Time

Today is Hubby’s and my 31st Anniversary, even I think that’s a long time. Hubby, I’m sure that he heard it somewhere, says that you don’t get that long for murder. Anyway, I came down this morning and on the table is a single red rose, a tradition, and a small gold box. Even without opening the box I know what it contains, a gold charm, another tradition. For my 21st birthday I was given a silver charm bracelet and on each anniversary Hubby gave me a silver charm. The charms were always something relevant, a cat, a longboat, a baby etc. and by the time we had notched up 25 years the bracelet was full so for our 25th he gave me a gold bracelet, and we started all over again. I wonder what it will be this year?

Daughters moving house saga goes on. They didn’t exchange on Friday, one of the solicitors went into hiding yesterday but they have been told they might exchange today. Meanwhile, daughter is expanding at an alarming rate, her ability to carry out day to day tasks is becoming increasingly limited, and she is having her C section in 3 weeks. This isn’t taking into account the concern about too much change happening all at once for a little girl called Amy, moving house is quite enough upheaval and almost guaranteed to cause her behaviour to become demanding without the birth of two babies to rock her little world even more. Some good news though, I ‘won’ a pushchair on Ebay, a new Jane twin two. I have never worked so hard to buy something off there before, every time I was just pipped at the post, but last night I was successful, hurrah, and for a hundred pounds less than its RRP. Now we’ve just got to get the two car seats to go with it.

Yesterday I went to visit one of my women who had suffered an IUD (intra-uterine death). Difficult, difficult visit but made easy by an amazingly stoic couple. I had never met J before as her antenatal appointments had always been covered by my job-share, perhaps that made it better, there was no pregnancy history and no chance that she may feel I could , somehow, have been to blame. The baby is having a post mortem toady, but they have been told that they will not receive the results for 6 weeks, a long time to wait.

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Too complacent?

After yesterdays entry I busied myself, mowing the grass, going to the garden centre, all the time waiting for the phone call to say that daughter had exchanged on her house and also pondering my caseload. I don’t know why I was mentally reviewing my pregnant ladies, something must have triggered my musing. Perhaps it was the fact that daughter is 33 weeks on Wednesday, has a scan and has asked me to go with her as it was at this gestation that the harbinger of doom she had met told her that, on scan, one of her twins had died. My thought processes were along the lines of how fortunate I was that a huge percentage, probably about 98%, of my caseload have quite uneventful pregnancies and that it is extremely rare that I have a family who experience a stillbirth, the explained loss of a baby, or a baby with a congenital problem. I eventually rounded up my mental meanderings by deciding that it is down to the area I practice in, on the whole quite affluent but not so ‘well-heeled’ that couples delay having a family until they are in their 40’s. Most women have the nuchal scan and there are rarely ‘non-attenders’ at antenatal clinic.

I returned from the garden centre and shouted through the window to Hubby, ‘ Any news?’ He came outside. Jack and Izzy’s Mummy had phoned to say that there was another hiccup in her sister’s moving saga and would I go round to see pregnant daughter and have a listen to the twins as someone had ‘rear ended’ her car and she had bumped her lump on the steering wheel ( not difficult really as it rests there anyway as she is now so huge.) By this time I was in the middle of making myself a coffee, down went the kettle, up came the phone and I was phoning daughter to tell her to get herself to the hospital NOW. Fortunately she was only 5 minutes from the hospital, unfortunately she had Amy with her. Daughter demurred, ‘I’m fine’ but I was not taking any chances. There is a nasty little complication that can occur in any pregnancy, but there are two known risk factors, one is a multiple pregnancy and the other, abdominal trauma, it’s called placental abruption. At this point I was 15 miles away from the hospital, her partner was uncontactable, golfing, and Amy was being a normal 2 year old, there was no way the hospital would be able to monitor the twins with Miss Into Everything in the room, so off I shot, still in gardening clothes. Cutting a long story short, daughter and babies were monitored and all is fine.

