Throughout your prenatal care, you may hear comments or experience reactions from your care provider that could signal a red flag that she is not providing care that is evidence based or that supports your preferences for birth. If you encounter any of the following red flags, open a dialogue…
If you’re a first year student midwife in the North West of England who had their tour of a certain big maternity hospital today…
I was watching you….
Hahahaha I’m not being creepy! I was actually in the hospital for mandatory training as part of my new job, and a big bunch of you were at the lifts when I came out of the stairway. I actually spoke to two of you, only a quick “Are you the new first years? I’m newly qualified. Good luck!” as I ran past.
Let me know if you think you know what hospital I am on about, or if you saw me/spoke to me! If not, any of you starting on the postnatal ward will see me soon!
This new campaign is so incredibly relevant right now.
Women are getting asked to go home from hospital earlier and earlier. My hospital now has an “enhanced recovery bay” that aims to send all women who are well after having a cesarean home the day after they have their baby.
Abdominal surgery can be difficult enough to recover from, never mind when you have a brand new baby to care for. Your entire core is sore, you don’t realise how much you use those muscles until you can’t use them as effectively because they’ve been messed with.
Going home on day one should be a choice. NICE guidelines say day 1 discharge should be offered. That means we shouldn’t be advising women to go home just because we can.
The same goes for women who need extra pain management, or feel they’d benefit from more support with breastfeeding. They should be able to stay.
But don’t get me wrong, it’s not the staff’s fault. Women are being discharged because the hospital is too small, there’s not enough beds or staff for women to stay longer than a day or two when they are clinically and obstetrically well.
Things desperately need to change, but with more maternity units closing down, I can’t see it happening any time soon.
Now I don’t know how many of you have watched any of The Mindy Project, but there was an episode on the other day that made me so incredibly angry!
The general plot consisted of Mindy and her fellow obstetricians getting angry because pregnant women were transferring their care to midwives.
Cue Mindy going upstairs and scaring the pants off of the women, claiming that midwifery is unsafe, that only doctors can handle high risk and emergencies, and therefore women should birth with an obstetrician in case such problems arise.
This is despite there being an insane amount of evidence that midwifery-led care is actually the safest model of care and is highly recommended. Yes, if complications arise you might benefit from the expertise of an obstetrician. But that is if they arise. And even if they do, you should be cared for in a multi-disciplinary team including midwives to keep promoting normality! I can promise you that no NHS obstetrician in the UK is going to spend their entire shift just looking after you, and only you, doing everything you need, providing round the clock care to keep you and baby safe, no matter how many complications you have. That falls to the midwife (and occasionally a HDU nurse if you’re extremely poorly). Why would an obstetrician trust a midwife to do this if we weren’t completely capable and qualified?
So yes, Mindy Project, obstetricians are necessary and valuable members of the medical profession. But midwives are not loony hippies putting women in danger, and you’re not going to help the USA move away from medicalisation of birth if you carry on vilifying midwives on television!
On Monday I started my first day at my new job as a fully qualified midwife.
I’m not clinical yet, I’ve been going through induction lectures, mandatory training and setting up of different logins and passwords, which carries on until next Tuesday.
But today I found out that I’ll be starting on the postnatal ward, which I have mixed feelings about. I really disliked the ward as a student, but that was mostly because I spent half of my time looking for a midwife to get pain relief out of the drug cupboard! Now I’m qualified, I’m hoping I can just get on with things my way, and enjoy it more.
However, despite the fact that I have finished my training, qualified & graduated (with first class honours!) and started the job, I’m not actually working as a midwife yet…
I have to wait for my NMC pin to come though, that could take anywhere from 2-10 weeks! So for now, I’ll be working as a band 4, which means I can do things like obs and most of a postnatal check, but won’t have my own women or be able to dispense pain relief…
So I don’t feel like a midwife yet. But hopefully I will soon!
As I’m sure you’ve realised, I’ve let this blog slip quite a bit. I’ve had the most hectic year of my life so far, and it’s been difficult to even get online, never mind keep this going.
I start my job on the 14th October, and so I hope once I’m in and settled I’ll have more of a routine again and be able to continue as I used to.
