To push or not to push...that is the question

Attended a lovely birth on New Years Day. In hospital, so I was unable to 'catch' the baby but was able to support my client and her partner throughout. Labour was induced for medical reasons and strong regular contractions quickly ensued. After a short while my client said she wanted to push and it became apparent that she was in second stage of labour. She was told by the hospital midwife not to push but to breathe through the contractions. She started pushing anyway and a lovely healthy baby born shortly afterwards.


This had made me think about lot of issues surrounding the issue of pushing.

Firstly, why women are so often not believed when they say they want to push? I have heard that story too often, even with a woman who have had babies before and the head is visible! Whether the urge signals the second stage of labour or not, being told to suppress those feelings and fight them is counterproductive. Just acknowledging that a woman has those feelings can help her by demonstrating that we believe her and trust in the normal physiology of birth.

Secondly, If a woman's cervix is fully dilated and her baby is moving down the birth canal then she is in second stage of labour and her baby will soon be born. Fantastic! So why tell her not to push for heaven's sake!

And thirdly, if her cervix is not fully dilated there isnt any compelling evidence from research that this will cause a woman or her baby harm.In fact early urges to push are common and in some labours may encourage baby into more a favourable position for birth.

Lastly, women's urges often ebb and flow. So encouraging them to be instinctive and push as they feel inclined will almost always result in strong overwhelming expulsive urges only when baby is well down in the birth canal and about to be born.

So I for one will always believe a woman when she says she wants to push and continue to tell her to do just what she feels she needs to do.

Strong women not good girls

Just wanted to have a moan about a little thing (or maybe it's the tip of a very big one!) ...but its bugged me for years. In fact since I was a student midwife a very long time ago and I noticed one particular midwife saying it. And I would say that midwives say it most, less so doctors, and that it tends to pop up in the second stage of labour.

Telling women that they are '...good girls'. I cringe inwardly and then want to scream and shout at same time. I think it's rude, patronising and infantilizes women.

So why is it said to women when they are doing one of the most strong, grown-up things in their lives?

Power and control may have a lot to do with it. Also the culture of birth, the labour ward etc. Or maybe it's just that as professionals we forget what messages our language conveys and we need to pay attention to it more.

Are gloves always necessary during birth?

As I have nothing to hide about my practice and am confident in what I do and the care I give, I agreed to take part in HOME BIRTH DIARIES which, in my opinion, is the best woman centred and positive programme about pregnancy and birth on the telly....

In comparison to it I hang my head in shame at some birth programs, especially ones that take pride in admitting they are demonstrating conveyor belt like care and that one born every program is more like one extracted every minute. However we wont go there in too much detail but I may just remind you of those type of birth shows after I have had my say....

Back to Home Birth Diaries and in particular the episode showing Sadie, a women from Rochester having her 2nd baby. The birth in that episode is clear, close up and beautiful. A baby being born just how it should be. I also happen to know that it ranks as one of Discovery Health's and viewers favorites yet I have come in for criticism from some viewers, those of which are midwives themselves. I am used to criticism, being an independent midwife, and usually do not rise to it for the reasons I began this blog with, but this particular criticism has been mentioned to me twice in a few days so I thought I would address it.

Why do health professionals wear gloves?

We do so to protect ourselves and our clients against infections and blood born diseases.

I do not, however wear gloves to catch babies......shock horror ? please let me explain.

I do not "deliver" babies or have hands on other than if help is needed or if I have to be invasive in any way. Should that type of assistance be needed I always wear gloves, if I need to perform vaginal examinations I wear gloves, during the third stage of labour I wear gloves, to clear up any mess of any description I wear gloves BUT if a baby is just falling into my hands, as in Sadies birth, I take OFF my gloves just prior to catching the baby. A healthy, clean (maybe a bit wet) baby falls into my hands....what is the difference than when I hold the baby an hour later?

