that foul. And that’s the thing, when people feel passionate about something, something that matters a lot to them then queue the opinions. If you’re not arsed about something then you don’t tend to have an opinion to spout. Ask a bloke for his opinion on the dress you’ve just bought and they tend to mutter something like ‘yea whatever you think love’, they’re really not arsed, they have no opinion. Ask a midwife what she thinks about an episode of One Born Every Minute and stand back, here we go, here come those opinions!!!! Yea but no but, yea but no but……

And it’s not just midwives, anyone involved in the business of birth has an opinion, it seems we’re an opinionated lot! For example:

The fantastic French male obstetrician Michel Odent loves a water birth, he also has his opinions on fathers at the birth, something along the lines of – they’re a bloody nuisance, they interrupt the flow, keep ‘em out the birth room, send ‘em all down the pub.

The American sceptical OB Amy Tuteur loves a caesarean section and has her opinions on homebirths, something along the lines of – women that choose to give birth are playing Russian roulette with their lives.

Two very different people with very different opinions. I guess they’re entitled to their opinions.

And it seems these days that everyman and his dog reading the daily mail also has an opinion on childbirth judging from the comment section, here are  just a few examples of articles that recently got the juices flowing, along with a few comments from Joe Public :-

Should women be entitled to an elective caesarean section through choice?

‘No way it costs the NHS too much, they should get on and bloody well push it out!’ Dennis32, Ipswich

‘Well if a caesarean is good enough for Victoria Beckham, it’s good enough for me, it’s not that I’m too posh to push, I’ve paid my taxes, give me my caesarean, my body my choice !’ Ruth, P, Essex.

Giving birth under hypnosis, does it work?

 ‘I’ll believe hypnobirthing works when I see a man volunteering to use it during a vasectomy.’ Janey, London

‘Yes hypnobirthing works, I had an easy, enjoyable labour thanks to hypnosis, – hypnobirthing rocks!!’ Mummyyummy31, UK

And wait for it, here comes ‘the big one’ –

Breast is best or is bottle feeding just as good?  Like a hand grenade going off, seems everyone’s got an opinion on that subject, let’s not even go there!

And what do I think?  Well, If you ask me what I think about hypnobirthing I’ll tell you my opinion, don’t be offended though if you don’t like my answer, it’s nothing personal, it’s just my opinion. But please don’t bother asking me what I think about Arsenals latest signing, I’m no football fan, I’m clueless when it comes to the off side rule, so I’ve no opinion, I’m really not arsed. That’s Arsenal – not arsehole, no pun intended!

Oh and please feel free to post your opinions on this article; they are after all just your opinions 😉

Sharon x

http://www.bumpsnbabies.org

There’s an iguana at my homebirth wot am I gonna do?

iguanaA student midwife asked me the other day what’s the best thing about being a midwife? Now I think she was expecting me to say something like – ‘Oh the sheer joy and privilege of being part of such a magical time in a woman’s life when she makes that huge transition from a woman to a mother and witnessing another family bond being created’.

That was not my answer, this was my answer –  The best thing about being a midwife is the crack. In no other job would you get caught up in such hilarious moments. I’m talking proper belly laughing moments that remind you to work your pelvic floor muscles more often.

For instance, I remember a night shift on labour ward when a midwife colleague arrived on the unit having just attended a homebirth. She had a slightly weary look about her as she dropped off her safety equipment and restocked her birth bag.

“Nice home birth was it?” I asked. She gave me ‘the look’. “Oh, not all plain sailing then?” I asked

“Would have been alright if it weren’t for Dave*” she replied.

“Dave? The birth partner? Bit over protective was he? An Alpha male type?” I asked.

Turns out Dave* was in fact an iguana. (*please note, name has been changed to protect the iguana’s identity). Dave was a free range iguana, free to roam around the house as he pleased. No staying in the tank for Dave that night, oh no, Dave wanted to be right where the action was.

My colleague went on to set the scene – Dim lights, the aroma of essential oils wafting around the room, relaxing music playing, woman floating serenely in the birth pool, making deep mooing type noises during each contraction that got louder as her labour progressed. With her, by her side was her partner, attentively mopping her brow. And then of course there was Dave, the iguana, scuttling across the top of the book shelves and along the curtain rail.

My colleague confessed she wasn’t a huge fan of reptiles and may have lost her focus slightly at this birth as she kept her beady eye on Dave’s beady eye as he hovered over her shoulder, just above the birth pool. In fact she paid so much attention to Dave, convinced that he would leap in the pool at the crucial ‘birthing moment’ that she almost missed the arrival of the baby altogether. “To be fair the room was very dark.” she said.

“Was he interested in the whole birthing thing d’you think? cos animal are very intelligent.” I said.

“No”, she replied “ I’m convinced he just fancied a dip in the pool and then I guess I would have to fill in a clinical incident form if that had happened cos I guess that would be classed as a health and safety risk?!”  Then we both laughed, a lot, at the thought of management receiving the clinical incident form and deciding on what action should be taken in any future incidents involving a midwife, an iguana, a labouring woman and a birth pool.

Look out for future posts on animals at the birth, so many stories to tell…!

If you want your partner (or pet iguana) to be fully prepared and supportive for you in labour then why not sign up for our hypnobirthing classes, visit our website  www.bumpsnbabies.org

Sharon x