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Archive for the ‘Musings’ Category

A cutting comic

One of my favourite comedians is Dara O’Briain. I love his forthright take on issues and his ability to spin off on a fantasy tangent, so imagine my joy when I was watching recently and he began talking about antenatal classes, both NCT and NHS. My ears perked up in rediness for some insightful side-swipes at the presentations he had sat through. It started well, the tone of voice we (some of us) use and the way midwives voice their opinions about doctors being over involved (true). It was during this second observation that my ears pricked up and I started shouting at the TV, something that only usually happens during One Born Every Minute. Mr O’Briain began talking about how the facilitator of the class exhorted the attendees not to let ‘the doctor near them with a knife’, it may have been scissors, or it may have been to cut them, but basically ‘Don’t let a doctor do an episiotomy’. The person went on to say that it was better to tear rather than to be cut, and it was this aspect which Dara went on to disect, using the fact that his wife is a surgeon to support his jocular comments which were ridiculing this attitude.

Tears versus cuts. Research has shown that the use of episiotomy should be restricted, for various reasons, but the one I shall highlight here is healing. As the person presenting Mr and Mrs O’Briain’s classes said, ‘a tear generally heals better than a cut’, this is especially true with muscle. During a caesarean section the surgeons tear the muscle. Why do they perpetrate this violence? If you tear a muscle it generally separates in the direction of the fibres, the fibres can then knit together better following surgery. Move from the abdomen to the perineum and the same logic must apply, with an episiotomy you just cut in a straight line, with a tear it is more likely to follow the fibres, therefore the chances are that it will heal quicker and with less pain. My final thought on this is that an episiotomy ‘may produce a larger wound to heal than would have been produced without intervention‘.

Less pain, better healing and a smaller wound? I know which option I would choose.

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Lazyitis

Nearly every night I think ‘I must blog’, and every night I get carried away with something else. Tonight I shall put fingers to keyboard though, after all  I started blogging to maintain an on-line diary, to recount my journey into Grandparenthood. I was amazed when I started receiving comments, I was amazed but I was also gratified. I used to blog freely about my family, but I drew my horns in when a reader took huge issue about a piece I had written and told me that she had discovered who I was and that she was going to notify my employers, and the NMC about my Blog. I was horrified. I was fairly sure that the NMC would not have complaint with me, after all I didn’t break confidentiality or bring the profession into disrepute  however, once my anonymity was compromised then confidentiality issues may have arisen. My employers, they may not have been too happy about my ‘musings’ as they sometimes referred to employment topics and local employment topics at that. I could have been in serious trouble. I closed down my blog for a couple of months, deleted the writing she found offensive and held my breath. Months later, when I had heard nothing, I started writing again. Momentum was suffered though and I had lost the ‘discipline’ of regular blogging. I am going to make a New Years resolution, blog at least once a week.

I’m still a midwife. Recently I received a ‘promotion’, really it is just an official recognition of a role I have been helping with for over a year, but it does give me a new job title. Over the last 18 months I have also assumed two other roles within the maternity services, one clinical and very few hours, the other non-clinical but together they take me up to full-time hours, and more. I am approaching retirement age but, due to my husbands pension having become negligible since G Brown did something, don’t know what but it made Hubby’s pension pot leak a huge amount, and my state pension age running away from me at breakneck speed, I can see that I shall have to put in the elbow grease for a few years yet. Midwives and childbirth have been much in the news over the past few months and, with Will and Kate announcing her pregnancy, I expect procreation will remain in the spotlight.

My family are all well. 16 of us now and all spending Christmas Day together. Hectic week ahead but culminating in a fabulous, chaotic, noisy but joyous celebration and, of course, Ruby’s first Christmas

Ruby Rose

Ruby Rose

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Time

Time, well it’s just flying at the moment. There’s a lot going on at work, so may machinations, some seemingly innocuous others are rather worrying and are leaving many of us ‘watching our backs’. I have my resignation letter composed and saved and I cannot count the number of times my finger has hovered over PRINT, Hubby is leaping to attention every time the printer goes into action. Tee hee. It is all just a matter of time though.

Jack is now 7 and Amy 6, and both had the same birthday present, a trampoline. I take the blame for this as I acquired one a few months ago and it has been such an amazing hit with all the grandchildren that their parents decided they should have one. I have strict rules in my garden about the trampoline, no bundles, no pushing, no food allowed, there are occasions when Nanny has to turn into a sergeant major but on the whole the children are kept healthily occupied for hours.

