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‘Your words and treatment will echo for a long time’ – Discussing Stillbirth Activism with David Moneith

I first met David Monteith via a big hug - he doesn't do handshakes.

He’d just survived another summer parenting day but whirlwinded in to the Neros where we were meeting to have a milkshake and educate me about male grief with his punchy, inspirational style.

If you have a look at the image for this post (above) you'll see David and his wife Siobhan have three daughters - Grace, their middle child, died before she was born and Siobhan chose to have a waterbirth. This family sound incredible to me, David dug Grace's grave as a way to be physically involved with his grief and Siobhan chose to be a breast milk donor.

David is an actor, teacher, director, and writer. He uses his skills as a stillbirth activist.

In this interview, David offers countless gems of insight into caring for bereaved parents. I’ll hand it over to him!

What would you most like student midwives and midwives to know about infant loss?

One of the most wonderful things was a midwife talking about Grace's fingers and begin able to have a conversation comparing them to mine. At a time when everything changed little moments of normality are so important. In so many ways you need to treat our babies as you would a live one.

What’s poor advice you hear given about infant loss?

Not so much personally - the only thing I would say is make no medical assumptions about treatment or about the way you interact with parents at such a time. Don't draw on your own worldview in being 'helpful' but be mindful that babyloss is not an event but an ongoing continuum of grief in which your words and treatment will echo for a long time.

What are your favourite resources that teach about infant loss?

An Exact Replica of a Figment of My Imagination by Elixabeth McCracken - at a time when reading is hard this book based on the authors own experience of baby loss was easy to read. Perehaps because she was already a writer it has a tone and structure that was mesmerising.

Carry Me by Dan Berry - a wordless comic about a Dad carrying his daughter through a field trying to keep her safe from a wolf. Beautifully drawn. It's not a comic about stillirth but in the weeks after Grace died it came to mean so much to me

The author said: 'Being a new parent is strange. Having a small new life who is totally reliant on you really got me thinking about death rather a lot. My death, my daughter’s death, my son’s death, my wife’s death: Death. DEATH. I’d obsess about it. Carry Me is a story about death and coming to terms with the inevitability of it all.'

In that unspeakable period of shock and grief just after a child dies – is there something someone did or bought for you which made things even a tiny bit more bearable?

Food is the best thing. At a time when you can't think, can't plan, working out meals is a much harder task than it has any right to be.

I got really annoyed with the amount of flowers we got. My daughter had died and people were buying me something I had to take care of and would also die within a week (disclaimer: Siobhan liked the flowers)

But we also ran out of vases after the 5th delivery!!! The other beautiful things were plants that would last - We have a rose bush and a Magnolia tree that still bring us comfort and stuff like this that acknowledges Grace's place in our family.

If you could have a giant billboard out there that everyone would see, what message would it have on it?

Dead or Alive

The baby is still a baby

The parent is still a parent

The birth is Still a birth

David is doing amazing things in the baby loss community and uses his incomparable talent for public speaking to teach. He has a huge range of thoughts and strategies to offer, and if he’s inspired you, check out his lectures and videos.

Now we’d love to hear from you.

What is one thing you took away from this post which will help you care for families who’ve suffered infant loss? Professionally or personally?

Much Love x

September 19, 2018 0

Mama Unexpected – Student Midwife, Mother to a Disabled Child, and Total Hero

Sometimes you come across a blog with a new and authentic voice which shows you what life is like for someone else. 'Mama Unexpected' is one of these rare finds.

Hana Young's blog is founded on writing about being a single parent to her disabled daughter. It describes a vibrant, challenging, loving life with Tilly, who has Guanidinoacetate Methyltransferase Deficiency or GAMT, a metabolic disorder which affects the nervous system and muscles.

Tilly has irreparable brain damage which means dangerous seizures and profound learning difficulties.

Hanna also has a little boy called Arlo and is a student midwife and hypnobirthing teacher. Hana is one of my heroes and I've chosen a few recent entries for you to get stuck in to.

21st August 2018

Tilly is away at the moment in Holland so I just have Arlo at home.

Good grief life is so much easier.

There’s no one to pin down to give meds. No nappies to change.

I eat my breakfast with both hands with no one to spoon feed theirs.

No thinking about whether my child is thirsty or hungry, he can just tell me so.

No very early wake ups.

No one to pull my hair or scratch my arms and face relentlessly.

No giant pushchair to think about.

No screaming in the back of the car.

No Mr Tumble.

No knobby stares from knobby members of the public.

We can go to the park and I can sit and watch, safe in the knowledge he won’t attack another child or attempt to kill himself.

We can pop places. Just in and out. It’s amazing. We can do whatever we want whenever we want. Just go and do it. No need to assess or plan. Just go with the flow.

Ultimate freedom.

And I hate it.

I miss my girl so very much that even writing this is making me well up. I miss how much she needs me, I feel lost not having to think at 100mph anticipating her every volatile move. I miss the ferocity with which she throws herself at me for a cuddle. I miss her so so much.

I didn’t think I was cut out to be a carer. I didn’t think being a mother to a disabled child was part of my identity, it was just the situation I was in. But I am a carer and a mother. Caring for my disabled child is a part of me and I didn’t realise how much I would miss it and how empty I would feel not having her with me. I’ve spent five and a half years with her by my side and it’s like missing an arm being without her.

It’s only been five days. I miss my best girl

28th August 2018

So today went well.

So well I ate a whole tub of Ben and Jerrys.

This morning a social worker came round to assess whether or not my children needed to be put under a child protection order.

I realised this about five minutes into the appointment, when I realised the social worker wasn’t from the disabilities team. That the team had decided Tilly didn’t meet their criteria (she does) without meeting her and sent a child protection social worker instead to make sure my children aren’t at risk. I had to answer questions about my relationship with my estranged husband, my childhood and what type of mother I am. I said tired if you’re wondering. All to check my children weren’t at risk in my care.

Turns out they aren’t, the social worker was embarrassed the disabilities team had passed us on without ever meeting Tilly and called me superwoman.

