The Independent Midwife

So very beautifully written. Grateful we are helping to make positive memories for bereaved parents.

Something good enough Our middle child was 72 minutes old when the midwife listened for his heartbeat and heard no sound. His peaceful death was the long-anticipated conclusion of a pregnancy fraught with inconclusive scans and tests, and eventually a diagnosis of anhydramnios that put all ambiguity to an end. With no mo...

What we have all known, all along. The ARRIVE trial needs to be exposed for its faults and binned. Please never let me hear you quoting it.

A new study has reinforced our knowledge that, in real world settings, healthy women are more likely to end up having a caesarean if they have induction of labour than if they go into labour on their own.
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The study will be published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.
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The authors conclude that, “Awaiting the natural onset of labor, if there are no maternal or fetal reasons to intervene, may yield no worse a perinatal outcome than an earlier induction of labor. The consequences of a cesarean delivery are known to be associated with immediate and longer-term maternal morbidity, and this may be potentially avoided, if elective inductions of labor can be minimized.” (Levine et al 2021).
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This result, which echoes that of a number of similar studies, is in contrast to the findings of the often cited ARRIVE trial.
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So why is that?
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One reason is that the participants in the ARRIVE trial were not representative of all women. Another is that women in the ARRIVE trial had very medicalised care. And, as Levine et al (2021) note, there’s a difference between what happens in the setting of a trial, and in the real world. I’ve written lots on this, so here are some resources if you’d like to know more.
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You can read Levine et al’s study at https://www.sciencedirect.com/science/article/pii/S0301211521002463
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If you’re wondering whether induction is right for you or wanting to read more about the evidence, check out the resources on my website or my book, “Inducing Labour: making informed decisions.” www.sarawickham.com/iol
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And if you’re a midwife or birth worker and you’d like to better understand the issues and develop your confidence with research, we’re looking at a number of aspects of induction in Gathering in the Knowledge 2021. See https://app.ruzuku.com/courses/66197/about
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💞A very Happy International Day of the Midwife💞

Literature from around the world shows that women who have midwife-led care have better outcomes, a higher chance of a live, healthy baby, less unwanted intervention and are more satisfied with their experience.
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There are no known downsides to midwifery-led care.
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Midwives can make a huge difference but, as the World Health Organization points out, socio-cultural, economic and professional barriers must be overcome to allow midwives to practice to their full potential.
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Today is International Day of the Midwife.
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Happy Midwives Day!
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And a huge thank you to midwives everywhere. (We'll be saying thank you to midwives in a more concrete way later this morning with an Insta giveaway, so if you're on Instagram, watch our tiles! We're )
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If you'd like to find out more about midwifery, birth options or midwifery-led care, there's lots of information available at www.sarawickham.com
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"Compared with other types of fetal surveillance, intermittent auscultation seems to reduce emergency cesarean deliveries in labour without increasing adverse neonatal and maternal outcomes. New fetal surveillance methods did not improve neonatal outcomes or reduce unnecessary maternal interventions. Further evidence is needed to evaluate the effects of fetal pulse oximetry and fetal heart electrocardiography in labour."
https://www.cmaj.ca/content/193/14/E468?fbclid=IwAR3C91m-vgvMk7weMIc5u5IqH59lxpa3vt-ZHWzEUlHDYj7PEyDSZxSPaQc

Effectiveness of intrapartum fetal surveillance to improve maternal and neonatal outcomes: a systematic review and network meta-analysis BACKGROUND: Cesarean delivery is the most common surgical procedure worldwide. Intrapartum fetal surveillance is routinely offered to improve neonatal outcomes, but the effects of different methods on the risk of emergency cesarean deliveries remains uncertain. We conducted a systematic review and n...

