“Informed consent is a redundancy, because being properly informed is a precondition of consent. Without being properly informed, a patient or client cannot give any legitimate, binding consent. Therefore, it is imperative that all professionals withhold any request for agreement…
We know that many of the caesarean sections that are carried out today aren’t medically warranted. A related concern is that a proportion of these may be being carried out in the interests of profit rather than for the benefit…
As this post goes live, I will be at the CAPERS Passage to Motherhood conference in Brisbane, Australia, and I rather hope that I will be spending a bit of my time in the red tent crafting area which is…
I love it when people remind me of brilliant ideas and analogies that I had forgotten. A couple of weeks ago, one of my post-term pregnancy online course participants reminded me of the wonderful and well-loved midwife Mary Cronk’s analogy…
A Finnish study exploring parent-infant closeness and separation has thrown more light on how hospital practices both promote closeness and cause separation in the first couple of hours after birth. And it’s kind of paradoxical, because the researchers discovered that,…
Last month (Wickham 2016), I wrote about a principle that I was taught and have subsequently shared with many other midwives. It involves asking oneself whether offering a screening test would change one’s management, or what one would offer to…
“Much, though by no means all, of what has been written and spoken around childbirth revolves around fear. Policies and practice at both national government level and local hospital level have frequently been based on the idea of ‘risk assessment’.…
Two more research studies have added to the concern that women who undergo induction of labour are more likely to end up with a caesarean section than if their labour began naturally. The first, an analysis of the outcomes of…
Suitcases are packed, liquids are corralled in the obligatory ziplock bag and – perhaps most importantly of all for me – my craft case is full to bursting with projects for me to make on the plane and while I’m…
“In short, normality is all about context. What is normal for one individual could be insufferable for another, and the same individual could be normal in one environment yet not in another. Just take a look at inborn differences in…
I find it really sad that midwifery regulators don’t seem to understand the enormous value that there is in continuity of care, which has been described as central to gold standard midwifery care. Nor is there much recognition that the…
I have found, over quite a few years of teaching midwifery, that people who are learning midwifery and similar arts often like to have building blocks in the form of rules, lists and principles that they can learn and explore…
A few weeks ago, I posted about the worrying situation in the UK, where the actions of midwifery regulator the NMC have led to midwives in the UK not being able to practice independently. “The impact of this ruling extends…
The topic of human rights in childbirth has never been so important, and today I am sharing a couple of resources in this area which offer interesting perspectives from obstetricians. The first is a freely available Reproductive Health article by…
I realised last week that it is two years this month since I sent out the first of our Birth Information Update newsletters and, as I love birthdays so much, this seems like a good point to pause, reflect on…
We are, and I must admit that I’m a bit shocked to realise this, nearly a quarter of the way through 2017. And, even more shockingly, I haven’t yet posted one post this year offering a reminder about self-care, so…
An article published in Birth has added to the debate about the different guidelines relating to the diagnosis* of active labour, considering which of them leads to the highest number of caesareans. *Before I move on, I’d like to quickly…
“Midwifery is beset with problems at present and, as we seek to deal with each crisis, there is no time to look at the source of the problems. As I am a retired academic and no longer practicing, thanks to…
“Many individuals do not behave according to statistical means, and population models will fit them poorly.” – J Christopher Glantz This quote is taken from a paper that I chose as my ‘study of the month’ in the February…
A study published in Acta Obstetricia et Gynecologica Scandinavica might be helpful to women who are frustrated by the discrepancy between their own due date (as calculated by the date of their last period) and that calculated through ultrasound scanning.…
This week, an important paper has been published (currently in draft form) in Midwifery. Titled ‘Midwifery continuity of carer in an area of high socio-economic disadvantage in London: a retrospective analysis of Albany Midwifery Practice outcomes using routine data (1997–2009)’,…
A few weeks ago, an obstetric colleague send me an email with a link to the Cochrane review on High-dose versus low-dose oxytocin infusion regimens for induction of labour at term with a note pointing me to the first line…
I’ve always been proud of the fact that I was one of the four per cent of babies who was born on their due date, although I’m not really sure why. I am so proud of this fact that I…
The previous two articles on this topic (part 1 here and part 2 here) explored some of the issues around the advantages and disadvantages of habits, customs and traditions and took a backwards look in order to see how some…
I [recently] wrote about some of the advantages and disadvantages of habits, customs and traditions and suggested that, as well as looking at the bigger issues of the routine interventions that need to be challenged, it may also be beneficial…
There’s something I’ve been wondering for a while. I know I’m not the only person who wonders it, because I’ve heard other people say similar things, but I’ve not yet heard a good answer to it. What I’m wondering is…
Aren’t habit, custom and tradition marvellously labour-saving devices?! It doesn’t matter how rational we might seek to be when making a decision that we have time to ponder; during the course of a day, we each have to make hundreds…
I noted in the first part of this article that the past few years have seen a trend towards recommending early induction for older women. The definition of older, however, along with the definitions of other key factors in this…
