Denise and her blog
Safe Maternity Care
Many women ask whether ginger is safe and effective for pregnancy sickness.
While ginger is one of the most commonly used natural remedies for nausea and vomiting, it is important that women receive balanced, information before using any complementary therapy.
As midwives, our role is not simply to recommend or discourage a therapy. It is to help women understand the potential benefits, limitations and considerations so they can make informed decisions.
Natural does not automatically mean safe, and comprehensive knowledge, understanding and an ability to apply theory to practice should always guide our advice.
Safe maternity care starts with informed conversations.
The Publication Of The Ockenden Report
The publication of the Ockenden report into systemic failings in Nottingham is sobering reading. My thoughts go out to those families affected by poor care, institutional issues and serious errors.
However, I fear that the wider effects of this damning report will be to cause a knee-jerk reaction that will exacerbate the fundamental factors that have, at least in part, contributed to the problems in Nottingham and elsewhere.
Above all, in my opinion, is the fact that modern society has lost sight of pregnancy and birth as normal physiological events that women's bodies are designed to achieve. Birth has been medicalised beyond all recognition of what women's bodies have been doing for millennia..
In almost 50 years of practising and teaching midwifery, I have seen maternity care ravaged by a paternalistic, risk averse, litigation conscious system that seeks to control birth - and women - not only in the UK, but across the world.
Yes, there are multiple complex, intertwining and possibly irrevocable factors that have led us to where we are now - and a solution to the innate problems of the maternity services is not easy.
We have an ageing maternity population with much more complex medical issues, women becoming pregnant due to medical advancements, who would never have been able to have children 50 years ago. We have an almost untenable increase in demand for maternity care in a completely overloaded NHS, simply unable to cope.
Poor staffing is compounded by lack of money to pay for more midwives, whilst conversely midwives are leaving the profession retiring early, changing direction and escaping the toxic, blame-throwing culture of the NHS. Universities are complicit in the issues, commercially recruiting students to a degree for which there are insufficient clinical placements - and no jobs at the end.
The Nursing and Midwifery Council has dumbed down the clinical requirements for midwifery training, changing the definition of "normal" birth to fit the falling numbers of completely physiological births available to students, rather than standing up to the medical establishment and demanding that students are legally required to conduct 40 entirely physiological births. This is akin to the suggestion made recently that we need more operating theatres to accommodate the rising Caesarean levels - instead of looking at how to reduce operative births
We have the contemporary agenda that focuses on BAME women's greater morbidity in childbirth, extending services for non-biological women who are pregnant and adapting to the needs of multicultural immigrants. I fervently believe that ALL maternity service users should be treated as individuals, whatever their colour, creed, religion, sexual preferences, ability, level of education or anything else. We should not single out specific groups as being more vulnerable than others. To do so risks omitting or disadvantaging others. ALL PREGNANCIES MATTER.
Student midwives are taught to attend to the needs of individuals, but they need time to be able to do this well. This requires more staff to accommodate the needs of ALL expectant and birthing parents. Increased staffing requires increased job availability, which is not currently sufficiently funded, leaving newly qualified midwives with nowhere to go.
I could go on, but it is impossible to unwind all the contributing factors that have accumulated over decades. Sadly, however, I fear things are only going to get worse, even if only temporarily. I fear intervention will become more intense in a futile attempt to reduce the issues that have led to increased mortality and morbidity. We will have an even more punitive approach to human errors, a higher managerial backlash to try to shore up a failing, completely inadequate NHS and an even more interventionist approach to pregnancy and childbirth to avoid further deaths.
So what are the answers? It is impossible for one person to address this question and it is not my intention to do so here. However, I would like to see an expansion of midwifery services outside the NHS, with greater options for expectant parents. This means educating students that the NHS is not their only option. A designated career pathway for midwives wishing to work privately is necessary with parameters that allow flexibility and choice whilst protecting parents and professionals.
A return to the fledgling idea of a maternity "passport" with which parents had a say in how their allocated budget could be used, might be a starting point. More education and information for people before and in early pregnancy to outline their options could help.
And, perhaps, most importantly of all, we need an acknowledgement that childbirth is not a medical condition for most women and that unnecessary, potentially harmful intervention must stop.
More from Denise at the 34th ICM Congress in Lisbon
The 34th ICM Congress in Lisbon has been both thought-provoking and inspiring.
The theme, One Million More Midwives, has highlighted some of the greatest challenges facing our profession globally, and the impact these challenges have on women, babies and families.
Whilst we face significant issues in the UK and other developed countries around intervention, maternity care and the status of midwives, it is humbling to hear the experiences of colleagues working in lower-income countries where access to safe maternity care remains a daily challenge.
Perhaps the most sobering thought is that, somewhere in the world, a woman may die in pregnancy or childbirth in the time it takes to read this post. In some cases, her baby may die too.
These are not just statistics. They are mothers, babies, families and communities.
The One Million More Midwives campaign recognises that investing in midwives is one of the most effective ways to improve outcomes for women and babies worldwide.
Please join me in supporting the campaign and advocating for a stronger midwifery workforce across the globe.
ICM Congress in Lisbon
A wonderful start to the 34th Triennial Congress of the International Confederation of Midwives with a fantastic opening ceremony. The theme this year is ‘One Million More Midwives’.
One of the things I enjoy most about attending international midwifery events is the opportunity to reconnect with friends and colleagues from around the world, whilst also meeting new people who share a passion for improving care for women and families.
It's always inspiring to hear different perspectives, exchange ideas and learn from one another.
Looking forward to the rest of the conference and the conversations still to come.
Birth Preparation
Birth preparation is about far more than packing a hospital bag.
For many women, preparation also means reducing fear, understanding physiology and feeling supported in the decisions they make during pregnancy and birth.
Simple approaches such as relaxation, massage, breathing techniques and appropriate complementary therapies can all help support confidence and calm during the transition to parenthood.
As midwives, we have an important role not only in clinical care, but in helping women feel informed, reassured and empowered throughout the process.
About Birth
Birth is not just physical. It is hormonal, emotional and environmental too.
When women feel calm, supported and safe, the body is better able to produce the hormones that help labour progress physiologically.
This is why environment, communication, reassurance and supportive care matter so much within maternity services.
Complementary approaches such as massage, relaxation and reflexology help reduce stress hormones such as cortisol and support the body’s natural processes by increasing oxyocin and the “feel good” chemicals, endorphins and encephalins.
Previous articles
Safe Maternity Care
The Publication Of The Ockenden Report
More from Denise at the 34th ICM Congress in Lisbon
ICM Congress in Lisbon
Birth Preparation
About Birth
Thinking Critically
Have We Lost Sight Of Physiological Birth?
The Humble Pineapple
Expanding Midwifery Knowlege