Sharon GamonHome Birth Group UK
Yesterday at 14:06 ·
"Good morning to my lovely colleagues. My name is Sharon and I am the Practice Development Midwife for Privatemidwives.com. We are a fully indemnified and CQC registered company looking after women in all settings in collaboration with the NHS.
I wanted to introduce myself and let you know a bit about us. Our number is growing all the time and we have midwives all across the UK and ROI. We come into contact with many of our NHS colleagues on a regular basis, and whilst many of you express an interest in how we work, there is also some uncertainty about who we are, how we are regulated, what we can do, and some confusion about the difference between us and our Independent midwifery colleagues.
In the spirit of facilitating better understanding of how we work in your settings, and to promote good working relationships we would like to offer the opportunity to get together via a number of virtual coffee mornings / workshops. We hope that we can create better understanding and enable good working relationships so we can all support women and families well together.
This pandemic has hit us all very hard and our workload at Private Midwives this past year has more than doubled. We are all getting through this together and we would love to meet you.
If any of you are interested please do private message me and I will let you know when the events are happening.
Thank you for reading this far, and I hope to be meeting some of you soon"
Private Midwives https://privatemidwives.com/?fbclid=IwAR05KQrfwRqI0GThxyWrx-a2_R2yhm5bnqj1SVKhrAp7xtxOuIlWFr-c0-Y

Private Midwives Private Midwives offer private midwifery services to offer you choices for your pregnancy and birth from home births to hospital births. Contact us today

Please sign !

Evidence not Prejudice: Deliver Better Births A group of mothers and midwives who care about quality maternity care have come together to start this petition. Last week, the major newspapers all ran high profile stories saying that Midwives were no longer supporting 'normal' birth, portraying it as a climb down. Midwives were attacked for 'push...

This study has really annoyed me! There has never been any evidence that the use of CTG improves neonatal outcomes but it does increase the cesarean section rate and morbidity for women, short term and long term. Recent studies have shown that the use of CTG may actually increase the cerebral palsy rate. So this study seems to be suggesting that the reason why CTG does not improve neonatal outcome and decrease C section is because the training of professionals is poor. CTG has been around since the 70's...over 50 years. Seriously, if we cannot interpret CTG after 50 years of use as well as trying to get computers to interpret then maybe it is not the training that has a problem maybe CTG is just not a useful tool for improving morbidity and mortality of babies? Maybe we need to really look at the evidence and be brave and bin all those lovely shiny machines? https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.16619

OBGYN Training in fetal monitoring: systematic review finds little evidence of impact on neonatal outcomes.

Since Covid I have seen a huge increase in requests from women wanting a home birth. All the clients I have at the moment except one (who has planned to give birth in a MLU birth centre) are planning to give birth to their baby at home and that includes 4 women who have had previous C sections.

‘Women feel they have no option but to give birth alone’: the rise of freebirthing As Covid infections rose, hospital felt like an increasingly dangerous place to have a baby. But is labouring without midwives or doctors the answer?

https://peppyhealth.typeform.com/to/yun6jyQr

National free Peppy Baby programme Trial to support expectant parents in Greater Manchester and Eastern Cheshire. Please share widely.

Such a wonderful letter written to Chrissy Teigen from Lucy Ruddle IBCLC. Thank you Lucy x

Did you give birth between March and August 2020? If so, the NPEU team would love to hear from you. Please take part in the You & Your Baby survey here: https://www.smartsurvey.co.uk/s/02FLCJ/

Very interesting critique on the OASI bundle.
'Recent systematic reviews in 2018 and 2020 on homebirth show a halving in SPT for low risk women birthing at home compared to obstetric units. The great irony is most women giving birth at home do so in water, are upright and have minimal perineal interference. Perhaps it is our medicalised models of care that are the bigger reason behind a rise in SPT, but this conversation challenges power and belief and so is always dismissed.'https://www.all4maternity.com/the-uk-oasi-care-bundle-the-results-are-out-but-so-is-the-jury/

The UK OASI Care Bundle: the results are out but so is the jury | All4Maternity The UK OASI Care Bundle: the results are out but so is the jury Gill Moncrieff Research Fellow/Midwife, University of Central Lancashire UK Hannah Dahlen Professor of Midwifery, Western Sydney University Australia In 2014 the UK Royal College of Obstetricians and Gynaecologists (RCOG), and the Royal...

Huge mental health toll that Covid restrictions have had on mums-to-be Nine in ten pregnant women and new mothers said virus curbs are damaging their mental wellbeing, with 97 per cent saying lockdown had increased their anxiety around childbirth.

Researchers are looking for women who have given birth since 16/03/2020 or who are at least 30 weeks pregnant, and planned/plan to labour or give birth in water.

The project aims to to explore the impact of Covid on expectations, decision making and experiences during pregnancy, birth and the postnatal period. Participation involves a short 20-minute survey with an optional phone/zoom interview.

