Your pregnancy, your midwife, your choice

Information

02 Jan

Changes to Midwifery Supervision – Piloting the new model

The 31st March 2017 looms the end of the statutory supervision of midwifery. Many midwives, women and indeed supervisors of midwives will be wondering what’s next? What does this mean for me?!

NHS England have set up an LSA national supervision taskforce who are leading on a pilot for the proposed new model of supervision – the A-EQUIP model –“Advocating and Educating for Quality Improvement”.

There are seven pilot sites for the model across England, with One to One being successful in our bid to become a pilot site. We have been warmly welcomed by Coventry NHS trust to complete the bridging course for the pilot and it has been wonderful to meet lots of new people. We all have the same goal of being involved in this groundbreaking change to midwifery supervision.

One to One are excited for the pilot, which officially starts in January 2017 and will run until March 31st 2017, where evaluation of the pilot will be collated and published, along with next steps for organisations.

For the A-EQUIP pilot, the Supervisors of Midwives trained to deliver the content will be known as Professional Midwifery Advocates (PMAs).

There are three main elements to the pilot:

1. Education and Development - aiming to develop and support practitioners with the knowledge and skills they require, and prepare them for appraisal, revalidation and develop leadership skills.

2. Personal Action for Quality Improvement – enabling practioners to make changes that make them more proactive at work, and ensure a safe proactive workforce, therefore enhancing safety.

3. Restorative Clinical Supervision (RCS) – This is a confidential space for practitioners slow down, take time, and restore. It is a space for reflection, thought processing and wind down, facilitated by the PMA. This is a fantastic tool, which is evidence based, showing a reduction in staff leaving, increase in staff morale, less sick leave and helping practitioners to recognise, prevent and alleviate stress. As part of the A-EQUIP training, the PMAs undergo sessions of RCS themselves, and it is a very valuable tool that I look forward to using with the staff.

There is a strong focus on midwives being advocates for women, and much of the role supervisors of midwives played in care planning and supporting complex care will be supported by the midwives within this model. One to One already operate in this way, and the new model will continue to support this advocating and empowering women to achieve their birth wishes.

The pilot sites will be evaluated and the details and further guidance will be sent out following March 31st 2017.

Keep your eye out for further updates and follow #midwiferysupervision on twitter.

Find out more at NHS ENGLAND: https://www.england.nhs.uk/ourwork/futurenhs/mat-transformation/midwifery-task-force/

Katie Wainwright, PMA for the Q-EQUIP pilot One to One.

14 Jun

One to One Midwives: June is breastfeeding awareness month

June is breastfeeding awareness month and we are celebrating the great benefits of breast milk for you and your baby.

As well as being convenient and perfectly designed for your baby, breast milk also protects your baby from infections and diseases. Breastfeeding can build a strong emotional bond between you and your baby and also provides health benefits for you too.

Here at One to One we have dedicated midwife and mothers assistants (MaMAs) on hand to offer advice on breastfeeding before your baby arrives and for six weeks after as part of our unique post-natal care, as well as your dedicated midwife who is with you throughout your pregnancy.

Two of our MaMAs, Julie and Sarah, have given us their top tips for breastfeeding:

Research and speak to a MaMa before you have your baby – ask your midwife
Understand how small your baby’s tummy is: http://www.ameda.com/breastfeeding/the-first-12-months
Get off to a good start, eat well and keep hydrated
Take a vitamin supplement that contains vitamin D
Understand when growth spurts stages are and why your baby is doing them: http://kellymom.com/bf/normal/growth-spurts/
Good positioning and attachment
Sleep when baby sleeps
Know about feeding cues and being baby lead
Effective sucking/supply and demand: http://youtu.be/Zln0LTkejIs
Ask for support: One to One Mama support/breastfeeding groups.

