The Power of a Woman

Now this isnt meant to sound like a feminist entry- power to the woman and all that. What I want to accolade is the capability of a woman in the birth process, and hopefully instill a bit of confidence in any woman reading this blog. I have had a couple of experiences recently which has truly instilled an awe and confidence in the womans ability to give birth. It truly is mind over matter- I have seen such extreme differences in the way that women cope with childbirth- one lady looked like she was possessed by the devil! No joke...and she was only 3 cm!! Such a long way still to go, and then just the other day, I had a client who though I could tell that she was going through a very intense and painful experience had determined within herself- yes, this is painful, but I am able to do this, and I will do this. It was inspiring! She breathed her way through labour, with her birth partners providing support along the way- through verbal assurances, back massage and reminding her to drink and eat a light diet.  It makes a massive difference how the birth partners support the labouring woman... men- it is really no time for being sarcastic, offensive or derogatory!! The woman is going through one of the most intense experiences known to human kind- and a slight or sarcasm really isn’t appreciated! However, in my experience of watching couples interact- humour, love, support, admiration- makes the process that little bit more bearable for the woman. As you know what- as a basic instinct- that woman needs affirmation that what she is doing is good, do-able, and is going to achieve something worthwhile- and while I as a midwife can and do do that... it is far more powerful coming from her nearest and dearest!

Women- don’t underestimate your body-it is made to give birth. You are a baby making and birthing machine! (Without wanting to sound too mechanical!) You create life. You are able to give birth. God is the greatest scientist ever- he knows how you work on a molecular and grand scale. He created women to create and give birth to miracles. Having been the first hand witness to this, I know that you can do it. Prepare for birth- its all in the mindset. If you go into birth terrified, and thinking- this is going to be the worst thing in my life- it will be- the more you fear, the more painful it will be (that is a scientifically proven fact). On the other hand, if you go into it thinking- I have sculpted and created new life, and now my body can and will give birth to a baby, new life... it is going to be intense, but I know that I can do it. You will do it. Your perception of the pain will be lower, and thus the level of pain will also be lower. Believe in your ability and power! 

Some tips from me to you

So first off, if you have decided to go for a hospital or birth centre labour- do NOT go in too early. If you are a first time mum- believe me, the majority of women will have a 12-48 hour early latent phase before you get to 4 cms. I know that this can get exhausting, discouraging and painful. But, truly truly, do not go into hospital if you are contracting 1-2 times in 10 minutes, even if its been 24 hours... your body is still heating up (with very few exceptions- you will still be 0-2 cms!) You really need to have been contracting 3-4 times in 10 mins, lasting a good 60-90 seconds in length for a good 4 hours before you will be on that target of 4-5 cms (then being classed as active labour). If you go in too early, you will either sent back home, or sent to “await events” on the antenatal ward, which really is not the most pleasant place to endure the early stage, or get admitted, and then possibly end up on Syntocinon (the hormone drip) if you dont progress according to protocol.. if you are at home, there is no Doctor shaking his/her head when you dont progress the 2cms in the designated time! So to help you at home, use a hot bath, or go for a walk in your favourite place, or stay mobile in your living room while watching your favourite comedian or film (my sister ever associates “The Wedding Planner” with labours!)

Essential, or my opinion essentials for labour- take music you enjoy with you to listen too.. unless silence is golden ;)

Take an extra pillow, for some reason pillows seem to dissapear like those elusive socks in the washing machine!

Essential oils- if you like their smells! Especially Clarysage, as this is a natural stimulator of contractions J Also, baby oil- if you are a fan of massage- either the midwife can provide you with deep lower back massage which works so well for labouring women.

Plenty of drinks! Istonic drinks expecially are perfect for ensuring you dont become dehydrated and ketotic in labour! Dehydrations and being ketotic could diminish your performance and turn you tachycardic- which would mean the Doctors may need to intervene (and as much as I appreciate them as people... we want them to stay away as much as possible J )

Light snacks- especially the sugary sweets like haribo or mento’s etc... helping to keep your glucose levels stable.

