Sara Wickham’s poem: “When I am an old midwife”.
Routine induction in healthy women not supported by evidence
Research looking at the effects of induction of labour shows this is associated with few beneficial outcomes and several adverse outcomes.
Why birth-related decision making is trickier than ever…
A number of features of our modern culture have made making birth-related decisions trickier than ever, says Sara Wickham.
Less is more…
When less may be more. Sara Wickham writes about the human tendency to want to prioritise action and ‘doing more’, when this may not be the best solution.
A midwife’s guide to birth fairies
Sara Wickham describes some of the birth fairies that hide around the labour ward in a fun article originally written for the holiday issue of a journal.
Cervical wisdom resources
Have you ever noticed what real women’s cervixes do in labour? How they haven’t read the textbooks? Sara Wickham shares her work on cervical wisdom.
Women’s experiences of augmentation of labour
A study looking at women’s experiences of augmentation of labour has highlighted problems with informed decision making and shown that having a synthetic oxytocin infusion in labour can cause an atypically painful labour and lead to negative birth experiences. Alòs-Pereñíguez…
Screening and the consequences of knowledge
Is it always good to know things, just because we can? Sara Wickham explores this idea in a series of blog posts about the consequences of knowledge.
Reflecting on risk assessment
Risk assessment is an integral part of midwifery and medical practice and yet also something we need to think about more. A few years ago, I spent some time reflecting on the issues raised by revised guidelines on venous thromboembolism…
Another study, another dodgy headline! Please don’t steal our coffee!
A study was published in the European Journal of Obstetrics & Gynecology and Reproductive Biology entitled ‘Associations between consumption of coffee and caffeinated soft drinks and late stillbirth—Findings from the Midland and North of England stillbirth case-control study’. The media…
Delaying cord clamping for six minutes is safe
Research has added to our knowledge about delaying cord clamping. We know now that it is safe to wait 6 minutes after birth, even when an oxytocic drug is given to assist with the birth of the placenta. Waiting, which…
May Contain Tigers
Warning: this blog post may contain tigers. As someone who lives with a serious food allergy, I have noticed some interesting changes in the information given on product labels over time. Over the years, I have thoroughly enjoyed the proliferation…
Midwifery Wisdom and Reflection
Sharing classic articles and blog posts written for and about midwives and midwifery practice by Dr Sara Wickham.
Trends in induction of labour
How are trends in induction of labour changing? And has the publication of the controversial ARRIVE Trial affected this? Two recent studies have added to our knowledge about the effects of changing guidelines and narratives on trends in induction of…
Which induction book do I need?
Which induction book should I read? I’m the author of two books about induction of labour. Inducing Labour: making informed decisions has been popular for nearly twenty years. I frequently update it with new information, so as long as you…
Labour progress resources
Labour progress resources available on Sara Wickham’s website. Everything from research challenging norms to the purple line!
Passing yarns forward: unravelling the dimensions of knitting and birth
I have long been interested in the links between knitting and birth. I have a childhood memory of a midwife once casting off my knitting for me when my mum was busy. A simple act of kindness which cemented my…
What time are babies most likely to be born?
What time are babies most likely to be born? As a home birth midwife, I’m well aware that a good many babies like to be born in the deep of the night. But what does the evidence say about this?…
Women are not given adequate information about induction
Another survey has identified a continuing problem with women not being able to get clear information about induction of labour (PIF 2021). This study was conducted by the Patient Information Forum in collaboration with a number of birth charities. It…
The 2021 NICE guideline on inducing labour
November 2021 saw the publication of the 2021 NICE guideline on inducing labour. The guideline “…concerns the circumstances, methods and monitoring for inducing labour in pregnant women.” (NICE 2021). The draft version of the guideline caused a lot of controversy when…
Anti-D in pregnancy: how we haven’t moved on…
The first Cochrane review of the research relating to the administration of Anti-D during pregnancy was undertaken in 1996. Nearly twenty years later, September 2015 saw the publication of the latest update. During that time, however, the only changes were…
Ten reasons to question the draft NICE Guideline on inducing labour
May 2021 saw the publication of a draft NICE guideline on inducing labour. NICE stands for the National Institute for Health and Care Excellence. It is the body that provides national guidance and advice to inform health and social care…
Unexpected home birth: let’s keep our shoelaces on…
Sara Wickham explains why advice given by the emergency services to use shoelaces to tie the cord at birth is incorrect and dangerous
How to share content so everyone benefits…
How to share content so that everyone benefits? Dr Sara Wickham offers some suggestions and tips to help you stay generous, friendly and legal.
Vitamin K: the stories behind the evidence
Sara Wickham shares ‘vitamin K stories’; the tales and context behind the evidence and knowledge that we have in relation to vitamin K for newborn babies.