I also want to open this blog up to you guys. If you want to help me out, I’m going to be welcoming members to the blog for the first time ever. This allows you to post on the blog anything you find interesting, anything you are thinking about and experiences/stories you want to share.
This would just help keep the blog running day to day when I’m at work, and keep notattthedinnertable alive.
I know a lot of you have your own midwifery blogs to run, but if any of you are interested, just send me a message/ask and we can chat about it more.
what's the difference between a doula and a midwife?
The best way it was ever described to me was by a fellow doula who said, "Well, midwives do the wet stuff, and we doulas do the dry stuff! Well, apart from snot and sweat and tears and vomit….that’s for everyone!" ;) Haha.
Midwives are trained medical professionals (In Canada there is a four year university degree program in order to become certified; in the US, certification rules, etc., differ state by state). A midwife is a equivalent medical provider to a doctor, do medical examinations, and actually birth the babies (well, in technical terms, they do, but I beg to differ — the mums are the ones who birth the babies!!!!)
Doulas are trained to provide emotional and physical support during labour/birth, and immediately postpartum (There are also postpartum doulas, however I am currently studying to be a labor/birth doula). We are trained in childbirth, breastfeeding, healing after birth, and so on. We provide the intimate care a midwife cannot provide by forming a relationship with mum and babe (and partner, if there is a partner!) before the birth (during pregnancy) We talk about their birth concerns, fears, values, plans, and it is our job to help them (emotionally and physically) during labour and birth. We help the mums understand what is happening, what the doctors are saying, etc. We help the dads/mums/friends/family members — partners — in their roles as birth partners and make sure they are involved and comfortable with everything that’s happening!
I’m getting all emotional and starting to ramble like I do when I get passionate about something, haha, sorry. ^_^
Room 8 was at the same number of centimeters later in the morning that she was early on, but many other factors about her labor had changed during that time, and I wasn’t worried. I was, in fact, confident. My Attending came back to the floor, and questioned her labor, with her voice and her questions showing that she was very concerned about needing to squeeze her in for a c-section with a busy surgical schedule. The Chief Resident chimed in, asking about internal monitoring and labor adequacy. I explained all the reasons why I thought she was fine, she had plenty of room for the baby, and the strip was the picture of perfection. They conferred quietly together while I charted on other patients, and then came back with more discussions. They didn’t trust.
And then I started questioning why they were questioning me. I average 4 births per shift, I always, always, let my Attending know when I’m uncomfortable or concerned. Always. She has come to trust me when I say that something is not working. Should not the opposite be true? Shouldn’t they trust me when I say I have used every approach I know and I’m out of options, as well as trust me when I say that I know everything is fine?
Then, in decompressing on the way home with my the endless listening potential of my partner, came to the realization that their lack of trust is not about me. They did not trust themselves, they did not trust her pelvis, they did not trust the baby, they did not trust birth. They did not trust me as a midwife, or my intuition, or my training. They had no trust.
Well I have to say I kinda agree with the last anon: I'm jealous too! We do have a midwifery school here, and it's one of the best ones in the world, but we have almost no jobs! So I'm probably gonna have to move to another country, but that's not a problem. Anyway, I'm also very very happy for you! Congratulations on your new job! I know you're gonna be an awesome midwife!
Thank you very much!
And yeah, jobs are very much on the short side here too!
The maternity hospital I’m now hired at is absolutely huge, and therefore had 27 jobs. However, because all the other hospitals in the area either offered no jobs or very few (one hospital offered 8, another just 1!), over 100 people applied for the 27 available jobs. Competition is high!
I am so jealous that you are officially a midwife now (and very happy for you)!! I would kill to be in your position... I'm still at the starting gate. Unfortunately where I live, there are no schools of midwifery, and I'm unable to move at the moment, so I am attending school to become a nurse first. Eventually I'll be able to move somewhere where I can continue my education, but it's looking like a long road. You are a great inspiration and encouragement, so thank you!!
Aww, thank you so much!
I moved overseas and 374 miles to become a midwife, and it felt like actually achieving my goal would never happen.
But it did. It took the longest 3 years of my life, and sometimes it felt like it would never end. But keep going, you will get there!