Can’t say I could appreciate the compliment after having nightmares the night before that they’d say no and tell me she wasn’t disabled enough for them.

If my children had been placed under a protection order today, if I had been having a bad day and broken down in front of the social worker, I would struggle to ever find a job as a midwife in the future.

An appointment that was meant to discuss direct payments for a carer or respite care for Tilly turned into that. This is the fun and games that come with raising a disabled child.

Fucking hell how is it only Tuesday?

Woman on the edge.

2nd September 2018

Sometimes it can feel like a bit too much having a disabled child. Some times I can’t make it into a funny story.

This evening whilst I was cleaning up dog poo Tilly stripped off naked and pooed on the landing, covering every single step and the floor at the bottom in poo before smearing it all over herself.

I shed a silent tear showering her off and scrubbing every single step. The carpet is ruined.

I shouldn’t have to scrub my almost six year olds adult sized shit off of the floor. I shouldn’t have to wrestle her to change her nappies or even keep them on. I shouldn’t have to desperately try to find pyjamas options she can’t get out of or else I’ll find her naked and wet (if I’m lucky) in the morning. I shouldn’t have to throw away outfits after the first wear because she’s completely destroyed them by chewing them instead of the stupid chew toys I have to tie to her.

Sometimes it’s absolute shite and sometimes it makes me really sad.

3rd September 2018

Player One Ready. Her bags are packed, her clothes are labelled, her meds are sorted. My biggest girl is back off to school. Back to the same class. Her first year was difficult, she lost her able to communicate, she ended the year much more violent and volatile despite the hard work of

her brilliant teachers. No amount of brilliant teaching could battle against the epilepsy raging through her body. This year will be different however because this year she has been on treatment for her metabolic now for six months. She is no longer ruled by seizures. She’s now able to learn and retain skills. She is changing every single day. I can’t wait to see what this school year will give her.

To put it mildly, I think getting more midwives or other professionals who have a background like Hana's into the profession is a good idea. It's the bootcamp of getting things done and standing up for people's rights and Hana appears to be made of oxytocin and titanium. I have no doubt that Hana will be a huge asset to midwifery and a voice for those who are vulnerable (she's currently campaigning to get GAMT on newborn blood screening tests).

And the nice thing about Hanna's Facebook blog is that she always makes me feel capable of changing the world too!

What are your thoughts?

Hana and I would love you to see you take action....get over to her Facebook page and click 'like' and you'll get her stories popping up in your feed. If you see something on there that you think the world needs to know about, please share it.

Also:

1. Have you got a friend or family member who's a carer or who has a disability? Anything you wish the general public knew?

2. If you're a student or qualified midwife, have you cared for a client who has a disability, or who's a carer? Is there anything we can learn from you?

September 12, 2018 2

How To Listen To A Baby’s Heart With No Equipment (Important Safety Point)

Today's post is chock-full of goodness on one midwifery topic: pinards in emergencies!

You know those moments in life when you find you’ve forgotten something critical? Passport. Housekeys. Drove to the vet and took all the correct paperwork and your purse only to find on arrival you haven't actually put the dog in the car 😛

There’s that sinking feeling and then maybe you laugh a bit as you start to put together a plan to correct the mistake.

But imagine you do that as a midwife and suddenly there are two people’s lives on the line.

Midwifery is full of safeguards and checks and it’s crucial to be diligent and careful. But mistakes can happen.

That’s why I wanted to publish this anonymous write in from a midwife who found themselves in a very sticky position (read on).

In those moments of hellish limbo, you need to keep your head and find a safe solution. The worst thing you can do is panic.

This midwife found their way through using an ancient practice that's underrated in the UK.

Of course, I’m talking about being able to auscultate a fetal heart using a pinard!

If you don’t know what pinards are, they’re a type of stethoscope used to listen to the fetal heart. They're low-tech and old-fashioned, a bit like a horn crossed with an egg cup, see here:

(loving the hat!)

It takes time to learn how to use a pinard. Electronic sonicaids, like the one below, pick up the fetal heart much easier and the sound is amplified.

But once you have the skill, pinards are more reliable and accurate. Not to mention more satisfying.

You can hear different tones and it’s easier to distinguish between a fetal heart and maternal blood vessels. You don’t need batteries (a crucial consideration in some parts of the world).

And because you have to be skilled in placing a pinard to pick up a fetal heart, you can also confirm your palpation and work out the position of the baby.

They’re so important that I wanted them to be a motif in my novel. Chloe the student midwife inherits a pinard from her Mum and is determined to use it at every opportunity.

This is the midwife’s email…

‘So I have a midwife birth story for you all.

In the early hours of this morning I was called to attend one of my ladies who had gone into labour. I set out on the 45 minute journey from my house to hers.

On my arrival I took one look at her and could see she was in established labour. So I began to get my birth kit sorted. I opened my kit bag to realise to my horror that I didn’t have my sonic aid or pinards.

At that moment I had realised I had left them by accident at one of our MLUs the day before when doing an antenatal check. This birth centre was approx 1.5hr drive from her home. I must of completely forgotten to pick them up when I left the unit.

I wanted the ground to open up and swallow me up. She was having good FM and I could clearly see these as she was naked and dancing through her labour in a very mammalian way.

So I called a colleague to come and bring me some kit, however she was an hour’s drive away herself so I had to improvise in the mean time, as I could see the labour was advancing quite quickly for a first time Mum.

I asked for a toilet roll tube. Luckily they had one! I used it just like a pinard and it worked wonders! It also gave her birth partners a good laugh but I definitely could hear a good fetal heart.

My lovely colleague arrived an hour later with a pinards and sonicaid.

I used it just like a pinard and it worked wonders! It also gave her birth partners a good laugh but I definitely could hear a good fetal heart.

The labour and birth progressed without any intervention or vaginal examinations to a home waterbirth and a physiological 3rd stage with an intact cord until after placenta birthed. Intact perineum.

So if any of you homebirth midwives do find yourself without something to listen to an FH with, then use a loo roll tube - works wonders!’

