A much needed revolution

“Centralisation, standardisation and market economics have been the dominant concepts in maternity care over recent years. Organisationally, NHS maternity care has been centralised into large units based on an industrial model where care is highly fragmented. Standardisation of services is…

Birth in Focus

I get sent lots of books, because of what I do. I always tell people who ask me, you’re welcome to send me your book, but regardless of whether I know you or any other factor, the independence of my…

EFM and conflicts of interest

“So the question is why would the BRPOs* of the world ignore obvious evidence of EFM harm, ignore informed consent, ignore the violation of mothers’ bioethical autonomy, and ignore the reality that most of the birth profession is lying daily…

The importance of everyday birth wisdom

I love research papers that tell me things I already know. I especially love those that tell me things I already know about everyday midwifery practice that I don’t think about on a daily basis but which, when I read…

Let there be mood lighting…

There can’t be many midwives or birth supporters who don’t already know about the advantages of low lighting for labour and birth. While we are still learning about whether and how darkness and light relate to the release of oxytocin…

More on consuming placenta…

A few weeks ago, I shared a two-part article that I had written about the practice of consuming the placenta (you can read part one here and part two here) and the lively discussion that followed highlighted one key thing:…

The ALTE mysteries

“Last month, I shared my frustration regarding the bias against normal birth and the ability of women’s bodies to grow, carry, birth and feed their babies. As is often the case when one starts to pay attention to an area,…

Risk: what is to be done?

“[R]isk has come to be defined as narrowly as possible, while there is a real and growing sense of concrete risks which overwhelm the poorer and more vulnerable on a daily basis. Within what Nicolas Rose, another sociologist calls the…

Midwives, resilience and sustainability

A discussion paper on sustainability and resilience in midwifery has highlighted the importance of self-care, self-determination, relationship and passion in midwifery (Crowther et al 2016). The research was led by a team of authors who have worked on past and…

A cautionary holiday tale

I’m sharing a bit of holiday cheer today, and am thinking especially of my friends who are in the Southern hemisphere and heading towards their midwinter. The nice people at The Practising Midwife let me share my Thinking Outside the…

The risks of documentation

“Documentation of care is at risk of overtaking the delivery of care in terms of time, clinician focus, and perceived importance. The medical record as currently used for documentation contributes to increased cognitive workload, strained clinician–patient relationships, and burnout. We…

Happy Midwives’ Day!

Happy Midwives’ Day! I’m spending International Day of the Midwife in Reykjavik where I’m discussing Recipes for Normal Birth with lovely Icelandic midwives, but I wanted to send my happy midwives’ day wishes out to my friends all around the…

Pondering placentophagy – part 2

“A recent systematic review, which looked at whether there are any benefits to placentophagy – the consumption of one’s placenta after birth – has concluded that there is no evidence of benefit or risk and that these require further investigation.…

The false economy of “busy-ness”

“Place shapes the ability of midwives to “be with” women. In the labour ward, strong cultural norms press midwives to engage in “busy work” while they feel more able to sit quietly with women in primary birth settings. Midwives are…

A small ‘seeding’ rant

May I jump into the microbiome/seeding debate really briefly, while acknowledging that the issues are much larger and more complex than I have room to discuss in one blog post? Because I have been watching several recent conversations in medical…

Pondering placentophagy – part 1

“A recent systematic review which looked at whether there are any benefits to placentophagy – the consumption of one’s placenta after birth – has concluded that there is no evidence of benefit or risk and that these require further investigation.…

Pelvic checks at the 6-week check

Sometimes, the combination of my travelling and reading of the midwifery and obstetric literature highlights areas where there is variation in what is seen as standard or usual practice in different areas of the world. There are lots of obvious…

Happy Spring (or Autumn!)

Here’s wishing you a very happy spring on this day of fertility, eggs and bunnies 😀 Or if you’re in the southern hemisphere, I hope the autumn leaves are bringing great colour to your life before you bed down for…

Midwife-led care works in Manitoba!

Over the past year or three, I have shared numerous studies and respected reviews that have shown midwifery-led care to be effective all around the world in countries from Australia to Ireland. Midwifery care helps keep birth normal and it…

How are you sleeping?

In your practice, do you routinely ask women how they’re sleeping? And if you do, what do you do with that information? Do you use sleep-related questions as a way of triggering and exploring all manner of topics with women?…