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Archive for March, 2008

homebirth.jpg 

God bless him, my favourite G.P is once again goading midwives, this time those who attend homebirths, in his offering ‘Midwives and home births: the truth’. I can’t seem to discover any ‘truth’ a la Dr Crippen in this, which I find surprising as he says that this Guardian article, concerning the journalist’s recent experience of his wife’s home birth and including an interview with one of the midwives, ‘sums it all up’, and he then concludes by advising ‘make sure that there is a doctor close by when you have your baby’. I’m not sure why, or how the article supports this advice but if I take the title of Dr C’s entry at face value, then I can only conclude that the good doctor has finally decided that there is a place within the maternity services for homebirth!

It will be sad to stop the debate but soon there should be a definitive answer to the question of where is the safest, best place to give birth, so then Drs C and T will either have the last say or, have to eat their words. A study, Birthplace, by The National Perinatal Epidemiology Unit is underway. The study will answer questions about wellbeing, safety and quality, women’s experience of care, the process of transfer from planned place of birth, and the cost-effectiveness of different systems for care. The study will reach it’s conclusions in 2009 so, within 18 months we should have an answer to the perennial question of how safe is home birth?

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Feet finding

Reflexology – disturbing experience. Someone sits there, massages some lovely, lavender lotion on your feet and proceeds to tell you your medical history, unprompted and freakishly accurate. Right down to the fact that you grind your teeth when you sleep. Mildly uncomfortable experience until they hit upon an area which feels very bruised and has the sensation that on object the size of a cherry stone is under the skin. ‘Hmm’ she goes, ‘that’s your uterus, and there’s something in it. Doesn’t feel like a baby.’ (Well it would be amazing if I had got a baby growing in there because I had my tubes clamped 20 plus years ago). She continued thumb prodding this point for ages, apparently she was hoping to break it up, lets just hope it isn’t a baby. After she had finished with my tootsies we had a chat about the problem. I related my comment to my G.P about having a 16 week uterus and so she palpated my abdomen and came to the same conclusion as me, except she thought more like 18 weeks (she is a midwife as well as a reflexologist). What now? Well, I’m seeing the consultant on Thursday, and if he is unsure of what my lump is shall ask for a scan, I would really like an answer, and if possible a solution. I don’t think I will mention reflexology, he doesn’t strike me as the type of medic who is open to ‘alternative’ therapies but, there again, I wouldn’t say that I usually hold them up as reliable remedies or diagnostic tools. I mean, really, believing that your feet hold the key to your well-being! Gullible, me? Yes, when clutching at straws.

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Fuji camera

My little Fuji camera was blank, it would download, upload, flash and re-charge, but it’s photos were black with streaks of psychedelia. I was sad, but having used it copiously for 5 years I shrugged and bought a new camera, which I dislike intensely. Being a bored, recuperating, grumpy old woman I e-mailed Fuji. 10 days ago a pre-paid envelope arrived with instructions on how to send it to it’s maker. Today my camera came home, with a little note from Fuji saying sorry that my camera had broken, explaining what had gone wrong with it and telling me that it was now as good as new. Thank you Fuji – 素晴らしいてくれてありがとう。ユーアーザベストです。

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Trial, by a sceptic

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Since my op, nearly 7 weeks weeks now, I have had an interesting hard lump about the size of a grapefruit above the scar. It is uncomfortable, basically feels as if someone has kicked me in the stomach, and by the end of the day it is dragging. When I saw the G.P last week to assess whether I’m fit for work, I’m not, I told him about my ‘phantom pregnancy’, which palpates as about 16 weeks gestation. He had a prod around, queried a haematoma and said he was pleased that I was seeing the consultant in 2 weeks and would I see him afterwards to let him know what the plan is. Plan is? I told him that I was NEVER letting anyone near me with a scalpel ever again so I expect that will be no plan to discuss! Over the last week I have become really p****d off with my lump as I have reached a plateau where I don’t seem to be achieving any further improvement so I have taken an extremely, for me, unusual action, I have booked to see a reflexologist. You see, I must be desperate. The most sceptical of people re alternative therapies is going to pay someone to twiddle their toes and put pressure on their soles. This flight in the face of belief is to take place on Saturday and hopefully by Sunday I will be able to potter and titivate in my garden. It’s all my own fault anyway, daughters told me to take Arnica after my op.

Lovely picture taken from http://blog.baliwww.com/guides/609/

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Now…….enjoy

I have a sat nav, which I hardly ever use but we decided that since we were going to far, far climes we would not do our usual route finder printout but allow the little gizmo to take us safely to the wedding in York. On the way up we didn’t ask her help until Nottingham, even we could manage to get on the M1 and sit in several traffic jams for 3 hours. After stopping for a ‘comfort break’ I powered up our little box of tricks and listened intently as she guided us faultlessly to our hotel. I have to admit that I did sit there studying a map, just to ensure that she wasn’t about to deposit us in some beautiful scenery, and I agreed with her that the route she chose was direct and concise.

