Your pregnancy, your midwife, your choice

Information

14 Dec

Personal Maternity Care Budget to be piloted in Liverpool

The 12th December 2016 saw the launch of the first pilot of the implementation of Personal Maternity Care Budgets by the Cheshire and Merseyside Pioneer. This is the first step in fulfilling one of the recommendations for the transformation of maternity services in the Better Births Report 2016. Better Births recommends that all women should have personalised care, centred on the woman, her baby and her family, based around their needs and their decisions, where they have genuine choice. Better Births also set out a vision that women should be able to choose the provider of their antenatal, birth and postnatal care and be in control of exercising those choices through their own NHS Personal Maternity Care Budget.

Initially the pilot is being rolled out by Liverpool Women’s Hospital with a handful of selected GP surgeries but the press launch has stated that other providers in the Pioneer will roll out PMCBs early in 2017. One to One Midwives, as a commissioned provider in Cheshire and Merseyside will be offered as a choice to women to use their PMCB but for One to One Midwives this will be ‘business as usual”.

One to One are already a choice option for women and their families – but what do One to One offer?

Quite simply One to One provides a service that is centred on the needs and choices of women and their families. We do this through our model of Continuity of Carer – every woman who books with One to One will be contacted by her named midwife and see her midwife for the vast majority of her antenatal visits.

One to One midwives see their women for 88% of their antenatal visits. 
One to One midwives attend 75% of the births of women that they know
One to One midwives see their women and babies for 80% of their postnatal visits.

This is what continuity of carer means to us.

What else can you expect from the One to One service?

As all care is based on your needs and choices, the number of visits is unlimited, both antenatally and postnatally and as well as face-to-face visits, you will also have access to your midwife 24 hours a day, 7 days a week by phone, text or email to discuss any concerns or advice that you may need.

The majority of visits take place in your own home, with the option to have your appointments in the evenings or at the weekend, which ensures that your partners can also participate in your care. One to One have three Pregnancy Advice Centres open in Cheshire and Merseyside and run local clinics and scan appointments out in the local community to ensure you have an additional choice of where to receive care, which will be as close to your home as possible.

One to One offers numerous social networking opportunities in our local community hubs and we also provide hypnobirthing and parent education and courses as standard.

We employ MaMAs (Mother and Midwife Assistants) to offer additional support in the antenatal as well as the postnatal period. Our MaMAs can support you with becoming more confident parents as well as providing you with practical advice and support regarding infant feeding and baby care.

Our midwives are trained to recognise and deal with any complications that occur and if necessary we can refer you to an obstetrician within a local hospital of your choice to ensure that you receive safe and appropriate care when needed.

If everything goes well with your pregnancy and you choose a homebirth, your One to One midwife will ensure that you have access to a pool (if you choose a waterbirth) and access to our KG Hynobirthing course, which can be booked directly via our One to One website.

After the birth your One to One midwife, with the support of your MaMA, will visit you at home as often as you need until at least 6 weeks after your baby has been born.

One to One Midwives are delivering what the pioneer is aiming to deliver across the rest of Cheshire and Merseyside in the future. If you want to know more about the One to One service or how you can access our care you can contact us via the following options:

o Send an enquiry via our website at: http://www.onetoonemidwives.org/enquiries 
o By telephone: 0330 3309 121
o Via your GP

To find out if One to One is available in your area, contact us on Facebook: https://www.facebook.com/OnetoOneMidwives or using any of the above contact methods.

26 Jun

Campaign for a normal birth

As a case loading midwife I love being able to empower women and families to make informed decisions about their pregnancy, birth and care they receive during and after this time. One of the tools I like to use is the Royal College of Midwives (RCM) – Campaign for normal birth: Ten top tips for midwives.

Normal is specific to each individual and my aim as a caseloading midwife is to help women and their families have a positive experience during their pregnancy, labour and birth. The RCM’s Campaign for normal birth has information for both midwives and women and can be adapted to all care settings.

One of the ten top tips is “build her a nest” and this promotes the midwife/partner/woman creating a safe environment for the woman to birth in. Regardless of whether you are birthing at home, in a midwifery led unit or obstetric unit; certain aspects can be used to help support physiological labour in all settings.

Please find below the link to the RCM Campaign for normal birth website and a short poem I have created capturing “building a nest” in labour.