And then of course your overnight stuff and baby essentials J

The Gross Miracle!

When people find out what my job is, more than often they say something along the lines of "doesnt that gross you out?!", and in response, I say "nope, but I do look at it as a "gross miracle"!

You know, where I trained, the midwives used to tell the women "Leave your dignity at the door love, and you can pick it up again when you leave!"

Don't even bother trying to keep up appearances when in labour, as pretty much everything which is undignified occurs during labour- you vomit, poop, get naked, scream gutterally,  lash out, gunge, bleed, get sweaty, tear- am I making having a baby sound appealing to all you broody folk? And for you preggers women- dont worry- you soon forget the grossness when you see the pure innocent child that you give birth too ;) Dont believe me- well, ask all those women who have more than one child! Or to put it another way- the grossness and undignifiedness and extreme pain is worth it for one little miracle- or so the mothers tell me, I have yet to have the honour and experience of giving birth... I'll let you know whenever I do have a baby!

Recently shifts that I have had, has reinstated and reconfirmed my wonder of women... 2 women who were giving birth, both on zero pain relief! One lady came in pushing and then gave birth 15 minutes later! (Trouper of a woman! The lovely husband had to go shortly after birth , but was like "I want to buy you a drink" "Sure, I dont drink alcohol though!" Next shift I came on, he'd brought the most enormous 3 litre bottle of lemonade in as a thank you! Bless him! Made me laugh) Their baby came out "face to pubes"- as its so lovelyly named! Normally when a baby is born, if the woman is sitting upright, then the head is facing downwards- this is the best way for a baby to be born as it means the smallest diameter of the head is exiting first, and so comes out "easiest" (I say "easiest" as its still a massive object coming out a tiny tunnel!). The official term of face to pubes, is occipito posterior (OP's). From the 4 OP's that I've seen, the pushing stage is very different- in that the women seem to push for a longer period than the Occipito Anteriors (OA's), but when the head comes- normally the vertex advances fraction by fraction with contraction by contraction, but with OP's you see a sliver of vertex, and then within a couple of pushes the whole head exits! This lucky woman didnt even sustain even a fraction of a tear! Amazing!

The other lady, came in and within the hour pushed her baby out- again, with no pain relief, not even Entenox- our "happy gas", when I came in, she was so calm, I would not have guessed she was 9cm! It is incredible the difference between one woman and another- one I have seen while a student literally looked possessed by the devil, thrashing around the bed, screaming, and was just 3cm, other women- like this woman, 9cm, getting to fully and just breathing through the contractions. Its would seem its how well these women can focus their mind, whereas the "possessed woman" just let the pain drive her into hysterics, this lady, when I asked her husband how she was coping so well (as she spoke very minimal English) said that she realised that if she allowed herself to get scared by the pain, the more painful it would be, so instead she focussed on breathing and detaching herself from the situation- a very similar technique to hypnobirthing (a topic which deserve's a post all to itself! Google it for the time being :)

Women of the world- dont let the pain get the better of you, I know this is more easily said than done, but, it is achievable. Don't worry about the mess birth makes, the midwife will sort that out... just focus on getting your baby introduced to the world :)

Working on the knife's edge!

One thing, one of the many things, about my job as a midwife, is how close one gets to "the edge" on a daily basis when working on labour ward. Now in this entry I do not wish to frighten anyone away from labour, and for ladies to remember that billions of women through the ages have given birth safely and without hinderance, and God himself, has declared that mankind is to multipy and replenish the earth- and so as such, that women are built for birthing babies!

