Sleep, an action I often have problems with, sometimes due to heaven knows what, often down to restless legs and frequently discouraged by Hubby’s snoring. One of the grandchildren is also displaying a disinclination to sleep but, unlike me who wanders quietly around without disturbing anyone, she feels that the rest of her family should join her in her noctunal wakefulness. This is not going down too well with her parents or brother who are all now becoming rather tetchy due to sleep deprivation. The nicely, nicely approach was tried; a night-light was introduced; lighter, then heavier bedding, no change. A reward system was tried, that didn’t work. Then Mummy and Daddy ceased being lovely about multiple, protracted wake-ups and responded with instant returning to bed, first soothing words, then sharp words, not successful. Next came punishment, toys were taken away. Yesterday the final toy was shut away, and last night they had their first night’s sleep in a month. Daughter was overjoyed and everyone received a joyous text message. Fingers are being crossed that there will be a repeat performance tonight.
Why is she doing this? Three years old and has always slept well. She started 5 half days a week at school at the beginning of the month and so you would think that she would be tired and sleep well. Is it school? On the one hand I think that’s doubtful, she had been doing two half days a week for the past 6 months and she loves it. She appears to be happy to go and is full of chat when you pick her up so I’d be surprised if school is making her anxious enough to affect sleep patterns. But, on the other hand I just wonder if school is over-stimulating her. Does that happen when you are 3?
Work is incredibly busy at the moment and it’s all thanks to the snow, apparently. Was it because couples were snowed in and bored, or just because it was so cold, whatever the motivation was it has resulted in a major baby boom. The maternity unit has been bursting at the seams so they have been calling community midwives in to help out. This has had the knock on effect of reducing staffing in community because 2 midwives, who should have been working, have been working for 24 hours. Totally understandable that midwives should be called in but those women who were in hospital having their baby then go home and need visits, but community is short-staffed. The result? Over 5 days I have managed to log an extra 10 hours, and that’s on a phased return after my op. I’m not as hard-done by as one of my colleagues though who finished at 8pm on Friday, bet her women thought that she was never going to arrive and her husband wondered where his other half had got to, she should have finished at 4.30pm.
When a baby boom happens all areas of the service are hit hard. The community midwives feel it first, suddenly an inordinate number of first meetings, the booking, need to be done. Next the ultrasonographers find they are scanning more women, appointments become like hen’s teeth and more have to be slotted in, so it has to function more like a conveyor belt. Hospital staff start increasing clinic lengths to try and fit in all those who need to see an obstetrician during their pregnancy, everyone is beginning to realise that September is going to be a bumper month for babies. The beginning of August sees both hospital and midwife antenatal clinics becoming really, really busy as the women are now being seen every two weeks. Bad timing, school holidays mean that it is the height of the leave taking and there are less bank staff able to work, the maternity services are staff poor. There never was any slack in the system and now the strain is showing.
The end of August, labour ward is getting busier. Hospital tours and study days are cancelled, midwives are needed on the coal face. On-call community midwives are being called into the unit, that’s the first move, then they are being rostered to work in on the unit, their colleagues battle to cover their commitments. Meanwhile, in on the unit the staff there are running, literally, from one labour room to another. Women and their new babies are being moved to the ward as soon as they have given birth as labouring women are queueing for the room. The staff on the ward are desperately trying to help the new Mums and care for those who are unable to care for themselves. A quick discharge is encouraged, beds are at a premium, the paperwork increases. Community starts to receive the discharged women and babies, often the stay in hospital has been so short that breastfeeding hasn’t really started, visits are longer as more help and support is required. The women aren’t just giving birth in the hospital, there are more homebirths to be attended, community is struggling.
Hopefully the situation should start to improve over the next couple of weeks, certainly the managers appear to believe this as the next off-duty hasn’t got community midwives allocated to the unit, it’s the Health Visitors who are now entering the squall, I feel for them.
The managers have sent us letters thanking us for our support and hardwork. They are also receiving letters. but these communications are complaints about the lack of care and attention. I hope they are blaming the snow and not their staff.
I am one sad person. We have Virgin Media and they emailed me the other day to let me know that, since I’m such an important customer, I can have a Blackberry free. Well not entirely free as I would have to sign up to their £10 a month contract but the Blackberry is free. Wow, result. One minor problem though, I am with O2 via Carphone Warehouse on a 24 month contract. Hmmm. Where’s the contract? I’m sure that 18 months was mentioned somewhere. Was it that I could stop it then, or was it an upgrade? After much delving in drawers, rummaging through files and searching along shelves I admitted defeat, I couldn’t find it. I emailed CPW with my query and they replied very quickly, with the news that to leave them I would have to pay £159 and that I’m not due for an upgrade until next July. Seems a trifle unfair as the disconnection is more than my contract but all that pales into insignificance when I consider that I’m missing out on a Blackberry. Oh woe, woe and thrice woe.