From somewhere, and through some movement I have developed ‘tennis elbow’, or lateral epicondylitis. Ouch, ouch, ouch. Nasty condition which catches me out regarding what will elicit an ‘ouch’ and, as a result, what actions I can perform. I can open a car door with no problems but cannot sew. I can get the ironing board out and carry the iron to the board, but I can’t iron (handy that one!). I can chop vegetables but cannot turn the tap on the water butt. On the up-side it is ‘self-limiting’, the down-side is that it can last between 6 months and 2 years. I just hope that time continues to fly.

I was thinking about time today and how we develop our concept of it. I’m not a philosopher, I just heard myself saying ‘You’ve got 10 minutes on the computer Amy’ and so realised that we often give children timings. I will say ‘In a minute’; ‘Give me a couple of minutes’; ‘You’ve got 5 minutes to tidy up’ and other time precise instructions, but they are anything but precise in reality. Do we develop our sense of time from comments like these and, if so, could it account in part for why some people are poor time keepers? Before we learn to tell the time from a clock our concept of time must come from clues given by those who do know about hours and minutes. I had been considering this when daughter came round to collect her off-spring. We sat on the patio having a chat (whilst the children bounced on the trampoline) and after a while she informed them that they had 5 minutes and then they were going home, I waited and timed what would actually happen. In reality it was 20 minutes before they were summoned from their leaping, and then a further 10 minutes before they left to go home. So, having been told that in 5 minutes they would be leaving they really had 6 times that number of minutes, with no correction to the initial instruction. Were they aware that it was more than 5 minutes, or do they now have an erroneous impression of time? Is time a learned concept?

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Back to life

We had a lovely break. Went on a boat and saw a whale and her baby. Stroked an Eagle Owl and and a Golden Eagle, really soft and downy. Swam, a teeny, tiny bit; got my sun-rash (bother, I usually only get it in the UK); got very tipsy one evening and tried to persuade Hubby that we should try out the mobility scooters which were re-charging in our apartment block, he pointed out the error of my ways; read 3 books, absolutely glorious, almost hedonistic! It then went downhill. Our flight was delayed and then, on the 4 hour flight home, I got my restless legs and thought that I might just go completely mad. Got to bed at 3am and at 10am daughter, she with Amy and twins, arrived having been evacuated from their house due to high levels of carbon monoxide, obviously they took up residence with us. The next day son arrived, very poorly with problems with his ileostomy, and got into the only spare bed, Hubby and I laughed, hysterically.

Daughters back boiler is now fixed, I commend EDF for providing them with a free heater to ensure they wouldn’t freeze and also the boiler man who sorted everything out for a very sensible and realistic price. Son’s blockage is now resolved and he has been returned to his wife and family.

Having cleared the house of off-spring I returned to work, 10 days away and everything has hit the fan. So many rumours flying around that I have decided to put ear-plugs in and stick my head in the sand, bad news for the women and even worse news for the midwives. When I decide to listen to things I really don’t want to hear I shall blog, possibly at length!

It is half-term this week so I have had 3 grandchildren staying, luckily I was able to put a star on Izzy’s reward chart to say she had slept through the night!

I got on my Wii with trepidation this evening. Over the last 6 months I have lost a stone and a half, at Christmas I put on 6lbs and it took me until the week before our holiday to lose it again, I was certain that a week of good eating (and drinking) would see me back at my Yuletide weight….wrong!! Hurrah, I’m 1 pound less than the day before we went, it’s amazing what a busy 5 days are capable of.

A serious point, Silverpoint. Now the holiday we had was a promotional deal with a company called Great Resorts, only it turned out that they had gone and a company called Silverpoint had taken their place. Part of our deal was that we had to attend a presentation, a morning or afternoon was to be dedicated for this, fair enough. In fact the ‘presentation’ took 5  hours, we thought we were hard done by but another couple we chatted to were talked at for 6 hours, and that’s what happened, not a presentation which implies the attendees all sitting together and being presented with facts, but a one-to-one with a well-trained, verbose salesman. He showed us his personal photos, told us his life history, drew flow charts and told us that for in the region of  £8,000 we could enjoy amazing holidays or ever. He then told us that his manager needed to speak to us to ‘make sure that he had given us all the facts’. After an interminable wait his manager appeared, amazing news, we could access the world of luxury holidays for nothing, well sort of, yes it would cost us money in the end but for the first year it would be free. I have a very laid back Hubby, in 36 years I have known him lose his temper about 10 times, it is now 11 as the only way to get the message through that we were not interested was to shout at this nasty, deceitful, apology for a  human being. Over the next 3 days we talked to several other couples, they had all been offered different deals, we talked to a couple who had handed over £100,000 chasing the dream of a lifetime of luxury holidays only to be disappointed, and then for Silverpoint to suggest that they hand over a further £3,000. They didn’t, thank heavens but if anyone should ever doubt how dangerous and distressing this type of selling can be then I wish that they could talk to this couple. Oh, I forgot to mention, part of the ‘presentation’ involved using Google maps to look at the couple’s home and comment on it’s condition and value, really spooky stuff. If you are offered a presentation week then I can really recommend it, you will get fantastic accommodation, you will have to put up with a few hours of slick sales patter but if you can resist a massive temptation then it will be worth your while as you will have had yourself a cheap break!