By Rebecca Dekker, PhD, RN, APRN of www.evidencebasedbirth.com What is a big baby? The medical term for big baby is macrosomia, which literally means âbig body.â Some experts consider a baby to be big when it weighs more than 4,000 grams (8 pounds 13 ounces) at birth, and others say a baby is big if&
This is a very important read because I’m sure everyone knows at least somebody who was either induced, or was sectioned, because of a “big baby”. Sometimes the babies are “big”, sometimes they turn out to be a very average 7 lb baby…but either way, is it the right thing to do?
So this is actually my dissertation topic!
Induction for macrosomia is a 100%, flat out, NO.
Delivery method does not have enough research behind it, but there is a general lean towards normal vaginal delivery because it is associated with far better neonatal outcomes as long as the baby is less than 5000g.
What uni are you in? My local trust hasn't released any jobs yet and I'm starting to feel the pressure! Looooads of jobs elsewhere but none released by the health board who has trained me :( its really disappointing!
This is happening to a lot of the girls at my uni.
One hospital offered just 8 jobs. One has jobs out at the moment, but has not yet confirmed just how many places they’re offering. Two haven’t put jobs out yet, and haven’t commented on whether they will. At least one has confirmed that it will not be hiring any newly qualified staff this year.
It sucks, doesn’t it? Spending 3 years in one hospital only to realise you’ll probably have to go elsewhere at the end! It’s definitely not the fault of the hospitals though, budgets are so tight at the moment! The government have made so many extra student midwife places in the universities, but the amount of jobs hasn’t increased at all. And it’s almost always down to lack of funds.
I’m applying everywhere. I’d rather get a job and have to move to somewhere I’ve never been before than not have a job at all :(
Good luck with your application though, hope your trust releases jobs for you soon! xx
I’m sure you’ve all noticed that this blog has been really quite inactive recently.
I’ve reached a point in my training where I am spending every waking moment either on shift, completing assignments or preparing for my final exam.
On top of that, I’m applying for jobs and trying to decide what I’m going to do with my life. I recently found out that there will not be a job for me at the hospital at home until at least this time next year, so I’m facing a full, pretty permanent relocation to the UK, away from my friends and family.
So to be blunt, I just haven’t had time to run this blog. I try to log on every day and answer any messages I have, but I don’t have the time anymore to write Midwifery 101s or other original posts. I hardly have the time to reblog.
This is going to be the case until the 29th July. As of that day, all of my assignments are handed in, and my final exam is over. I’ll still be on placement, and I’ll still be finding somewhere to live and sorting out my move, but it won’t be nearly as bad.
So really this is just an apology for being so inactive with the blog. I’m not quitting it. I’m not ignoring it. I just don’t have time to keep it going every day.
I'm writing a literature review on spont v directed pushing, but i'm so lost. I've got articles, but they reference other writers, so I don't know how to reference which articles i've picked for the review, but also reference what these authors have used, please help!!!
It’s hard for me to help you because I have no idea what referencing system your university uses, sorry!
Are the articles you have actual studies or systematic reviews? I don’t know about your uni, but mine wouldn’t include a systematic review in a lit review, you’d instead include the studies they’re discussing.
It doesn’t matter if studies reference others, as long as the data you’re reviewing as theirs is what they have done themselves, if that makes sense.
E.g. I could say “The data collected in this study found that X amount of babies delivered vaginally and X delivered via caesarean section, which agrees with BLAHBLAHS’s 2007 study etc”.
The study is by me, so I’d reference myself, but I’ve talked about another author’s work too.
If you’re saying “Smith discusses work by Rogers” then you’d have both in your reference list. But if the article you’re critiquing is Smiths, then it’s him you’d reference as part of your lit review.
1. Seeing a woman’s face when she hears her babies heartbeat for the first time. She just goes far away, somewhere, just for a bit and it’s just beautiful.
2. Seeing a woman go from absolute determination, pushing out her baby, to that very first moment when that baby is born and put up on her chest. Her whole body, demenor, life, changes in one second. The overwhelming tears and joy (and relief) all at once as she comforts her brand new baby.
3. Seeing a new mum happy and relaxed after a good night (and lots of sleep) after seeing her just the day before, crying and overwhelmed. It’s amazing what sleep can do!