I want to be that mother who can stand up and say I am a strong confident mother and I know what is best for my children. We breastfeed and co sleep, We listen, We include, We eat chocolate and snot smoothies, we trampoline and grow frogs, we sling, we carry and we try and understand and work with our children without resorting to punishments, threats or coercion.

Friday, 11 November 2011

Not just another midwife. Interventions, Intuition and Timing

Another reiki session with my midwife Alison. Today we did it sitting up straddling a chair and  her hands felt freezing on my back.

We also discussed her and my minimum and maximum intervention levels during labour...so now feeling safer more connected and our trust is building YAY!!

I realised last night one of the reasons I felt Maia's birth stalled and events turned the way they did was in part due to having NO trust or connction to the strange woman who were in my home..one of whom could easily have been the 'drive by leafleting' person.  

Ina May Gaskin in her book Guide to Childbirth, states "A woman needs to be emotionally supported, undisturbed by strangers or people that could make her fearful, free to eat and drink as needed, and freedom to move helping baby's descend into the birth canal"  The all important Sphincter Law takes effect here. (A conversation with Ina may Gaskin here)

Last night, I wrote in my birth questions book: -

"If I have no interventions, are you able to know things are ok?  What is your minimum intervention requirement?"

Which led me to question 'what constitutes an intervention?'  For me, my list was :

Internal - I don't want to feel pressurised into having an internal due to the midwife following protocol or not feeling confident.  So unless one was absolutely necessary(vaginal exams - When are they really necessary by Brenda Manning), I would prefer not to, unless of course my curiosity wants to know too!  During Maia's birth, I felt the fear in the midwives who wanted to examine me and felt like I ought to whereas during Ellie's birth, I felt it was a relaxed request for information and even although I would have preferred not to, I was slightly curious myself.

Temperature - A high temperature in labour can be an indicator of infection.  When I went into early labour at 36+5 with Ellie, I dutifully charted my temperature and her heart rate until I was absolutely convinced that I was indeed in labour and she was definitely coming that day!  with Maia, I kind of did it automatically because she was slightly early too (37+4).  It can be a comforting and not so invasive technique in early labour should the need arise and one that can be done by myself.

Baby's Heart Rate - Which would she be using, a machine or a foetal scope? She prefers the machine simply because it is easier and IS less invasive than the scope.  The scope seems like such a cool instrument to me and makes me think of simpler times when machines were not invading labour and taking over.

Positioning - During labour, there can be occasions when a suggestion to move can be intrusive and unnecessary.  My question surrounding this was WHEN would she feel it was appropriate to make a suggestion? 

Palpating - How often would she feel the need to do this? How much could she tell from this?  I am still at a loss to know how the midwives were not aware that Maia had completely turned the day before (my own knowledge of this was pretty shocking too, HOW could I not have realised that was what had happened?)  It took them nearly 12 hours to work this out.

Feeling - I am not sure now whether I was meaning instinctual feeling that there was something amiss or whether i meant gentle feeling rather than full on palpating but as I also wrote,

Looking - How much can she tell just by observing.  I am inclined to think I was wondering about her level of knowledge and intuition.  Obviously not something that can be sufficiently known or answered in one session.

So, these were my thoughts the night before.  

Funnily, I had completely forgotten that Alison was coming today for reiki but I am very pleased because it meant everything was still fresh in my mind.  Serendipitously, Barry was also off work and had taken Maia out so we had peace and quiet to discuss things.  When I told her I had some deep questions, she was quite open to bringing them up, even though it wasn't our midwife appointment, feeling her role as reiki and midwife were interconnected now.  When she heard the questions, she pointed out that this was usually something she discussed at 35weeks (I am nearly 20) but she could tell I wasn't going to rest easy unless we discussed them!!

Alison's basic modus operandi is to arrive and observe for the next 30-40minutes after which she generally finds her base line information in terms of my blood pressure, my temperature, my pulse.  She will palpate me and the baby and check the babies heart rate.  NICE Guidelines state that these interventions monitoring should be done every 15minutes taking a whole minute to listen to the baby's heart rate.  Alison let me know that I had the option to opt out of these at any time and she would state in my notes that it was entirely my decision (she has a statement prepared).  Also, if a woman has had normal blood pressure throughout her pregnancy, the likelihood of there being issues during labour is minimal, although it can happen for example with Placenta Previa.

Even knowing that this is how she proceeds has alleviated a lot of my concerns and she also made it really clear to me that she is able to garner information simply from observing my movements and body language and listening to the noises I make.

During my reiki treatment, I was regaled with one of Alison's own birth story's (it was fresh in her mind, since it is her son's birthday, another timely occurrence) which opened with statistics of her birth attendances she had had to that point.  She said she had 3 years without a CS and 2 and half years without a transfer. 22 Home Births in a row without transfer! The CS rate of her practice is about 10% ( about 50/50 elective vs emergency). She had been an NHS midwife and was taking a break from the system to have a baby and reassess her needs within the establishment.  They basically illustrated to me that there had been very few 'problem' cases and she was fully knowledgeable of normal births, before and after becoming an independent midwife.  It was also so lovely to hear one of her birth story's and how times have changed and how it helped augment her decision to become an independent midwife.

The upshot is, my concerns and questions were listened to and discussed and we are that one step closer to the birth I am hoping this one to be.

Meltdowns - no one is here!!
Losing the Plot - I'm all alone
Breastfeeding - been thinking about the whole newborn feeding again recently 

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