My One Born Every Minute Blogalong. S.8 Ep.2

Good morning, folks.

I know it was only a few days ago that I posted for episode one – but I had exams last week so had to watch on catch up TV.

Because the show was on last night, it’s clear that there was a Twitter team “on duty” and my hash tagged Tweet containing the link to the last post was noted by the Supervisors of Midwives team.

First, GOOD that there is a Twitter account for this team! YASSSS!!! Second, I think it was clear, or at least it was my intention that I was acknowledging the care of the midwives despite the editing…but I’m left a little baffled by that “no birth partners” epidural thing. Anyway, I’m not ever irked by the care, only by the editing and portrayal of situations. Best case scenarios, it makes it look like short labours. Worst case scenarios, it can be seen to exclude care given and make it look as if midwives are doing less than they are.

Having said that, when I posted the link on BookFace, a midwife friend commented that it’s the same in her trust, which is in, um, I want to say Croydon? So yeah. What’s the deal, policy makers? Why are you devising ways to isolate women? It’s not cool.

Anyway this episode will be sowing a pool birth according to last week’s preview!

rubber-duck-toy-image1

So I’m about to launch 4oD to watch last night’s episode as I couldn’t watch live last night, and after that, I’m hash tag hunting to get the good, the bad and the ugly reactions…


I’m pausing it ALREADY – on the 4oD website, the tagline for this episode is “A young couple worry about their premature baby as the mum’s waters broke at 18 weeks”, it would be nice to acknowledge the other births in this as well, but sadly a safe water birth is not good click bait.

In the montage preceding the episode’s content could we just use that woman’s exclamation as a shout out to everyone “Stop pushin’ me ‘ead!”
Yes. Stop forcing a woman’s head forwards during a contraction; the perceived reason for it is to curl the spine, or close the trachea, or gawd knows what (couldn’t find a study quickly!), but if a woman can’t do it herself, don’t do it for her becuse yes it does in inhibit breathing and she knows when she needs to breathe!

Essential oils
Not going to lie, boxes of essential oil. I’m excited about this episode

Ah THANK YOU
Item 647 on my list of things that grind my gears – calling a woman’s mother / father “mum”/”dad”. Unless that person is your OWN mum or dad, or you live in the 60s and call your husband or wife by that term of endearment, you really should have learned that person’s name – or at least asked it at some point. This FABULOUS (MCA?) did exactly that as Emma’s mum came in. Top work. TOP work.

Do we go to another room for the birth?
Yep, you hear that a lot in an MLU. I think it’s because it’s that different from a hospital room that people’s preconceptions end up confusing them.

Bright lights
Again. Is this an OBEM thing, or hospital thing, or woman thing? They are mad bright.

Needs to lean on something
“Lean out the window” suggests mum Jeanette. How about the back of that chair in which you’ve set up camp, Jeanette?

What’s your story going to be?
Absolutely. There are a few different types of admissions for women coming in to hospitals, but when it comes to the MLU women tend to call when they think that they are in labour. Midwives ask some basic questions to make sure they are heading to the right place (they may have the wrong number and need to go to an obstetric unit), try and assess labour over the phone (this is why women need to be on the phone themselves, not partners or parents!) and if appropriate, encourage them to stay at home for as long as they feel they can. Women tend to labour better at home, a number of other things may mean she needs to come in sooner rather than later – if her first baby took 45 mins to arrive for example, and this is baby number 2.

Hana
I like Hana A LOT, she’s warm and open and calm.

Paul and Sam
I might have missed some detail here, but they were in this room last time, right? Did she actually have her baby in that room? I’m only asking because she makes reference to an epidural and I don’t know if it’s an off hand comment (I can’t quite hear what she says) or if she’s had one before. If you opt for an epidural in birth at an MLU, you get transferred to the obstetric led unit. I love this little family unit; Sam’s mum (haven’t heard her name) is my cup of tea! Dry as you like.