The key thing to note about this story is the midwife in question has to be skilled with a pinard to be able to find a substitute.

I’ve heard really experienced midwives can sometimes find and listen to a baby’s heartbeat just using their ear to a woman’s abdomen! Amazing!

I know how difficult it is to find the time to learn how to use a pinard, as sonicaids are quicker. But be brave and start asking women and mentors.

There are some brilliant learning resources on how to use a pinard over on Sara Wickham’s blog:

Pinard Wisdom Part One

Pinard Wisdom Part Two

You never know how useful this skill could be one day. And during the zombie apocalypse, or maybe just if you forget your bag, don't forget the toilet roll trick.

Have you ever been in this position? Or have you used anything else as a pinard? I've heard of wine glasses but would love to know your story, leave a comment 🙂

Please do share this post with anyone who might find it useful as well.

Much Love, Ellie x

P.S. Goes without saying but please don't use a pinard or homemade pinard as reassurance that your baby's okay. Even if you have midwifery training, it's important to get medical advice if you're worried about movements or anything else.

September 5, 2018 1

What I Learned From Thinking Respectfully About Vaginal Steaming!

I have a particular acquaintance who's an amazing business woman. She’s clever and beautiful and leads her family and community in ways I have so much respect for.

Every so often, though, she brings up something that just knocks me sideways.

Like employing a psychic to analyse what her dog’s thinking.

Younger Ellie was a harsh critic with no time for anyone’s beliefs if they weren’t evidence based. When I was sixteen I was proudly reading Richard Dawkins and similar authors and loudly criticising everything.

I’ve now grown up a bit and understand a) I don’t know everything, no matter how many books I read b) being friends with people who think differently is a healthy, stretching experience.

But still – when it comes to pet psychics, the evil judgemental bit of me is thinking, oh, god, really? And then I muse on the fact that she enjoys it, it'll probably help with her dog's behaviour as they're spending time together and getting advice, it's not my place to judge...

It’s okay, I have a jokey relationship with this person and some of the things I do make her think I’m mad so we’re even.

Recently she’s started to go for vaginal steams, otherwise known as yoni steams. She feels they are making her periods lighter.

Based on this, I reflected on how midwives might discuss such a practice with clients, and learnt about my own prejudices and how best to cope with them.

If you haven’t come across vaginal steams, they’re a type of alternative medicine, or spa treatment, which involves sitting or squatting over steaming water infused with herbs. It’s claimed they’re good for reproductive organ diseases or issues, including fertility, but there doesn’t seem to be any evidence to back up these claims.

Some midwives I know like the idea as a nurturing activity for women and feel it's a historic practice that celebrates femininity.

Other professionals like gynaecologist Virginia Beckett, from RCOG and via the BBC, suggests the treatment is unlikely to be beneficial.

What is a midwife’s responsibility here?

Factors to consider:

· It's likely vaginal steaming will produce a placebo effect for some women.

· Placebos are very powerful

· But they work best when you’re not aware you’re getting a placebo

· Midwives have a responsibility to give evidence based information as per the NMC Code

· But they also have to respect client choice and there are cultural and spiritual needs to think about

My friend is completely genuine in feeling this treatment is helping her.

There is no formal evidence to show vaginal steams don’t work – but if we trust physiology we know that dilute herbs in steam absorbed by the vagina are unlikely to help with heavy periods.

It may be that the outcome of lighter periods is due to decreased inflammation and increased endorphins as placebos are known to cause these effects.

If my friend was your midwifery client, what would you do?

We have to be careful about validating treatments that aren’t evidence-based, but we also have to maintain good relationships.

After all, a good midwife/mother relationship is responsible for the amazing outcomes of continuous midwifery care.

It might be more simple to say ‘do whatever you feel is best’ but I’m not sure midwives can get off the hook that easily either.

Midwives sometimes work with women who are desperate for treatment to work, for instance, those having IVF.

Vaginal steams can be over £100 a treatment and some practitioners claim they can help with fertility issues. I think midwives have a responsibility to advocate for their clients in this situation, especially as this treatment could be recreated at home for pennies!

The cleanliness of facilities and dangers of hot steam on delicate bits of our anatomy might be worth discussing too. I wonder what this treatment might do to the vaginal pH, as well, could it kill off some of the healthy bacteria perhaps?

It’s also a little concerning that in some countries vaginal steams are performed as women feel they need to 'tighten' their vagina to make sex better, or because they think their vaginas are inherently dirty. I'm a little afraid that vaginal steaming might be similar to waxing or douching - it's done because vaginas are presented as needing maintenance to stay clean when really they're very good at staying clean all on their own.

If women are booking steams because they think there’s something wrong with their normal physiology, that’s an issue.

If you pick up on this kind of belief, it's might be a prime opportunity to quote Ina May Gaskin when she says ‘Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.’

On balance I think that midwives can be supportive of vaginal steaming. Like any other choice, it's important to offer information. But women might feel a special connection with the practice, or simply enjoy it. If you've offered all the evidence, you've fulfilled your professional requirements.

After that, trusting women to make their own choices and being a good, kind, respectful person is the name of the game.

What do you think - have you ever had a vaginal steam? Would you?

How do you deal with differences in opinion when it comes to clients?

Leave me a comment letting me know and please do share this post with anyone considering these issues!

Much Love x

August 29, 2018 4

Travels of a Newbie Midwifery Novellist: First Meeting With My Publisher

**This blog is outside my comfort zone because I usually try to write things that offer value to midwives. This is a post about what happened when I went to meet my publisher for the first time, with lots of my uncut fears and thoughts.

It's an experiment, I may or may not write things like this again.

I've noticed the hardest bit of writing my novel, by far, has been promoting it. It's really grim. I'd much rather just release a book into the wild and see how it gets on - but that's not the job description for writers these days.

It's also true that I love reading about anything that happens writers.

And I think women should talk about their achievements more.

I'm trying to learn and grow with all that in mind.

So, this is what happened!

Pinter and Martin are my wonderful publishers and they requested a meeting at their bookshop in London.

