A childbirth revolution

When I was at the centre of a traumatic litigation case for 9 years following a home birth I facilitated, I believed my life would never be the same again. I have very recently been reminded of those harrowing days, months and years, but am now able to breathe a sigh of relief. On the 20^th September I watched the premiere screening of Freedom for Birth,  in Holland. I was graciously invited to the home of Nicola Philbin to see the film, which was a God send as I was in the Netherlands visiting my grandchildren. Nicola is a lawyer, a doula and an antenatal teacher, and I met her months earlier at the Human Rights in Childbirth Conference in the Netherlands simply by admiring her dress. Along with a friend of hers, an English midwife who works in the Hague, we sat glued to the TV as the documentary played.

Since the aforesaid conference I thought I had a broad understanding of many of the global issues surrounding childbirth and human rights, but I was wrong. The Freedom for Birth film was a revelation. The talented filmmaker couple Toni  Harman and Alex Wakeford succeeded in delving deep into the detail of events where the human rights of individual women have been catastrophically violated during the childbirth period.

The film mainly focuses on the plight of Agnes Gereb, a Hungarian  obstetrician/midwife who has been subjected to what can only be described as a witch hunt for facilitating homebirth, she was sentenced to a prison sentence and is currently under house arrest pending the outcome of an appeal.  Toni and Alex take us to Agnes’s doorstep, and we hear her gently spoken account of her situation, and what she is experiencing internally.

Freedom for Birth highlighted to me the relatively fortunate position we are in in the UK, with regard to parental choice in place of birth (including home birth), and professional regulation and autonomy for midwives. But that doesn’t mean our system is perfect, far from it. The reality of women being able to choose where to give birth varies from area to area and there are many compounding elements influencing the fact that most women continue to choose to have their baby in hospital believing it to be safer.  There is also the potential erosion of choice for mothers and midwives if a solution isn’t found to the inability of Independent Midwives obtaining indemnity insurance, as practice without insurance will be illegal from October 2013. AIMS are concerned that if this situation is realized the potential for women choosing to birth outside the system and without a midwife will increase (AIMS 2012).

And each day the evidence revealed in the Birthplace Study (2011) that for low risk women there is a greater incidence of intervention and Caesarean section when birth takes place in hospital is apparent.

In addition, there is FEAR amongst the health care professionals working in maternity services.

Fear of retribution

Fear of litigation

Fear of the press

The workloads are frequently unmanageable, and the pressure increasing. The concept and delivery of risk management strategies are eating at each element of care so that 'records' are the focus, not the individual and her family.

But there are mini revolutions happening every day too. In my experience when midwives support mothers and push the boundaries of organizational and professional constraint and they are supported by obstetricians, change is possible. I witnessed first hand radical shifts in culture in maternity services that were once burdened with destructive  oppression from medical and midwifery staff. Bullying was common place. But the ‘revolution’ took decades, and was achieved with small steps and a handful of committed individuals. There was a tipping point in the service, which is now successfully offering the full range of choice of place of birth for women, and promoting positive birth outcomes for all women.   This was made possible through staying focused, collectively gather momentum, and developing collaborative, respectful relationships.

Reading and listening to others and their stance on Agnes makes me angry and frustrated. How can it happen?

But we must keep going, pushing, influencing, lobbying, and be committed to give back birth to women.

My hands are joined with others across the world, I hope yours are too.

Other related blogs:

The Mule

The Hackney Doula 

Valerie Gommon Midwife's Blog

And an interesting thought 

References:

Dresner Barnes H (2012) Professional indemnity insurance for independent midwives AIMS Journal 24(2):18-9

Photograph credit

Old head, young shoulders

Do you remember things that your parents or ‘elderly’ relatives used to say when you were growing up? In my family there was definitely a special language…sayings and quotes that were passed down through generations, some were common, well known phrases and some that we think were made up, and used only by those connected to the Dixon family.

My Mum and her sister Maud spent a lot of time together during my early adolescent years. Mum was running the bakers shop in Great Harwood and Aunty Maud just lived down the road and used to come and help. I used to listen to them chatting on the special occasions I was allowed to, and I loved it.

Their conversations intrigued me, and they invariably got on to the subject of their youth and how things had changed.  

Some of their expressions and sayings come to mind more and more as I reach the grandmother/'older' aunty stage, and I understand the meanings of some of them much more clearly. When Mum was trying to give me advice as a young girl, and particularly when I didn’t want to follow her suggestions, my Aunty would say ‘Kathleen, you can’t put an old head on young shoulders’.  

How true is that? I didn’t quite understand the meaning as a youngster, but I sure do now.

It’s not that age brings total wisdom, not at all. And it doesn’t mean that parents always know best. But as I observe younger family members I often wish I could save potential hurt or discomfort by making a suggestion (and sometimes I do!) Wouldn’t it be great if all the experience and wisdom that mattered from our lives transferred through osmosis to our offspring ?

But it can’t be.

And one day they too will understand and maybe say that on young shoulders an old head won’t fit.

A letter to a special midwife....

Dear Shelley,

When I saw your face nestled amongst other delegates in a lecture theatre at Coventry University this week, I was overwhelmed. The joy of seeing you made my day, and I am still smiling. How could it be that we lost touch after sharing such a close relationship as young midwives, and young mothers? We grew together didn’t we? You shared your sunshine personality with so many others, and everyone loved you. Including me. I was always delighted when I knew we would be on the same shift, caring for mothers and babies, as I knew the hours would be full of smiles and compassion even when it was busier than we thought possible. I can see you now, coming through the doors of a birth room with a great big smile to help someone else. Always helping- ‘no’ wasn’t in your vocabulary.