The Sign
I trust in my ability to give birth to my baby. YES, LIVERPOOL! YES! That’s a great sign,

Ed Sheeran
I used to like Ed Sheeran, then during my placements, the radio station of choice was Heart…now it makes me cringe a bit!

The corridor
Just caught sight of a proper view of the corridor, doesn’t reflect the rooms, does it? I’ll have to look at LWH’s website* to see if there’s more info about the MLU. I’m used to seeing a self contained unit which resembles more of a spa when you go in 🙂 *had a quick look at the website and there are no photos of any of the rooms or units.

The Epidural
Look, no matter what any antenatal classes tell you, there is no gleaming medal for birth without analgesia (pain relief), there’s no failure in it either. I’ve been with at least two women who have broken down in tears at the thought of what their antenatal class would think if they opted to have an epidural (are there really antenatal teachers out there putting the words “failure” in ANYTHING to do with birth? Seriously? Then the failure is YOURS as an “educator”.).
However, listening to what women want and having an open conversation with them that you believe in them (seriously, Hana, you’re making me cry with pride) may help them in realising what they are capable of. MLUs don’t mean no pain relief at all (paracetamol, diamorphine, pethedine, entonox, essential oils, the pool…), it’s just that an epidural requires obstetric observation.

The hospital gown
What happened there then? So, I am assuming that there was a bit of a gush, and that Emma was then laying in a wet nightie which needed changing. However, it kind of looks to the casual observer that in order to be ready to have baby, you’d better be dressed as a patient. You don’t. Channel flippin 4. (Yep seeing a bit later, her waters went and looking at the track marks on her legs – her bloke or mum could have helped her clean a little bit! – she got up to change into that gown). Ah the glamour of birth!

Calm?
Ha! Poor chap looks like Sam Beckett just jumped into his body and is waiting for Al to appear! Oh boy!

STOP CHEERLEADING HER, JEANETTE!
Sorry. But. Seriously. And pushing her head about.

What’s this?

what are this

What is going on in this picture? Is that water in there? What’s it being used for? Is it warm? I, um, I am not sure what is happening here and would be glad if anyone does know, if they could explain it?

Our kid
Oh come on, look at that baby looking up into his dad’s eyes, that’s magic. That’s love happening.

Hana
“It’s so lovely to see someone come in feeling vulnerable and scared and to support that person” Have I said I love her enough yet? “It’s not just a job it’s more than that. It has to be doesn’t it?” Are you listening, Jeremy?

To the obstetric unit!
You can tell, can’t you, because when women have complications in their pregnancy they don’t deserve the nicely decorated rooms, or to feel like they are more than a lab experiment…oh wait, yes they  do. This room is everything that is wrong with hospital birth, it’s stark, it’s hard, it’s everything birth isn’t.
Extra care is being taken over this birth because this baby is at the gestation of 28 weeks (term is 37 weeks or more), but why can’t the birth environment be created within this situation? I’m not talking a yurt in the car park, I’m just saying that this clinical feel is not relaxing…and she’s already panicking over that five minute interval between fetal heart rate dropping. (I actually huffed after writing this paragraph). I’ve clearly been spoilt by our facilities for women.

Paracetamol
Ladies, yes this is a form of pain relief, but mainly it’s for your rising temp as it helps reduce it 🙂

Editing…I hope
Words along the lines of “I have spoken with a doctor about you and we are going to do this to you now”. So this edit means that channel 4 are missing the point of the meeting that we had with their production team a LONG time ago (before the Bristol season). WHAT YOU SHOW ON TV, WOMEN LARGELY UNDERSTAND TO BE TRUE. This makes it look like this care has not been discussed with the woman (which is what happens before things like this) or why it needs to happen. The edit undermines informed consent, it ads to the lab rat vibes that are coming out of this situation, and it’s not ok.

Sitting with the woman
Finally we get to see this midwife having the time to sit with Aleysha and talk to her about the baby. There is so much to do at times, that you feel that this sort of care is a luxury.