I live near Cambridge so the journey is a couple of hours. The meeting was at 2pm, but I wanted to get to the station at about 9.30am so I could sit in the waiting room and draft a new chapter for the next book in my midwifery series.

Here I am at the station!

You can’t see but I wore my charity shop little black dress with flowers, a cardy and some sensible black boots. Everyone needs a power outfit for the big days.

My train was at 10.44 so at 10.30 I was still sat there having a coffee and writing.

Then I realised the persistent and annoying tannoys were about my train. It was cancelled. Wonderful. I followed the crowd to talk to a harassed National Rail employee but the next announcement was about the train being put back on, so after a crowd of us ran over the bridge with just a few minutes to board, we got on our way.

There were no free seats so I sat on the floor of a vestibule with a Terry Pratchett novel (comfort reading). But I was happy curled up on the floor, it's better than a seat. After getting off at Kings Cross I got the Tube to Brixton, and then went and sat in a coffee shop to write a bit more.

I’m introverted in many ways so trips to London feel intense. I love the place, it’s associated with gigs, conferences and friends but still, I don't understand how eight million people can co-exist in one city. I always feel like I’ve met all of them by the time I've got home.

And things happen in London. After a while sat writing I looked up and got concerned because a guy was staring at me. This wasn’t paranoia, every time I looked up from my laptop he was giving me eye contact, no smiling, just staring.

As a security guard walked past (you get security guards in Brixton Costas) the guy deftly picked up an empty cup from another table to make it look like he’d bought a drink. I guess he couldn’t afford to buy anything. After a while he got up and went out. No idea what it was about or why he was staring at me in particular and I didn’t see him again.

I wrote for a while longer and it was coming out okay. I wanted to write a chapter about a woman becoming very ill after an unexpected postpartum haemorrhage. I have lots of awesome midwives in the first novel, but I also want to show doctors at their best.

After about an hour I needed a break and looked up to see a woman and her baby sat breastfeeding in the corner. I started to leave and she saw me grinning so I mouthed ‘beautiful baby’ and she smiled back like the sun coming up.

At 13.30 began to walk through Brixton, past Electric Avenue which was the first street in London to be illuminated using electric lights, past fish stalls, fruit and veg places and wholefoods markets.

I found Martin, the director of Pinter and Martin, behind the counter. He looks like he's from the book world, with Neil Gaiman cheekbones.

See exhibit A! Martin Wagner:

Zoe, who's the publishing manager, popped out from the office over the road. I needn’t have worried about being nervous, they were lovely.

If you're ever in London, 'Effraspace', which is Pinter and Martin's bookshop, named after the street it's on, is well worth a look. It's beautiful and has a rare and wonderful collection of books on midwifery, birth and parenting. And a coffee shop! And they do film festivals, yoga and events in their sunny, wooden floored attached room.

I'm not sure I was coming across as very sensible but Martin is a reassuring person who started the business a few years ago and his aim is to have the best bookshop on birth in the UK. And he made me a cup of builders tea.

We discussed a few things, the contract, some ideas for getting the book into the media including making some artwork out of quotes, and when preview copies should arrive (hopefully this coming week! Aieeeee!! I’ll let you know!).

We also talked about the trailer that’s coming out to advertise book one.

I had a few facepalm moments. When they asked me what my evening plans were I said I was going to see the new Alan Bennett play at The Bridge theatre near ‘The Shaft’. Rather than ‘The Shard’. Eerg. But they didn’t even laugh at me (though my London friends did later!)

We decided on a date for the book launch – anyone can come, there’ll be wine and snacks and books and I’d be so thrilled to meet anyone who reads the blog. It’ll be 7.30pm, 19th October at Effraspace, a day before my 30th Birthday.

Finally I thanked Martin and told him how amazed I was that ‘New Walk’ got picked up and how grateful I was.

I know it sounds stupid but I feel this stuff deeply, always have done. I’ve wanted to write and get a book out since I was about eight. Martin said some very nice supportive things that I'm too embarrassed to write about here and then I set off back to the Tube station, over to London Bridge, my nervous system like a lit sparkler.

I was joined there by two of my childhood friends – this is us, Hollie on the left is a games designer and Jenna on the right is an anaesthetist and that’s me in the middle:

I've known them since I was eleven. They've always read my scribbles and supported me. These days they live in London, and we were off to the theatre to see 'Allelujah', a play on NHS elderly care.

It was one of those plays that make you talk a lot afterwards, there's an evil character in it who thinks she's doing the right thing. No spoilers but it was horrid to see someone in an NHS uniform doing something so awful.

After a quick debrief, we let Hollie go home, it'd been a long day for everyone.

Jenna and I got back to hers around eleven, and sat around eating cherry scones with butter and discussing the play, how her shift had gone that day, and worshiping Alfie, her black and white rescue cat. When I went to bed I was so tired I ended up accidentally falling asleep without brushing my teeth.

I woke the next morning in the pale London sunlight. I love the early hours when no-one else is awake yet.

I sat on Jenna’s L-shaped sofa in her little flat. It's furnished so skillfully – inherited dressers that she’s repainted soft grey, paisley patterns, a clock made out of a bike wheel. And Alfie making happy pigeon like coos because I’d given him breakfast.

I had one of those moments where you take stock and realised the day previously I'd met with a company who were printing my book.

Written over four years, more or less an hour a day. Bizarre. In any given moment I don't have the faintest idea how I managed to get the first book done. And I constantly fight off feelings of being inadequate to write about such controversial subjects.

With my head split between concern that I couldn’t finish the next book and this brilliant feeling of the next book being an unopened present which will let me discover it bit by bit, I kept typing.

Alfie curled up beside me. I drank my coffee and after a while I got pulled into the story and didn’t worry any more.

New Walk is out 18th October. You can pre-order here. I'll love you forever if you do.

August 20, 2018 3

I Get Sent Midwifery Books Through the Post!…here’s what I thought of the latest

‘An Armful of Babies and a Cup of Tea’ provides a social history of a 1950s health visitor, just as the role was created and the NHS took off.