Can I justify having 2 mobile contracts just to get a Blackberry? Hubby thinks not.
Tonight on Mumsnet was a webchat with Nick Clegg. Mumsnet are the people who revealed to us the biscuits Gordon Brown likes to eat, and I suspect that was a better, more revealing discussion than tonight’s was with Mr Clegg. Questions were asked, few, if any, were answered. Guess what I asked about, was it what pushchair to buy, was it what hair styling products do you use? No, I asked about the maternity services and the funding and after an hour, and several message prods from me and another NHS employee we received a sort of answer –
“It’s difficult for me to know exactly what’s going on in your ward/hospital – as you know, it depends on what PCTs, hospital Trusts are deciding in each area. But I think it’s important to remember that we’ve explicitly excluded the NHS from the cuts falling elsewhere, ringfencing the NHS budget is really important for a public service which is not only crucial to every family in the country, but also the largest public sector employer in the country.”
Clever, clever answer. Basically what he’s saying is ” I don’t know what’s going on around the country within the NHS but what I can tell you is that if bad things are happening it’s nothing to do with the government, it’s all down to how your local providers are spending the money. We are not going to take any money away, obviously we are not going to give any more, even though we have promised people improvements to the services already on offer. As the monies for the maternity services were before, and got used elsewhere, the monies for the NHS in general will be ring-fenced.” I feel SO reassured. Not.
This post is unsponsored and is entirely my own, unsolicited opinion.
I have been the proud owner or user of several pushchairs designed to be used by twins. The twins are now 3, they started off quite small, 6lbs and are now chunky lads of 2 stones 5lbs
Before daughter discovered that she was growing 2 babies instead of the 1 I had a Cosatto Kiwi side-by-side double buggy, advertised as being from birth. It had all the bits, raincover, footmuffs, sun-shades but was rather wobbly and it felt as if the handles may snap at any moment. This was with a 1 and 2 year old in it, so once I felt I no longer needed a buggy which would take 2 I donated it to the local charity shop. Major mistake, so I thought, when just a few months later the twins were discovered on scan.
Daughter is someone who investigates thoroughly before making a decision so every avenue was explored before she decided upon which pushchair she would buy for the boys. After much debate she made a decision, she was going to get the Jane Twin Two plus 2 rebel car seats.
She made a great choice. Lightweight, folds neatly, takes two newborns and performed problem free. The car seats slot easily onto it and are a generous size but really, really light. Very important when you are struggling to carry one in each hand.♥
I went for the side-by-side option, the Bertini Bidwell. It should have been great, but I hated it. It was huge, with the hood up I couldn’t see the front of it so was always rear-ending innocent pedestrians. Despite the 4 by 4 steering it was clumsy, and boy was it heavy and very bulky to store. Looked good, definitely eye-catching but, ultimately for me a poor choice.
Bertini
By the time the boys were 6 months I had given up on the Bertini, I sold it on E-Bay and traded it in for a MacLaren Twin Techno.
I was really pleased with it, It felt sturdier than the Cosatto. It looked comfy, had two good sized shopping baskets and wasn’t too difficult to fold or store, it’s freestanding. I could manoeuvre it quite easily but I could have done with the handles not being so far apart, it’s probably better if you’re taller, I’m only 5ft 3ins. It was good when daughter went abroad on holiday as it went in the aircraft. Problem though, once the boys got to a year old I was having to run at kerbs and then jump and push down hard on the handles to get up on to the pavement, and all this with my arms wide apart. I started dreading going out for walks but then fate smiled on me, the Mum who lives opposite asked me if I wanted her Out & About Nipper, free!
What can I say? It’s easy to manoeuvre, it’s light, it fits in the boot of my hatchback, none of the others did, and folds down quite compactly. I can zoom through woods and up and down hills. It has two baskets, not as generous as the MacClaren but large enough for bits and bobs, a potty does fit in them. Downside is that I get punctures, luckily Hubby is good at repairing them. The handlebar has foam padding which has split on the corners, purely cosmetic though, I’ve repaired it with duck-tape. ♥
Meanwhile, daughter had decided that the Jane twin two was no good for cross-country hiking so she traded it for a secondhand Jane Powertwin. (She chose Jane again as her previous one was so reliable).
It is smaller than it’s counterpart, the Twin Two, and is good for older babies or children of different ages, it can only be used for newborns with the car seats. It was certainly easier for going ‘off-road’ but the boys had less room and the one in the back found it easier to grab his brother’s hair! The front wheel gradually adopted a jaunty angle which made it difficult to manoeuvre, I refused to be left in charge of it as the twisted wheel made it go to one side so you had to fight it constantly. Daughter persevered with it until one day I returned from work and found that my beloved Nipper had gone walkabout, she had borrowed it. No way was my pushchair disappearing, EBay was searched and within the week I had another Nipper. DIL has now bought a Nipper, she has pronounced it better than her Phil and Ted’s!