Ten to Ten
And THAT is why it’s cowboy time 🙂

Labour Selfie
Here I am blathering on about OBEM and sticking it on social media. You found the link via social media. I LOVE social media. When I’ve talked about my own birth when asked, a couple of people have said they are sure I will live Tweet it, or that it will be on FB within minutes. And actually, no it won’t. There are times when we need to switch off, there are things that don’t need to be shared. I’m not saying that this picture is headed for social media, but it certainly was the catalyst for me to talk about it.

The poo sieve!
Hana says she’s joking about its use…but she’s not! You’re more than likely going to poo in labour, and that’s ok. We scoop it out because you’re not going to want it floating towards your face as you continue to labour!

The Howes!
Did you know that mirror that looks like a square cake slice was devised by Virginia Howes because she kept breaking her glass ones? Well now you do.

Dat pool labour tho.
Look at what a massive contrast that is to the birth we have already seen. No cheerleading, just encouraging her to listen to her body. Talking to her about breathing deeply. Telling her she’s being amazing.
Compare it with the labour in the other room, the lab rat room. Why do these women get such different birth experiences? Because of the “risks” *spit* that come along with their pregnancies. I am not saying get someone with a premature labour into the pool. Nope. I am not. So don’t start. I’m talking about their surroundings and how they are portrayed by their attendants. Births are all different and need to be treated as such. Holistic care of a woman should always be paramount. I’m not talking about Liverpool here specifically, but that’s the example being presented; no matter what a woman’s history or pregnancy, or any of those things, there is always a way to help her connect with the birth and her baby more.

The intimacy of the room changes
Yep. But the dignity shouldn’t. There’s always time for “Hello, my name is…” especially in cases like this where fear level is at a maximum.

The plastic bag
Pre-term babies have a large surface area with less insulating layers of fat, the best way to help prevent heat loss is to pop him or her into one of these bags while the checks are carried out.

Baby Ollie
I’ve yet to go into a neonatal unit where the staff aren’t excellent and happy to answer all questions for parents (and students!). They know it’s their bread and butter, but they know that it’s unusual and frightening for other people. True awesome folk of the world.

Losing a child
We took part in a bereavement study day at uni with our Midwifery Society last year and one thing stuck in my mind from the speaker. “He’ll never have his heart broken, but he’ll never laugh either”. That’s never going to leave me as I take part in the care of bereaved parents, I wish I’d never heard it.

So in summary *through my tears* yet more great care from the maternity team in Liverpool, impeded by the editing of the post production team. Let’s see what Twitter says.

Now this last Tweet here was the start of the following conversation, so I would like to just deliver Robbie a MASSIVE high give for getting it spot on, and an eye roll for the other participant.

Fred here seems to think that Midwives should decide who gets to have NHS care, and who doesn’t.

https://twitter.com/SirFredFeast/status/626493051389771776

https://twitter.com/SirFredFeast/status/626495478151151620

The far right, ladies and gentleman, not to forget this gem:

Skin to Skin “Declined” 

As always, when looking for a great explanation of skin to skin for a friend, I can rely on Jenny to sum it up perfectly xxx

@JennyTheM

  • When a woman gives birth and the birth is complicated , skin to skin contact can help her to re-centre on the beautiful relationship with her baby/babies. The way that midwives discuss skin to skin can and does have an impact on a woman’s decision – evidence shows that skin to skin contact at birth by ceasarean section is rising every day and I’d like to argue that it is not an ‘offer’ to be taken up or not – SKIN to SKIN is indeed a human right .
  • Declining something means that the choice to “not accept” has been fully explained -I.E the effects of NOT having skin skin contact have been fully explained as much as the effects of HAVING skin to skin contact
  • Asking a woman if she “wants” skin to skin is not an invite or a request – it is one of the rights of…

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My One Born Every Minute Blogalong. S.8 Ep.1

First: Hi.