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Touring the cybersphere I visited The Sceptical OB, oh yes Dr Amy Tuteur ex-The Homebirth Debate blogger, is writing away and as usual is thought provoking. Her latest offering is a scathing scribe about The Feminist Breeder who is going to be live blogging her homebirth, Dr Amy is not impressed by this concept, in fact she calls it ‘pathetic narcissism’. Is she right? Oh, I don’t know. TFB says that one of the reasons that she is doing it is to educate women on natural birth, presumably that is why she also posted a photo to Facebook of her positive pregnancy test even before she left the toilet. I just wonder though, are those women who agree to have their births aired on ‘One born every minute’ narcissistic? I have to admit that I haven’t even considered that before, I’ve just thought that they were brave and uninhibited. I suppose that all bloggers could all be accused, to a greater or lesser extent, of being self-involved and having a need for admiration but does that make us narcissistic? For me the similarity between TFB and me is that to we both hope to educate on a subject close to us via our blogging, but there the resemblance ends, I write and expect no remuneration. I have many companies asking me to promote their wares, to place links etc in my sidebar, but I always decline, in fact I generally just ignore them. If I ever mention a product it is because I have independently used it and feel that it is either worth mentioning, as it is good or should be exposed as it failed to impress, it isn’t because I have received either monies or gifts. TFB, now a quick perusal of her sidebars shows 12+ advertising widgets, how independent are her opinions, how unbiased is her information giving? She is honest though, she does disclose that her live birth blog is being sponsored by Brio Birth, a company specialising in childbirth education classes. Here I am the sceptic, what better way to increase traffic to a blog than to live blog and video stream a birth? What does TFB have to say about the financial aspect of her blog?  Running this ship comes with both tangible costs and opportunity costs. It takes real money to pay for the server space and domain registration that keeps this blog online. It also takes time and a great deal of effort for me to research, write, and moderate a blog with this much traffic and This is why I accept advertising sponsorships – but, and this is really important – I don’t just accept any sponsorships, and that’s what makes the ones appearing on this page so important.  You see, I am extremely picky about who I will let advertise here. Great, so she’s ‘picky’, really, but you then goes on to say But, trust me when I say that most businesses with an advertising budget are not pounding down the doors to advertise on a blog like mine. Hmm, inconsistencies here, there’s even a Feminist Shopper page which is all reviews and advertising, no wonder she spends so much time researching and writing her blog.  Oh, I don’t know, I’m just a grumpy old woman who is alarmed to find herself agreeing with Dr Tuteur.

So will I be logging on to The Feminist Breeder in April when baby is due? If I remember then I will, but I’m not setting up an alert.

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I know, during all the newspaper coverage regarding the state of the maternity services I have been silent. The truth, I’ve given up hoping that things will change for the better, am so disillusioned and demotivated that I cannot be bothered to rant, report or rue the erosion of a service I entered with passion in my belly and will leave with an extremely sour taste in my mouth. Fingers crossed, one year now until I retire.

In the absence of an urge to blog I have been reading The 19th Wife by David Ebershoff, food for thought in this 600+ page book about The Church of the Latter Day Saints and in particular polygamy or, as the church calls it, celestial marriage. I have many, many thoughts on this practise, I suspect tat my outlook as a female would be quite different to that of a male. However, feeling benevolent toward Joseph Smith, I will say that he hit upon an excellent way to rapidly increase the membership of his church, after all a couple are likely to only manage one child a year, and let’s not forget how high infant mortality was back then so only around 35% would reach their fifth birthday, but if a man takes several wives then the family increases at a rapid rate and the population surges. All the more faithful for the church and all the more power for a community. Brilliant wheeze. The book is one of those set in two time frames, one historical and the other contemporary, I sometimes find this a distraction and spend loads of time flicking back to see where the story had been, or who a character was, I didn’t with this one, which must be a tribute to the author for ensuring appropriate breaks in the narrative.

