With woman

💛Midwife means with with woman .
There is so much depth to this word – it doesn’t just mean that as a midwife you are present at a birth but so much more.
To me “with woman” means you are “with the women of the world with your every breath” – it means you believe in compassion, feminism, women in society , the future of humanity and life itself
Today I started thinking (ooh look out when Jenny The M starts to think!) what if…….
There were no womankind
no births
no midwives
where would the world be?

Women are the backbone of society but somehow in its own delusion society has slightly forgotten all this. Emily Pankhurst fought with her comrades to get women the vote – yet female authors hide behind a male name

Being with a woman in labour who is single and labouring alone -you take on the role of a friend as well as a midwife and I defy any midwife not to feel like this.
Midwifery is all about women and that doesn’t mean that male midwives can’t be feminists too after all they like us were ‘brought up and raised’ in the organ that rocks – the female uterus
Does society truly value the fact that women give birth? Do midwives realise the implications that a child’s birth has on the mother and the child ? Does society see the effect birth has on the earth?

See the strength and courage in women who suffer from domestic violence- imagine the fear a woman feels in such a relationship and her shame to admit it to anyone

Embrace the power of many women who support their female friend whether she is grieving, being bullied , giving birth or facing challenges – women rush to other women’s aid.

We are one voice and we have to remember this every single day
So each day I get out of my bed I say to myself ” I am a strong woman, I am proud to be a woman and know other women who are strong. I will help any woman who may need my help and support today ” help and support may just be a chat, a reassuring hand on a shoulder or it may mean a hug , a way to help change a situation or a way to get help from someone else . So if you are working with women , as a midwife or in a role where you are in contact with women – just focus on how amazing women are and where the world would be without them – give support – be womankind

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This post is dedicated to my friend – a strong courageous woman

Birth by caesarean

I’m writing today about birth by caesarean . I want to try and make everyone who visits my blog arrive with an open mind and leave after reading it with a fresh perspective. 💭

“If we do what we have always done there is no change there is no development things stay the same” (by me 📝)

Operating theatres have to be sterile, organised and have processes for risk in place – safety is paramount . At the heart of the operating theatre is the patient – the staff do their job every single day it is a routine to them – running an infusion through, ensuring the sterility of instruments, making sure that the staff present are trained and that the correct checks have taken place. Al these things take place prior to the patient entering theatre.
I would like you to consider this – we come to work to do our job, we love our job and if not for the patient we would not have a job – do we see the patient as our employer ? In an indirect way the patient is our employer and yet simultaneously our customer . If our customer and employer has a good experience they will not always shout it from the rooftops as much as if they have a bad experience – so we must put this thought into our heads daily – a bad experience is more likely to be shared than a good experience.

As an independent human you access food, drink and warmth whenever you want it – you are thirsty so you get a drink you need food so you eat – if you ever become a patient the ability to do this stops or reduces – you cannot access food immediately, you have to ask for a warm drink and also you may have to ask to use the toilet 🚽. Your have to ask to satisfy your basic needs. These are some of the hard parts about becoming a patient – to access these things that you took for granted which you never considered you have to call another human by pressing a buzzer or asking permission. Add to this the fact that you may have had an operation or an illness which has compromised your ability to mobilise , access pain relief and compromised your high standards of hygiene . I’m not trying to influence your thoughts I just want you to think about these things.

Who does an NHS Women’s Unit theatre belong to ? In my eyes it belongs to Women so this means that NHS staff are the guardians of it . The theatre environment is very white bright and clinical because it’s always been that way – hang on “because it’s always been that way ?” Well let’s try to change that – why can’t we have paintings on the walls which are part of the wall ? imagine lying on a theatre bed staring into a blank void or imagine looking at a beautiful scene above you – which would you prefer?

A woman enters theatre knowing this will be the birthplace of her child. Her individuality has been removed by placing her into a generic gown removing her jewellery and make-up All the people in theatre will share the event of her child’s birth. The first thing that she sees are staff in pale blue gowns, masks and hats with only eyes peering out. The ability to communicate is lessened and there is a sense of stage and routine . Instruments on the trolley been arranged in place neatly ready for her operation to begin. If the woman is wheeled in she feels vulnerable and compliant on her hospital bed whilst others look upon her .

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“All the world’s a stage,
And all the men and women merely players;
They have their exits and their entrances,
And one man in his time plays many parts,
His acts being seven ages. At first, the infant
…….”
William Shakespeare

We have one thing in common we are all born we all die . I am passionate that women who give birth in theatre either by Caesarean section or by forceps or ventouse are facilitated to feel as positive about their birth as women who give birth without intervention. I also want you to question your own units practices – do women who may require a manual removal of their placenta hold their babies routinely ? Do women who may have to have a repair of perineal trauma in theatre routinely hold their babies ?