I probably wouldn’t have picked this book up had I not been sent a review copy. I thought my 1950s needs were met by ‘Call The Midwife’. But I’m glad I read it, I learnt some stuff.

Molly Corbally worked in a world before social workers when health visitors were the ones helping families make decisions about teenage pregnancy, crippling poverty and end of life care.

She actually wrote her book well before the ‘Call The Midwife’ craze started and it’s been rediscovered and republished.

Molly is starting out in a small Coventry village with new equipment, a new NHS role and a smart blue uniform, but she’s really treading a path that’s always been there. She’s overseeing the complex ethical and physical dilemmas that face mothers holding families together. An original NHS wise woman.

WHAT'S CHANGED

What struck me most is how much more relaxed life for an NHS worker was back then.

Molly had her dog with her in the car, or walked to appointments, stopping back at home for lunch and getting the shopping done in the middle of the day.

In one chapter, Molly pops in to see a postnatal mother and gets distracted by the rose garden and the new puppies.

As she turns to leave she realises she’s forgotten to do any checks. Rather than going back, she’s waved off by the mother and makes an appointment for a few weeks time.

This is the talk of the village – they find it very funny that the new health visitor forgot to even set eyes on the babies.

But can you imagine doing this today? What on earth would you document? ‘Saw rose garden (gorgeous but weak stems!), will assess twins on next visit’.

I don’t mean to sound critical, the relationship Molly builds with her clients protects them and her skill is immense.

But forgetting to do any of the checks simply wouldn’t be an option today, the risks of litigation are too high.

INEQUALITY

I guess we could wish we were back in that world of relationships being more important than documentation.

But as twee and heartwarming as the description of village life is, if you read between the lines, you can see oppression.

You can tell Molly is a gentle soul, but there are moments when she directs women a bit more than we’d think was okay. One woman isn’t told about her daughter's diagnosis of Down’s Syndrome until the baby is over 6 months old – something I think is deeply unfair, though Molly suggests this was a good thing for mother/infant bonding. Sexism shows through with most women not able to choose careers over childcare and the cast of characters are 100% white.

There are also no gay people.

I wondered for a little while whether Molly the health visitor might in a relationship with another woman. She lives with a nursing colleague who’s also her best friend. The village and their relatives don’t understand this, worrying about them not being able to balance out their dinner parties with male company.

But as the book progresses I realised that it’s impossible to tell, this information just isn’t offered to us. It’s like a world without LBGTQ people. I guess this is because homosexuality was illegal in the UK until 1967 but I thought health visitors and nurses would have insight and offer support for family members in this position.

I think I’m underestimating quite how much things have progressed since then. Having just watched the epic pro gay rights stand up ‘Nannette’ I can see how much damage this environment must have inflicted on the gay population.

POLIO

Molly also describes the summer of 1956, which was when the polio epidemic broke out. This section was fascinating and heartbreaking and clearly getting vaccines to the whole of the UK meant every NHS staff member was more or less on active service for a while.

If you don’t know much about polio, you’re not alone, there aren’t many people left who have it in living memory. But it’s a horrible disease which goes for the young and causes the breakdown of muscles. This means death or paralysis. You might have heard about the use of an ‘iron lung’ - essentially if children has muscle weakness around their chest, they needed to be immobilised inside a machine that breathed for them. This could be a lifelong treatment for them.

Good to remember how lucky we are now.

THE RELATIONSHIPS

the relationships with the women are what shone through, as with any book on this subject.

Molly follows whole families through their lives and her advice is accepted because she's built genuine, trusting friendships with her clients.

It's this which the slower pace of life prompts. You can see why The National Maternity Review from 2016 is aiming for continuity of care. I think it's really important for all new students to read books like this and see what time spent with clients can do.

The 1950s weren't an idyllic time, no matter how much nostalgia for A-line skirts and nursing hats we have.

The NHS today is more accepting of clients who aren't straight, white and 'normal' and we have better clinical care.

It’d just be nice to remember how important time in the rose garden is too.

What are your thoughts? Have you read this book? Let me know in the comments below!

August 15, 2018 2

How We Moderate The Secret Community

I run The Secret Community for Midwives in the Making, the 20,000+ member Facebook group that discusses all things midwifery.

We’re having some challenges at the moment. I've needed several glasses of wine and long runs. Don't feel sorry for me - I chose this job and for the most part I love it. But I have some things to say.

Topics like breastfeeding, abortion, circumcision and vaccination frequently come up. While this is brilliant and we get to hear opinions and stories from across the planet, they’re also subjects that make us vulnerable.

Often debates turn into anger. As the group grows, this is getting more common.

I’m aware that some people can campaign for better care using anger – but I’ve never been that person. I’ve always been quick to cry when I’m angry and that’s not a very persuasive place to start debating from.

In the Secret Community, we have one main rule which is that every post and comment has to be written in an overtly kind way.

Passionate debate is fine but anger or contempt directed at someone isn’t.

The reason for this emphasis on kindness is that I’m at the helm. I didn’t think for a moment that The Secret Community would end up this big but it has, and because I’m in charge, we’re going to have to do things my way.

This means being extravagantly kind, even when you disagree with who you’re debating with. Even if what they are saying is in your opinion, unsafe or disrespectful. Contact a mod by all means and we'll follow our procedure, we sometimes get in touch with trusts or universities and we have a policy for what to do if someone's letting us know they want to hurt or kill themselves (it happens).

But don't start or engage in a fight about midwifery issues.

This rule is because, in my experience, an angry debate in an online setting doesn’t usually change anyone’s mind.

People typically have one response to anger and that’s to get angry back. Even if they agree with you in principle, if you have fighting energy they will likely have a similar response and you’ll get nowhere.

Think about it – when was the last time someone was shouting at you and you listened and changed your mind?

People don’t say ‘oh yes, you’re quite right. There is something fundamentally wrong with me as a human and mother. I’ll change that at once!’

They just think, what a horrible person for making me feel this way.