I returned home and job-share phoned to update me on three of our ladies who I will be seeing on Monday. At 34 weeks one lady had not felt any movements all morning, so had gone to the G.P, who could not hear the baby’s heartbeat and asked her to go to the hospital where a scan revealed that baby had died. The labour was induced, they could see no reason for baby’s death but there was a minor limb deformity so they are questioning if there is a syndrome involved, obviously the family are devastated. Then more sad news, another one of our pregnant women had been for her 20 week scan and was told that baby had a heart defect incompatible with life, they using this weekend to say goodbye to baby before going to the hospital on Sunday to have the labour induced. The final information was that, due to complications during the birth, another of our women had undergone an hysterectomy, baby is well but she is now having to come to terms with the fact that this little one will be one and only baby. I now feel almost guilty. You know, one of those ‘counting your chickens’ moments. There I was pottering around in the garden, confident that my caseload experienced very few dire problems, whilst a couple of miles away 3 of them were having to cope with tremendous grief.

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Bits and Bobs

Seem to be really busy, but not doing an awful lot! This week was my last week of being Amy’s ‘childcare’, I felt really sad about it. Silly really as I’m sure I shall be seeing almost as much of her as before, just not from 7.30 in the morning! On the last evening Daughter bought me a pressie and gave me a card. We were all sitting at the kitchen table while Amy had her dinner, I opened the card and started snivelling, daughter joined in (hormones) and Amy obviously didn’t want to be left out so produced a few tears as well.

On the twin front, its all getting very exciting. 4 weeks yesterday daughter has her C-Section. The other day she e-mailed me through a list of her friends who want pictures of the babies when they are born, apparently that’s my task when I get back from the hospital. I said once before that having daughters who are pregnant has given me a whole new perspective as a midwife. I had never had a caesarian, had a late miscarriage, experienced an ECV for breech, given birth at home or had twins, now I am having all these vicarious experiences more intensely than I do with my women and I hope that it improves my approach to the women in my care.

On the twin-carrying daughters house move front there have been ups and down. It has been an almost farcical episode, exchanging, not exchanging. Chain fallen apart, chain intact and proceeding. The status quo at this moment is that all parties should exchange today, with a moving date of next Friday. Please, please could every one keep their fingers crossed. Even daughters prolonged, stressful move saga has taught me something, stress can cause an increase in the amniotic fluid.

Other daughter, Jack and Izzys Mummy, has been having a stressful time herself. Her partner, having been knocked off his motorbike during a race has been off work with both arms in plaster for a couple of months now, and two weeks ago his firm told him that they had made him redundant. This is the last news they needed. After his bowel resection last year which all went wrong (hospital infection) they were in a poor financial state but were just managing to sort their finances out, now this has hit them so all is pretty bleak for them at the moment.

Had an interesting approach from a journalist a couple of days ago asking me to contact her, the temptation is huge but I shall have to decline as my job is a necessary evil and I can’t afford to put myself in the ‘firing’ line.

Dispatches on Monday? I thought that it painted a very true picture. I only shouted when they had an entirely untrue statement from a Trust I have worked for. Will anything happen as a result of this highlighting of the staff shortages? NO. 

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Here we go……again

And in the blue corner we have Dispatches, Channel 4, 8pm, Monday night, they are showing ‘Undercover Mother’, and then in the blue corner we have Maternity Services, aka ‘The Midwives’. I am so looking forward to this hour long programme which is promising to highlight the shortfalls in the maternity services. I reality I am sure that I will be sitting there cringing at some of the behaviour, berating the commentator when s/he says something that is obstetrically incorrect, and fuming if they interview anyone in authority who dodges the issue or passes the buck.