Breastfeeding reduces the risk of:

• Infections, with fewer visits to hospital as a result 
• Diarrhoea and vomiting, with fewer visits to hospital as a result 
• Sudden infant death syndrome (SIDS) 
• Childhood leukaemia 
• Type 2 diabetes 
• Obesity 
• Cardiovascular disease in adulthood

For mums breastfeeding and making breast milk also has health benefits. Breastfeeding lowers your risk of:

• Breast cancer 
• Ovarian cancer 
• Osteoporosis (weak bones) 
• Cardiovascular disease 
• Obesity

One to One breastfeeding facts and figures:

Initiation rate for all women: One to One: 79% England: 73.9% 
Initiation rate for homebirth: One to One: 91% 
Still breastfeeding at 14 days: One to One (All Women): 69% England: NA 
Still breastfeeding at 14 days home birth: One to One: 81% 
Still breastfeeding on discharge (6weeks): One to One: 57% England: 47.2%
Still breastfeeding for home birth: One to One: 67%

* Figures taken from One to One’s Quality Report 2014/2015
** Breastfeeding information taken from www.NHS.uk

The Liverpool One to One Team will be joining the Breastfeeding Celebration Parade on Monday, June 20, to celebrate Breastfeeding Feeding Awareness Week. The Parade will assemble at St Georges Hall at 11:30AM and will officially start at 12:00PM. It will end at Chavasse Park close to 12:30pm. There will then be a picnic in Chavasse Park (weather permitting) and if it rains we would love to see you at John Lewis Café for cake and coffee! Midwife Lorna and Mama Michelle will be there.

To find details of Wirral breastfeeding events please visit: http://www.wirralct.nhs.uk/news-campaigns/news/latest-news/celebrate-breastfeeding-awareness-month-with-us

16 Aug

Eating Dates During Pregnancy

Are you expecting? Congratulations!!

Pregnancy is a time of various cravings and food indulgences. As an expectant mommy, you want to be sure that what you eat is indeed healthy for you and the baby. Once you are pregnant, almost everyone starts advising you on what to eat and what to avoid. One such food item that has a lot of confusion surrounding it is dates. It is important to know the positives and negatives about eating dates in pregnancy that will help you make an informed choice.

A Sneak Peek At The Nutritional Value Of Dates:

Per 100 grams, *% of daily value

Energy 282 Kcal
Proteins 2.5 g
Fiber 8 g
Fat 0.4 g
Folate 19 mu gs
Iron 1.09 mg
Vitamin K 2.7 mu g
Magnesium 43 mg
Potassium 656 mg

Eating Dates During Pregnancy:

There is no clear study to indicate that dates should not be had during pregnancy. In fact, they are loaded with nutrients that can benefit both you and your baby.

Benefits Of Eating Dates:

Dates are rich sources of proteins, fiber and many vitamins, while being very low in fat. They contain a combination of soluble and insoluble fiber and thus are helpful in maintaining your digestive system. Dates have a good amount of natural sugars. They are rich in potassium and low in sodium, and thus help regulate the nervous system.

Here are some of the most important benefits of eating dates:

1. Good Sugars: During pregnancy your body needs a lot of energy. Sugar is the fastest energy provider.

2. Protein: Protein consists of amino acids, which are the building blocks of your body. Even as your body stretches and grows to accommodate the baby, so does the fetus. To support this growth, your body needs an adequate amount of proteins.

3. Fibre: It helps in maintaining a healthy digestive system and helps in dealing with pregnancy related constipation. It reduces the cholesterol levels and keeps you protected from infections. There is always a chance of developing pregnancy related blood pressure and diabetes and this is where fibre helps. It helps in maintaining a healthy weight during pregnancy. You will often feel hungry and the fibre in dates will provide a feeling of fullness for a long time.

4. Folate: Folate or folic acid aids in the formation of new cells and prevents a form of anaemia. It helps in the prevention of dangerous birth defects, which may damage the brain and spinal cord of your new-born, like Spina bifida and Anencephaly.

5. Vitamin K: Vitamin K plays a key role in blood clotting and keeping the bones strong. Babies are generally born with low levels of Vitamin K and thus the need for compensation during pregnancy. Deficiency of Vitamin K in infants can be hazardous since it affects the blood clotting and can lead to a life-threatening situation. It also aids in bone development of the baby.

6. Iron: Iron plays an important role in a number of metabolic processes. Along with globin molecules, iron helps in making oxygen reach all the cells of the body. It is particularly important during pregnancy because iron is an integral part of myoglobin, collagen and enzymes. It prevents anaemia in the child and makes immunity stronger.