A few years ago I read ‘Call the Midwife’ by Jennifer Worth, very interesting, especially as my Mother was a district midwife in East London in the late 50’s, the time covered in the book, and I have patchy memories of accompanying her on the back of her bike and waiting in front rooms with a man, and sometimes other children. Then I would hear a baby crying and a red-faced, smiling mother would open the door and call the man out. Anyway, daughter bought the trilogy ‘Tales from a Midwife’ around the other day and having refreshed myself on the first part I am now reading the two new sections. Crikey, if I as a midwife or child-bearing women think things are bad now this book certainly brings us up short, the working day for midwives was long and hard, with terrible conditions but their lot was nothing in comparison to what the women and their families endured. I hear that the BBC have serialised it and that there will be 6 episodes shown sometime this year, can’t wait.

Talking of childbirth/midwifery on TV brings me to ‘One born every minute’, channel 4’s look at the realities of giving birth. This weeks was great, I hardly shouted at the telly at all. The couples shown were brilliant, the births were uplifting and the midwives a credit to the profession. I had stopped watching it last series as I found I was getting so cross with the midwives, and their love of confining women to the bed and strapping monitors on for no apparent reason, that it was increasing my despondency, full marks this week though, nearly made me feel enthusiastic.

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Christmas Day came and went. Absolutely frenetic, much wrapping paper, steam, yes steam is my major impression of Christmas Day because of all those pots bubbling away, full glass of red wine over my oatmeal coloured carpet and then peace when all the little people were asleep.

Work was busy and foggy with numerous offers of mince pies. I have been desperately trying to ‘book’ a newly pregnant woman, twice we have made appointments and she has phoned minutes before them to cancel, I almost know her phone number off by heart now as I’ve rung her so many times to reschedule but been met by her voicemail. She has left me a message to tell me that she needs to see me before her scan, I KNOW, but when I return the call guess what, voicemail. Hubby is now getting annoyed with it as I am always phoning her, yes on my days off. Get up in the morning, phone. In the car on the way to the DIY store (we are going to decorate and put down a new floor in the shower-room), phone. Cooking dinner, phone. As I was so desperate to speak to the woman I’ve been leaving my work phone on, bad mistake as I keep having to answer it. Swine flu, that is the number 1 topic. Last year I was quite reticent on advising women to have it, I gave them the info and told them to make up their own minds, this year I am swaying toward the ‘it’s probably a good idea’ stance. In my mind I feel somewhat happier about reinforcing the party-line as the vaccine has been around for a year, babies have been born to Mums who had the jab last year, and so far I have not been made aware of any adverse outcomes as a result of it. Next in the things to phone your midwife about is ‘I’ve got a cough, what can I take?’ Now, presumably these coughing ladies will have to go to a pharmacy to purchase the medications I suggest, how about asking the pharmacist? I have recollections of an ad campaign encouraging people to speak to the pharmacist and chemists now have a ‘consulting room’ for that purpose, why ask a midwife when there is a highly trained person who is far better placed to advise?  One of the phone calls was from Children Services asking me if I had seen someone, who I had never heard of, and who there was a meeting about on Thursday. Oh b****r, my heart dropped. After much questioning it turned out that they were giving me the name of her child, who has a different surname to her, my shoulders relaxed. Yes, I knew her, I had seen her, she was ‘co-operating’ with the maternity services but no, I couldn’t come to the meeting as I don’t work that day and, where usually I will attend these meeting if possible on a day off, that is one of the days when I have the boys and they hadn’t given me enough notice to rearrange childcare. Had they got a creche? No. Now I’m consumed with guilt, female thing, but they really should either give more notice or consult with ALL parties on when is a convenient time.

Homebirths are in the news again, apparently doctors are trying to put women off them. Why are the RCM and NCT suddenly getting hot under the collar about this, doctors have always tried to put women off them. When I say ‘doctors’ I actually mean G.P’s, obstetricians, well the ones locally, are supportive as long as the woman fits the criteria for a homebirth, i.e the pregnancy is low-risk. Cathy Warwick, RCM leader, calls for a ‘seismic shift’ in the maternity services and recognises that midwives are unable to offer choice. Sorry, Ms Warwick but we do offer choice around here, and the rest of the service suffers as a result. Yes, we need a shift, seismic or otherwise, but something definitely needs to happen, and soon and not just to enable more women to have a home birth but to allow that to happen without depriving other women of the care they deserve and putting midwives under so much pressure of work that they leave.

So, on this last day of 2010, I wish everyone a wonderful 2011. My resolutions? To carry on with my diet, I have lost over a stone, and lose the 3lbs I have put on over Christmas! To allocate some ‘me time’. 

HAPPY NEW YEAR

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