What might be better is staying calm, or if you can, using humour? Not sarcasm directed at the person but just something to get rid of the tension. It often builds bridges and then you can teach.

This is why I often start my moderation posts with something like ‘oof, G and T time for the mods!’

It helps get us back to human communication.

Notice I'm not saying 'keep your opinions to yourself'.

I'm saying be kind.

I know. It’s not perfect.

Many of you will be saying that nothing will stop you fighting for the rights of women. That if we can’t handle flashes of anger then we can’t be good midwives and censorship of any kind is wrong.

But the internet has some dark holes of horrible comments and threads which make most of us lose faith in humans. I’ve seen these in the context of midwifery and I’m not willing to be responsible for a community doing this, especially not one debating such important subjects.

If I and the mods stopped moderating, the community would go feral, you know it would.

In the Secret Community, if our policy of kindness means removing members, even if they’re esteemed midwives who we really respect, we have to do it.

It's 'just' a Facebook group. But everyone gets to have their own corner of the social media world and this is ours. If you'd prefer a different kind of moderation, please set up your own group for angry debates. I'd totally support it if you can find a way to get it working!

We have a truly amazing moderator team who do so much behind the scenes and I can’t let them down either.

Keep it kind, everyone, please. Online midwifery will be better for it.

Much Love and RESPECT to all x

(This post was directly inspired by Caitlin Moran, one of my feminist idols, and Reni Eddo-Lodge, who wrote ‘Why I’m No Longer Talking To White People About Race' – both are angry at injustice, both using techniques other than anger to teach and change things).

P.S. Let me know your thoughts in the comments.

August 8, 2018 1

Women With Big Families – do we unthinkingly offend them?

Would you know what to say to a woman with four or five, or even ten or more children?

Finding the courage to speak up about something isn’t easy. Today’s post is from Rosie Brown, mum of five, who's expecting number six. She's an aspiring midwife and her open letter to women and midwives is about having a large family and some of the comments she’s received from medical professionals.

'Dear Ladies and Gents,

Would you take a moment to listen? I promise you will be a blessing to others like me.

I'm an aspiring midwife and now I guess I am a 'Grand Multigravida' too.

I've had something on my weighing on my heart for a while and it's been stirred by the opening scenes of One Born Every Minute series 11.

There's a lady expecting her 6th baby and the midwife says something along the lines of "haven't you worked out what's causing it?"

Future and current midwives. We might laugh it off and make a funny come back like we don't care, but do you know how exhausting this is?

Every day, every week when we are out with our children, here is what we encounter, from complete strangers.

"Don't you know what causes that?"

"Don't you own a TV?"

"Aren't you a glutton for punishment."

"Wow, how old are you?"

"Do they all have the same dad ?"

"Don't you know what birth control is?"

"Are you done?'

And then to have your midwife or health care assistant do the same when you are vulnerable can be overwhelming.

We sit on a ward listening to midwives go to other couples with 1 or 2, even 3 kids, and there are sweet and reassuring comments.

And then it's our turn.

For whatever reason, parents with big families don't get reassured.

Last week I was in A&E and a health care assistant was taking me for a test, and do you know how relieved I was when he said "Oh how lovely! Your house must be full of fun! Did you always want a big family?"

Us proud mums will probably answer willingly all the above as we chat about our kids, but this question was the correct one to ask.

Personally, we are Byzantine Catholic and my husband is training to be a priest and yes we did always want a big family, and I'm happy to tell you that. But 'Are you done?'.... that's an immediate judgement and I suddenly feel like as you check my cervix I have to justify my entire life, my religion and my sanity.

Please take a moment when encountering a big family to think about your words.

Just because this is our 6th or 10th baby, doesn't mean we aren't every bit as delighted and excited as if it was our first baby. Whether you agree or not, we come for support. Not to be shamed.

Thank you for listening if you made it this far :)'

I personally don’t believe any midwife will mean to be unkind but in our society, we tend to comment on mothers and their choices. Especially if there’s something unusual about them.

Seeing things from a woman’s point of view amidst busy practice and the rocky terrain of trying to keep humour and connection front and center is hard.

I think Rosie’s post contains valuable insight. Especially about the healthcare assistant with the kind and thoughtful comment, this is a great example of being with woman, understanding what it must be like to lead her life and talking with her accordingly.

As Rosie says, thanks so much for reading this!

And thanks to Rosie for writing it, it's brave and how gorgeous is her family?!

Do you have anything to add – have you cared for a woman with a big family? How did you talk about it? Or are you from a big family, is there anything else we should know?

Leave a comment below.

Much love xx

August 1, 2018 5

A New Way to Train as a Student Midwife in the UK

Not to sound like mystic meg, but I knew something like this would happen.

After the bursary went, I think many of us thought it was only a matter of time before midwifery applicant numbers went down. And the obvious solution to that is to provide some more funding to get midwives into the profession.

I’ve been stalking the RCM website for news about this situation and of course, up popped a post on ‘Midwifery Apprenticeships’. These courses are currently being created, looking to take their first midwifery candidates in 2019.

It’s big news for anyone wanting to become a midwife in the UK.

Apprenticeships train you while working and the government pay course fees while you receive a wage.

I love the idea – you shouldn’t have to pay for your qualification and getting a wage on the job is an even bigger endorsement of the importance of midwives

But I’m gutted for the students currently getting a midwifery degree and paying for their course fees as well as taking out a big loan so they can live.

The course fees only disappeared in 2016/7 and at the time the government seemed to think they’d get even more midwives applying. Something about student midwives being able to borrow more money so they’d be more solvent while training.

I don’t think anyone was fooled by the concept of having more debt being better for us, but regardless some aspiring midwives love the profession so much they chose to train regardless.

But some couldn’t, for financial reasons.

There is the argument that a midwifery degree is a higher qualification worth paying for. An apprenticeship might not open up as many options, especially if you want a Masters or to go into research.

But as a route to becoming a practising midwife, it’s a solid option.

In terms of whether midwives need to be academic and have a degree, there are a few ways of looking at it.