“Holding on to what we have been told is true is not the same as having a true place of knowing.” – Jeanne Ohm If that thought interests you, I’m going to be re-posting some articles that I wrote a…
“The baby comes from the womb relatively germ-free, and yet within one hour, scientists say the human baby has been colonized with millions of microbes. The question is, whose microbes? One person should be doing this “seeding”, and it is…
Another study has confirmed that freestanding midwifery units are a safe and reasonable option for mothers and babies and that women who use them are less likely to have a caesarean section, even if transfer is involved (Monk et al…
The UK Nursing and Midwifery Council has been deemed to be acting irresponsibly by denying choice to women and “directly jeopardi[sing] the health and safety of the women it is supposed to safeguard”. On January 13th 2017, the independent midwifery…
I first published a version of this post on bedlessness in 2013. I had received quite a few positive comments on a post about being womanside and was also spurred on by conversations about how midwives and birth folk can…
“In randomised clinical trials comparing electronic monitoring with intermittent auscultation, electronic monitoring increased the risk of caesarean by 63% (relative risk=1.63, 95% confidence interval 1.29 to 2.07). This suggests that, if electronic monitoring had not been used in those 620…
As a student midwife, I looked after a few women who were having their first baby near or around the age of 40. As far as I can recall, my mentor midwives had two main concerns. The first was the…
A survey of pregnant women planning a hospital birth in Australia offers interesting food for thought in relation to women’s views and knowledge about the ‘due date’ and the timing of birth. As many readers of my work will know,…
When a biological function such as birth is forbidden or restricted, as we see in hospital or practice protocols; when threats, coercion, lies, bullying and disparity become common place, as we see in such statements as, “So, you just want…
There’s something about the change of weather in the Autumn that makes me want to shift from quilting – my spring, summer and travel craft – to knitting. I don’t know if it’s the cold, or the changing colours of…
An analysis of the language used in the documents created by midwifery professional bodies to describe the scope of practice of midwifery has shown that many of these definitions of scope of practice reveal a continuing orientation to a medical…
Cassie, who has given me permission to tell her story and who chose her own pseudonym, became pregnant via IVF. She was thus one of those women who know the exact date when they conceived, and she and her midwife…
A new and groundbreaking research study has found that, “Upright vaginal breech delivery was associated with reductions in duration of the second stage of labor, maneuvers required, maternal/neonatal injuries, and cesarean rate when compared with vaginal delivery in the dorsal…
A midwife friend asked me recently whether, during a baby’s birth, I routinely felt for the cord around the baby’s neck as it emerges. I replied that I didn’t, not least because I tend to be quite ‘hands-off’ about catching…
I’d like to offer another riff about language today. I have heard and read a number of comments lately about women being “at risk of needing a caesarean”. But there’s so much to unpack in that statement! What do we…
It is now more than 40 years since some countries introduced a policy wherein anti-D is offered to rhesus negative women who have given birth to a rhesus positive baby. In that time, a number of related developments have also…
When midwife Susanne Houd was interviewed about the history of home birth in Denmark, she shared her thoughts on how to bring about change.. “The consumers need to get together and get visible. That is really the number one thing.…
I like to spend time trying to make the world a better place. Within my tiny segment of the universe, I do that by offering information and education to midwives and birth folk in the hope that together we can…
“Health-care organisations should move beyond a culture of endurance, which overvalues stoicism and dismisses complaints as signs of weakness, and help clinicians be better at self-care than they are at present. 21st-century patients demand more than in the past, rightfully…
I had only been a midwifery student for a few months when I first heard the late, great Marsden Wagner speak about the lack of evidence for electronic fetal heart monitoring (EFM). At the time, he told us, more than…
“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…
My recent travels have led to another build-up of my reading pile and, as I do a few times each year, I am sharing a few articles in one post so that I can clear the backlog and keep you…
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…
A study looking at women’s experiences of different types of birth has again reinforced the idea that we should be doing all we can to promote physiological birth and reduce interventions. (Yes, we also definitely need to work on making…
“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…
During my recent workshop in Iceland, one of the midwives told us that she had made a youtube video featuring birth photos. As you might imagine, we were all very keen to see it and we put it on during…
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…
I go on quite a bit about self-care. I write blog posts about it, sharing lists and ideas and reminders at special times, and one of the reasons I do this is because I think that it is easy to…
“With the right person in the right team, the community can offer everything that a newly qualified midwife needs, and more: the opportunity to hold a caseload, manage the entire care pathway for low risk women and develop skills in…
I know I often write about the risks of risk management and our constant focus on measuring women and their babies, but I really feel that papers like the one that I spotted this week need to be shared. That’s…
A few weeks ago, a woman said to a midwife friend of mine, “I really don’t want to have induction if I go overdue. Everyone I know who has one has a horrible lonely experience in the hospital for days…
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…