The culture of the staff in the operating theatre is one of the largest barriers to skin to skin care taking place after a woman has undergone a Caesarean. Several clinicians have reported the implementation of immediate skin-to-skin care (within 30 minutes after birth) in their hospitals’ operating rooms (Smith, Plaat et al. 2008; Hung and Berg 2011) The authors noted that operating room staff members were initially skeptical, reluctant, and afraid to change their routine habits and behaviors. But after seeing the benefits of this family-friendly procedure, staff became supportive of the change
– read this link for further references
http://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/

If every HCP in the theatre setting considered the promotion and facilitation of skin to skin in theatre as intrinsic part of their role – rates would soar and women and babies would be shouting from the rooftops . Patchiness is no good – just the other day I asked about the “Theatre list” and was sad to hear that two women and their babies did not have skin to skin discussed with them – Jenny The M can’t be everywhere – if only I could be like a fairy and zip into theatre with my wings and dust skin to skin thoughts on everyone around – imagine 💡.Read the following about cHange by Helen Bevan and Steve Fairman

NHS Change and transformation – Helen Bevan and Steve Fairman </a.

the NHS thrives on change it’s time to lose tradition and focus on the new – this is a slide I made for a presentation about optimal and appropriate use of an area – to do with Competence and the 6cs and it applies to any area involved in Women’s Health

It can be applied to the theatre setting and also to the process of skin to skin contact – so please please if you work in theatre and come into contact with a woman who may have to have a caesarean ask her if someone has discussed skin to skin contact and if they have not make it your goal to do this

Be rebellious for women out there – we are a crucial and core part of society and humankind – being rebellious for a woman’s cause shows courage and will have a profound effect on that persons life and first experiences.be a rebel
You might fear rejection but eventually you’ll get noticed and people will start to follow your lead and do the same 💡

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I know where the skin to skin fairy lives

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If you think you can’t make a difference just search #skinToSkin on twitter – 💕

Skin to skin

@JennyTheM

Breathing , visualisation and psychoprophylaxis for labour and birth

Breathing through labour why is it beneficial ? Here’s how I explain it to women I meet
The Cervix
The cervix is an extension and integral part of the uterus – I recall learning about the cervix parrot fashion ‘finger like projection from the uterus’ . I uses the analogy of a ‘balloons tie’ for the cervix – a ‘balloons tie’ is holding in the air – the cervix is maintaining the integrity of the membranes – except it’s tightly closed not tied . The cervix is very vascular and has a mesh of nerves supplying it – hence it is very sensitive rich in blood supply .
A tightening / surge or contraction begins in the pacemaker(top) of the uterus situated close to the fundus and sends the signal down to push the baby’s presenting part onto the cervix which hopefully will cause it to efface and then dilate. This process is faster in subsequent pregnancies and may take hours in the first labour – no one really knows how long anyone’s labour will last-how fast-how slow – but breathing correctly can make a difference to the way it is approached and managed by you (by YOU I mean the woman) A lot of women I meet think they should feel pain high up in their abdomen and when I explain they are quite surprised but delighted.

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The pressure of the presenting part on the cervix leads to discomfort and this is due in part to an ischaemic (lack of oxygen) effect on the cervix – for example press hard on the palm of your hand with one finger then watch the skin go white then quickly return to a normal colour – this is capillary refill time – the time when the area is white is when the oxygen and blood supply is diminished . Now imagine that in context to the cervix which is a lot more vascular and nerve enriched than the hand . If a woman learns how to relax through pain and breathe deeply staying calm absolving stress the pain will be reduced . I’m not waffling, I talk and teach women this technique daily. I’ve had comments such as ” how did you do that ?” “Thank you I feel better ” – but in fact I’ve done nothing they have done it all themselves . A major part of breathing is the ‘art of visualisation’ the ability to close your eyes and see in your mind what is happening – this gives focus and assists the woman in the process . I say “if you are saying ‘I’m allowing myself to efface and dilate’ then you are believing more in the process – calmness mindfulness and self-belief will all assist and make the journey less arduous .
Effacement and Dilatation
How to describe dilatation and effacement? You cannot see this body mechanism so I thought of a polo-neck jumper – before it is pulled onto the presenting part(pp) the polo-neck (cervix) is un-effaced , as it is pulled onto the pp the polo-neck(cervix) is starting to efface . As the top of the polo-neck (cervix) reaches the pp dilatation begins

So here is an example of a surge/contraction/tightening

“Your cervical pressure is starting – stay calm focus on your calmness, the beauty of your unborn child and visualise your cervix being pressed and the oxygen you are breathing in rushing to replace the oxygen that is being pressed out – you are fantastic – believe in your body – breathe deep , allow yourself to dilate and relax “think of this like climbing a hill the happiness in your heart you feel as you reach the top (height of surge) then run down (surge reducing) this breaks the discomfort into manageable parts . All the time this is happening it is crucial that there is minimal disturbance 1.no-one entering or leaving room 2. Calm ‘generic’ music with no beat 3. Supporters who believe in the woman 3. Low lights – in other words tranquility – other mammals go to seek out quiet places where they cannot be disturbed and so we as midwives must make this happen for women. Interruptions stop the flow of oxytocin and can lead to an increase in intervention

This technique can be used throughout labour and also with the use of gas and air and is also helpful in a pool or even during a vaginal examination – but I feel that woman should be offered gas and air during examinations must be given the choice to do so.

A happy positive approach to labour and birth as well as intricate and detailed communication will give women strength . Knowledge of her body will give her the ability to entrust in her own body

My son has just asked to read this and said he’s found it interesting and can see that it would work. My inspiration for this blog comes from the women I meet every day that believe in themselves plus their supportive birth partners who take my words on board and continue to support their partners through labour- from the latent phase, right through to the birth of their wondrous children . Also thank you to the student midwives I work with who have encouraged me to write about the way I teach ‘breathing’

Breathe,Relax,Calm,Believe,Visualise and interrupt NOT!