Your journey is starting and instincts kick in,
Peacefully find a dark place to relax in.
Warm and secure surrounded by love.
Allowing your hormones to blossom and bud.
Privacy and quiet you must be allowed,
In your nesting environment as calm as a cloud.
Feel the support that your body can do
Confidently ending your journey
Baby and you!!!!

http://www.rcmnormalbirth.org.uk/

Post by Sarah Jurd, One to One Midwife

18 Jun

Induction of labour

There are so many discrepancies in hospitals across the UK as to when is the best time to offer an Induction of Labour (IOL). It is important to understand that an IOL is just an offer of care and like every choice you make in pregnancy, you do not have to accept it.

Your One to One midwife will talk to you about the risks and benefits of this option towards the end of your pregnancy. Your midwife can also discuss what plan of care can be put in place to reassure you if you chose to decline an IOL. We call this 'conservative management'.

An IOL is performed in hospital and can be done in many ways. The main types of induction are:

1. A pessary (a small vaginal tablet) 
2. A gel (inserted vaginally) 
3. Artificial Rupture of Membranes (breaking the waters) 
4. Intravenous Syntocinon (hormone drip given through a cannula).

The main aim of types 1 and 2 IOL is to soften and "ripen" the cervix so that your body will begin to labour and dilate the cervix without further assistance. Sometimes if this is unsuccessful in producing spontaneous tightening’s/surges you may be offered type 3 IOL, if this is unsuccessful in producing spontaneous tightening’s/surges you may be offered type 4 IOL.

IOL is a long process sometimes spanning over a 1-2 days depending on how many different stages/types of IOL is required. It is important in this time to mobilise as much as possible, eat and hydrate so that you can prime your body for labour and birth.

What are your experiences or thoughts on IOL? What are your experiences or thoughts on conservative management?

Post by Lorna, One to One midwife

02 Jun

The Expected Date of Delivery

The Expected Date of Delivery (or EDD) is something deeply ingrained in our social management of pregnancy. It may be the first question asked when someone becomes aware of a pregnancy. However, midwives know that focusing obsessively on this fixed point can cause expectant mothers much anguish and even bring about unwarranted intervention. The pressure on mothers to give birth to their baby on this day can be overwhelming.

Midwife researcher Sara Wickham calls this "fixed point expectation syndrome". She states that it is of course a natural and understandable human process and to some degree is necessary in order to manage our busy lives. However when the expectation is not met, mothers and their families can feel confused, disappointed and may be more likely to interrupt the natural pregnancy process.

The idea of substituting a wider range of probable birthing time for baby is one way to combat the disappointment often associated with EDDs. Midwife Brenda van der Kooy notes that, “as elsewhere in nature, normality has a range”.

Could it be feasible to start to refer to a Due Month instead? Indeed, as only about 4% of babies are actually born on their "due date", but most babies will make an appearance between 37 and 42 weeks gestation, it could be realistic to dismiss the EDD altogether and start to broaden the language we use when discussing when baby might be born.

What are your thoughts?

References

Davies, R (2003). “I’m ready for you, baby, why won’t you come?” How long is a pregnancy and how long is too long? New Zealand College of Midwives Journal 28(1): 8-10.

Mongelli, M (2010) Evaluation of gestation. eMedicine. emedicine.medscape.com

NHS (2010) Singleton, twin and higher order multiple deliveries by gestation and birth status, 2008-2009. NHS Information Centre for health and social care. www.hesonline.nhs.uk

Stickler, G B. (1994). Expected date of confinement (correspondence). The Journal of Family Practice 39(4): 325.

Van der Kooy, B (1994). Calculating expected date of delivery – its accuracy and relevance. Midwifery Matters 60: 4-7, 24.

Post by Sarah, One to One Midwife

24 Jan

What is hypnobirthing?

I often get funny looks when I discuss the concept of hypnobirthing with women and their partners. 'Were not that type of people' is a common answer when I discuss it, however what does hypnobirthing really involve and what 'type' of people is it for?