There is no risk AT ALL to a mother, baby or myself if my hands are clean, not cut or have any abrasions and I am aware of both the mother and my own HIV and Hepatitis B status. There is more chance of the latex gloves causing an allergic reaction to the baby. Furthermore how nice that baby is welcomed into the warm, clean hands of, if it cant be its own mother or father, a midwife who so well known to the family that she feels part OF the family.

Please my fellow colleagues and critics do not compare what I do to with what goes on in hospitals where strangers care for strangers, unless you are comparing my outcomes to those outcomes....in 13 years of practicing the way I do I have caused or caught no infections. My clients only have the ones they left hospitals with....My way of working is called individualised care...try it you may like it.

funny breastfeeding video

Well 7 months of hard work is over and now its just the waiting and seeing. Just before christmas last year a group of us including my good friend Bernie from www.mybirthtv.com thought about making a breastfeeding video. Not an educational one, (not to say they are not amazing because they all are), but a funny, cheeky one that will provoke attention and get the subject talked about. We were looking for a funny modern topical idea and it all gradually came together.....I have written the whole story about the making of it and why etc already so wont go into long detail again but if you want you can read it here. Anyway the video is on You Tube and the response is pretty amazing...both ways....I would say 99% positive but with a few people just not "getting it". Glamorous women saying "we are proud of who we are, proud of what we do, come and do it too its fun", not taking themselves too seriously, poking fun at themselves even and all for a very good reason....feeding our babies in the best possible way. We had lots of mums turn up on the day of filming all looking beautiful in their own ways, all willing to feed on camera...I say to everyone who took part ....very well done...didnt we have fun?
watch it here

breast is always

Shovels at the ready!

Restocked my birth box and checked all my equipment again over the weekend. Have some additional items that I was carrying around with me but don't need now, thank heavens. A shovel and a piece of carpet - cardboard works equally well though!

Heavy snow seems to be a fairly routine occurance now but nightmareish for us midwives and pregnant women.

If the snow returns though the stuff will be back in my car. And winter tyres fitted next season I think.

Back sleeping for pregnancy

I am repeatedly hearing women state that they must not sleep on their backs and are really concerned because they wake up on their back and have somehow harmed their unborn baby. I have been meaning to write about this for sometime but the straw that broke the camels back for me was a couple of days ago when a new client told me her previous midwife had told her not to back sleep or she could suffocate her baby!
Goodness me how on earth did our human race survive this treacherous journey called pregnancy and child birth? In one breathe we tell women they are not ill but going through a life event then we give them a whole list of what they must and must not do, places they must not go, things they must not eat and now which way to even sleep!
Rest assured dear sisters you can sleep how ever you feel most comfortable and you will do yourself or your baby no harm at all. In fact truth be known the worry of trying to sleep in a position you are self imposing on your body and the subsequent lack of sleep due to be less than comfortable will do you more harm.
On thinking long and hard I do believe that this myth has come about through a small grain of fact that has grown into huge Chinese whisper. In my opinion the myth has grown from the early days of dense paralysing epidurals and woman being left for hours alone in labour and on their backs.
It is true that there are huge oxygen carrying blood vessels in the lower back that if squashed by a heavy baby filled uterus did in the past lead to out of breath mothers who, due to the paralysis of an epidural were unable to move and the consequence was oxygen deprived babies. Once it was realised this was happening women were placed on their sides with a pillow wedged under them so they did not roll onto their backs, following administration of an epidural block.
These days epidurals are nowhere near so dense and most woman can move themselves around in the bed once it has been administered and can easy change position with minimal help.
As for a non labouring pregnant women, well that is whole different story because if she does happen to be squashing those all important blood vessels the first thing she will feel is a lack of oxygen which will lead to her feeling breathless and she will wake up and move! The baby will not suffer in any way. The human race has mechanisms to help us survive and will not allow us quietly suffocate ourselves (or our growing babies) in our sleep.
So sleep, pregnant women, however it suits your comfort.