Us Midwives are to be balloted on strike action. Wow, that’s something to muse upon, will I, could I, should I? No. There, that was easy, what next? Will I work to rule? No. Should I? Yes. Why won’t I then? Hmm, it’s not that sort of job. I can just picture it, ‘Come on Sue, just a bit longer. I can just see baby’s head. Golly he’s got lots of hair. Oh right, I’m off now ‘cos my shift just ended. Yes, I know it’s a bad time but it’s always a bad time and you have go to go it alone so I can prove how worthy I am of a pay rise in line with the rest of the UK and how fed-up I am of the powers that be taking advantage of ‘goodwill’.’ I would love to be able to go on strike, or work to rule, but it’s impossible. I suppose midwives who pick up extra bank-shifts could not do them, or we could refuse to go to meetings outside of working time, the first would make the short staffing problem even worse and the second would only mean that the meetings missed would have to be re-scheduled and squeezed into an already log-jammed system. Lets just do what we always do, have a moan, but let the government get away with doing what they do best, rip us off. ( For anyone who doesn’t know why English midwives and nurses are cross, here’s the answer.) Anyway, I shall vote YES, just to shock them.

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Maternity leave

I really think that maternity benefits, specifically leave, should be standardised for all employed women. There are huge differences in the workplace as to the leave allowances provided by employers. I know that maternity leave has now been extended to 9 months but here we are just talking about statutory leave and pay not how employers, as individuals, offer different benefits to their employees.

At clinic on Thursday I saw a woman who I booked 6 weeks ago, she is a bus driver. When I booked her the company had taken her off driving duties and given her ‘desk duties’, sensible, caring company I decided. On Thursday I asked her what was happening to her now at work, I’m on Maternity Leave she replied. I immediately thought that, far from being a caring company, they were taking advantage of her pregnancy and seeking to save themselves money by forcing her to take leave too early. When I became all righteous about it she told me that what they have done is sign her off, on full pay, until she gives birth at which point her paid maternity leave starts, for a year. Wonderful for her, I would have thought an economic problem for the company, and a real kick in the guts for all those women who have equally demanding, often more physical jobs than her but who have to struggle on for as long as possible in their pregnancies so they can spend more time at home afterwards with their new baby. Here I’m thinking of examples like midwives who carry on working right until the end, I have literally been working with midwives whose waters have gone whilst they have been working and who have given birth before their shift ends. I’m not overly keen on ‘guidelines’ and dictates from quangos but I am thinking that perhaps there should be more equality as far as benefits to pregnant workers, every other ‘perk’ seems to be categorized and valued, why not deviations from a standardised practice?

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Packed weekend

Whilst we were in Jersey Son phoned and asked us if we wanted to go to the Air Tattoo at RAF Fairford. I love air shows, there is something about the power of the planes that grips me and has me grinning like a mad-woman. I asked him how much the tickets were, £32.50, each. He and partner could get their tickets for £16, something to do with the company he works for, but he was limited to 2 tickets at that price. With our finances slightly tight at moment I felt that we could do without that expenditure so told him that unfortunately we couldn’t go. He expressed his disappointment, especially as they were taking Jack and Amy with them who would then be spending the night with them. I chuckled. Jack and Amy are both lovely children, lively and generally well-behaved but when they are together they are a handful and they do wind each other up so the thought of Son and DIL having them on a longish car journey, all day at a crowded, noisy air show, and then all night conjured up a picture of chaos and frayed tempers. Anyway, by Thursday Son had managed, some how, to get 2 more ‘cheap’ tickets so Hubby and I were Fairford bound by 8am Saturday morning, complete with Amy. Journey, until we were 7 miles away, was great then we got into the queue to park. I’m not joking, I’m being horribly serious, 2 and half hours is how long we had to queue to park. Obviously we were not alone, there were thousands of us making friends, taking short breaks on grass verges, and watching far off airplanes cavorting about in the sky, even Jenson Button was sitting in his car, not the F1, trying to keep his cool in the most poorly organised approach to a major event that I have ever had the misfortune to be stuck in. If we could have turned around we would have, but we were effectively prisoners in a traffic jam. Thank heavens Amy was in an angelic frame of mind otherwise I might have completely lost the plot. As it was Son was getting out of his car with Jack and I was getting out of ours with Amy and we were having impromptu races up and down the road. If you have ever seen the REM video ‘Everybody Hurts’ you have a fairly good idea of what we could see when we looked inside the other cars. Once in the airshow it was noisy, very noisy but so exciting. Helicopters looping the loop and plummeting earthwards, then pulling up just as you thought you were about to witness an accident. The American Thunderbirds in their F16s soaring skywards at huge speeds to amazing heights, then swooping down and screeching past the crowd, afterburners blazing. Stealth was an eerie counterpart to these raging acrobats, when its black shape passed low, giving no warning of it’s approach, it seemed alien and though it did nothing extraordinary it appeared, to me, all the more powerful for that. Then came my favourites, the Red Arrows. As their distinctive red shapes appeared in formation Son and I turned to each other and exchanged huge grins, Hubby swung Jack up to sit on his shoulders and Son put Amy on his, my little tribe joined together in appreciation of a wonderful aerobatic show, Jack and Amy have now been introduced to another family tradition. Jack loved everything but I think the thing he will remember longest was just as we were leaving. We were walking past as the Italian Airforce were preparing to taxi out to start their display so we stopped to watch them leave. They pulled out one by one and were following each other down the apron  and as they drew level with us Jack waved at each of the pilots and all, except 2, waved back. I had a real lump in my throat as he was so pleased that these pilots, in their wow factor planes, had returned his greeting. They made a little boy really, really happy. Amy enjoyed herself but would take to her pushchair, obviously some kind of security thing, if a plane was too loud and she became our aerial spotter, always the first to see a plane approaching she would shout ‘Here he comes’ and clap her little hands, before putting them over her ears!

