3 babies

Two weeks off for Christmas and some time to indulge in my hobbies. One of the first things I did was to photograph my friends babies....something I'd been looking forward to all year. Despite there being a month between my friends due dates, the babies actually arrived 9 days apart. 

First born was Alice - born at home as planned on the 25th November. 

Then came Siena on the 30th November - who was born by Caesarean Section, not quite as originally planned as Mum had hoped for a VBAC at home. However as her amniotic fluid began to leak at 34 weeks, it was decided that the safest option was a planned Caesarean. 

And finally came Sam's baby, who arrived in hospital on the 4th December. I think the world of Facebook held it's breath awaiting the arrival. All of Sam's friends knew that Sam was in labour. We'd witnessed the snow updates, and the worries about whether or not a midwife would make it to her house for the homebirth she had planned. We then witnessed the updates about her contractions beginning and then her leaving to go to the hospital. I've talked about Sam in a previous post and how she lost her first son Malachi. Sam was desperate to have a little boy, and we were all praying for a little boy for her.  When her updates went quiet, we knew that there was a good chance that the baby had been born. Finally the update that we had all been waiting for....her family was complete and baby Bauer had been born. As it turned out, being in hospital rather than at home, had been the very best thing for them. 

Two days before Christmas I took the opportunity to photograph the three of them together and I felt so very very lucky.

What kind of midwife do I want to be?

All of the posts about breastfeeding, discussions with friends about breastfeeding and then listening to qualified midwives talk about breastfeeding got me to thinking about what kind of midwife I want to be. I don't have these grand illusions that I can get every woman breastfeeding their babies. I don't think I can change the world after all. So what can I do? What kind of difference can I make?

Well this is my dream....I want to support those women that do want to breastfeed. I want to help them have skin to skin with their babies, to breastfeed as soon as possible after the birth of their babies. I want to make sure that women know where and how to access support should they want and/or need it. I want to provide women with accurate information, without ramming it down their throats. Then following this, I hope that gradually more and more woman have a positive breastfeeding experience, and that this drip feeds to more and more women, that breastfeeding can be easy and enjoyable. That breastfeeding becomes commonplace to be seen everywhere and that women can learn by example, just like women used to do.

I also want to ensure women know about their choices for birth - whether that is where to give birth, what position to give birth in or whether it is how to still feel in control should they need a Caesarean delivery. I want to be able to support women in their choices without cynicism. Of course, I also want to be able to know what to do in the event of an emergency, or when things don't go to plan. And when things don't go to plan, I still want to be able to support women in their choices. I want to be able to help women know what their choices are. I want them to still be able to have a positive birth experience knowing everything possible was done.

I have no doubt that some people think my dreams are daft, that I am aiming too high. But if I can support one woman, help one woman to feel that I made a difference, then it's a start. I am writing this in the hope that I don't forget my dreams; that I remember what is in important to me and that I try and keep to it as much as I can. I'll aim for making a tiny difference and hope that I succeed.

The good and the bad

I have often heard of others poor experiences of breastfeeding support in hospitals, and I cannot deny that my own experience wasn't that great either. However I have also witnessed first hand some wonderful support from both midwives and Maternity Care Assistants.

This is Clare's experience of breastfeeding support:
"Before I had my first baby, I had always assumed I would breastfeed him. I didn’t really give it much more thought, so when James was born 7 weeks early by Caesarean section, weighing 5lb 1oz, and taken away from me to the Special Care Baby Unit (SCBU) it was a real shock that I wasn’t able to breastfeed him. At first, he was fed through a tube in SCBU, but they switched to bottle-feeding without discussing it with me first. I didn’t really question this, as I just assumed that the hospital knows best. I was given a pump to express milk with, not shown how to use it and left to get on with it.

In SCBU James’s weight was monitored constantly, and when I started to try breastfeeding, rather than just expressing milk for him, on about day 5 or 6, he lost weight on that day. This meant that we couldn’t take him home and the nurses insisted on feeding him from the bottle themselves to make sure he took in enough food. This was incredibly upsetting and in the end I gave up attempting to breastfeed in the hospital. I decided to carry on expressing and wait to try when I got home.

