A clear view of birth

I haven't written my blog for sometime now and thought I ought to get on with it really! Last Monday I visited independent midwife Virginia Howes in order to film her Howes Birth Mirror http://www.kentmidwiferypractice.co.uk/2006/shop.htm
Virginia is entering a Barclays Bank competition to see if she can win the prize money in order to promote her product further afield. I think the mirror is a great invention as in the past I have filmed many waterbirths http://www.mybirth.tv/video-play.cfm?id=244 where midwives have used a conventional mirror- the downside of a conventional mirror is that it usually has an edge on it (perfect for bacteria to thrive) and is made of glass- probably something best avoided. Virginia's new mirror is made of polished steel- no sharp edges, unbreakable, and it can be sterilised in an autoclave. to view her product visit this link https://www.takeonesmallstep.co.uk/Entry/View/3043 I for one am backing it, as it is a fantastic, simple product and will be perfect for all those women wishing to get a clear view as their baby is being born.

Marathons and Mothers

Last weekend I had the opportunity to film a man who plans to complete 20 record breaking achievements in twelve months. His first to be recorded for Record Holders Republic is running for 48 hours on a treadmill with a 40lb pack on his back, all of the money he raises will go to Help for Heroes. So, on Saturday morning I arrived in Swindon at the Brunel Shopping Centre to watch Mike Buss as he started on this crazy marathon. On Sunday evening I returned to see how he was doing- and to look at his war torn feet, and then on Monday at midday he finished his record breaking achievement- not only had he achieved a world record for 24 hours non stop, but the 48 hour record too, and he had covered 76.2 miles. As I watched him on the treadmill I pondered the fact that women achieve great marathons every day- when they have long drawn out labours and their strength flags, yet somehow most of these women continue and eventually give birth on their own. In the final hours of a labour they find an inner strength and this was what I saw in Mike on Sunday night and Monday morning.

One of the areas that he talked about whilst continually tramping the treadmill was that he feels he needs to research his diet more carefully before he takes on another record attempt. I think, in this respect women should do the same- many midwives give advice on foods that might prove palatable whilst in labour and energy rich snacks which help them through. Mike, like a woman in labour, couldn’t stomach large meals and so small snacks and high energy drinks were the order of the day- he also learnt late into his marathon that pastries from the local café in the shopping centre proved to be a great energy booster. So, for those of you who are about to undertake possibly the biggest marathon of your life here are some ideas for foods that will help you through:

Carbohydrates that will provide sustained energy such as bread, cereals, cereal bars, pasta, bananas and yoghurt. Iced freeze pops for rehydrating and cooling, fruit juices and plenty of liquids especially water. Drinks are best served in sports bottles or cups with a straw. Dextrose tablets are useful – especially if you can’t keep food down as they will provide that necessary energy, you can buy them in your local chemist. The other piece of advice is not to eat anything too heavy or bulky- little and often is key.

• Record Holders Republic
• Help for Heroes
• The Brunel
• Eating in Labour
• Sally’s Birth Diary

When to call the Midwife

Last week started with a bang - at 2.30 on Monday afternoon I got a call from the mother of a young woman I was filming who was planning on a homebirth. She told me that Amy’s contractions were coming every 3 to 5 minutes so I dropped everything, jumped in the car and drove like a bat out of hell to get to Ashford in time.

When I got there all was peaceful and calm, Amy’s Mum opened the door and I went in to find Amy in the pool, everything seemed under control and I set about getting my camera ready. I asked if Virginia her midwife had been called and they told me that she was at home, so I relaxed as Virginia lives no more than five minutes away. After 15 minutes had passed I felt that Amy was moving on in her labour and suggested that they call Virginia, both Kate (Amy’s Mum ) and Amy seemed surprised that I thought it was time to call a midwife but I felt she was closer to giving birth than they realised. Amy had been practicing her Hypnobirthing technique and I do believe that it can help in blocking some of those messages of pain. Hypnobirthing and Natal Hypnotherapy practitioners do not talk about pain and contractions, but powerful surges instead, pain, being negative and powerful surge being a positive word, so Amy was dealing very well with her surges.