Alas, this does not take away from the fact that so many things can go wrong so very easily in pregnancy. Uterine rupture, postpartum or antepartum haemorrhages, cord prolapses, shoulder dystocia, maternal sepsis, eclampsia, babies born "flat", placental abruption, puerperal sepsis, fetal bradycardia's etc. However, a word to reassure, these emergencies are on the rare side, and I mean 1 in many thousands for the most part. The majority of women deliver without things going pear-shaped. I think though as a newly qualified midwife, these potential emergencies can play havoc with one's confidence occasionally. I was blessed, or maybe not blessed to not once come across a true emergency of the above during my 3 years of training (which goes to show how rare these obstetric emergencies are), and thus my concern was whether I would recognise an emergency in time to pull that "emergency buzzer". Would I see the turtleling of the vertex, or pick up on the mother's abdominal pain being different from contractions, or act quickly enough if a baby was born flat.

Blessedly, the first emergency I had, the co-ordinator was in the room when the lady "decided" to haemorrhage (PPH) on me, before I had worried that I wouldn't recognise a PPH, but gosh- there's no mistaking it, the sheer volume of blood which escapes a woman in such a short period of time, I knew most certainly that the emergency buzzer needed to be pulled to alert the Doctors to the situation. Women are robust creatures, even though the lady lost so much blood, she was still conscious, and if it wasn't for the fact that I could see copious amount of blood being lost, from the woman's behaviour, I would not have guessed for a moment she was haemorrhaging.

There are so many things to keep track of when caring for a labouring woman- especially if the woman's body decides to become high risk... can I advocate the MEOWS chart here for all midwives!! I didnt realise until the last week (after it was highlighted to me by the risk manager) that I needed to be keeping a MEOWS chart for labouring women, and filling that in as well as the partogram... gosh there is a lot of repetition in our note-making, but now speaking from personal experience, this really helps flag up women who are taking a turn for the worse side- those white, yellow and red alerts- really pointedly help one see that the woman needs reviewing! Temperatures, pulses, blood pressures, fetal heart, cervical dilation, position and presentation of babies, urinalysis etc etc, certainly is one heck of a list of things to keep on top of in the care of a lady. I love it when I get a nice low risk woman, I love my high risk woman for the sheer miracle that they are... but its so nice just having to listen in to the baby every 15 mins, and letting the women mobilise as much as they desire, without having to constantly readjust those blinkin toco's and transducers!

Its hard core is my job at times. Its scary and stressful at times. Its gross at times. Its tragic at times.

But I love it (at almost all times!). Because, I am in the business of helping babies be born!

A life never lived.

This topic I know is going to be a controversial one. One which I know people have opposing view on. That of abortion. The reason my opinion has been further cemented is due to an experience I had the other day in hospital. I came on shift, to discover a woman had miscarried her child at 22 weeks. I had never up until that point seen a foetus of that gestation. And so all day, I knew that I had to look at the the foetus, as one day, I will have to care for a woman who has miscarried, and I did not want to confront the body of a dead baby for the first time while looking after the the mother, as I knew that I would be a wreck.

I eventually plucked up the courage to go and look at this child. I say child, because this baby was perfect in its form, her little hands and feet were miniature versions of the healthy term baby which I had delivered earlier that day, while her skin was not yet the healthy pink, and her head in comparison to the rest of her body was overly large- looking at this baby- she was perfectly formed.

Her mother had no doubt had dreamt of, and already visualised how she would raise her, and cherish her, before that fateful day struck. And yes, I did cry. I wept for the loss of a baby. For the loss of life which the mother had so very much wanted to bring into this world. It took me quite the while to regain my composure, and only after several hugs and conversations with my lovely matron and fellow midwives.

I feel blessed that I believe, and know that this mother will have the chance to raise her daughter in the life hereafter, that perhaps this daughter is now going to become one of her mothers guardian angels. That this baby will be reunited with its mother in the life here after. I couldn't tell the mother this, as it is not allowed by the rules and regulations of the NMC. But, I know it to be true.