One occasion when we worked together stands out above all the others.  You came out of one of the birth rooms on the Delivery Suite at Blackburn and asked me to ‘mind’ Julie, the woman you were looking after, whilst you went to have some lunch.  You sought me out. ‘Sheena this young girl is in early labour and is frightened of me leaving her’.  ‘I promised her I would find someone kind to sit with her whilst I had a quick bite’ you said. You explained that Julie had distressing social circumstances, and she had learning difficulties. I was flattered that you trusted me, and followed behind you into the room. The young woman was crying because you’d gone.  So you hugged her, and kissed her forehead, and as I looked on I caught glimpse of the head lice crawling around her locks of hair. I also became aware of the stench and saw the grime on Julie’s skin and nails, and I bent to her level to try to reassure her that I would stay as close and carefully take good care of her whilst you were gone. Julie swore at me, and said she didn’t want me, only you. You asked if you could go for just 15 minutes, as you were so hungry, and she screamed ‘NO!’.

So you stayed. You stoked her hair, and put your arms around her neck and then moved back to get eye contact. ‘OK Julie, I won’t leave you’.  You didn’t worry about catching the lice, or the offensive smell, you didn’t just care for Julie, you loved her. And she felt it. It may have been a first for her.

I have often recounted this tale Shelley, especially when talking to student or new midwives about real humanity and compassion. I have always considered myself as being up there with others in my ability to nurture, empower and to be kind. But you go beyond that. You are the ultimate midwife, your sensitivity and love is a rare gift, and I am thankful that I witnessed your capacity to make a difference to so many women.

At our unexpected reunion at the Baby Lifeline study day we talked and talked of times gone by, we laughed and we cried. And we spoke of other stars, Anita, Louise Slater, Sue Henry and Katie were amongst those we remembered.

Later that evening I posted the photograph above on Facebook, and these comments from some of your friends quickly appeared:

Patti Hughes Shelley Shore! Lovely lady - and doesn't look a bloody day older!

Jean Duerden Loved it knowing she was in York. A very special person. X

Tina Chatburn Shelley Shore .....loved her tales !!

What do you think about that?

Shelley Shore: a legend

Love from your friend,

Sheena x

From one Rose to another

Dear Marie (Rose Marie)

You were my wonderful mother-in-law for decades.

You were the amazing mother to baby Rosemary who died before you saw her little face, and whom you never held. And you were the fine, strong mother of Stephen, Paul, Mark and David. You always seemed happy in your life, yet you suffered more hardship than most.

This photo was taken at Butlins holiday camp, when you were young, carefree and unaware of what life was going to deal you.

I remember when Anna was born. Your first grandchild, and a girl. Did she remind you of the little girl you lost? Of Rosemary? I never asked you. I am sorry about that. As you curled your loving fingers around hers and cupped her face with both your hands did you cry silent tears? As I grow older as a mother and grandmother I can only be sure that you did.

And now we have another Rose! I want to introduce her to you, as your namesake.

Here she is in the arms of your son, her Grandad Paul. She was born to Anna and Garry surrounded by love, and we were as you were when Anna was born, looking on in amazement as the next generation emerged strong into the Byrom family.

And so Elizabeth Rose (Betsy) will carry your name on into the future. We will be sure to tell her what she has to live up to, and about the legacy you left for her through the life that you lived; loved and respected by all. As time moves on, your strength and values are passed on Marie, and for those things we are blessed.

My love to you,

Sheena x

PS

Marie, I heard shortly after writing this letter to you that we have another lovely baby Rose, born before Betsy! How could I miss that? Pheobe Rose has your name too, and is the beautiful baby girl born to Jordan and Jemma. Pheobe has brought much joy too, and is Gill and Mark's first grandchild. She too will hear about you, and carry your love and positive spirit with her through her life....here she is Marie; what a beauty.

Why is the birth room being used for mass entertainment?

I don't like this photograph. It actually depicts the worst possible scenario. That is, a labouring mother flat on her back, vulnerable with her legs wide open. The midwives hold the power. As a midwife this is certainly not how I want my profession to be represented.

I imagine that the photo was taken to attract media attention, to draw potential viewers to the BBC TV programme it is associated with...and there will be those who don't notice the image particularly. But there is a message in the pose that has the potential to negatively influence society, and childbearing women. As the documentary programmes have too....ITV's One Born Every Minute, and BBC's The Midwives.

I have to admit that I always avoid watching TV documentaries about maternity services. My decision stems from the fact that I can’t bear to watch poor midwifery or obstetric practice without the ability to influence, and I think the intimate moment of a baby’s birth should take place in a private ‘space’ where the woman feels safe and protected. It certainly isn’t the place for TV cameras, even those that are hidden.

Childbirth is important for humanity, and the ultimate aim of maternity care workers is to ensure women have a positive childbirth experience. When women are in labour the hormones that aid the birth process are heavily influenced by the environment she is in.  Michel Odent, a highly acclaimed French obstetrician gives his expert opinion; one which I fully support after observing childbirth first hand for 35 years. He said:

The best environment I know for an easy birth is when there is nobody around the woman in labor but an experienced midwife or doula – an experienced mother figure who is there, and who can remain silent. Silence is a basic need for a woman in labor. Privacy is another basic need. Michel Odent

So that's a big enough reason not to have cameras in the birth room that broadcast private and intimate moments to millions, with no control over who watches.

