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Ellie Durant
Hi, I'm Ellie and my goal is to help you become a fantastic midwife. I qualified as a midwife in the UK and have worked in both the UK and New Zealand. Now I'm a midwifery writer and support giver.

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

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 1

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

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.

pinard

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 0

What I Learned From Thinking Respectfully About Vaginal Steaming!

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

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