As a One to One midwife I have been trained to be a hypnobirthing practitioner. Hypnobirthing is not about hypnotising you or making you do things you have no control over. It is in fact the complete opposite. Hypnobirthing encourages you to take control of your birth experience through educating you about what to expect in labour (physiology) as well as teaching you techniques to manage your experience. Hypnobirthing involves self-hypnosis or deep relaxation which is practiced prior to birth and enables you to feel calm and in control when the time comes to birth your baby. We also encourage women and their partners to consider the importance of protecting the birth environment, which includes careful consideration of birth partners as well as environmental factors such as lighting and noise.

We are socialised to believe that birth is a frightening experience with many risks involved. Although there is no denying that sometimes situations arise that can affect the risk involved in a pregnancy/birth there is also no denying that our bodies are designed to birth our babies. Research suggests that the level of control felt by a woman during her birth is the main factor involved in her satisfaction with the experience. Hypnobirthing aims to empower women and their partners to believe in their bodies ability and if necessary to have the confidence to question their care.

In my experience as a One to One midwife I have found that being in attendance at births where hypnobirthing is being used is truly inspiring. Women who believe in their abilities and allow their bodies to take over the process as nature intends rather than allowing their mind to control the process.

So to answer the question of what type of person is hypnobirthing for, I would say any woman who wishes to listen to her body and trust it to birth her baby in a calm relaxed environment.

If this is you then ask your One to One midwife for more information and about availability in your area for the free hypnobirthing courses ran by our team. I promise, you won't regret it!

Post by Emma Healey (One to One midwife & Hypnobirthing practitioner)

15 Apr

Top five tips for preconception health

As Easter approaches we may be thinking about what that means to us or even telling the Easter story to our children.

Easter is celebrated in many ways such as with the Easter bunny, Easter eggs and fluffy chicks. This is to represent new life and new beginnings.

This may be a time when you’re considering starting that new life by trying for a baby.

Did you know that care before your pregnant is as important as when you’re pregnant?

A healthy mum + healthy dad = healthy baby

Ideally preconception care should be started at least three months prior to conceiving. In fact all women should be thinking about their health even if they are not considering starting a family. One reason is that about half of the pregnancies are unplanned.

Five things to boost your preconception health

• Take 400 micrograms of folic acid every day. This will lower your risk of some birth defects such as spina bifida. 
• Aim for an optimal BMI. A person’s BMI can affect their fertility status along with their health. 
• Stop smoking and drinking alcohol. Smoking can affect the women’s sexual and reproductive health as well as their long term health and that of their children. Women who smoke are twice more likely to be infertile or take longer to conceive than those who do not. In men, smoking affects the sperm morphology can cause low sperm count
• If you have a medical condition, be sure it is under control. Some conditions that can affect pregnancy or be affected by it include asthma, diabetes, oral health, obesity, or epilepsy.
• Seek advice if you’re taking any over-the-counter or prescribed medicines. These include dietary or herbal supplements. Be sure your vaccinations are up to date.

Preconception care can improve your chances of getting pregnant, having a healthy pregnancy, and having a healthy baby.

Post by Cheryl Tomlinson, One to One Midwife

29 Aug

Why choose a home birth?

WHY CHOOSE A HOME BIRTH?

It is shown to be as safe as hospital birth for low risk women and women feel calmer, more relaxed, and in control because they are in their own familiar surroundings, therefore needing less pain relief. They can move around at will, and birth where they feel most comfortable.

ENVIRONMENT?

Women can prepare their own birth place. They can 'nest' and have their birthing space quiet, with low lighting, scented candles and favourite music playing. Food and drinks can be taken as needed and mum can rest and sleep at will.

HOW?

Women can birth in whatever position they wish, wherever they feel most comfortable. In a birthing Pool, bedroom, on a settee? On all fours, squatting or supported by their birth partner. They can utilise Hypnobirthing techniques, engaging in positive visualisation and breathing techniques.

WHO?

At home women can choose who they would like to support them with their birth. Other family and children may be around, One to One midwives will be on hand for guidance and encouragement.

During the pregnancy, women and their birth partners can 'plan' with their One to One midwife where and how they give birth. This will ensure a more positive birth experience, where mum is in complete control, secure in the knowledge that she is in a safe hands.

If you were wondering about home birth, never considered it, or want to know more, speak to your One to One midwife who will be happy to discuss it with you. Home Birth Groups are also available, speak to your midwife for more information or message directly from our website: http://www.onetoonemidwives.org/enquiries

Post by: Kim Sefia, One to One Midwife


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