Caring for midwifes = Better care for mama's
The recent NHS report on midwifery staffing was reason for concern, but this is not news. This has been a problem which has been brewing for some time. And the shortage of midwives is not just down to finances, or lack of (although this is obviously a major problem).
Lack of support or care for our midwives from within the system also plays a major part in this, leading to midwife burn out. A lack of opportunities for midwives to de-brief their version of experiences, occurrences of stress and even post-traumatic stress disorder- to name but a few conditions which are hindering our wonderful midwives - and could be resolved.Those in practice need more support and care so they can be nurtured and fill up, ready so that they in turn can nurture, support and care the women they are looking after.
Those in training need more encouragement to complete their training - and not be failed on assignments for missing out "3 words". This happened to a trainee friend of mine. So gutting, someone so dedicated to becoming a midwife literally having the passion drained out of her during training. Her and many others. For me, this article which featured on The Pool this week speaks volumes. The birth story the writer describes gives us another reason to encourage MORE Home Births or Births in Midwife Led Units, across the country.
The NICE Guidelines and latest evidence based research on 'Places To Give Birth' (carried out in 2014), confirmed Home Births and Midwife Led Units are the two SAFEST PLACES for mums and their babies to birth (specifically in regards for low risk pregnancies). Simple fact - if you PLAN a home birth and go for it there, you have a 7% chance of ending up with a caesarean. Compare this to if you PLAN a hospital birth, where that risk increases to 37%. That’s well over 1 in 3 births ending in caesarean JUST BECAUSE OF WHERE THE LABOUR IS TAKING PLACE. Why is this? Schedules, resourcing, protocols, finances, an inherent need to do something about something and many more...
This article highlights one experience of her birth not progressing - probably due to lack of support, a feeling of fear around not having anyone there to encourage her or make her feel safe. This led to zero oxytocin, increasing adrenaline and eventually the cascade of interventions leading to a c.section. Now I'm not saying all c.sections are bad. Far from it. Some are amazing and beautiful, when needed. I am saying those that could be avoided, probably should be avoided, and if we can achieve that through better CARE and support alone, then it's unethical it's not happening.
This article also highlights the growing trend of having a Doula (birth support person) with you - someone who can help create a safe protective space for mums to be, someone who can offer massage, hand holding, eye contact, love, and be there as a practical support giving mum and her partner space to be together within the experience. There is actually evidence that shows that having a Doula present at births reduces chances of interventions by 60%!! Yes, 60%. This fact led world-famous obstetrician, Michel Dent to say, "Based on this statistical fact, if having a doula was a drug, it would be unethical not to provide it."
Back to midwives... legally, there is a duty of care to provide a midwife at all births. In this article, in the hospital, this mum went under the radar. At home, a midwife would be sent out to you - she may stay with you or go away and come back again. But the legal obligation for her presence is there, especially as Free Birthing is not currently supported by the legal or health care system. Ironically, this article also shows why it is perhaps on the increase too - people would rather go it alone than risk shoddy care interrupting the natural flow of things. The question to ask is WHO should that kind of decision rest upon? And we'll all have different answers for that and perhaps a discussion needs to take place.
What is clear- what is certain, is that change is coming to the Birthing Space, for women on their journeys to motherhood and the babies coming in! And this is positive and exciting because it is based on empowerment. More women are getting more prepared for birth experiences through regular pregnancy yoga and birth prep classes, relaxation classes and fear release programmes like CBT, NTP and hypno-birthing have come a long way. Women are thinking about getting a 'team' on board to support them through birth - their partners, a doula, a trusted midwife. And we are seeing small increases in the numbers of women going for it at home (YES!!!).
As a society we need to enable women to create and find, or be in safe places where they feel protected when they give birth. This helps them relax with the necessary support and guidance and love around them, so they can trust their bodies and their bodies can feel safe enough to give birth - there is a whole physiological process behind this of course which we need to understand and then help create the conditions for that process to unfold. And on the occasions when it doesn't go to plan, perhaps the BABIES have a different birth in mind for themselves - ever considered that? And in those situations, then yes, aren't we lucky to have amazing midwives and doctors and technology at our fingertips. It absolutely has its place. When it's needed. However, it shouldn't be the guiding principle when it's not.
Food for thought...
Further research:
https://www.nct.org.uk/professional/research/pregnancy-birth-and-postnatal-care/birth/birthplace-study
Doula effect
http://evidencebasedbirth.com/the-evidence-for-doulas/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/
Midwife Burnout
Clare Maddalena
Senior Yoga Teacher, Doula & Founder of LushTums.
Clare teaches Pregnancy Yoga, Postnatal Yoga, Women’s Yoga and Antenatal Courses in Brighton and Hove.