A degree can give you the skills to assess research and this is needed to practice with critical awareness. But frankly I have a degree and the most I’ve understood on this subject has been from Ben Goldacre’s ‘Bad Science’ and there excellent free podcasts and blogs that can teach you this stuff if you’re motivated.

There are plenty of midwifery mentors out there who don’t have a degree or a diploma and they seem amazing at their jobs.

I suspect that different strengths on the shop floor is a good idea; if some midwives come from apprenticeships and they’re amazing at co-ordinating a busy ward and dextrous at tricky clinical skills, and some midwives come from degrees with advanced knowledge of research, women will get better care overall. Different training options might help us play to our strengths.

So good might come out of this situation yet.

I can’t help but be frustrated about the government taking away the bursary and then having to address the lack of candidates with an apprenticeship. Could they not have just listened and left things as they were?

Adapting to the political situation has always been part of a midwifery role, however 🙂

What are your thoughts?

Are apprenticeships a good idea, helping bring practically minded midwives into the profession?

Or is it unjust to the midwives currently training and paying for their courses?

Let me know in the comments!

Much Love, Ellie x

P.S. Yesterday my novel 'New Walk' went to print.

I spent four years working on it.

I'm so grateful to have been able to complete it, for the experiences that led to it, for the guts and soul of midwifery that I was able to spend time with while writing, for Pinter & Martin deciding it had a place on their list.

I'm a little sorrowful that I don't get to spend time writing inside this book anymore but mostly joyful.

Thanks for your giant-hearted support.

Time for a glass of wine

Links for New Walk:

Available for preorder from: https://goo.gl/iV9z6C

Kindle version available for preorder at: https://goo.gl/nJJ1WK

July 25, 2018 27

‘Look at my face, not my uterus’ – Your No Guilt Pregnancy Plan

I’ve read quite a lot of pregnancy guides and I wasn’t sure there was much call for another one.

With the burst of amazing writers releasing things like ‘Birthing for Blokes’ and ‘The Positive Birth Book’ I thought it was covered.

I was completely wrong.

This particular birth book is designed for any pregnant woman who feels like a bit of iron filing caught between two magnets.

Rebecca Schiller is a doula, journalist and campaigner for women’s birth rights.

The book is snappy and balanced and talks to women like they’re intelligent. Not that other books don’t, but it prioritises making the reader feel in control.

It gets into the choices that need to be made in pregnancy and how they can impact us mentally. Overall it has a kind approach that fosters sensible self-belief and it focuses on preventing guilt.

It made me sad to recognise how crucial addressing guilt is.

But it’s a strong and unusual woman who manages to avoid feeling bad about her choices as she becomes a mother.

According to our society, ‘successful’ women are supposed to be thin, pretty and accommodating of others’ needs (study). The scope for us feeling bad is pretty big even before pregnancy.

I believe that pregnancy can hothouse shame because of the physical and personal needs that conflict with how women ‘should’ look and how they should feel about their child.

Self-care is something we talk about but it’s a hard concept to get to work in real life when we’re all so busy and focused on the people we love.

Rebecca’s book covers all the standard information needed. From screening to cord clamping to infant feeding, the facts have been collected and presented well, with resources for those who want to assess the science further.

Mental illness is addressed and it’s great to see the unspoken fear tackled – many women who suffer from depression worry about having their baby taken away and so don’t ask for help. But as Rebecca mentions, the odds of a child being removed purely because of depression are next to zero.

I won’t go into every topic mentioned but I was impressed by the breadth. The only thing missing is race – women from black and ethnic minority backgrounds experience a different story in pregnancy which ultimately puts them at higher risk. It would have been great to see this addressed in detail (I’ve become more aware of this social injustice problem in the birth world recently).

My way of telling if a pregnancy book is successful or not overall is ‘would I send this to my sister (a neuroscientist researcher) if she was pregnant again?’

I absolutely would – it’s more like a letter from a well-informed best friend than a pregnancy guide. And the vignettes included from the experiences of women help illustrate how different we all are. From those who wanted an epidural, to those who find masturbation in labour helpful.

The weird thing was, 'Your No Guilt Pregnancy Plan' was even useful for me personally. I’m not pregnant but everyone needs reassurance about trusting yourself when overwhelmed with options and choices.

I suspect that we all have these mental hurdles. It’s just that in pregnancy they’re more intense.

I enjoyed the way Rebecca presented it all as a challenge to develop self-trust, not an ordeal.

Now I’d love to hear from you.

Have you read this book? What did you think?

Do you think women face guilt in pregnancy? How do you address this as a student or midwife?

Leave a comment below!

July 19, 2018 0

Why I’m No Longer Ignoring Racism As A White Person

You know those books that you read and feel yourself being changed? I think it's called 'internalisation'.

This is one of those. Especially if you're white.

Reni Eddo-Lodge is a journalist and author who wrote the book 'Why I’m No Longer Talking to White People About Race'.

Her work focuses on racism and feminism. I think it's the exhaustion in her tone that gets me.

Did you know:

A slogan put about by the Conservative government was 'if you want a n**** as your neighbour, vote labour' - this was 1985
Children of colour get marked down in school
But when their work is assessed independently under a white British sounding name, they get the grades they deserve
Bristol was a slave port and the UK has a lot of its wealth from black slavery
Black and ethnic minority women are three times more likely to die during childbearing.

It's a hard one. If you're white, you might be thinking 'well I'm not racist'.

I believe you. But we live in a society that's got racism baked into it. Not our fault. Still our responsibility.

Reverse racism hits the news sometimes. White people being at a disadvantage because people from a black or ethnic minority group are discriminating against them.

The problem is that reverse racism doesn't happen in a way that takes meaningful power away from white people.

White people might find themselves in a single situation - say working for an ethnic minority family who pass them over for a promotion in favour of someone from their own background - but that white person will have more many opportunities over the course of their lifetime based on their ethnicity.

Ethnic minority groups literally do not have enough people in positions of power to even begin to level the playing field.

I think it's so important for midwives and students to be aware of the tension and inequality that black and ethnic minority people face.

