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Archive for April 2nd, 2008

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Three weeks ago I gave a ‘one-on-one’ parentcraft/antenatal chat to my daughter’s friend and her husband. She had a poor experience during her first labour, little support from her husband, and they both eager to avoid a repeat experience this time around. It all went really well, it even prompted me to have my demonstration pelvis repaired, I had dropped it some time ago and it had sprung apart. I say it went well, it went so well that they both then decided on a home birth, not something that I had expected, or suggested.

Well, on Easter Sunday, term +4 days they were round at daughter’s house and C’s waters went, there were niggles but little else. The hospital were contacted and they were invited in for monitoring. All was well so they were sent home to await the onset of labour. By Monday morning nothing was happening, a community midwife went round and explained to C that if she did labour now it would be advisable that she went into hospital, as our policy is that if the membranes have been ruptured for over 18 hours then the woman should receive IV antibiotics in labour as there is a risk of infection for the baby. C phoned me up to check that this was right and see if it would be safe to avoid this advise, I advised that she should give birth in hospital, and in fact, since they really want to get 2 doses of antibiotics in not to leave going in too late as they would then pressurise her to allow blood cultures on baby and a 3 days of antibiotics IV for baby, just in case. I then asked her when she was going in to be induced, Tuesday morning. That’s 48 hours though, I know policy changes frequently but in February it had been 24 hours rupture of membranes and then induction. I decided to shed my midwives skin and just be happy for her that she would have her baby. I’m off-sick so shouldn’t be getting involved.

Tuesday morning, prior to admission she went into labour. Coped really well at home and went in when her contractions were 10 minutes apart, on admission her cervix was 4 cms dilated. All progressed well, TEN’s, birthing ball, huge amount of back pain. Eventually she couldn’t cope any longer and had an epidural, which only worked on one side. Throughout labour baby was happy, even with C pushing for an hour. Ultimately though an obstetrician came in and helped baby out with a Kiwi ventouse, at birth baby was in a occipito posterior position, basically he was facing forward rather than back. Baby well, if a trifle bruised, weighing in at a healthy 9lbs 6 ozs which was slightly less than his brother two years before. Happy family. 

Yesterday I saw Dad at Amy’s nursery and asked how things were going, I hadn’t spoken to them since the birth. If I’m honest I felt as if I had let them down in some way. Not sure how, or why, but that’s a midwife for you, always blaming yourself. Anyway, he was really happy with everything and was really grateful for the chat we had, he felt it had helped. He told me he was worried about baby’s cord as it was smelly, wet and the cotton wool was stuck firm. I didn’t really pick up on the cotton wool comment, I just assumed they had been cleaning it with that and so some fibres were left behind. Since I was going to be near them when I dropped Amy back to her Mummy I asked if he wanted me to drop some swabs round so they could give it a good clean up, he said that would be great as they weren’t seeing a midwife until Thursday. Round I went, admired baby and smelt what he meant about the cord, it was rank. I offered to give it a clean and was amazed when I took the baby’s nappy off to expose the cord area, it had a strip of cotton wool wound around the stump. So that’s what he meant about the cotton wool being stuck. As I disentangled the offending material from the cord I asked how it had ended up there. Apparently, when they attended the ‘drop-in’ postnatal clinic on Sunday, the midwife they saw recommended this as the way to care for the cord. I have searched and I cannot find any recommendation for this. Everyone seems to be united on the care of the cord, clean if necessary, and avoid dry cotton wool as it sticks (!). I just wonder of they misinterpreted what the midwife was saying, I hope so as her advise was not good. Once I had talked through what they should be doing with the cord I asked C about her birthing experience. She was really happy with everything. Full of praise for all the staff, impressed by how much better it had been than last time and had felt ‘in control’. Apparently her husband had been fantastic, really supportive and they put it all down to our chat. C said that it had made a huge difference just being able to ask as many questions as they wanted and being given ‘down to earth’ advice. Her husband then went on to suggest that I start doing it privately and be paid for it as before they had attended private childbirth classes which were useless and that my chat was more informative and realistic.

So, now I’m pondering. I can’t afford to give up work but I could suppliment my income by running classes. I have all the teaching aids as I bought my own for conducting NHS classes because that equipment was so decrepit. I live in an area where there is a demand for private childbirth classes. I have the qualifications. Right, contact the NMC, our regulatory body, to check if there is a problem with me setting up privately and running them from my own home. Bloody answerphone, unable to take my call. I know me, I run with an idea but lose my energy if I can’t start acting on it. At the moment my head is buzzing with ideas for content (loads), structure (minimal), advertising (local amenities & the paper, perhaps even a website, with e-mail). Oh come on NMC, speak to me, I want to deliver but I can’t without your assistance.

(Don’t suggest I speak to my SOM (supervisor of midwives), she is in the pay of the Trust and therefore any advice from her on personal schemes is going to be tainted by Trust concerns.) 

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