I had no one to turn to for advice on how to start breastfeeding from this point and was panic stricken that if James hadn’t gained enough weight by the time the midwife came to visit at home he would be taken back into hospital. Every time I tried to feed, he wouldn’t latch on, so I would switch to giving him a bottle for the rest of the feed. My milk never really came in and after 6 weeks of trying, expressing milk and feeling totally shattered I gave up on breastfeeding completely.

I felt that I had failed James and it still upsets me to think about how little support I was given in the hospital to establish breast (rather than bottle) feeding before bringing him home. I am convinced it is because he was healthy in all other respects and they needed the space in SCBU for another less fortunate baby.

Fast forward to August 2008 and the birth of my second child, a baby girl called Claudia, also born by Caesarean section for breech, this time it was a (sort of) planned section and was at 39 weeks, so a lot calmer all round.

As you can imagine I was pretty determined to succeed at breastfeeding this time, having failed spectacularly with James. I had read up a lot on what to expect, including stories from mums who hadn’t managed to breastfeed first time round but did it second time around.

Claud latched on with relative ease very shortly after she was born. The midwife showed me how to latch her on and then I was left to get on with it. She was sleepy-ish for the first couple of days but she seemed to be doing well and I was happy. Cue day 3 and the visit from the paediatrician who wanted to top her up with formula on day 3. She had very slightly low blood sugar and my milk hadn't yet come in. Not unknown in women who have had C-sections!! Luckily I knew this and argued my corner. The midwives were hugely supportive when I explained what had happened with James and we all agreed that I would put her to the breast more, so that she was getting more in that way and they would monitor her blood sugar. Luckily for us her blood sugar went up and everyone was happy. Hurray, we could go home!

So what happened next? Well, my milk came in and any pain I had eased off. She fed and fed and fed and fed some more. I remember getting very fed up at how often she was feeding. And her sleep was rubbish. But we carried on. We learned how to co-sleep, which helped a lot and the feeds settled down a bit. They really eased off at around 9 months, when she really “got” solid food, and started at nursery. This was a good job, because I was really really sick of breastfeeding at that point! Eventually I wasn’t feeding her during the day at all, just morning, evening and all through the night! Although I had originally intended to give up breastfeeding at around 5 months in preparation for going back to work, that didn’t quite happen as she refused point blank to take a bottle. I had to delay my return for 3 months, which thankfully I could, and then she simply didn’t have milk while she was there. That was hard, but we did it!

I do feel very proud to have succeeded at breastfeeding second time around, and I would urge anyone who didn’t manage it first time to give it a second go if you feel you can. I had woeful support after having James, and very little (in terms of help on technique etc) after having Claud. Luckily for me, Claud was a natural and we never really looked back."

Breast is Best?

The WHO (World Health Organisation) guidelines state:

"Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproduction process with important implications for the health of mothers. As a global health recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years or beyond. Exclusive breastfeeding from birth is possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production."

So there you have it - the official guidelines from those in the know....so why is there so much debate over breastfeeding? Why are people surprised to see babies older than 6 months breastfeeding? Obviously I am only talking about in the UK here, as I can't speak for anywhere else. I think the answers are quite simple really:

1) Breastfeeding can be hard work to get established. It can be painful and sore.

2) Breastfeeding is often hidden away as something private, particularly with older children. Therefore unless you know someone who breastfeeds, your experience with it may be very limited or even non-existent. 

3) It's an emotional topic and when breastfeeding doesn't work out for someone, it can affect how they feel about it. 

Apparently only 2% of women cannot physically breastfeed either due to medical conditions or for an unknown reason. A common misconception, particularly in the 1960's and 1970's, was an inability to feed due to a lack of milk. It is unlikely that this would truly have been the case for the majority of women who switched to formula milk. This was a time when women were advised to put their babies into 4 hourly routines and not feed them in the night time which is has since been evidenced as being detrimental to milk supply. However it is something that is still said today, and many mothers are still worrying about routines and length of time between feeds, and consequently questioning their ability to produce enough milk. There is also little known about growth spurts, so when the baby is suddenly feeding all day and all night to increase milk supply,  again mother's can question their milk production - sometimes leading to early weaning onto solids; but that's another debate! 