We were in York for a wedding, it all went wonderfully. The snow stayed away, the sun shone and not one punch was thrown. I enjoyed an interesting chat with a gentleman who helps to decide social policy. After about 20 minutes of him questioning whether or not pregnant women require any medical care, his suggestion being that they are not unwell and should therefore be capable of seeking help when their pregnancies deviated from normality, I realised that he was playing Devil’s Advocate and wanted to see how I would justify the role, and the cost, of midwives. We spent an hour verbally jousting, at the end of which he congratulated me on not losing my temper, he has no idea how close I came to it!

On the way home from York we decided to use sat nav Sarah from the start. All went well, she even found a shortcut to the M62. Once we got on to the M1 we were slightly confused when she told us we would be going for quite a short distance, I had a moments concern that I may have entered the wrong destination but that wasn’t right so I got out the map and tried to second guess her. Eventually I decided that Sarah thought that going M40 would be better, I passed this on to Hubby, we voted to go with her and see what happened. As we toured some beautiful little Warwickshire villages Hubby decided that we were using a satellite sponsored by the Warwickshire Tourist Board. I was right, Sarah did, eventually, navigate us to the M40 but via the most tortuous route possible, luckily we were not in a hurry otherwise I think Sarah would now be residing in the Wheelie Bin.

Halfway home my mobile rang. Daughter’s friend, who is having a homebirth, was round at their house having lunch and her ‘water’s’ had gone, what should they do? My advice was to protect the chair she was sitting on and finish lunch. I had asked if the waters were clear and if she had any contractions, they were and she hadn’t!

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Easter message

Jack (aged 3) – Nanny do you know what happens at Easter?

Nanny – The Easter bunny gives you Easter eggs.

Jack – Yes, I did get Easter eggs and I got them because Jesus grows again.

Nanny – Yes. Mmm. (Unsure what to say to this theological perspective)

Jack – Yes, Jesus grows again and so we are all happy.

Not quite sure how he will interpret transubstantiation.

Jack’s Mummy – It’s ‘rose’, not ‘grows’ Jack. Jesus rose again.

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“Unscheduled closures should only occur in very exceptional circumstances when to keep a unit open would be unsafe.” so said the NCT. What caused this statement? The news today that 50% of maternity units had to turn away women because they were full and 10% also had to close because of shortage of staff or facilities.  Thanks to the Conservative party this is now public knowledge and they are using the figures to show that  smaller maternity units shouldn’t close as they have fewer closures. I applaud their effort but do worry about their rationale for the link. Larger units, on the whole, provide care to ‘higher’ risk women as they have more specialist obstetric services, facilities and a higher level of special care units for premature or poorly babies. On this basis they are in higher demand and so more likely to experience having to turn women away if the woman, or baby is need of specialist services. I do agree though that the current policy of closing smaller units is unfortunate. They are there to serve a local community, whereas the ‘new’ larger units require women to travel 15 plus miles which has two effects. The first is that some women will go to the hospital earlier than they need to as they are aware they have some distance to go, frequently involving problems with traffic congestion, and once there are reluctant to return home until labour is established, and who can blame them? However, this has the effect of the unit becoming ‘clogged up’ with women who really do not need to be there. The other problem this can cause is that the labour is more likely to be subject to intervention, either early use of epidural or augmentation in an effort to speed up transit through the labour ward and so requiring increased vigilance as this is no longer ‘normal’ labour. As a result the staff are more pressurised, safety on the unit, due to staffing levels, becomes a concern and so the unit temporarily closes it’s doors. One of the reasons that smaller units are closing, and I’m not talking about ‘stand alone’ birth units here, is that because of the reduced hours of junior doctors smaller units are not able to sustain adequate medical cover, particularly paediatric, the solution is to consolidate services in one location. I’ve mentioned the stand alone birthing centres, these are midwife-led and have no medical cover so the shortage of medics cannot be used as the excuse as to why these are opening to great fanfare and then, all too often, closing after a couple of years. No, these close due to midwife staffing problems at the obstetric unit they are linked to. In the end, as usual, it’s all down to the finances as, if staffing levels, doctors and midwives, were not kept at minimal possible numbers, frequently below those recommended by Birthrate Plus, the units would not find themselves having to turn women away.

“It is difficult to precisely predict when a mother will go into labour and sometimes, at times of peak demand, maternity units do temporarily divert women to nearby facilities,” said a spokesperson for the DOH.

“True, this is something that will happen occasionally, but improving the numbers of Doctors and Midwives and keeping smaller units and birth centres open should make it less likely that this or this tragedywill be repeated.” said Midwifemuse.

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