Sunday saw Hubby and I down at the South Coast to bury his Mum’s ashes with his Dad’s. It was a very short, little ceremony laying her to rest with her first love, they had married when she was 17, and it had been her wish that when she died she be reunited with her Paddy, now that wish has been fulfilled.

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Can’t relax, on call. Should be ironing but that would be too dangerous. Just suppose that I was in the middle of battling my way through the mountain of ironing that has been multiplying in the wash basket and the phone went summoning me to a homebirth? I might rush off, all in a tizz, leave the iron on, one of the cats might come in brush against the ironing board, off would fall the iron, and 1) Seriously injure the cat 2) Set fire to the house. Ironing, not worth the risk.

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Two sides to this midwife

Anyone who has read me in my other blog will know that I have problems detaching my non-work life from my role as a midwife. Well, it’s not so much that I have problems, more that my Head of Midwifery believes that I should be able to switch off my midwife persona at will and, as I find that I am unable to this, it causes her problems. The issue climaxes when one of my daughters is pregnant and I am ‘allowed’ to be her birth partner but not act as a midwife. The truly absurd aspect to this is that my daughters are exercising choice, the buzz word in maternity care, and I am facilitating, another popular word, their choice. Don’t get me wrong, I have no objections to providing their antenatal care, where appropriate, but I have declined acting as ‘first’ midwife at the birth. Of course it is an amazing privilege to accompany my daughters through the whole pregnancy, birth process but if they had not expressed a desire for me to be involved I wouldn’t have been. The problem is, it’s not just family who call on my services outside of work, it’s colleagues, my friends, daughter’s friends and now friend’s daughters, how do I refuse? It would seem churlish, or it does to me anyway. If I were a computer buff, I wish, and a friend asked me to help them out with a computer upgrade or to show them how to work a programme I would do it, really it’s no different. As long as it’s within my sphere of practice and in my intention to practice area then it should be alright, but I do seem to get into a little bit of trouble every so often and I’ve a nasty feeling that it may happen again. Friends daughter, S, is pregnant, 31 weeks, and has been seeing one of my colleagues, well, has seen her twice, the other times she has seen the G.P, she has not exactly hit it off with her midwife. S is filled to the brim with expectations of the care she will receive. She has trawled the internet, read all the pregnancy books, is attending NCT, is high on alternative therapies and boy, is she disappointed with her care to date. Tonight she phoned me and asked if I could become involved in her care, ‘why?’, I asked, basically she has no faith in the midwife and feels she is not doing her job properly. I have agreed to see her on Monday, do an antenatal check-up and chat through any queries she has, but I have not said anymore than that. I really don’t want any more trouble.