Anyway, back to the story; Virginia was surprised to hear that Amy had got in the pool and was having regular contractions, but somewhere in the communications between midwife and mother the wires were crossed and Virginia was not at home but visiting a client for an ante natal appointment, she left her client immediately and set off back to Ashford.

Virginia called whilst on her way back to Ashford to see if I was already there and so she asked to speak to me, I told her that I thought Amy was close to giving birth and Virginia told me to get her on the floor with her bottom in the air, and for Amy to start panting if she felt like pushing. It was really difficult to get Amy out of the pool as she was comfortable there but I knew I had to do what Virginia asked. At some point Hannah who had covered for me on my trip to Los Angeles had arrived as she had grown close to Amy and didn’t want to miss the birth, so I handed her the camera and I got on with trying to get Amy out of the pool. Another contraction went by and then Amy managed to get out and on to the floor. By this stage it was obvious that the baby wasn’t going to wait and all the will in the world wasn’t going to stop it- about half an hour had passed by since Kate had called Virginia and I asked Hannah to call an ambulance and Virginia too. Hannah called Virginia first and she told us she was only two minutes away, an ambulance would have taken longer than that two minutes so I was glad she was so close. The baby’s head appeared and with the next contraction I caught the baby’s body and put her through Amy’s legs and placed all 8lb 9oz Honey Sofia on Amy’s chest as Virginia rushed through the door.

It had all happened so quickly that it was only afterwards and now as I write it that the shock of what happened hits me. Virginia was disappointed to miss the birth but I’m just so glad that she got there immediately after. Honey Sofia was in perfect condition, she cried immediately as she was born (Apgar 9) and looked very healthy.

So the lesson of this tale is, If in doubt call the midwife sooner rather than later, better to waste their time than for them to miss the event.

Amy’s birth story should be on the Mybirth.tv site by the beginning of October. You can view Nancy's hypnobirth here.

I HATE EXERCISE- but it's good for me, and you too.

Those of you that know me well, know that I HATE EXERCISE- so it might come as some surprise when I was asked recently if I minded being photographed at my local cardiac fitness class for my instructor’s site! I have always known that I needed to get fitter, especially when I have been up all night filming a birth, and of course I’m not getting any younger. I started these classes last November when my husband had been attending them for several months, I could see the physical difference in him, and I wanted some of the same. So, although I have not had any cardiac surgery I went along to the class and have been enjoying the benefits ever since. In fact I think I’m a bit like a former smoker who has become a zealot, totally convinced that everyone should do this form of exercise, and I preach to any who will listen! I was chuffed yesterday as I am planning a short break to Los Angeles and needed someone to cover filming for me while I’m away, as I have been following someone who is due to have a homebirth this week . I asked Hannah to stand in for me as she is involved in the local Maternity Services Liaison Committee (MSLC) and is a former producer director with camera experience. She came along to Amy’s 39 week ante natal check up which was with Independent midwife Virginia Howes. Halfway through the check up she asked if she could do some filming and I handed over the camera. After twenty minutes or so there was a lull in the filming and she took a break. Her arms were killing her because, although my camera is quite small it still seems to weigh a ton when you’ve been holding it for a while. She looked at me and commented that I had muscles of steel and how did I manage to keep the camera so steady for such a long time? Some of the births that I have been lucky enough to film have been drawn out affairs, as long as 37 hours and the filming has been hard, but I think now with the extra exercise classes I will be able to cope even better with holding that camera for a long time if necessary.

On the note of exercise I think it’s also very important to keep levels of stamina and fitness up whilst pregnant. There are many types of ante natal classes available that can give you time to focus on you and the baby- life can be so hectic at times, especially when there are other children to look after and perhaps a job to keep down too, so don’t forget to attend a class when you can. Pregnancy, labour and birth and the weeks and months following can be some of the toughest times in a woman’s life, and taking a fitness, aquanatal or yoga class can be just what is needed to get you through.