And then there's the issue of editing. The producers want to draw viewers in with drama...and the drama is having the desired effect and the viewing is said to be 'compelling'...but what else is happening?

Globally, we are in a situation where women are becoming increasingly afraid of childbirth and unsure of their ability to give birth without medical assistance. There are lots of factors that influence this position, and the media play a huge part.

As a Facebook and Twitter user I have read so many comments in response to the midwifery documentary programmes, from mothers, women, midwives and student midwives. The comments mostly demonstrate the fact that the content of the programmes have stimulated fear. Some midwives, whilst acknowledging the scary and distressing scenes highlighting their colleagues 'under pressure', believe it to be good as it raises the issue of the shortage of midwives nationally. But should this be at the expense of those potentially and actually using maternity services?

Let's read the comments.

The Telegraph reviewed The Midwives

There is a gruesomeness to childbirth TV that I find partly compelling and mildly horrifying. I understand that births where nothing goes wrong don’t make for exciting enough footage but, as a childless, slightly broody 31 year-old, I found some of the scenes pretty harrowing, and had to watch with my fingers over my eyes. There were complications with almost every birth – is this the BBC’s attempt to keep that soaring birth rate down? If so, it’s certainly worked on me… 

One tweet from a student midwife said that she was scared to go on her next shift following the programme....

Twitter:

'It seems such a shame they always show midwives shouting at women, calling them good girls, or do the 'silent midwives' not want to be on TV…'

Facebook (taken from One Born Every Minute-the truth page)

Susan:

'I watched it last night and couldn't believe the triage midwife with the short blonde hair telling the soon to be mother of 5 that she was definitely not in labour. It was her fifth baby, she knew her own body!! I wanted to shout at the telly. I was so smug when the labouring woman progressed quickly and birthed not long after that. I did not like that midwife's manner at all, and she only seemed to get worse throughout the programme..'

Jane:

'I am 21 weeks pregnant with my third baby, and watched the first programme last night. Honestly, despite having been very lucky both other times, it has left me petrified. Must get a sense of perspective....'

Oh dear. How to demoralise women.

We really need to turn the tide. In addition to #moremidwives we need some positive media....positive stories to raise the bar. What do you think?

P.S. On the contrary, I LOVED Call the Midwife. Quite different.

Photograph 

Time to relax....and the fragrance really matters

So it's been a couple of weeks since I posted on my blog; life took over! Births, weddings, sick friends, grandchildren and meetings in London (where I got to catch up with my special Doula friend Mars Lord) scooped me up and took me away from sitting and pondering....but now there is so much to reflect on!

But before I do that I have to talk about the things that frequently save my soul and help me to take time to relax....Melt Candles

I have always loved candles. I prefer candle lit rooms to any other and the mood candles create is perfect for so many occasions.

But Melt candles are something else. They not only look luxurious and world class, but they provide a wonderful fragrance in each room that stimulates my senses just perfectly. The scents are subtle and carefully selected by the founder and owner of the company, Cheryl Hook. Cheryl has a unique talent for identifying wonderful fragrances and blending them with the perfect colour; both the scent and the colour compliment nature and there are many to choose from. They are simply the best.

I don't need to say any more except I am thankful to Melt candles for all the pleasure (and assisted rest!) they give me....if you want to know what others think then you could  read reviews from more satisfied customers.

Now where was I? Oh planning my next blog....

This is not a sponsored advert

UK Student Midwives-something to be proud of

It's a long time ago since I was a student midwife (1970's), we were then known as a pupil midwives. It's even a long time since my daughter was a student midwife...and that does make me feel old! I have worked very closely with so many incredible students throughout my career, and I have instantly recognised the ones who I felt 'had it'- that is, the sensitivity and kindness that makes a difference to childbearing women in their most vulnerable yet special moments of their life.

But during the past year I have been incredibly fortunate to have 'met' hundreds of students from throughout the UK and beyond, in the virtual world. This has been made possible because of two things: writing my midwifery memoir Catching Babies, and using Twitter.

So many student midwives have contacted me and given feedback about my book, and I am touch with dozens on Twitter. I have also been approached by several individual students with requests to talk at their University conferences, and have been humbled and honoured to attend and support them.

So what is it that makes me feel proud? From my experience I feel this new generation of student midwives have not only 'got it', but they have other attributes that really impress me. I have seen a confidence and maturity that enables them to express themselves respectfully, with humility and graciousness. But this assertiveness is not at the cost of kindness and compassion; this is in abundance, along with an enormous passion to make a difference to women and families during the childbirth period.

My belief was further consolidated on the 16th July when several student midwives dressed in 1950's Call the Midwife style uniforms cycled 6 miles through London raising awareness of the desperate need for 5000 more midwives and the petition that the Royal College of Midwives have organised. The event was organised by Rebecca Ashley, and she and her colleagues have demonstrated courage and determination, innovation and leadership and they are still in their first year. We (midwives) are eternally grateful to them.

http://www.youtube.com/watch?v=bqHGuQdUS0U

The more I communicate with, see, hear and chat to our country's student midwives, the more my heart sings. We are incredibly fortunate, and the future health of our nation depends on their ability to say strong, positive and focused.

And these student midwives need midwifery posts when they qualify. HAVE YOU SIGNED THE PETITION? 