I’m so sorry, I’ve been gone n awfully long time and I wasn’t supposed to be, but that stupid life thing happened and I didn’t handle it very well. However, here I am at the end of my second year looking at the gorgeous graduation pictures of my friends in their caps and gowns outside the cathedral and it has spurred me on like no one’s business.

So I am asking myself if this particular blog post is a good idea.

During my second year I’ve had two placements in Delivery (CDS), no not the internal post service ;), come on, put semantics aside. You know what I’m talking about – the unit where women come to give birth if they need some extra care because of complications. I had a good saying for that once. I’ll find it because I promised Sheena and Jenny that I would make a poster.

Rare-Beautiful-Treasures-DIY-Child-Paint-8

(Photo courtesy of Little Picasso)

I digress.

Anyway, yes, there I was on CDS and feeling lucky to be in an acute learning environment, giving one to one care to a variety of wonderful women. And as they always do, each of them said some amazing things which made me feel proud to be part of their care team. I bloody love the women. They are rock stars.

As part of one to one care, you spend a LONG time with women and their families, and you know what? I’m a nosey so and so, so I love that. If you are ever in the position that I am your student midwife, or midwife, we’re going to get to know each other. You will hear several of my lame jokes, you will find out that I love Harry Potter…that happens quite early on actually. I can’t help it. A lot of families ask if we (my mentor and I) watch the midwife TV stuff – Call the Midwife, and of course, One Born Every Minute.

I am honest with them and tell them that I don’t; I tell them that it makes me irritated because a lot of women only have this type of insight into childbirth and it’s either frightening them because they don’t know about the birth units and less complicated births, or home births, but also that you don’t have your baby within the hour. (See Milli Hill’s latest blog post.)

Maybe some of the wonderful women I’ve been with wish they could edit their labour in post-production so that the few hour of half sleep with contractions every few minutes, could be shortened to 17 minutes with a bed of music. (That’s right, I know technical terms).

Well that’s why I stay away from it, it doesn’t seem to reflect the situations I have been in – yes we have had emergency Cat 1 caesareans, and yes we’ve called the paediatrician for those births that have CTG traces from text books. But largely, they are births with rock star women, lovely families, and one to one care.

So I decided I would do a “series” of blogalongs. I’m watching on catch up so that I can pause and type…and here it is.


Delia (great name), Midwife and Shift leader: “The first time you look at your baby is amazing”
Yes. Oh boy do I wish I could bottle that feeling I get watching parents meet their baby properly for the first time. It’s rare you get to watch someone fall in love – we’re very lucky to see it a lot.

Brooke and Tim: nervous because they haven’t come up with a name
It may surprise people to know that in some cultures, Jewish for example, the name is not decided until about a week after birth. Well, it’s probably decided but until the baby is named properly, the families don’t tell other people. I like this.
Some parents want to know what baby will look like when he or she comes out before they decide, yep I get that too. But baby will come, name or not. So chill, sir. They’re daft, I like these two.
But I do like Forest.

Nicola – lush.
Walked in and introduced herself straight away wit a smile. did!

The Room
Ok, so this room they are in, very bright isn’t it? A couple of “chemo” chairs (they make me think of when mum was having chemo so that’s how I call them) but kind of like a big clinical room. Meh.

Lady in glasses with her husband and daughter
This is obviously a woman who’s had a baby before because she’s asked “are your legs going to be up on them blue fings” and she says “Not necessarily, no”
That’s right – just because the litho poles are there, doesn’t mean they are there to be used 🙂

What do we think of a 16 year old birthing partner?
We think it’s none of my business. It’s a bit odd to hear some of the questions she has (I would have probably asked more when I was that age), but it’s really nice to see her relationship with her mum.

Holly – again lush!
Everyone here seems so nice. This is a good thing, calm, friendly faces.

Holistic birth support
16 year old daughter Courtney giving beautiful holistic support to her mum, and incredible reflective appraisal of her earlier teenage self and her “off the rails” ways.