So anyway that's the guidelines and official figures - still doesn't tell you my opinion does it? 98% of women can breastfeed....does that mean that 98% should? No I don't believe it does. Nor do I believe that repeatedly telling people the health benefits is the way to increase the number of breastfeeding mothers. I believe that some antenatal class teachers, some of whom are midwives, are almost frightened to talk about the difficulties that women may have with breastfeeding, worried that it will stop women from even trying. Some midwives don't discuss breastfeeding at appointments for a variety of reasons, such as not having enough time, thinking it's too early to consider, that it will be covered by antenatal classes, that anything that is said won't be remembered anyway etc. 

Some women don't want to breastfeed. They don't want to try and it doesn't matter what anyone says to them, they simply don't want to do it. Is that wrong? Well it might be an alien feeling to my own, but it doesn't make it wrong. We are lucky to live in a country of choice, where formula can be made up safely with clean water and for some women the choice is clear, and they choose formula. 

A lack of support is probably the most common reason for women to stop breastfeeding - whether it is a lack of support from health professionals or family and friends. This can be combined with pain, or a lack of knowledge about how breastfed babies feed. I have alluded to routines and growth spurts already but this aggravated by comments such as "are you feeding that baby again?" or "why don't you give that baby a bottle?". There is no benefit to comments such as this and for a mother who has pain and is unsure what she is doing, it can't help. 

Some women try to breastfeed but stop because of pain and soreness. There can be a number of reasons that there is pain during breastfeeding, most of which can be corrected. If the baby is positioned incorrectly, then the nipple can become very sore, cracked, even bleeding. If the mother is given support and advice before too much damage is caused, then the mother can go on to breastfeed as long as she likes. Poor positioning can sometimes also lead to mastitis as the milk ducts aren't emptied properly but again with the correct support and advice this is easily remedied. Nipple thrush can be another cause of pain to the mother, but also to the baby. Once identified, both the mother and baby must be treated simultaneously or it will continue to be passed from one to the other. Thrush can be a nuisance to get rid of, and it can be a nuisance to get the correct treatment for, but with the correct support and advice, it is easily dealt with. Engorgement is also a common cause of pain for the mother, especially when the milk first comes in. The easiest way to deal with it is feeding the baby although it can make it harder to get the baby latched on, in which case, it can be easier to express a little milk off just to make the breast softer. There are other causes of pain of course, but these tend to be the most common so I have focused on these for now.

However before anyone thinks this is a pro-formula post, it isn't. For me, it is like choosing to buy powdered dried milk in the supermarket instead of the bottles of milk in the chiller. It is a perfectly good substitute but it's not what I would choose - give me fresh every time! Wouldn't you say that's what most people do? Isn't that how breastfeeding should be? The norm? In cultures where breastfeeding is the norm, problems with positioning are practically non-existent. Women are used to seeing breastfeeding, and learn from childhood how to position their babies. They automatically support each other, and after giving birth, the family rallies around so that the mother can get used to her baby and get feeding established, without worrying about visitors and the housework. 

I am proud that I have breastfed my children. Whilst the health benefits didn't matter to me before, they do now. I am glad that I have given them the best start in life but at the same time I am incredibly grateful that I had the right support in order for that to happen. I hope I don't come across as smug about it, but actually help to further the view that breastfeeding can be easy, pain free and enjoyable and that it might just be worth a go?

Breastfeeding - my experience

Those that know me know that I am still feeding my almost three year old daughter and those that don't know this about me, may be surprised to know this. I feel passionate about breastfeeding and I know a lot about breastfeeding, positive and negative. Anyway I felt it was time to talk a little bit about my experiences, my opinions and my expectations; and I will say now that some of what I say may surprise you.

My Experience

When I fell pregnant with my first daughter and thought about how I planned to feed her, I merely thought "well I'll give breastfeeding a go but if it doesn't work out then I'm not going to beat myself up over it"....and I don't think that's a rare way to feel at all. I went to my antenatal class about feeding and noticed that there was a distinct drop in numbers attending. I listened dutifully to all the benefits to me and the baby and felt no real difference, and certainly no more prepared. I don't recall them discussing problems at all, though it is possible they did.