Photo of keychain

On the other side of the fence-the relative

During each and every one of the 36 years I worked for our glorious NHS, I always tried to put myself in the shoes of those I cared for. It's strange and quite nerve wracking to be on the other side of the fence, and to be receiving care. When I was a patient myself last year I was ever alert to what was happening around me, and I was truly nervous.

Last week my eldest daughter gave birth to Elizabeth (Betsy), and I was 'the relative'. This was yet a different experience; I was still as anxious and even more out of control. But I was delighted with the care and attention; in fact it was first class. I expected high standards, as I know the maternity service is second to none and receives excellent feedback. Even so, we found the staff to be exemplary, and they went out of their way to make sure us 'relatives' were OK too.

I have to mention two people (there are many more but A will tell all). The first is Leigh Halliwell, the wonderful midwife who worked hard with Anna, loving and supporting her for 12 solid hours. Thank you so very much Leigh. And then there is Mrs Liz Martindale, the obstetrician who supported choice, gave commitment and encouragement, and even supported me via text in the hours leading up to Betsy's arrival. Just moments before the birth, Mrs M told us she was going to make A's birth experience (emergency caesarian section) the most positive ever, and she did just that.

Those who know me, or who have heard me talk at conferences will know that I frequently sing the praises of this particular doctor. This is because she is exceptional in so many ways; pushing boundaries to ensure women feel in control and happy with their birth experience. Mrs Martindale is quite famous for her innovative work (1), especially the 'Martindale Manoeuvre'. Do you know what that is?

So an enormous THANK YOU Liz from all our family for all you did for daughter A, and Betsy Byrom.

(1) Byrom S, Fardella L, Sandford J et al (2010) Collaborating to push boundaries to promote positive birth :an inspirational reflection MIDIRS Midwifery Digest 20(2): 199-204

Photograph of fence

A Girl for my Girl

Dear Betsy,

The night before last the anticipation of your birth was replaced by sheer joy as you made your grand entrance into the world, and your Mummy and Daddy saw you for the very first time.

As well as shedding plenty of tears, we heaved a sigh of relief; you and your Mummy were safe and happy. And now all we feel is love for you, and we can't wait to share your life with you.

So Betsy, may you give joy to your parents......have fun with your Daddy and be best friends with your Mummy.....

When your Mummy was born, my lovely mother told me:

'A son is a son 'til he takes him a wife

But your daughter's your daughter the rest of her life'

And she should know, she had 5

Grandmother in waiting

I am at home anxiously awaiting the birth of my eldest daughter's second baby. When the little one arrives, we will have 5 grandchildren, and each one caused a tummy twisting turmoil just before they made their appearance. When I gave birth to my four I was confident and happy as I approached labour and was lucky enough to have four positive experiences.

So why am I sat here in a tizzy? I swing from staring at my mobile for messages, to looking at the house phone and wondering whether I should call...and then I walk round the house doing half tasks.

It's hard being a mother to a mother that's labouring in another place, so hard. Please come safely and soon little one.

And then I wonder if my lovely late Mum had the same worries when me and my sisters laboured hard for hours?

That's what I'll do; I'll go to her grave and I'll ask her...

Photograph

Five nights in Firenze

Being already connected to the Latin country of Italy, I was ready to relish the never before ventured city of Florence last week. Our lovely friends, Eileen and Michael Whitehead generously invited us to accompany them to their favourite haunts and we accepted....along with my sister Eileen and husband Denis, and the fabulous Frank and Lynne. We stayed in Max and Beatrice's fabulous Bed and Breakfast in the city. Residenza Casanuova is a magnificent house that has been owned by the same family for generations, and Max gave us a potted history. The rooms were themed and luxurious and we felt rather grand going to bed there...almost like being in a period drama!

Under the hot sun and Michael's knowledgeable (when truthful!) guidance, we trod the worn paths of the Medici family in complete awe of the culture and history. Climbing the almost vertical but winding steps of the dome in the Basilica di Santa Maria del Fiore, otherwise known as the Duomo, was hard.....but so worth it! We were able to take a close up view of Giorgio Vasari's much-reviled frescoes of the Last Judgment (1572-9) which was spectacular. I wasn't too keen on the artist's interpretation of Hell, so I hope I don't go there.

My special friend Katie is always alarmed at my lack of knowledge when it comes to art, but as children my sisters and I weren't really introduced to the subject outside school. But as the Uffizi Gallery hosts some of the most revered paintings in the world we spent an afternoon there checking it out. Just wish I'd researched some of the work a little more before going!

On the last day we strolled around and over Ponte Vecchio, the famous old bridge that has a history of its own. There are several jewellers shops on both sides and above them a passage, which connects some of Florence's palaces and stately buildings. The passage was built by the Medici family so that they could walk between the buildings and not mix with 'minions' on the streets below. It is alleged that the jewellers were once butchers and fishmongers, but the noble family ordered they were closed down due to the stench.

Michael and Eileen knew where to take us to dine, and from the delicious plates served in Semolina (their favourite) to the amazing taster menu at the Cibreo Cafe we were treated like royalty by some rather handsome young men....

Romantic Florence is all I thought it would be, and the best part of all was being in the company of my family and friends; boy did we laugh.