I'm not saying white people don't have adversity or don't work hard. I had my first job at age 12 and I've worked ever since then. My family was often financially insecure when me and my siblings were growing up. I've faced sexism as well, in a workplace that still thought the men were more likely to be correct than the women.

It's just that there's a huge bias that black and ethnic minority people have to fight against all the time. You can't really fight against sexism without understanding racism. You miss so much of the picture.

The problem is to understand race as a white person, you need to put your own way of seeing the world on hold. This is pretty much impossible. The only way to do it is to think of a time when you've been so frustrated that someone couldn't see the inequality in a situation.

For instance, many women will have had a conversation with someone who doesn't see the point of International Women's Day as there's no International Men's Day.

I've been in a situation where I've been frustrated to tears trying to get a guy to understand why International Women's Day is important.

The risk of FGM, pay differences, the tension women face balancing having children and a career etc. It falls on deaf ears. It's like it doesn't even exist.

This is what black and ethnic minority people are trying to tell us. There's a whole existence in parallel with ours as white people. We're blind to it.

It's not for me to tell anyone what to do but I'd encourage you to read Reni Eddo-Lodge's book, listen to her podcast, or listen to Sprogcast, the episode with Doula Mars Lord.

Listening and understanding is only fair.

But also, if like me, the best bit of midwifery or caring for others is the privilege of understanding their stories: there is so much more to learn.

So many more ways of existing in the world to get to know.

I find this exciting.

Now I'd love to hear from you.

Please comment, especially if you're from a black or minority ethnic group, especially if you think I've left anything out!

Or if you're white - do you already know this?

Much Love,

p.s. I don't feel wise enough to write this. But I have a platform and I'm white. Even if I get it wrong I need to be trying. Feel free to correct me and please know - if I have made mistakes or caused offence, this is due to my ignorance, not malice. I'll keep learning, I'm sorry I and others haven't noticed in a meaningful way until now and I'm LISTENING.

July 11, 2018 9

Being a Doula with 4 Kids, How to Cope and Birth Magic [Audio]

'When I walk in it's like a part of me extends to her. I put my own stuff in a box. It's like my heart grows for her.'

I spotted Doula Katy Hemmus leaving wise and insightful comments about birth in The Secret Community. After following a few threads knew I wanted to talk to her properly.

The way she describes entering the birth space is so inspiring - Katy doesn't use the phrase 'birth magic' but the way she talks about supporting labouring women makes it clear it's transcendent for her.

(more…)

July 4, 2018 0

10 Responses

Katie Fox
- February 21, 2015 - 2:02 am
- Reply
Hi I’m 12 and hope to become a midwife when I am older do you have any tips or know anything I could work on now towards it??

Ellie
- February 21, 2015 - 7:52 am
- Post Author
- Reply
Hi Katie, thanks for you comment, wow you’re very focused at such a young age! I would come and subscribe to midwifediaries.com for free blog posts on midwifery which are up to date, I have fun with them too so they’re good to read! Volunteering with people is always a good thing to do to develop your transferrable skills, could you get involved via your school with any caring volunteer positions? I’d also start to read everything you can get your hands on midwifery wise, and perhaps come over to the Secret Community for Midwives in the Making on Facebook for an idea of what midwives talk about x

Alicia
- January 21, 2016 - 1:55 am
- Reply
I love your blog and am currently reading your book. Unfortunately, I am from the US so the educational path and such is much different than what you describe in the UK. Do you know of any American midwife blogs? I’ve tried searching online but most are very, very established in their careers and the things they write about are so far off from where I am in my journey to be a midwife.

Ellie
- January 22, 2016 - 6:05 pm
- Post Author
- Reply
Hi Alicia,

Great question! I don’t know many American midwife blogs sadly, though MidwifeThinking is a great Australian one, and SaraWickham.com is one of my favourite UK ones. Please do let me know if you find any good American midwife blogs, I’m always on the lookout! x

Bettina Dwyer
- October 13, 2016 - 3:36 am
- Reply
Hi Ellie,
I just wanted to share a bit of the furore that is occurring in the Queensland state of Australia. Obstetricians are moaning about the poor outcomes etc etc of midwifery led care. http://www.couriermail.com.au/news/queensland/ama-queensland-seeks-urgent-change-to-way-maternal-services-delivered-in-queensland/news-story/5fa372d6478e4cdbba9de7977df224e1
I thought we were passed all this but apparently not.
Pille
- March 23, 2017 - 9:19 pm
- Reply
Hi Ellie,
I’m a first year student midwife, and would eventually like to work as a midwife on First Nations reserves in Canada. Do you have any contacts who have trained as a midwife in the uk and moved over to Canada? Or do you yourself have any idea how the transfer would work?

Rachel Wild
- October 18, 2017 - 11:52 am
- Reply
Hi Ellie – if you particularly want to work for First Nations’ families I would first contact some of the Aboriginal health organisations or governance bodies to scope out how they would see a midwife from the UK working out. Perhaps you have First Nations/ Aboriginal heritage yourself, but if not you’d need to consider the implications of working as a outsider in communities that have a history of colonialism harming their existing birth cultures. e.g. http://www.naho.ca/midwifery/ also your immigration and work visa would be through the Canadian government but perhaps you could also ask permission of First Nation government for the area you’d like to practice in?

Miroslava
- October 29, 2017 - 2:27 pm
- Reply
Hi Ellie, i am a second year student of midwifery in Slovakia.
I would like to ask you, what’s your posture for needs of women who are in puerperium ? What is your opinion for lactation and sports activities in postpartal period?

Thanks, for answer 🙂
Alysia
- November 1, 2018 - 3:42 pm
- Reply
Hello, I have always been interested in midwifery at young age. At the moment, I am a Senior in high school and I am writing a paper on a career that I am interested in. I am required to have an interview with a midwife for research for my pages.Would you mind if I interviewed you for the role?

Ellie
- November 2, 2018 - 7:28 am
- Post Author
- Reply
Hi Alysia, please email team@midwifediaries.com and we can sort something 🙂