When my daughter was born, we did have skin-to-skin but in the immediate time following the birth there was no mention of feeding her. I certainly didn't have a clue what to do, or whether I should be trying to feed her or not. Anyway eventually someone did come to try and help me to breastfeed, I have no idea whether or not she was a midwife or maternity support worker. She certainly did her best, but my boobs would challenge most I think, as they are on the large side. Anyway she did manage to get her latched on but she didn't feed for long, and just wanted to sleep. Overnight she was very unsettled and I did my best to feed her but had no idea whether or not I was doing it right and come the morning I asked the midwives for some support. They did their best but she just didn't want to feed at the time they were able to help me, and when she did feed it was only for about 5 minutes. The midwives in the morning wanted me to stay a bit longer and get some more support with feeding, the afternoon midwives discharged me home. Did I feel confident? No, but having said that, I wanted to go home because I didn't feel that I was getting the support I needed whilst I was there anyway.

Over the next few days I gradually got sorer and my nipples cracked and were bleeding. I dreaded every single feed. However if someone suggested I switch to formula, I was like a stubborn child, I dug my heels in and was determined that it wasn't going to beat me. It was at this time, I actually discovered how much being able to breastfeed, mattered to me. I couldn't tell you why it mattered all I know is that it did. At that moment I certainly didn't give a monkey's about the health benefits, and I certainly wasn't thinking that formula was evil; I just knew that I wanted to breastfeed. Even now I can remember how determined I was whilst at the same time, I sobbed through every feed, and curled my toes.

Before I scare anyone who hasn't had children off breastfeeding for life....I would like to add that it changed very quickly - once I got the right support. I've actually already mentioned the inspirational midwife Annie who corrected my positioning and helped me on the road to pain free feeding. I saw Annie at home on day 5, and attended the breastfeeding group the same day. By the time I returned to the group a week later, the pain was gone. With my eldest daughter I went on to be pain free for the remainder of our breastfeeding journey which was ended by her when she was 13 months 1 week old. I attended the breastfeeding support group every week.....ok I wasn't experiencing pain but I did feel like I needed support. I made a lot of friends at that group, some of whom I consider amongst my closest friends now, one of which is in fact my second daughter's godmother. Having friends that had experienced the growth spurts, the distracted nursing child, the sleepless nights was essential.  Of course some of things are nothing to do with breastfeeding, but neither were the conversations about our husbands or families! The point was, someone had always had the same or similar experience and it meant you didn't feel quite as alone. At the time I was grieving the loss of my brother, who had died when my eldest was 10 weeks old; and whilst many of them may not have known that, they helped me more than they could ever know.


With my second daughter, I didn't anticipate any problems - after all, I had attended the group for well over a year, I'd already breastfed one child, I knew about all the problems to look out for...what could go wrong? Well...my daughter hadn't done all those things and she needed to learn how to feed, even if I didn't. There were no major problems, but boy did she have a strong suck on her and I experienced a couple of days of soreness as a result. When she was weighed on day 5, she'd already gained 13 ounces, so there was nothing wrong with her latch.

Over the coming months we experienced reflux , breast refusal, biting, mastitis and even a fairly long period of time where she would only feed from one side. I still have no idea why she only fed from one side; there seemed to be no real reason to it. She'd refuse to feed completely when she was teething but we invested in an amber teething necklace which seemed to do the trick. I was once a sceptic when it came to these alternative methods but the one and only other time she refused to feed, my husband had forgotten to put her necklace back on after her bath. The group helped support me, in that I knew it was quite common for babies to refuse to feed when they were teething, and that it was normal for different babies to react in different ways. With my first daughter, we'd never known she was teething, we'd just suddenly realise she had a new tooth.

When people found out that I had breastfed babies with teeth, they would always ask me about biting and doesn't it hurt. I have been bitten, and in all honesty, my second daughter once bit me so hard it drew blood. Not once did it occur to me, to stop breastfeeding because of it. I dealt with it in the same way I dealt with it any time she did something naughty. I told her very firmly no, and put her on the floor. She'd yell and cry, and I'd pick her up, tell her firmly not to bite and we'd continue. I'd like to say I only had to tell her once but it wouldn't be true. However I also learnt the signals for when she was considering biting, and the continued consistent reaction from me, ensured that it was soon a thing of the past; and she certainly never once bit me as hard again.