Home birth after caesarean
Home birth after caesarean (or HBAC) is an increasingly popular option. Women and families know that they will be less subject to monitoring and interference at home. It is thought by some that home birth after caesarean may lead to…
Six principles for effectively managing your research project
Dr Sara Wickham offers six tips for managing your research project. What to keep, what to do with it, and how often to remove the cat from your in-basket…
Induction and synchronised swimming: Mary Cronk words of wisdom
Sara Wickham shares the wisdom of Mary Cronk, one of midwifery’s heroes. Thoughts on induction, labour and synchronised swimming…
Top ten technologies that have improved the lives of women and midwives
Dr Sara Wickham shares the top ten technologies that have improved the lives of women and midwives, voted for by midwifery and medical colleages.
Black women are five times more likely to die in childbirth, so what can we do?
Black women are five times more likely to die in childbirth than white women. That was the finding of the MBRRACE-UK: Saving Lives, Improving Mothers’ Care report (Knight et al 2019). While the statistics change over time, the problem remains.…
The induction decision: what do women want?
What do women want when it comes to the induction decision? Dr Sara Wickham investigates research which shows that it’s more complex than we might think.
A Tribute to Tricia’s Lab Cats
Sara Wickham dedicates a poem to Tricia Anderson and their shared love of writing about birth and cats.
Vitamin K and tongue tie division
What happens when parents want a tongue tie division but the baby hasn’t had vitamin K? Can professionals decline to do this? What are the issues?
Reclaiming the Art in Birth
Sara Wickham discusses art, craft, birth and knitting, revisiting a topic she first wrote about twenty years ago whose content is still as relevant today.
Self-care: caring for ourselves…
Self-care is vital. Sara Wickham offers a bit of background and a long list of ideas for those who need to focus more on themselves.
Bad science and the limitations of choice
Dr Sara Wickham discusses ‘bad science’ and the papers which purport to show that birth is risky. But is risk being used as a means to control?
Why are some women dissatisfied after induction of labour?
Dr Sara Wickham looks at new research. Why are some women dissatisfied after induction of labour? What aspects do they dislike?
Membrane sweeping for induction of labour
Sara Wickham looks at the latest edition of the Cochrane review on membrane sweeping for induction of labour. What are the key points?
Seven tips for finding old copies of guidelines
Sara Wickham explains how to find old copies of guidelines, such as those put out by professional or governmental bodies.
Twenty birth kit essentials
Sara Wickham unpacks the birthkit essentials carried by midwifery colleagues and shares some great tips of things you might want to have at a birth.
Home fetal dopplers “strongly discouraged”
Government and professional bodies in the UK have publicly advised against the use of fetal dopplers by parents in the home. Dr Sara Wickham explains.
Screening: what are we missing?
Does the use of modern screening technology come with downsides? Sara Wickham argues that it does, both in life and birth.
Induction of labour at or before 42 weeks of pregnancy: new evidence
Sara Wickham looks at Danish research which compared induction of labout at 42 weeks with induction of labour at 41+3 weeks, with interesting results.
The Poo Taboo
Sara Wickham presents the results of a conversation amongst women who are also midwives on the topic of poo in labour.
Induction of labour and avoidable harm
Sara Wickham shares research which highlights the issue of induction of labour and avoidable harm, showing us that there’s another side to the story…
The folly of fully dilated
There are a few myths about the idea that women need to be fully dilated to give birth, and that this means the same thing for every woman.
Stepping Stones and Cervical Wisdom
What is cervical wisdom, why is it important, and why have many midwifery and medical textbooks got it so wrong? Sara Wickham explains.
Tips for physiological birth of the placenta
Sara Wickham shares tips for physiological birth of the placenta which emerged from a discussion held with a circle of midwives.
Pondering the post-birth tea break
Sara Wickham explores the uniquely British ritual of having a cup of tea after birth, with the help of midwives and women who share their thoughts on this.
Homebirth: Safe & Sacred
Can I have a natural placental birth after induction?
“Is it possible to have a natural placental birth after induction?” That’s a question I get asked a lot. So here’s my answer… So what do we mean by ‘natural’? My first reply to this question usually begins with me…
Giant Breakthrough in Screening or Great Big Stressor?
Sara Wickham’s 2004 article in which she looks at the pros and cons of offering screening for the group B strep bacteria in pregnancy.
What I knew about placental birth that my obstetrician friend didn’t…
Evidence is important, but it isn’t enough. Sara Wickham explains why we need to learn from stories as well as science.
We are all biased by what we see…
Sara Wickham looks at how we are all biased by our experiences, and how different viewpoints depend on what we see.
Women’s experiences of birthing their placenta
Australian researchers have carried out an important study looking at women’s decisions about, and experiences of birthing their placenta.
A few reasons to be cautious about the idea of routinely scanning for breech presentation near term
Sara Wickham looks at the ides of routinely offering a scan to see if a baby is breech. This raises more issues than many people realise.
Obstetric cholestasis – who is really at risk?
Sara Wickham looks at new research into obstetric cholestasis, which may help determine which babies are really at risk and thus reduce over-intervention.
The trusty toilet
Sara Wickham discusses midwives’ experience of using toilets as birth stools, and looks at their effectiveness at facilitating normal birth.
Update to the Cochrane review on approaches to the birth of the placenta
An updated version of the Cochrane review on Active versus expectant management for women in the third stage of labour has just been published.