Still on work and personal life overlap, I took Amy to toddlers gym this morning and 5 women from my previous caseload were there. I acknowledged them, ruffled their tot’s hair and went off to bounce on the trampoline, with Amy of course! Next thing, all of them are are with me, chatting away, catching up with how my ‘new’ post is and inviting Amy and me out to lunch with them. You see, how can I separate my private and work life when it seems to integrate with little impetus from me?

It was back to work yesterday. Quite a low-key return really. Enough work, postnatal visits and a booking, to give me the time to ‘create’ a brochure one of my G.P practices had requested  to give out to pregnant women outlining the care they can expect from ‘us’.  I also took the liberty of downloading the NICE antenatal care guidelines, which they seem to have no knowledge of, and distributing a copy to each of them. Strange they don’t seem to know of the existence of the guideline when I had a copy sent to me at the surgery and via E-Mail when they were released.

One of the postnatal visits illustrates the problem of short hospital stays after giving birth, especially if it is a first baby. This Mother wanted to breastfeed but her and baby were having problems, whilst still in hospital, working out how things should go. The hospital advised her to stay until baby was feeding but she insisted on coming home. As a result I visited a Mum and baby where nothing was happening on the breastfeeding/feeding front. Baby hadn’t fed since birth, some 40 hours, and Mum and Dad were both of the belief that this little, slightly jaundiced, jittery baby was just a ‘good baby’. Two hours later and I had run out of ideas, skin to skin, stimulation (foot tickling), expressing, nothing was working, I gave up and sent them back in to whence they had departed with such haste. Antenatally I do try to impress upon couples how advantageous it is to stay in until feeding is sorted out but to them an extra 24 hours seems too much to ask. Having to go back in though means that baby is going to have pins stuck in it’s foot, blood taken and be given bottles until the doctors are happy baby is well. What price an early discharge?

Pregnant daughter is back at the hospital tomorrow, another scan to see if the liquor is still increasing. Fingers crossed that all has calmed down.

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Where seagulls never sleep

We are home, no not the royal ‘we’ but Hubby and I and I are home from the States, the State of Jersey, Channel Island. The weather was not much better there than it was at home, but we made the most of it, from experiencing the War Tunnels, very salutary and extremely well presented to peering hopefully into enclosures at Durrell, Jersey Zoo as was, and convincing ourselves that we had just seen a maned wolf. The break was good though, the travel was excellent, the hotel was okay, good restaurants, beautiful beaches but, the seagulls never sleep or they take it in turns so there is always one to screech loudly outside the hotel.

We very nearly didn’t go as pregnant daughter was ‘tightening’ ferociously all day Sunday and I had worked myself into a state of high anxiety. Van and Lorry were scanned again on Wednesday, they are now both on the 90th centile, in other words big babies, and wallowing about in too much liquor, as with Amy daughter has developed polyhydramnios. Today she had a GTT, glucose tolerance test, and she should hear the results on Monday/Tuesday, the concern is that she may have developed gestational diabetes but as this is mirroring her pregnancy with Amy I think she just has big babies! Her CS is booked for 23rd August, another 7 weeks away, I wouldn’t put money on the pregnancy lasting that long but she hung on in there with Amy, so who knows. During the week daughter had met a Mum at a playgroup and they had got chatting. It turned out that this woman had been expecting identical twins, was scanned at 29 weeks, all well, but at her next scan at 32 weeks one of the babies had died, daughter is now well and truly freaked.

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Freebirthing

Gosh. I’m really pleased that the RCOG have released such an informative statement about freebirthing. This should really make the issue much clearer. I wonder how long, and how many eminent brains it took to come up with such a decisive piece of prose.

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