The couple of times I had mastitis, I was lucky in that I knew the signals and I was able to beat it becoming a more serious issue by feeding, feeding and feeding some more. I'd use a variety of positions to ensure that all the ducts were emptied properly. Again I am grateful to my attendance at the group, for knowing just how to handle it.

If you've learnt anything from this blog post, you should have worked out just how much I value the breastfeeding support group; it should therefore come as no surprise that I went on to become a breastfeeding mother helper and along with a friend, facilitated the group. I was awaiting training to become a peer supporter but I actually got my place at University before that happened. I did however attend the monthly training meetings with other mother helpers and peer supporters so I gained a wealth of knowledge about how to support women.

You might think from this blog post that I believe every woman should breastfeed...well you'd be wrong but I shall save telling you all about my opinion for my next blog post......

Coping with negativity

I am now 6 months into my first year, have completed my first placement, my first assignment and my first exam and already in this time I have experienced a large degree of negativity.

There can be negativity before you even begin the course, from professionals, from family and friends, from complete strangers....those who wonder why you want to be a midwife as they couldn't imagine anything worse as well as those who know how difficult it is to get a place and wonder why you want to put yourself through it. In all honesty, I partially feel this is like the first test of how much you really want it. If someone can put you off so easily, before you've even tried, then maybe you don't want it enough.  That said, I have been lucky in that the response from my friends and family has been incredibly supportive and I know that I will need them when things are tough, when perhaps I do doubt if I am doing the right thing.

I have talked before about reading on forums about poor placement experiences some students have had at the beginning of my "What Makes a Good Mentor?" post, and I don't want to repeat myself, so you can just go back and re-read it. However in a nutshell, I guess I am talking about the negative attitudes of others towards students. I know that I have said to my fellow students that as first years, we truly are the lowest of the low, and I have heard tales of being treated as a completely different person once qualified. Is it right? No of course it isn't but is it going to stop happening? Not any time soon, I am sorry to say. The only thing I would like to be sure of, is that I won't treat students that way or anyone in fact.

The other kind of negativity you can come across, is the negativity of qualified midwives towards the job, and sadly the women. As a first year, I am at a stage where I feel passionate about childbirth, choice, breastfeeding and supporting women in their choices. I don't want to change how midwifery is practised (I'm not wanting to change the design of the wheel after all), I have no urge to change the world, but I do want to support women to the best of my ability. I don't want to lose that passion that I arrived with, through working with midwives that are jaded about childbirth through the experiences they have had. I certainly don't want to criticise anyone I have worked with; I am hardly in any position to do so with the limited experience and knowledge that I have. So instead I thought I'd write a little bit about how I hope to deal with it and maintain positivity.

By keeping a record of my passion in this blog, I hope that I can always read back on it and remember why I wanted to become a midwife in the first place. That after a difficult shift, or when I am in the midst of assignments and feeling stressed, I can come here and read this and just remind myself why. That I can read about the people that inspired me, the stories that saddened me, the women who I wished had had better experiences to remind me how I don't want to be.

I also have an excellent support network of friends and family who I know will always lend me an ear, and encourage me when I most need it. They are also there to help me take a break, and give me some time out from the pressure. My husband is wonderful and will take the children out so I can have some space, and not only to study, sometimes so I can just have a bath and watch the TV in peace. I think it's valuable to know when to stop and take some time for yourself as this helps you to keep going.

I am also a member of forums where I can share opinions and ideas, gain support and have debates over all sorts of topics. I can also speak with my fellow students, in particular those that are based with the same trust as me, as they know the same people as me. It is going to be interesting to see how we all change and grow along our journey to be midwives. I think we will all learn just as much from each other, as we do from our own experiences.

I've recommended to friends who are pregnant, to listen to all the advice, take what you want and leave the rest behind. I hope I can apply this to my learning too, whilst of course maintaining my knowledge for safe practice.

Inspirational Midwives

I have heard it said that along the way in my training it is likely I will see some bad practice, some ways of practising that I won't want to use and hopefully a lot of good practise. So it got me to thinking about putting down in writing what it was about the two midwives that I know, that inspired me so much, so that when I am suffering from a lack of confidence I can look back and read it. Of course it will be hard to convey exactly why they are so inspiring in writing but I shall do my very best. Those that know me and are local to me will know exactly who I am talking about but obviously I need to keep this confidential so I shan't be mentioning their names - I shall call them Jo and Annie for the purpose of this post.