7. Potassium: Potassium is one of the most important electrolytes in the body. It helps in maintaining the blood pressure. Potassium also helps in maintaining water balance during pregnancy. It helps in maintaining heart health, digestive tract and optimal muscle functioning. During pregnancy, consumption of adequate amount of potassium helps in your nerves and muscles function. A deficiency of potassium causes kidney problems and can also lead to death.

8. Magnesium: Magnesium helps in the active transport of calcium and potassium ions across the cell membranes, which help in muscle contraction and normal heart rhythm. It helps in the formation of teeth and bones and also maintains blood sugar levels. Research suggests that inadequate intake of magnesium during pregnancy can lead to elevated blood pressure, liver and kidney abnormalities, poor vision, etc. A study from Journal of Obstetrics and Gynaecology, 2011 suggests that dates can help in easy delivery since it causes cervical dilation and also reduces the duration of labor.

It is always essential to remember that anything you consume should be held in moderation. The same applies to dates, and you should only have a handful a day, not more.

Post by Renee, One to One midwife

25 Sep

Perineal massage

Perineal massage is a technique which slowly and gently stretches the skin and tissues around the vagina and perineum. The perineum is the area between your vagina and rectum. Perineal massage helps reduce both the risk of tearing during birth and the need for an episiotomy (or “stitches”).

Perineal massage helps prepare you for the feelings of pressure and stretching that come as your baby’s head is born. Knowing what some of the sensations will be like can help you to relax and give birth instead of tensing up and fighting the sensations such as stinging, tingling or burning that you may feel as your baby’s head is born. Perineal massage can also encourage you to relax when you have a vaginal exam.

It is also helpful to learn relaxation techniques, information about your anatomy and what will happen during labour and birth.

CAUTIONS:

1.Avoid the urinary opening  to prevent urinary tract infections.

2.Do NOT do perineal massage if you have active herpes lesions, as you could spread the herpes infection to other areas.

General Hints:

The first few times It’s helpful to use a mirror to find the vagina and perineum and see what they look like.

If you feel tense, take a warm bath or use warm compresses on your perineum for 5 to 10 minutes.

If you have had an episiotomy with a previous birth, concentrate part of your massage on that area, Scar tissue isn’t as stretchy as the rest of your skin and needs extra attention.

The position in which you give birth can affect the likelihood of perineal tearing and the need for an episiotomy. Upright positions (sitting, squatting1 kneeling) or side-lying positions reduce the strain on the perineum. Lying on your back with feet up in stirrups makes an episiotomy almost inevitable.

After childbirth, tone up the stretched muscles in the vagina by continuing the pelvic floor (Kegel) exercises that you learned in childbirth preparation classes.

Directions:

1.Wash your hands

2 . Find a private, comfortable place and sit or lean back in a comfortable position.

 3 . Put a lubricant such as KY Jelly, cocoa also butter, vitamin E oil, or pure vegetable oil on your thumbs and around the perineum. You can also use your body’s own natural lubrication.

 4 . Place your thumbs about 1-1 1/2″ (3-4 cm) inside your vagina Press downwards and to the sides at the same time. Gently and firmly keep stretching until you feel a slight burning, tingling, or stinging sensation.

 5. Hold the pressure steady at that point with your thumbs for about 2 minutes until the area becomes a little numb and you don’t feel the tingling as much. 

 6. Keep pressing with your thumbs. Slowly and gently massage back and forth over the lower half of your vagina, working the lubricant into the tissues. Keep this up for 3-4 minutes. Remember to avoid the urinary opening.

7. As you massage, pull gently outwards (forwards) on the lower part of the vagina with your thumbs hooked inside. This helps stretch the skin as the baby’s head will stretch it during birth.

8. Do this massage once a day starting around the 34th week of pregnancy. After about a week you should notice an increase in flexibility and stretchiness.

 PARTNER MASSAGE:

General Hints:

You may use either your index fingers or your thumbs. Sometimes only one finger or thumb will fit into the vagina until the skin has become stretched.

Listen to your partner. It is her body. Be sensitive to what she wants you to do. Massage firmly but gently. She will tell you how much pressure to apply

Directions:

1.Wash your hands.

2.Put some lubricant on your fingers and on your partner’s perineum.