Conflicting Advice - Swine Flu

Pregnancy should be a wonderful time in a woman’s life, as she looks forward to a positive birth experience and the excitement of impending motherhood. For many, these emotions are mixed with a sense of fear about the unknown, how will she cope with labour and birth, and how will she cope with a small baby? Even for the low percentage of those with a high risk pregnancy, good ante natal care and monitoring should get them through it unscathed with a healthy baby at the end of their pregnancy, so it is a little unhelpful and frightening that added to these natural worries we are bombarded on a daily basis about the impending flu epidemic, and the conflicting advice given. For example women are told to stay away from crowded areas, avoid public transport and stay at home- how does that work then when they are expected to visit their ante natal clinic, usually in their Dr’s surgery, an area no doubt bombarded on a daily basis with the virus?

Then, when they go into labour the advice is MAYBE to have a homebirth thus cutting the risk of infection or passing it on to other new mothers, OR to have a hospital birth because there won’t be enough midwives (as they will be sick too), and so the few that are left will be expected to care for more women in labour than usual. You can’t have it both ways, but department of health guidelines are written in order to cover all possibilities, they don’t want to be accused of not doing the right thing.

The thing is that none of us know how this will pan out, and maybe the DOH should be honest and declare it. So far the death rate of healthy individuals has been mercifully low – on the NHS choices site on the 27th July the statement read : There were an estimated 100,000 new cases of swine flu in the UK in the week ending July 19. Total deaths stand at 31.

I suspect that the infection rates are much higher than this with many people not visiting their Drs and self treating at home. Statistically the predictions are that as many as a third of the population will get the H1N1 virus over the coming months with a predicted death rate in the region of 0.1 to 0.35%. Sir Liam Donaldson the Chief Medical Officer, announced last week that the death rate could be as high as 65,000 or as low as 3,100, the truth is they don’t know and won’t know until it has run its course, in a normal year there will be as many as 6000 deaths from seasonal flu, so maybe we should calm down . Putting another perspective on this crisis is this: In the UK in 2006 ‘Cancer accounted for 29 per cent of all deaths in males and 25 per cent in females’. That’s 242,200 men and women in one year of mainly preventable deaths, and yet I don’t see the politicians, the newspapers or other media wringing their hands over that statistic.

Having said all that, it’s a known fact that pregnant women are more susceptible to infections with a lowered immune system, and so they can try to protect themselves by careful hand washing and so on, but in the crowded cities and towns that we live in I think the chances of not coming into contact with the virus must be pretty slim. Eating a well balanced diet, drinking plenty of fluids and getting enough rest is probably as good a protection as anything else, and for the time being keep to your plans of a home or hospital birth, whichever you prefer.

NCT Swine Flu Information

NHS Swine Flue Information

Swine Flu Symptom Checker swine flu symptom checker

Flu statistics on BBC site

Cancer Statistics UK

Just How Dangerous is Swine Flu - Guardian article

Harry Potter star talks about his flu experience- video

Scans, homebirths and mothers

Eli and Dan with their three boys- Toby, Luca and Gabriel and Elis' Mum Vicky Katherine, Bryan and Beatrix before the birth of Lucie




Whenever I have filmed a birth I ensure that the family sees the finished film before it goes online or is broadcast. Although I love this part I also find it quite daunting; other people are going to look at how I filmed their birth experience and I worry that it won’t meet their expectations.
A few weeks ago I went to see Katherine and Bryan to show them the film of the birth of their second baby Lucie. I had already filmed the birth of Beatrix, so Katherine and Bryan knew what to expect and had not been worried about me filming this second birth. For a mother to watch
the birth of their baby it must be quite hard- flashbacks of what they were feeling at the time and emotions that were going through their heads must bring it all flooding back. As Katherine and Bryan watched, they were reminded of the early pregnancy when Katherine had a Nuchal fold scan and the baby would not co-operate by showing its fold of fat on the neck. How small Beatrix seemed at the time, and now, several months later how much she has grown and adopted her role as older sister. The labour was relatively short but sharp, Bryan had been rubbing Katherine's back furiously and her mother had come over to look after Beatrix. Katherine watched in silence with tears running down her face as she saw her baby Lucie being born. I am relieved to say that Katherine and Bryan loved the programme and it's now uploaded to the site.