Why theatre?
So I have to assume (as it hasn’t been explained) that Brooke is in for an elective section. Nicola has her scrubs and snazzy theatre hat on, and Brooke is in a gown – but at no point has it been explained why she is giving birth this way. Maybe that will come later? Maybe not normalising a caesarean would be good, Ch4?

Um what??? Why is she saying goodbye to Tim?
Is she really going into theatre without him? Why is she wearing a hat? Why can’t Tim go with her? See, I want to know if he has DECIDED not to go in, or if he is not allowed. When women watch this do they and their partners assume they will not be allowed into theatre? This will elevate fear. I shall watch more to see…

Yeah that’s really odd.
Why wasn’t he able to sit with her whilst they sited her epidural, then scoot back, then come in before the procedure started? It can be a scary thing and to have the most familiar face with you the whole time would be beneficial. Anyone know why they don’t do that at this unit? I wonder if she would have cried less if he had been allowed to go in with her before they started?

Always a tingly moment
Nothing will ever change how I feel when I see parents meet their baby for the first time – no matter the mode of birth. It’s incredible.

Now if this had been Jenny The M’s unit’s theatre…
That baby would have been skin to skin already. But it’s not, and I don’t think it happens in a lot of hospitals, but it’s  bit confusing really. Because why do we not now have the facility to get that baby skin to skin with mum where she feels comfortable enough to hold him or her? When we take baby to mum she often wants the partner to hold baby after a few minutes because she is lying down an baby’s on her chest, so it’s awkward and she might feel quite woozy from the drugs. I think we seriously need to revisit this maternity wide – but don’t forget, that’s my humble opinion.

Surgical bonnets?
They are weird looking. I want one.

Family Name – reduced fetal movements?
Good to know. Thanks white board that wasn’t blurred by Ch4

Nick and Hayley
Again these briiiiiiiiiight rooms! It has a pool in it…sad for units that don’t have the wireless CTGs we do 🙂
These two are lovely, but this is what it’s like – you sit and you talk and you find out everything about couples. It’s the strangest, most wonderful thing, people tell you everything. A majorly privileged position of trust! I’m in love with these two. Lush.

Delia, again
She’s a ray of sunshine. What a great presence to have there!

Ok, back to Courtney and her mum
So her mum has said something interesting here – she’s nice and calm, and half of it is to keep her daughter calm as well. This is lovely, because the result is that she is calm, but shows her mum’s great care for her. The flip side of it is that when you have birth attendants / partners who need support themselves, it can detract from focus on the woman and her baby. Sorry dads, I’m including you in this too. See Denis Walsh for his take on men at births there. However, the relationship here is a complex one as you learn more about the things they have been through.

Camp beds
This is a great idea in some ways – we have reclining chairs. But I’m thinking about it more – what if there is an emergency and the bed’s in the way? I don’t normally think like this, but as she’s in the CDS it’s worth thinking about.

Why is she there?
Sorry, I really don’t understand why she’s there. She’s not on continual CTG, she’s cannulated for a Synt drip, but it’s not connected. So is it induction, that’s been paused? Do we think they could make a midwife’s edit for stuff like this? 😀 If it was the BBC maybe the woman’s Hx would be on the red button!

Where is the midwife?
Again, I am confused. There’s a lot of in and out of these rooms, and for a multip who’s contracting well, I don’t understand why she doesn’t have a midwife in the room. I wish this show gave more information! It’s edited to look like she’s been left to it, but I doubt she was out of the room for more than a couple of minutes!

Sterile Gloves and Sterile birth

Birth isn’t sterile, it’s really not, but we wear sterile gloves…then see someone pick up a non sterile towel, move the draw sheet with gloved hands. Weird innit?

Delia
Brilliant 🙂 Into the room and they clearly connect with her quickly – editing or not, this woman is born to it.