As we finished our meal the night before flying home, we heard some pretty spectacular singing nearby. The girls in our party located the spot where a teenage girl gospel choir was performing in the open air, and we rushed to take up the only four remaining front seats. We couldn't believe it...the young women's energy was electrifying, and we were spellbound as they smiled and danced whilst their voices gave us goosebumps. Song after song they thrilled the crowd and as we whooped and cheered they seemed to entertain us more. What I found most pleasing was the fact that each girl had the opportunity to do a short solo as part of the act, and every voice was as perfect as the next. It was when I heard the girls sing Something Inside So Strong that I thought of the connection with the Human Rights and Childbirth movement and I started to consider the potential for the choir to team up with One World Birth to do something.....

Eileen and I rushed over after the final song to speak to the MD, and met delightful Jennifer Yard. Jennifer humbly told us the choir was from Wallington High School for Girls in Surrey. Congratulations to you Jennifer!

So as I sit and reflect and remember the week with a smile, all I can say is thank you a million times Eileen and Michael. And who's for an ice-cream?

Desert Island Discs

I heard about this brilliant Radio 4 programme late on in life...just 10 months ago. How did I miss it, given the fact that it's been around since before I was born? Anyway, my sisters Anne and Eileen discovered the delights of the channel and told me to tune in...

I love it. If you've never listened, I will briefly explain.

Individuals  who have made a contribution to UK society, or who are famous, are chosen to be a guest on the programme, and they are asked to choose eight music tracks or 'records' (originally gramophone records) that they would like to take with them to a desert island. Each piece of music or song has to be relevant to a part of their life, so listeners get to know a little bit about the person. The presenters ask quite searching questions at times, and the 'interviews' are frequently revealing. Now I think choosing eight music tracks would be so hard. This year I was invited to be a guest on Radio Lancashire's very own take of DID... Lunchtime Favourites and I had to choose 12 of my favourite songs. I found it extremely difficult to narrow it down to so few!

Here are the chosen ones:

 1 We are family: Sisters Sledge (I am youngest of five girls and this is 'our' tune!)

2 I'll take you home again Kathleen: The Fureys

3 Long and winding road: Beatles

4 Sweet Baby James: James Taylor

5 It's getting better: Mama Cass

6 If we try: Don McLean

7 As: Stevie Wonder

8 Rock with you Michael Jackson

9 The Moon and St Christopher: Mary Black

10 Italia: Chris Botti

 11 Why worry: Dire Straits

12 Back to black: Amy Whinehouse

So, I download the episodes of Desert Island Discs to my iPod, and at night I often plug in and enjoy the music and the stories of the lives of so many interesting individuals. Here are a few of my favourites:

Doreen Lawrence

Lord Victor Adebowale

Heather Rabbatts

Andrea Levy

Alfie Boe

Who are your favourites?

Five countries in a week

After spending two weeks in Holland with Minnie and Quentin, whilst their Dad (our son) entertained guests on a cruise ship in the Mediterranean, we went on a whistle-stop tour of four other countries.

Frank and Lynne joined us on Thursday night, and on Friday we left for Germany. We made a perfect choice when we decided to stay in Boppard, on the banks of the River Rhine. The tourist resort had everything we needed from the quirky and reasonably priced hotel, to the recommended local eating houses. Because of the weather on the first day we took a boat trip up the river, and were introduced to the majestic ancient castles on the hills along the way. A few drinks and some food helped us to relax and ignore the grey skies, and we played our favourite card game.

The weather forecast was right, and the day after we were able to hire bikes and we rode 42km in the bright warm sunshine visiting quaint historic villages along the way. So, it was cakes (massive!) and coffee in St Goar, and iced beer in Oberwesel. It was along the road from the impressive hotel where we slurped the alcohol that we found a touching and thought provoking memorial; a Star of David symbol and the names of the Jewish inhabitants who were tragically deported and murdered.

The cycling was great fun, and we crossed the river on a short ferry which then enabled us to travel back on the opposite side.

From Boppard we travelled to Luxemburg, and again stumbled upon an interesting village Ehnen famous for it’s vineyards and impressive walks. After a ramble through the hillside rows of budding grapes,  we sipped glorious Rose and Riesling wine on white chairs in sparkling sunshine, and laughed a lot. There was a period of concern in the early evening as we watched a low flying helicopter spraying vast quantities of pesticides onto the vines…and then there was a debate as to the effect on the environment and on individuals.

It was great to be able to converse with the locals in French, though we discovered that most spoke Luxembourgish! Never heard of it….

The day after there was mutual agreement that the idea to go to Bruges for our last night was a good one. We set off early and once more found great lodgings near the city. The bed and breakfast accommodation was situated above the owner’s spa and treatment centre, what a haven it was! The rooms were contemporary, stylish, and very comfortable. We will most definitely go back there!

Lastly, we spent a few hours in France; our last relax in the sun. We sailed across the English Chanel in warmth and comfort...and for the first time beheld the white cliffs against clear blue.

 God Bless the Queen!

Advertising formula milk through sponsorship and professional journals: why the debate?

From the time I can remember, my lovely mum taught my sisters and I to try to always tell the truth and to consider speaking up in unjust situations. Mum held on to her beliefs right up until she died, and frequently shared her views on situations that she considered inappropriate.  I think I’ve upheld mum’s principles, and on reflection I believe it’s always helped me to stand firm when pushing boundaries to facilitate women’s choices during their childbirth experience, and has assisted me when I have succeeded in implementing or supporting change.  It is with this in mind that I write this blog, about formula milk companies and their drive to make money through exploiting relationships with healthcare professionals, and parents.