I first met Annie when my eldest daughter was about 5 days old. She visited me at home to perform her heel prick test and she unfortunately had to come back and repeat it when she was 9 days old as she just hadn't bled well enough. I opened the door to her and cried with relief at seeing her. Now I shall talk in more detail about breastfeeding later but on day 9, I was at the end of my tether with breastfeeding. I was sore, my nipples were cracked and bleeding, I was incredibly engorged and I had a baby that wanted to be constantly feeding. Annie helped me to get her latched properly, and encouraged me to attend the breastfeeding support group later on that day. So later on that day I managed, somehow, to get myself out the door and down to the group. I shan't bang on about the group now, as I will cover it in more detail when I talk about breastfeeding, but Annie ran this group so amazingly well. She'd manage to balance supporting women, without ever judging them or pressuring them. She knew when it would help for someone to have a peer supporter provide one on one support and when someone needed more. When Annie ran the group we had a thriving membership, sometimes there weren't enough chairs; yet when government funding was pulled back, it meant she was only able to drop in on the group when she could, and the running of the group fell to the peer supporters themselves. Whilst the peer supporters did a fantastic job, the membership dwindled considerably. It was down to Annie and that group that led me to breastfeed as long as I did, as well as myself of course.

I can't remember when exactly I first met Jo as she'd sometimes come along to the breastfeeding group, though that was more Annie's domain, or whether or not it was at the  Baby Massage class that she ran. Jo has a wealth of knowledge on many many subjects not just midwifery related and I believe she has recently completed her Masters.

Together Jo and Annie ran the antenatal group/drop in. They were much like the antenatal classes run by the hospitals in some ways but far far better. They would cover all the usual topics you'd expect at, such as pain relief, positions in labour, instrumental deliveries, episiotomies etc. However what made this group so fantastic is that there was no limit on how often you attended. When I fell pregnant with my second daughter, I attended early on following some bleeding I had and then more regularly from around 28 weeks. It meant that you got to know the others that attended, some would be further along than you, and some would be earlier in pregnancy. When I attended the hospital classes when I was pregnant with my first daughter, we had one of those awkward get to know each other games and everyone was uncomfortable. At drop-in, as I shall call it, we did always introduce ourselves and although it was always a little bit uncomfortable, it got it over and done with, not to mention once you'd been a few times you found it easy. It also gave you a chance to say what had been going on with you that week, to raise something that might be worrying you, to moan about work or relatives. And it always felt like someone else had been through the same or was currently experiencing the same and that made for a very reassuring environment. So Annie and Jo provided this opportunity to access the information we needed, time to speak to a midwife but also time to speak with our peers. Separately they are both brilliant but together they are the best!

When I fell pregnant with my second daughter it was only natural to me to book with Annie. I saw her every week at the breastfeeding group and I felt so comfortable with her. Throughout my pregnancy I saw either Annie or Jo and got to know them both so much more. They gave me the confidence and the information to choose a home water birth. It was the ultimate joy when it was Annie and Jo that were present for the birth of my 2nd born. My first daughter was delivered by the midwives, my second daughter was delivered by me. Annie and Jo helped that to happen and in the case of a normal birth, this is how it should happen. The best part of this is, it's not only me they have this effect on. Amongst my friends, I can see how many they have empowered in their births....whether they were home births, Cesarean sections, instrumental deliveries or inductions....Annie and Jo inspired them all.

If I can be half as good a midwife as either of them, I shall be proud. I feel honoured to have known them, and words can't describe how I lucky I feel to have had them at the birth of my second daughter.

Assessment, Assignments and Exams

I have now had half of my results for the year, thankfully all passed, and it's got me thinking about the different ways in which we are tested. Before even getting into University we all had to pass a Maths and English test and it has felt a bit like we've been constantly tested since then. So I thought I'd tell you all a bit more about the tests that we've had to do and how I have "survived" them.