“The thought of being separated for the epidural is the thing I am not looking forward to most”
Sorry not sorry, Liverpool I’ve got to ask – why do you do it? You could take the chap down to get changed (it’s a planned LSCS), midwife could then go and get changed, and then everyone could toddle off to theatre together. She’s sitting there literally telling you that your procedure frightens her. A procedure that differs in other Trusts. Please someone explain this! So even smiley Delia is separating the two when she needs him most. At least she is there with her, but it should be Nick.
And we still don’t know why she is there for an LSCS.

That “imminent birth” music is playing
It heightens anxiety and then swells just before baby is born, it’s clever music.

Oooh, hang on. She can feel it.
(sarcasm) You’ve got to love televising someone being able to feel their caesarean, I’m sure that will quell many fears of expectant mothers. (/sarcasm) So she’s having to have a general anaesthetic, and neither she nor Nick will get to meet baby immediately.
Going to offer some personal advice from this point about general anaesthetics (GA) – you will never know when a woman can hear what you are saying, so talk as if she’s awake. Positives of this whole scenario? Gives Liverpool a chance to show how their staff react and involve the parents in the care – and it’s good.

Having to hear your baby’s first cry from outside the room

Then watching the brilliant staff getting him skin to skin with his dad. HIGH FREAKING FIVE!

So then the summary of the show. It could really do with a voiceover – “Brooke has come in for a caesarean because she has had multiple growth scans which show her baby is large, and the fetopelvic ratio may not facilitate a vaginal birth.” Or, you know, less jargony. But that would help, it would give context to the major abdominal surgery these women are having.

I like the 24 Hours in A&E format of seeing a bit more of the midwives and staff; one thing about this episode is that the women who were caring for the women seemed lovely, really warm and caring. If women could see a bit more of that, I’m sure it would help alleviate some fears – the GA at the end, for exmple, Sunny Delia was brilliant with Brooke and then Tim (anyone think they should have named their son “Taylor”…just me? Showing my age there) and if people coul see how the staff are with you as much as they are, it would seem less scary.

While there are still some things I would like to change – unanswered questions which probably comes from my natural instincts to ask more about the woman’s history and clinical decisions. This is actually an improvement on seasons I’ve seen before (first one? An episode a couple of seasons ago?); I’m hopeful for next week – and I’m a sucker for a Scouse accent!

Next week – looks like a waterbirth and birth centre week!!! 

CTG – Cardiotocography – This is the print out / computer screen that shows baby’s heart rate, mother’s contractions, baby movement, and mother’s heart rate.

Wireless CTG – the sensors on the abdomen work with wireless technology so the woman doens’t have to be “chained” to the bed. They are awesome.

Litho poles – These are what you might know as “stirrups” most delivery suite beds have ones that unfold from under the bed, and are spongy, blue, leg rests to prop up a woman’s legs either during birth, or for any stitches. The bits that unfold can actually be used for her to bear against, and there are handles at the side of the beds as well if she wan’t to pull against something. These beds are TRANSFORMERS

Cesarean / Elective section / Lower Section Caesarean Section (LSCS), Category 1 section – all mean baby being born by surgical means of an incision being made to the abdomen an uterus for baby to be lifted out.

Scrubs – Work Pyjamas…ok, they are the simple clothes, like overalls, worn in theatre

Siting an epidural – putting a needle in the back (epi = between) (dura mater = surrounds the spinal cord) to then put in a tube (no needle stays in the back) to give pain relief by largely numbing sensation from that point downwards

Cannula / Cannulated – having a tube inserted into the back(ish) of your hand so that samples can be taken / fluids can be given via a tube / drip.

Synt – Syntocinon – it’s artificial Oxytocin and is a hormone. It makes the uterine muscles contract and is used to help labour progress. Given via a cannula connected to a syringe which has an automatic movement to administer it at a certain amount per hour.

Hx = History – yeah sorry, that one was just LAZY

Mulitp = Multiparous = a woman who has had more than one baby, not pregnancy, but baby born.