Breast v Bottle

Before go on I want to be clear I am fully committed to the promotion and support of breastfeeding.  I successfully breastfed my four children, and have witnessed the health and social benefits of breastfeeding through my extensive work as a midwife of 35 years. I could go on. But I am a true advocate of choice, and believe that if a mother has considered relevant evidenced based information in relation to feeding her baby and she chooses to use artificial milk, then her decision should be respected and supported.  My words here do not intend to debate breast v bottle feeding, but to present my position and moral stance on whether multi-million pound formula milk companies should advertise their products through health professionals.

Once more the British Journal of Midwifery (BJM) has responded to criticism about their continuing allegiance to formula milk companies (Lewis 2012), and attempted to justify their actions. The article fails to convince me that the intent to continue to engage with formula milk companies is anything other than financial.  In 2004 I wrote to the BJM [link on the page] (Byrom 2004) following the editor’s reply to a reader’s letter about her dismay that the journal advertised formula milk. Although my letter was printed, it brought about no change.

Quite recently it was brought to my attention that the BJM was also advertising study days sponsored by Cow and Gate, and research grants.  In response to this activity various blogs and social media campaigns are raising awareness of the ethical implications, and the push for change is speedily gaining momentum.

Targeted marketing= increased sales

I am totally flabbergasted and bemused as to why organisations whose aim is to educate health professions continue to accept unethical sponsorship and advertise products that potentially undermine health benefits (Renfrew et al 2005).

But the debate surrounding the marketing of formula milk in professional journals and sponsorship is long-standing and controversial (Sachs 2005).  Yet for me it is simple, and doesn’t need academic reasoning or debate as to whether or not the practice breaks any legal code.  Formula milk companies would NOT sponsor studies or financially support professional journals if it wasn’t lucrative for them. They KNOW that the influence on professionals is subtle, but it increases sales.

A well used ‘excuse’ from professional journals who accept financial support through advertising formula milk on their pages is that the adverts serve to provide information on milk products to its readers so that they can in turn provide advice to parents. But this is neither necessary nor advisable on many counts.  How can we provide advice from information from an advert? There are resources available that provide the detail needed to help mothers choose which artificial milk to use, so adverts which introduce bias and confusion are not needed.

So come on BJM, the opinion of your midwifery readership doesn't change. It would be so good if you would follow the example of your sister journal the African Journal of Midwifery, and decline to engage with formula milk company financial aid. A moral conscience is so important.

And midwives, if you are happy to accept sponsorship from formula milk companies, consider the impact. The only benefit is the increased wealth of the milk manufacturer, and the detriment is to mothers and babies.

Be the change you want to see in the world....

References

Byrom S (2004) Correspondence British Journal of Midwifery Vol 10 12 P608

Lewis P (2012) Breast is best but choice is paramount British Journal of Midwifery Vol 20:6 386-387

Renfrew, M. et al (2005) The effectiveness of public health interventions to promote the duration of breastfeeding: systematic review, National Institute for Health and Clinical Excellence, London www.publichealth.nice.org.uk

Sachs M (2005) Debate: Milk advertising should not be allowed in journals. British Journal of Midwifery Vol 13:11 714-715.

Photo: Danielleford.com

The bicycle and the Netherlands:perspective and fact

At the risk of being boring, I am once again going to applaud the Dutch and their transport system, especially the way they get around on their bicycles. I have raved about this phenomena before, and I may do it again!

This trip to Holland has given us a new insight into riding on bikes. Paul has got used to taking the children in Daphne's Bakfiets and that's no mean feat!

And I have had a great bike to ride on...

Now as a fairly competent cyclist in the UK, going uphill and down dale...I am finding that here cycling here is completely different. It's a common sight to see folks transporting their whole family (literally) on one bike! There are NO helmets, but health and safety is very much apparent as cyclists have priority in most instances and the cycle paths are everywhere. The children are taught road safety from an early age and are therefore aware of potential dangers.

But for me, my senses are well and truly heightened! I really have to keep my wits about me as I negotiate riding on the right-hand side, watching for trams, cars, bikes and pedestrians and traffic lights! Aaargh! But it's SO worth it. I absolutely love it.

From birth to football....Holland is turning orange!

As my county celebrated the Diamond Jubilee and we watched the spectacular events on the BBC from Scheveningen in the Netherlands, we felt an enormous sense of pride at belonging to a British culture that supports the Royal Family and makes an enormous effort to let them know. Before we left for Holland I was struck by the amount of bunting, flags and Jubilee paraphernalia on sale in the shops and already displayed in streets and houses around the country. But of course it is a unique event and something to party for!

And here in the Netherlands there is an equal display of patriotic fever,

but it's all related to football! Orange bunting brightens up already beautiful streets, flags, tea shirts, dolls.....hats, everything that can be turned orange...is orange. Yesterday we saw four orange footballs dangling from a balcony of a house, in orange string bags!  Incredible. I am informed that what I see is mild compared to how it will be when the European Championship begins....

I really hope the efforts of the Dutch in supporting their country in this tournament passes over to their football team, and gives them the enthusiasm they need to do well.

Good on ya Dutch folks...your sense of community and loyalty is enviable.

London photo courtesy of zimbio.com

Home Birth in the Netherlands......back to the future?

Attending the second day of the Human Rights in Childbirth Conference  in the Hague on the 2nd June was a revelation, and a remarkable opportunity. I was unable to be part of the first day, as I was travelling by car to the Netherlands for a two week stay to see our brilliant Dutch grandchildren. When I wrote about the conference previously, I didn't think I would be able to attend at all.