So, from my experience the Nipper comes out on top.
If you find that you have twins on the way –
Try out all the pushchairs. How easy are they to put up and then collapse?
Does it take two newborns?
Remember they will not be small for very long, how easy is the pushchair to push with toddlers on board?
Is there enough capacity for all the bits and bobs which accompany two little people?
Will it fit in the car?
Where will you store it? Is there enough room?
Will it fit through doorways?
Shop around.
P.S I’m not advocating Kiddicare, it’s just that they provide a video demonstration, as I said ‘shop around’.
I’ve learnt from long experience never to take what is said by hierachy at face value, so it is with fingers crossed that I write that the ’emergency’ meeting last week was reassuring. Certainly the head of midwifery acknowledged that community has been bearing the brunt of the staff shortages, that cracks are showing and that complaints have increased. The point was reinforced though that, even when the situation has improved staff-wise, postnatal visits must be kept to a minimum and that all our efforts must concentrate on the booking appointment and the antenatal care. Grrrr, so short-sighted, it is true that postnatal care is now the Cinderella component of maternity care.
There has been lots everywhere about the midwife who was struck off at the beginning of last week, the headlines were eye-catching, Midwife banned for God quip after couple’s newborn baby died, Midwife banned after telling grieving Mother ‘ God knows best’ but that is just what they were, eye-catching, but they were not actually correct as the midwife was struck off for misconduct in that she failed to provide appropriate care, behaved dishonestly with regard to her record keeping etc. This midwife broke numerous rules, breached standards and then attempted to cover her ommisions up, and for this this she deserves to be sanctioned, but, with regard to he God comment the NMC acknowledge that the words were spoken at an emotional time and were not meant to be deliberately insensitive. This is not the reason she was struck off. Read the full findings on the NMC website.
Last week daughter announced that she was seeing light at the end of the tunnel as far as the boys are concerned, then Friday happened. She was downstairs when sh noticed water coming from around the light fitting in her hall, swiftly followed by an ominous dripping sound in the utility room. She rushed upstairs to discover Louis watching with interest what happens when you’ve blocked the plughole of a sink with loo paper and then turned on the tap. It was all too late though. By the time she had mopped up all the water from the bathroom floor, water was coming out of the light switches and the ceiling plaster downstairs had descended onto the sopping wet hall carpet. Along with her home lights the light at the end of the tunnel has gone out.
Tomorrow I return to work and the day starts well with a meeting to discuss the staff shortages. Staffing is dire and, according to reports, this is due to an increase in midwifery posts remaining unfilled. I wonder why there is a problem with retention of midwives, I don’t really as I talk to midwives who are leaving and everyone has the same gripe (locally), I don’t do this job to be treated like ****, be unsupported and not provide the care I would like to. When people ask what work I do the majority of people respond with ‘ Oh, what an amazing job, so rewarding’. I used to agree with them, it was rewarding, I did feel appreciated, I was supported and, most importantly, I felt I did a good job. Now? Well now I spend all my time watching my back, if a woman isn’t looking to complain about something, then the Trust is on the lookout for ways to get rid of expensive, experienced midwives. I read articles in the media assuring women that they ‘have a right’, government initiatives lead women to expect that their every wish will be fulfilled, and faceless commentators on sites such as Mumsnet reinforce women’s belief that a midwife’s personal safety* should not be an issue as she ‘has a duty of care’. I feel as if any rights that I may have thought I had have been swept away and left me, as a midwife, extremely vulnerable and, worse of all, I’m not able to provide the routine care that I feel the women and their families deserve.
I think that midwives should take a leaf out of the tube workers book, after all we have a lot in common, both our work involves tubes, they drive through them and I take blood from them, test fluid from them, investigate them and help extract little people from them. There the similarities end. They are taking industrial action as they feel that safety is being compromised due to the reduction in staffing, us midwives, we just leave or carry on covering up the gaps in the service. We are voiceless and ultimately colluders in our own unhappiness.
‘Black Dog’ was the phrase Winston Churchill used for his depression. I’m not clinically depressed, just depressed about the current state of the maternity services and knowing that there is worse to come.
* This demonstrates the measures taken by one Trust to reduce risk for their community midwives. My Trust gives us a training day on personal safety, if they didn’t then they would be at risk of failing in their duty of care as it is recognised as good practice. We all have mobile phones, handy for anyone who wants to contact us but pretty useless if we encounter an unexpected, sudden threat. We do not go out in pairs at night, the first contact is by a lone midwife as sending out 2 midwives is ‘too expensive’.
A Midwife's Muse 
