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.

22 Dec

One to One – Early help achievement

Sometimes, families can require support from one or more agencies to ensure that they live their lives to their full potential. Sometimes, this need only comes to light at such times in their lives as the journey to become parents or to expand their family begins.

Without early help and intervention, families can at times become overwhelmed and require a more formal assessment or support, which can often lead to referrals being made to social care.

Early help services, can offer support and guidance to help families get back on track, and stay on track with ongoing support, ensuring that all the family needs are met, without further intervention.

Midwives working with families are in an opportune position to identify and react to early help needs and work with the families they care for to become the best they can be. They can use tools such as the Common Assessment Framework (CAF) to help them work with families to ensure the right services and support is available to them.

One to One Midwives have always been committed to support the effective delivery of Early Help and universal services and have embraced the opportunity of being involved in the common assessment Framework (CAF) in its various formats e.g. Team Around the Family (TAF).

One to One Midwives are proud to announce that Moira Ferguson, a member of the safeguarding team has completed an intense training programme and has recently graduated as a CAF champion. Her role will involve offering support to the midwives from One to One and be available for partner agencies, to assume the role of Lead Professional, when identified as the most relevant agency. This role will also support the midwives when they are involved in an open CAF/TAF, thus ensuring that the families that are under the care of One to One Midwives have the support and guidance, to be the best that they can be.

11 Aug

The Newborn and Infant Physical Examination (NIPE)

Shortly after birth, your baby will be offered a number of tests and examinations to screen for any health conditions that may be present. The Newborn and Infant Physical Examination (NIPE) is one of the tests offered and as the name suggests, consists of a physical examination of your baby. It will be offered to you within 72 hours of birth and again between 6-8 weeks of age.

The main purpose of the NIPE is to identify babies born with heart, hip and eye problems so that any necessary treatment can be started quickly. For baby boys, it also screens for problems with the testes. In addition, the health professional carrying out the examination will be looking for anything unusual about your baby’s general appearance and wellbeing that may indicate an underlying problem.

Before the start of the examination, you will be asked a few questions around your pregnancy, your own health and any medical conditions that may be present in any of your baby’s immediate family members. You will also be asked about your baby’s behaviour and feeding pattern since birth and should be given the opportunity to discuss any concerns you may have about your baby’s health and behaviour. Your baby will need to be undressed for part of the examination and although your baby may cry, the examination is not painful for your baby. You will be told the results of the examination immediately. If a problem has been found, a referral to a specialist may be necessary for further investigations and to confirm a diagnosis.

Although it is recommended that every newborn baby has a NIPE examination, you have the right to decline it, or part of it. If you have any worries or concerns about the examination then please speak to your midwife or other health professional. It is also important to know that not every condition will be identified during the NIPE, as some conditions don’t develop or show symptoms immediately. If you notice anything about your baby that you are worried about, you should therefore speak to your midwife, health visitor or a doctor without delay.

Post by Jo, One to One midwife

20 Oct

Nub Theory

What is nub theory?

Is it true about the angle of the dangle?

Can you really find out your babies sex at 12 weeks?

Any best guess would be only slightly better than 50/50 and would have to be confirmed again at the anomaly scan at around 20 weeks. The honest truth is that it is very difficult for a sonographer to see clearly all the structures at dating scan and the genitalia of a fetus at this stage is very unclear and looks very very similar for both male and female foetuses.

'The correct visualization of any fetal part depends on many factors such as fetal position, amount of amniotic fluid and thickness of the abdominal wall. Establishing gender can sometimes be very difficult.'

The theory is as follows:

The following images are from 12-14 weeks.

Image 1: Supposed male fetus in development. With the male fetus, the genital tubercle usually creates an angle of greater than 30° with the lower part of the spine.

Image 2: Supposed female fetus in early development. In the female fetuses, the genital tubercle protrudes in the same direction as the lower portion of the spine with an angle of less than 30° relative to the backbone.

Various studies have supposedly been done to test this theory.

Studies have been conducted in Brazil, London (2studies) and Israel. Out of a total of 1619 pregnancies; gender was assigned and confirmed in 1424.

The results when combined together found that genre was accurately predicted at:

11 weeks 68%
12 weeks 88%
13 weeks 94%
14 weeks 98%

From: http://baby2see.com/gender/study_ultrasound.html#Brazil

I must highlight that I have searched one of the biggest online journal forums on the internet (which has never failed me when it comes to medical research) and I couldn't find any of these supposed studies!!

You must also remember ladies that not all sonographers will be trained to recognise and capture images like the ones here. This is not something we usually look at so early on.

I personally and professionally am not convinced. You may believe what ever you like though and I would LOVE to see the original articles and research if anyone has any links to them then please post them below.

Post by Sally Barnes, 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


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