It was Hermine Hayes-Klein, an American Lawyer, who developed the idea for a conference with others after researching the politics of birth in the Netherlands and USA following the birth of her two children. Women's right and authority to choose the place of birth for their baby, and to be supported in her choice was the key driver for Hermine.

The first day of the event aimed to bring attention to and focus on the issues surrounding the Ternovszky v. Hungary case. Although I thought I knew a fair deal about the horrific plight of Agnes Gereb, I learnt so much more as I absorbed the text within the conference's detailed publication.

The implications of the Ternovsky case are apparent in other countries other than Hungary, and the holding of the case offers a potential solution globally. Experts from around the world were carefully chosen and they gathered willingly to debate human rights and childbirth and explore a way forward.

Day two was of particular interest to me because of my family link with Holland, and as an advocate of home birth, midwifery and maternity care in the Netherlands has always caught my attention.

It was utterly incredible to be in Den Haag and to listen to the debate surrounding birth in this small country. I found Dr Raymond De Vries's keynote address inspirational, and I couldn't get enough of it. From Dr De Vries and then the panel of experts I heard an array of perspectives about the controversy surrounding the perinatal mortality rate in Holland, how it is higher than other European countries and proposed as one of the factors that is influencing women's decisions on where to give birth. I heard how these statistics are being challenged, and how health professionals are exploring every opportunity to understand the situation.

Another issue raised was the Dutch maternity guideline, Verloskundige IndicatieLijst (VIL) and the restrictions it increasingly imposes on women's choice to birth their baby at home. The introduction of market forces within Dutch health services and changes to how maternity services are funded is also believed to be a factor in the decline in home birth. And some suggest that some women in Holland have different priorities and are preferring to give birth in hospital...although others contest this claim.

I was particularly moved by Rebekka Visser  and  Marjolein Faber's address to the conference, they received standing ovations from the delegates and they gave the impression that they are forces to be reckoned with.

So what did I learn?

1. A country that has been the shining light for birth practice globally for decades is potentially under threat, and that is a travesty. I desperately hope the Netherlands doesn't follow other countries in their quest to improve.

2. I realised that during my career as a midwife in East Lancashire in the UK I experienced something special. Because...

During her address Rebekka Visser said:

To me it's of great importance to really listen to the woman - and to the way she assesses risk for herself. To guarantee absolute trust that she is the one in charge. To provide her with all the information she asks for. To be open about this towards other people.. My dream is to be able to do my work as a midwife in close cooperation with gynecologist and hospital, thus creating a network where women can be respected and supported in their choices.

I was able to provide such care. Obstetricians working closely with midwives to facilitate woman centred care collaboratively meant (and still means) that women do have a choice in home birth, birth centre birth and hospital birth...and their choice is respected and supported even if their individual needs and requests do not 'fit' a guideline.

3. That women in Holland using maternity services now and in the future need to ensure their voice is heard and maintain momentum from the conference. It is crucial.

I feel privileged to have been part of what I consider to be the cusp of a birth revolution. If you would like to learn more  you can visit the conference website and consider subscribing to the webinar.

You may also wish to read comments on Twitter from the two days, and pursue the various links from the posts.

Many thanks to Simone Valk and all the conference organisers for welcoming me on the 2nd.

Other blogs about the Conference:

Rebecca Schiller-The Hackney Doula

Dr Amali Lokugamage 

Ellis Island, Page Three and a Blog Nomination!

 The excitement this week has surpassed that of the week of the 10^th of May for many reasons. The Diamond Jubilee Garden Party was beyond belief, and on top of that I got to meet up with the lovely Mars Lord, and to attend a midwives debate at a WI meeting in North London.

We also spent time with my nephew and his wife Chris and Julie, and their handsomely happy boys in their magnificent home in Highgate. Then I saw Frances and Gillian when I chaired the Campaign for Normal Birth meeting at the Royal College of Midwives headquarters.

The week started with a bang, when the amazing Emma Lee Potter nominated my blog as one that she follows. Now that is really something. If you know anything about blogging, writing or journalism you’ll know that my blog is quite elementary…I still feel very much the novice. You will also recognise Emma's blog as an award winning personal journal. So this revelation made my day, and week! I am still smiling.

Emma’s blog, A House with No Name has been my greatest inspiration as her posts are incredibly varied, entertaining and highly interesting. I have learnt so much about life itself from her, and from those she’s connected with. I have bought and enjoyed books she has recommended, and the positive influence goes on….

As well as all that, I was once Emma’s community midwife, and she influenced me then too through her love of Bridgewater Pottery!

So thank you Emma for all the above, and for nominating me! I am totally indebted, and thrilled to bits.

Now I must follow Emma’s instructions:

“Thank the person who gave you this award, and include a link to their blog,” she told me. “Next, select 15 blogs/bloggers you've recently discovered or follow regularly - I'd pick blogs or bloggers that are excellent! If it's a bit of a task to list 15, and I don't want you to feel being nominated is a burden, but mention as many as you can – eight or ten is fine. List them, and you might like to include a link to the sites, and let them know that you've nominated them. And then tell the person who nominated you seven things about yourself.”

So, in no particular order, I’d like to nominate:

Kate Takes 5, Darren Cockle, Northern Mum, Sarah’s Musings, Loosing Sanity, Doula-lly, Mummy, wife and student midwife

And here are seven random facts about me:

I travelled to Italy by car with my neigbours when I was 8 years old. This was remarkable as: a) it was for four weeks and I had no family with me, and b) I had never been out of the country before. We spent the holiday in Santa Anatolia, a small village near Rome, and I was stunned by the sight of a chicken neck breaking ritual immediately prior to the bird being served up in a dish for dinner.