Find out more here: https://brookeshls.co1.qualtrics.com/jfe/form/SV_b9tdzuZ3Pv9oiah?fbclid=IwAR21l5USsDB9YeQpADCGcHO9erKPBHTyZbskPN4j4mCBAB-EfDnWOMiwIHU

London clients and Mums! Have you thought how you are going to care for your pets when you give birth? If you would like some help I can highly recommend Sweet Paws Pet Services. Flora is absolutely reliable and can be trusted to take the very best of care with your furry friends 😍

Sweet Paws Pet Services Happy pets are our passion. Reliable dog walking, horse grooming & general pet services in and around the Holyport, Maidenhead area. Please get in touch for any pet services you might need. Fully insured, Canine First Aid Trained and Enhanced DBS checked.

Did you use One to One Midwives? There is an independent review taking place by a consultancy company called Niche and they want to speak to people who used the service. Contact Ruth Laird via email [email protected] or phone 0161 785 1000.

The NHS has commissioned an independent review of One to One Midwives who provided midwifery care, often at home, to lots of women in Greater Manchester several years ago. If you were one of those, please could you complete this short survey about your experiences. Many thanks, Cathy :)

https://www.surveymonkey.co.uk/r/S2WVHR8

Thank you Hannah Dahlen
Well done Liz Newnham on this prospective cohort study of epidural use in nulliparous women. As midwives we know this reality and with the large cross over and select populations involved in the RCTs this is what is not fully picked up (much like the Induction research). More than 3 times as likely to have a vacuum birth, nearly 12 times as likely to have a forcepts. Longer first and second stage of labour and much higher rates of syntocinon, antibiotics and temperature and half as likely to be breastfeeding by three months. This is the cascade of intervention that results from epidural. Not to mention all the implications for worse perineal trauma and pelvic floor injury when you have this kind of increase in instrumental birth. It’s time to be really honest with women about the implications of epidurals and provide real and easy to access alternatives for women to help support them with working with the pain of labour and birth. Let’s build this into the consent process instead of only mentioning the very rare possibility of paralysis!

Women using EA were more likely to require a vacuum-assisted birth (RRR 3.35, p < 0.01) or forceps-assisted birth (RRR 11.69, p < 0.01). Exposure to EA was associated with significantly greater risk of ≥10 h first (OR 6.72, p = 0.01) and ≥2 h second (OR 2.25, p < 0.01) stage labour, increased likelihood of receiving IV syntocinon (OR 9.38, p < 0.01), antibiotics (OR 2.97, p < 0.01) and a greater probability of pyrexia (OR 10.26, p < 0.01). Women who used EA were half as likely to be breastfeeding at three months postpartum (OR 0.53, p < 0.01). No differences were observed between groups in neonatal outcomes.

Comparison of labour and birth outcomes between nulliparous women who used epidural analgesia in labour and those who did not: A prospective cohort study To compare labour and birth outcomes between nulliparous women who used versus did not use intrapartum epidural analgesia.Prospective cohort study.Two…

More scientific evidence that interventions during birth can effect the long term and short term health of the baby. Interventions are not benign.

https://theconversation.com/amp/how-birth-interventions-affect-babies-health-in-the-short-and-long-term-93426?__twitter_impression=true

How birth interventions affect babies' health in the short and long term Our study found babies born via medical or surgical intervention were at increased risk of health problems, from jaundice and feeding issues, to diabetes, respiratory infections and eczema.

Someone has offered to donate £10 (up to £2500 i.e 250 donations), everytime someone donates £20 or more. Please keep donating, ask your friends or maybe organise a fundraising event! Thank you so much for your generosity xx

Childbirth Choices Matter - Stronger Maternity Now Please join me and make a difference? Every donation will help. Thank you in advance for your contribution to this cause that means so much

I have been receiving the most overwhelming and supportive messages in response to the Childbirth Choices Matter fundraising campaign and have decided that they are so wonderful that I need to publish a few. I have anonymised them. If you haven’t already donated please do consider doing so. You will see from reading that the care Independent Midwives give is truly transformative and life changing https://www.crowdfunder.co.uk/childbirth-choices-matter. Dear Annabel,

I am so sorry to hear that you and all self-employed independent midwives are once again in this situation. It just doesn’t seem fair! I will of course be happy to support you in any way I can and I will take a look at the campaign.

