About 20 years ago, it was while sitting on the floor among friends at a Midwifery Today conference that I first encountered the use of the colourful woven shawls that Mexican midwives call rebozos. During a workshop led by midwife…
“Parenting is, hands down, the most challenging thing you will ever do. It is scary, troubling, enthralling and exciting. It requires long hours, Herculean patience, trust and thousands of other skills and characteristics that our kids deserve and demand. As…
“Although evidence based medicine has reshaped medicine, nursing, and allied health professions into knowledge driven, scientific (sometimes pseudoscientific) professions, it fails to tackle the multifactorial reality of what actually happens to patients—the “art” of helping humans. The science of evidence…
I often hear midwives and birth folk lamenting the way that one-sided, fear-based, sometimes mysogynistic and frequently inaccurate depictions and representations of birth permeate modern culture, and I share their concerns. Participants in my workshops and online courses note the…
My grandmother gave birth to all of her babies at home. There were simply no other options (Lee and Wickham 2000). But by the time her daughters were ready to birth, just a couple of decades later, they were offered…
What is the BRAN analysis? I have heard you speak about this, but I can’t find a simple explanation of what it means that I can share with my clients. Can you help? Yes I can. I did write about…
Midwives have done a lot of reflecting on their language over the last few years. While visible changes in practice inevitably take a while to evolve, there is a clear movement in the progressive midwifery literature from use of words…
A review article written by Danish doctors and published in the British Journal of Obstetrics and Gynaecology has stated that the benefits of vaginal seeding “do not outweigh the risks”. This paper and the inevitable news stories which have been…
‘Language is important and influential. I request that the Journal stop using (and letting authors use) the term obstetric when talking about midwifery care. Obstetrics is what obstetricians do, midwifery is what midwives do, and maternity care is what we…
The authors of an updated Cochrane review entitled ‘Antibiotic prophylaxis for operative vaginal delivery’ have drawn the same conclusion as in previous versions of the review: that routinely giving antibiotics to women who have forceps or ventouse births leads to…
It occurred to me recently, while presenting on the topic of labour progress, that there is a blog post that I use frequently as a reference when I’m speaking about labour and birth – in particular, the question of what…
“The Victorian parliamentarian and novelist Edward Bulwer-Lytton declared, “A reform is a correction of abuses; a revolution is a transfer of power.” Patient centred care began as a correction of abuses, a response to patients being treated like “imbeciles and…
I’ve ranted before about what I see as the inappropriateness of the term ‘shared decision-making’ in medical circles. Calling a decision a ‘shared decision’ implies that the practitioner gets a say in what the person chooses. Yet when it comes…
For a few years now, I have been blogging regularly about birth, midwifery and my work in these areas and, as a result of this, I have learned quite a bit about how the Internet works. Blogs, for instance, come…
Australian researchers have published a review and meta-synthesis of twenty research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. This is an important and valuable piece of work because, although we know that…
Another study has suggested that the differences in birth outcomes experienced by women of size may be due as much to provider attitudes and biases as to any intrinsic difference or disadvantage. Ellekjaer et al’s (2017) research, carried out in…
When I post and discuss birth-related articles in my newsletter, blog or on social media, people often ask, “how can I see the full text of this?” I know this is a problem for many people. Because I work completely…
A study carried out in Finland has provided more evidence of how we can use fetal rhesus group testing in order to offer anti-D prophylaxis only to those rhesus negative women who are carring rhesus positive babies and thus reduce…
“Do you know of any good resources on the subject of questioning/declining vaginal examination? I’m thinking of vaginal examinations in a number of contexts – well woman exams, vaginal examinations in labour and especially at the end of pregnancy, as…
“Do you know of any good resources on the subject of questioning/declining vaginal examination? I’m thinking of vaginal examinations in a number of contexts – well woman exams, vaginal examinations in labour and especially at the end of pregnancy, as…
I recently read the most fascinating paper. Called ‘A critical analysis of Australian policies and guidelines for water immersion during labour and birth’, it aimed “to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to…
“Whilst for many women pregnancy and birth is a wonderful, life affirming experience, the findings from this study have highlighted how birth trauma can be experienced by women as a culmination of previous life events, pregnancy and birth trauma and…
Language is something that we learn unconsciously rather than in a deliberate fashion, and in our busy world we often say things without thinking too much about why we say them or where they come from. But words have a…
“To study neonatal Streptococcal B infection is to enter the realm of mysteries… How to explain that microbes from maternal origin may be pathogenic for the baby? Several decades ago, we learned that, compared with the placenta of other mammals,…
“Being with someone, murmuring along with their heartbeat, breathing with them, is a lost art. The true midwives of birth and death, those who keep vigil at the bedposts, are rare. They are the people whose eyes are accustomed to…
A new Cochrane review has been published on the subject of reducing perineal trauma by using certain techniques during the second stage of labour. This is a controversial topic and I know that this is going to be of interest…
I am very happy to announce the birth of my latest online course, Group B Strep Explored! Our online courses run on set dates, usually in the spring and autumn. You can see if we have current dates open on…
Babies born to women who have diabetes are known to have a higher chance of experiencing hypoglycaemia (or low blood sugar). They are more likely to be admitted to a special care baby unit and there is a lower chance…
“Our hands are skilled in the art of touching, of catching, of wiping the brow, but they should also be skilled in the art of knowing when to do nothing. Much too frequently eager birth attendants or doulas cannot just…
A case study shared in this month’s International Journal of Obstetric Anesthesia carries an important warning message for women choosing to (and, almost more importantly, those supporting or working with women choosing to) use epidural or other forms of regional…
“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…
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…