In my teenage years I was a Page Three Girl.  If you know me, I hear your gasp and your eyes will now be out on stalks. But don’t worry….the story goes that I was a student nurse on Ward 2 at Blackburn Royal Infirmary and a blackbird built a nest on one of the window ledges and laid eggs. The press found out and wanted to run with the story and I posed looking out of the window at the expectant ‘mother’. The article was published on page three of the Daily Mail.

I was nominated to meet the Prime Minister Tony Blair, twice in 2004. Both times I went to Number 10, and I spoke with him and his wife, Cherie. It was a great opportunity as I was interested in his position in relation to reducing health inequalities.

I once tried to eat a sacred stone that was being used as a tribal blessing on water, in Mexico. It would take me too long to explain, but I thought the stone was a sarsaparilla sweet! The toothless white haired elder leading the ceremony was about to spear me just before I spat it out. Not good.

I used to knit most of my children’s clothes, and even had my own label.

I delivered my sister’s baby. This was an incredible moment, and one that could never be repeated as although I was the immediate carer, I was a student midwife so the qualified midwife held the main responsibility. Francesca (my niece) has recently had her first baby!

We believe that the name Martin Murray engraved on one of the remembrance pillars on Ellis Island in the USA is that of my paternal grandfather, who travelled to America to make his fortune. He never returned to his family, in County Sligo Ireland.

I and so I wonder what will next week bring? Lots of love I think as I spend it with my wonderful Dutch Grandchildren in Holland.

A Diamond Jubilee Garden Party and Alice Wynne

My husband and I were lucky enough be invited once more to Buckingham Palace. We still can't believe it; visiting this magnificent Royal residence twice in one year, and the Diamond Jubilee year at that! Yesterday was the Queen’s Garden Party, and on a hot afternoon we approached Buckingham Palace Rd amidst swarms of other party revelers anticipating a memorable occasion. The attire of both female and male guests was outstanding, from vibrant colourful dresses to Jane Austen lookalikes , and the men wearing tails and top hats were by far the greatest head turners!

Eight thousand guests mingled around until 4pm when the National Anthem alerted us all that the Queen was present in the garden, and would be walking amongst us soon.  The numerous Lord Lieutenants encouraged some of the masses to form a passage for the Royal family members to walk through, and to allow them enough space to talk to the chosen few.

We were in a prime position at the edge of the line, and had a close up view of the Queen in a beautiful lilac outfit chatting cheerily to a lucky family. My mind was racing as I watched her, I thought of her mother, my mum and all the years that had passed under her Reign. I was delighted; she was just as I imagined, petite and fragile looking (though in relation to the latter of course she is not).

Queen Elizabeth looked glorious.

The refreshments were perfect, cucumber and mint sandwiches in true English

style, iced coffee and cream scones helped us to feel that we were indeed at a Royal event.

I did feel rather excited to learn that Kate was with us, and that it was her very first Garden Party. Through the throngs we eventually found her beaming a smile that lit up the faces of those she talked to. In fact the smile never stopped. Kate looked radiant and happy.

And then I met Alice. Alice was in a wheelchair and was next to me in the line up to see Prince Charles, and I picked up on her carer's Yorkshire accent immediately. I bent down to talk to Alice whilst we waited, and soon learned she was profoundly deaf and her mind was beginning to fade. Not surprising, as Alice will be 108 years this July. Georgina, her carer, informed me they had been writing for years to ask come to a Garden Party, as Alice wanted to see 'Princess Elizabeth' before she died. And so as Charles advanced quickly towards us I mentioned to one of the officials some of the details I had just learned. Luckily, he responded and planned to direct Charles to Alice as he passed....which he did. Prince Charles bent to speak to her...well, to shout! Alice asked him if he 'was OK' and she seemed to take it all in her stride. When Charles moved on, Georgina and I asked her if she knew who the man was. 'No?' she replied....'Oh, was it the King?'

Meeting Alice made my day. I am just sorry I didn't snap a photograph of her for my memory, and sorry her family didn't share this special moment with her.

Photos (some) courtesy of The Mail Online

Promoting normal birth on the Throne of Words

When I was invited to Southlands High School in Chorley to talk about my book Catching Babies, I wasn't sure what to expect. The email inviting me specified that the health and social care students in year 10 would ask me questions in relation to my career as a midwife. This was quite a different process to what I am used to; I usually give a short talk about my career and my book, and the questions follow. But this group of 40 14 years olds hadn't read my book, but were as their teacher later told me 'interested in healthcare professions'.

So I arrived at the school at 8.30 ready for the 9 o'clock bell and first session of the morning. I was warmly welcomed by one of the subject teachers, Jill. Jill explained that the students had prepared questions for me, and she thought the questions were bob on.

As I watched the girls (no boys in this group!) slope in, in couldn't help propelling their teachers into the realms of the most esteemed group of professional workers; coping with this adolescent group on a daily basis. Respect.

But I was impressed with their questions. 'What do you think about home birth?' was the first enquiry. 'What was your  scariest moment?' 'When I watch "One Born Every Minute" women say they can't go on, what do you do in those situations?'

So. I was able to talk to these impressionable young women about birth. Birth as a right of passage, birth as a normal physiological process- a social occurrence not a medical procedure. I realised that this was a wonderful opportunity, and I was in a very privileged position.

I wonder what they thought?