3.Place your fingers gently inside her vagina about 1-1½” (34 cm). Press down until she tells you it is beginning to sting and burn.

4.Hold the pressure there for about 2 minutes until she tells you it is getting numb.

5.Gently and slowly sweep your fingers from the center to the sides and back to the center again, pulling forward slightly as you massage. Give extra attention to any episiotomy scar. Remember to avoid the urinary opening.

6.Massage for about 3-4 minutes once a day.

Blog post by Amanda Wardle, One to One midwife
20 Mar

When a Bad Birth Haunts You

Birth Trauma is the term used to describe Post Traumatic Stress Disorder (PTSD) following childbirth. PTSD is a psychological response to a frightening or even life threatening experience where, within the context of birth, a woman may have felt danger to herself or her baby; loss of control and dignity; experienced hostile attitudes from the people around them or have felt their informed consent was not respected. Up to 10 000 women a year develop Birth Trauma and around 200,000 women develop symptoms of PTSD following birth.

Symptoms of PTSD stemming from birth trauma include:

• An experience involving the threat of death or serious injury to an individual or another person close to them (e.g. their baby).
• A response of intense fear, helplessness or horror to that experience.
• The persistent re-experiencing of the event by way of recurrent intrusive memories, flashbacks and nightmares. The individual will usually feel distressed, anxious or panicky when exposed to things which remind them of the event.
• Avoidance of anything that reminds them of the trauma. This can include talking about it, although sometimes women may go through a stage of talking of their traumatic experience a lot so that it obsesses them at times.
• Bad memories and the need to avoid any reminders of the trauma, will often result in difficulties with sleeping and concentrating. Sufferers may also feel angry, irritable and be hyper vigilant (feel jumpy or on their guard all the time).

PTSD occurs as the mind attempts to make sense of traumatic events and this process is accompanied by anxiety and fear which are beyond the sufferers control and it is important to remember that this is not a sign of ‘weakness’ or a woman’s inability to cope. Birth Trauma is in the eye of the beholder and events that lead to such feelings will be different for each woman, however, research shows that certain experiences will put women at increased risk of PTSD such as:

• Lengthy labour or short and very painful labour
• Induction
• Poor pain relief
• Feelings of loss of control
• High levels of medical intervention
• Traumatic or emergency deliveries, e.g. emergency caesarean section
• Impersonal treatment or problems with the staff attitudes
• Not being listened to
• Lack of information or explanation
• Lack of privacy and dignity
• Fear for baby's safety
• Stillbirth
• Birth of a damaged baby (a disability resulting from birth trauma)
• Baby’s stay in SCBU/NICU
• Poor postnatal care
• Previous trauma (for example, in childhood, with a previous birth or domestic violence)

PTSD is different from Postnatal Depression (PND) and requires different treatment therapies; however, the two conditions may overlap or be confused by health care providers.

http://www.bestdaily.co.uk/your-life/news/a555944/confusing-pnd-with-ptsd-and-why-we-need-to-listen-to-women-with-birth-trauma.html

If you feel you can identify with any of the above information or need further support and help please do not hesitate to discuss this further with your midwife, GP or health visitor. Below are some links for further support and information on Birth Trauma:

http://www.birthtraumaassociation.org.uk/what_is_trauma.htm

http://www.sheilakitzinger.com/birthcrisis.htm

http://www.solaceformothers.org/what_birth_trauma.html 

http://www.hypnotherapy-directory.org.uk/articles/ptsd.html

Information taken from http://www.birthtraumaassociation.org.uk/ 

Information provided by Rebecca Stephens, 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

17 Aug

Would you consume your placenta?

Would you consume your placenta?

The placenta is the organ which functions to feed your baby with oxygen and nutrients via the umbilical cord until they are born. After birthing the baby the placenta is also passed and routinely disposed of as clinical waste. However, the placenta is believed to have healing and nutritional qualities and therefore some women choose to consume their placenta following birth to reap these benefits. Two common ways of consuming your placenta are by blending it raw into a smoothie or having it made into capsules to be taken following the birth.

Research claims that the benefits include:

Improved energy levels
Reduced bleeding post birth
Increased milk production

For more information and some recipes see the Independent Placenta Encapsulation Network website http://placentanetwork.com/

Have you or would you consume your placenta?


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