So, yes, abortion. Why this came to mind, was that I realised, that this baby was 22 weeks, and was already a fully formed baby from 12 weeks. And yet, women can abort their baby up until 24 weeks, if its medically "not perfect" . Its pure murder- this is strong language, but this is how I see it. If a woman could see the child that she is consenting to kill, I wonder  how many would go through with it. I've been on the ward when a foetus with Downs Syndrome was aborted at 22 weeks- one mother, who was so desperate to have a child, and another who voluntarily took the life of her child. If only, they could see and realise how precious this child is- its a creation of God, it has a soul. While its "quality of life" may be different- it is life that the mother is toying with and taking away. Every baby has the right to life. No one would ever consent to killing a baby once its out of the uterus, and yet somehow its seen as ok to kill a baby while it is living in the womb.

Every soul is precious in the eyes of God- whether they are a 12 week baby or a 100 year old woman! Respect life. Love life. Love the miracle that is a creation baby.

Pure Joy and Wonder!

You know what my favourite part of being a midwife is? Or one of the parts- is seeing the pure adoration in the parents eyes when they first gaze into the face of their newborn, whether it be their first or their eighth. The mothers shine with love (and sweat!), and the fathers glow with pride at the incredible feat which their wife has just performed in bringing to life a newborn soul.

I still remember vividly "my" first baby, back as a student, I was terrified, grossed out, and delighted all at once in the process, bless the midwife I was working with, she had to keep reminding me- "Your face! Control your face!"- you, see I have quite the expressive face, and whatever is going on in my mind- shows on my face! But, when that incredible mother delivered a healthy, screaming baby boy- I was overcome with awe and wonder and the miracle that is life, God is one great scientist- to be able to create a being who can then create a life! I take my hat of to Him!

I love watching mothers and fathers as they carefully examine every little feature of their newborn, the perfect little hands, with their tiny fingernails, the chubby little bodies, and round perfectly innocent faces. For every parent their child is the most perfect and beautiful of them all... (it takes an uncle or brother to point out  that the baby's face is sometimes rather scrunched up looking!)

One of my sisters let me come to the birth of her child Celeste- which was wonderful miracle to witness, and helped me understand on a more powerfully emotional level the bond between a mother and baby which is formed almost instantaneously from birth!

Mothers are incredible beings to me. I am in awe of women- they go through what has been described as one of the most painful events that can happen to a person, and yet a woman chooses to go through this, as they know that they are going to have a miracle at the end, who they can love, cherish and raise as their own.

Mothers- I salute you, I am in awe of you. Thank you for being the wonders that you are!

The wonder of skin to skin

So as a midwife on a postnatal ward, it can be excessively busy, and one never seems to have the time to do every that one would wish. One key thing that often seems to get neglected is that of breastfeeding support. Wonderfully in the hospital in which I work, we have dedicated volunteer breastfeeding support workers who come almost daily, and a full time employed "breastfeeding specialist"- who is amazing- and seems to be able to get any baby latched on!! But, still, breastfeeding is one of those things that can rarely have enough support.

While studying I wrote a 5,000 word essay on the wonder of skin to skin... and can I just tell you- its amazing! From the very first hours onwards- it works miracles. For you midwives who never seem to have enough time to give breastfeeding support, and you ladies who don't seem to be able to latch your baby on; use skin to skin. Strip the baby off to the nappy, and place the baby diagonally across the stomach, so that the baby's nose brushes the nipple, and just leave the baby there, it can take up to 45 minutes, but baby's almost always latch on successfully, in what is known as the "biological nurturing" position.

http://breastcrawl.org/

Skin to skin helps to regulate breathing, temperature, heart rate, initiate bonding and successful breastfeeding as well as a medley of other benefits (like I said there's 5,000 words worth on this topic.. and more!) So if you are at 3 o'clock in the morning and wanting to pull your hair out because you cant seem to get baby to latch on, or if you're a midwife and have 5 women all at the same time wanting to get breastfeeding support, just strip that baby off, and place it in the biological nurturing position, and ask the women to call you in 45 minutes if the baby hasn't latched on... I tell thee! Rarely do they call you back. It is a beautiful and uber natural thing to see a woman there skin to skin with her baby. The mum loves it, and the baby loves it! And so, I love it!