Although the care I received with the NHS for my first birth was absolutely adequate, I felt so reassured when facing birth for a second and then third time with an independent midwife by my side. The fact that I knew you and you knew me, the fact that we had discussed (at length) what was important to me, the fact that I could totally relax and get on with the business of birthing my baby in a safe and secure environment with a trusted, chosen midwife was nothing short of transformative.

I can’t remember if I have ever told you this, but I actively ENJOYED my labour with Tillie. I remember singing and swaying between contractions and riding high on the biggest wave of endorphins. I remember going to the loo at one point and thinking that I couldn’t wait to get back into the birthing room, I was excited and READY. A large, enormous, part of that was because I could just give in to it. I totally trusted you to keep me and my baby safe. I could let go. The last part of labour, as my baby made her way down and out into the world I found very intense and again, having you there beside me gave me such strength. You could not put a price on the value of your presence at that birth. Of my three births, Tillie’s is definitely my favourite! Every woman deserves the chance to experience birth like that!

I hope that you manage, as a community, to get your own insurance product sorted.

If there is anything I can do, please let me know.

With love

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Thank you for such a wonderful account of the difference I made to your birthing experience # # #

Childbirth Choices Matter - Stronger Maternity Now Please join me and make a difference? Every donation will help. Thank you in advance for your contribution to this cause that means so much

Very grateful for all the donations but don't forget to talk to your 10 friends and ask them to donate too 🙏

The Childbirth Choices Matter page and website http://www.childbirthchoicesmatter.co.uk/ are now live. Please check them out, donate and share 💕

My Site

AS FROM 30th JUNE 2020 INDEPENDENT MIDWIVES CAN NO LONGER WORK.

Birthing people will no longer have the choice to choose their Midwife.

We need YOUR help to sort this out.

Please take 2 minutes to read this and please please share.

From 30th June 2020 you will no longer be able to have a self-employed Independent Midwife at your birth. You will no longer have that choice. There are NO insurance options for IMs. So I have no job. Student Midwives have no career options to become IMs and birthing people cannot choose which Midwife they want to have with them at their birth.

Everyone who knows me knows how passionate I am about Midwifery and giving continuity of care to my clients so we are not going to allow this to happen. We can't. Choice is too important. You and I and your friends will sort this problem out - All we need is money, lots of it. Please, please contribute any amount you can. Every penny will make a difference.

I will be writing to all my previous clients with a cunning plan (The Power of Ten). All we need is for everyone to give £10 (or more if you can!!) and then ask the 10 most important women in your life to give £10 (or more) - and then in turn they ask their 10 influencers to give £10. It really will add up and we will be able to go back to work again.
Much love to you all xx

https://www.crowdfunder.co.uk/childbirth-choices-matter/comments

Please join me and make a difference? Every donation will help. Thank you in advance for your contribution to this cause that means so much

Childbirth Choices Matter - Stronger Maternity Now - Comments Please join me and make a difference? Every donation will help. Thank you in advance for your contribution to this cause that means so much

Awww thanks for posting this Glenn Caley 💕💕

Happy International Midwife’s Day!

Here’s to the wonderful humans out there who are trained to keep mum’s relaxed, educated and safe.
Specifically, a huge celebration to OUR midwife, Annabel Bryant who was phenomenal at doing absolutely nothing (at the birth, because all the work was already done before - let’s make that clear 😉). Thank you for looking after Amy and Sesame for those important months, and for keeping us all on the right track. Your calming nature, logical look at pregnancy and birth allowed us to enjoy every second of the experience.
We had hoped for a natural water birth in our own home, and what we got was that and so much more.
Thank you for your friendship to the 3 of us and we hope to see you soon.
Hugs, Sesame ❤️

Lovely lovely video made by the Hospital I used to work at and still supports me with my Independent work 💕

Midwives should be valued and appreciated every day, they are amazing.

Day of the Midwife 2020 This is "Day of the Midwife 2020" by Chelsea and Westminster Comms on Vimeo, the home for high quality videos and the people who love them.

To all the Midwives all over the World - Happy International Day of the Midwife. To the ones I know personally thank you for your friendship and support and thank you to all my clients for allowing me to be part of their pregnancy and birth 💕🙏💕

Lots of charities are offering remote support 💕🙏💕

Charities offering remote support to pregnant families and new parents Here you can find links to support from National and Regional groups from across the UK.