A couple of weeks ago I went to see Eli and Dan with the rough cut film of their third baby’s birth. I filmed it last summer and now eleven months later it is finally ready to go online. Eli, Dan and Eli’s mum Vicky watched as we saw Eli having an anomaly scan at 21 weeks of pregnancy. Her two older boys Toby and Luca were at the scan too and they waited to hear if the baby was a boy or girl. No mistaking its sex as the grey and black picture focussed on a prominent part between the unborn baby’s legs- ‘Yes, it’s another boy’!
Eli is heard to say something about the amount of testosterone that will be flowing around her home in a few years time! We laughed at Eli and Dan’s interview where he only manages to get a word or two in edgeways- and sympathised with my editor who had to view all six hours of Eli’s birth diaries!
At this point I looked across to see Vicky wiping tears away; she had already started to cry and I realised that it must be even harder for a mother to watch her daughter going through the birth process.
When the programme reached the labour and birth Vicky was in full flow and Eli followed suit, it was a wonderful waterbirth with Gabriel coming up through the water with his eyes already open.
I hope that one day when my children decide to have babies of their own that they will allow me to be present at the birth of my grandchildren, although my daughters have already told me in no uncertain terms how they wont want me at the birth of their babies, so it seems amazing that so many women have asked me to be present to film and document their birth experiences, and several have asked me back to film more than once, which I find an honour and a privilege. I do hope that in time my daughters will change their minds, and in return I will promise to be a supportive and sympathetic birth partner, even if I do cry.


http://www.babycentre.co.uk/pregnancy/antenatalhealth/scans/secondtrimesterscans/

Cutting the cord

Eons ago when I was training as a midwife (1979-1980) the whole birth process was over technical. I remember the birth pack which comprised of two layers of paper, gauze swabs, Gallipot, cotton wool swabs, plastic kidney dish, cord clamps, cord scissors and episiotomy scissors – OUCH! (I suspect with the passage of time I have forgotten some elements). These were all placed in a particular order of use to ensure that you made your episiotomy before the baby was born, and you didn’t cut the cord before clamping it!

I remember the speed at which you had to deliver the baby, clamp and cut the cord, dry the baby down, wrap it in a towel and hand it to the mother, it was always in a matter of seconds provided there were no problems to deal with like a baby not breathing or a haemorrhaging mother.

There was also the element of keeping a sterile field – the mother was discouraged from putting her feet on the paper, as this was where the baby would lie whilst the cord was clamped and cut- I always wondered about this ‘sterile’ field when the mother would regularly open her bowels during the birth process- that definitely wasn’t sterile. Having said that of course, she sometimes would be given suppositories or even an enema prior to the birth or induction of labour. There was also the matter of the ‘Shave’- What indignities. In addition to all of this she would give birth lying down or reclining – in order to give a good view and access for that all important episiotomy!

Thankfully, times have changed; no longer are women given suppositories, enemas or shaves, unless of course they request one! They can birth in any number of positions, and the episiotomy scissors are kept well out of sight. At the time of birth some women are asking that the cord be left until it stops pulsating to ensure that the baby receives its full quota of blood and has time to establish a regular breathing pattern. Whilst the cord continues to pulsate the baby is receiving oxygen via the placenta- this could be particularly useful when a birth has been complicated or traumatic and the baby is unable to breathe for itself. I have observed this myself when a baby was born making little or no effort to breathe- the cord was left intact and the baby received life giving oxygen for a matter of minutes whilst the midwives resuscitated the baby, the baby appears to have suffered no ill effects. Had the cord been clamped and cut at the time of birth I have no doubt that this baby would have suffered some degree of brain damage. Fortunately doctors and midwives are recognising the positive effects of late cord clamping and are even introducing this procedure into the operating theatre at caesarean sections.

There is still room for improvement on this area though, as resuscitaire’s are built with accessibility for the paediatricians and are designed to be chest height- too high for a recently delivered mother to remain attached to her baby by the umbilical cord. Perhaps the manufacturers of such equipment could develop a new, bed height one, which would enable doctors to work on the baby whilst leaving the cord intact to give life saving oxygen to the baby.

Apgar score / resuscitation
Lotus Birth