Academic Skills - 2000 word assignment.
I enjoyed this assignment in some ways and in other ways it frustrated me. The assignment was, depending on our prior experience, teaching/reminding us how to write an essay and how to source references. We also had sessions on how to do Harvard Referencing  and four activities designed to help us so that by the time we came to actually write our assignment we'd done most of the work already. For the assignment itself we had to summarise our chosen article and then write about how we it links to our future role. Finally we had to talk about the academic skills we had learnt in the process. I enjoyed it from the perspective that I actually enjoy writing essays and I enjoy doing further reading. I felt frustrated because I was limited by it in so many ways. I would have enjoyed exploring the focal point of my article some more but it wasn't what the assignment was for. That said I am thoroughly enjoying researching my psycho-social assignment which is my next one due in.

Practice Assessment Document (PAD)
I have made reference to this book before. This is the book we carry everywhere with us on placement. For each placement that we do we have key areas that we have to achieve e.g. supporting women to breastfeed in challenging circumstances, recognise the onset of labour, be the initial port of contact for pregnant women, competently provide information regarding screening etc... You'll have to excuse me a little here as my book is currently with my personal tutor so I have had to rely on my memory and I couldn't recall exactly how they were written. When I first got my book and I looked through everything that we had to get signed off, it felt so overwhelming. Once on placement it almost felt even more overwhelming. The opportunity to get anything looked at let alone signed off, felt very remote. However I soon learnt you had to find the right balance of forceful, respectful and keen. However it is important to note that the balance can be different for everyone that you work with. I certainly found it far easier to get my book signed once I was into the Community part of my placement. Anyway for each section of our PAD we have to have at least one formative assessment before the summative assessment is done and a mark awarded. The mark given definitely depends on who you are working with, not just your ability and it seems that our mentors were every bit as confused as us; however in their defence it is a fairly new way of doing it so they are still learning too.

Exam - Biological Basis of Health.
A 2 hour exam consisting of 25 multiple choice questions, a midwifery specific diagram and 4 midwifery specific short answer questions. Now I am the first to admit that Biology is not my strong point. When I was at school and was choosing my options (is that showing my age or do they still call it that?) I could choose whatever I wanted. I wanted to do a science but knew it wasn't my strong point so I went to my teachers in turn to ask their advice. They each advised me not to take their subject......and this was a grammar school. looking back I think that says more about the teachers than it does me but hey that was then and this is now. So having said that I do sometimes wonder whether I was really that bad or more that I wasn't good enough. Either way it has left me with this feeling that I am no good at science. Having said that I think I have a good enough understanding of where things are in my body, and how the reproductive system works, and there are certain parts of our lectures I have found easier than others. Anyway to cut a long story short, I studied hard for my exam. Of all my assessments, exams are what I dread the most.

Other students have often asked how I revise and I can only tell you what I do and say that it works for me. During lectures I take extensive notes even if they tell me it's going to be put up on our portal system. Following the lectures, I head to the library and type up my notes (not always immediately before anyone thinks I am a complete geek, I actually tend to do big chunks at a time) and when I reach a part that I've written that I don't understand I can reach for a book and read up some more so that I do understand it. I may include flow charts so that I can see that x leads to y and so on and so forth. I won't say it leads to me remembering it all but it does help and it does mean I understand it better.

Drugs Calculation Test
We had two weeks in which we had to log in and answer 20 drugs calculation questions. We were allowed to use a calculator and perform the test wherever we liked, although they did request that we did it on our own. In the two weeks preceding we could access practice tests so that we could get used to the format and the kinds of questions we'd be asked. We did have to get 100% to pass but in all honesty, would you want me to be correct with drugs calculations anything less than 100%? I wasn't nervous about the test; I hadn't had any problems with the practice questions after all. I guess the only thing I was worried about was making a silly mistake or misreading the question. It would be too difficult to misread mg as mcg or similar. Thankfully I passed first time but I was surprised by how nervous I was when I was doing it.

So what's left for this year? My next task is my Psycho-Social assignment, then my Values assignment and then my PAD for my second placement this year. Oh and I almost forgot, we have a poster presentation as part of our Psycho-Social this Friday; although it's not graded.

My advice to current students and future students is plan early! For us, we were given all our assignment details early, so I started to think about them early. I have had to plan my study time around my children and family commitments. When we had only one lecture in a day, I didn't go home, I went to the library. This gave me time to rewrite parts I wasn't happy with. It also gave me time to look through the assessment criteria and see if I had covered all I needed to. With my revision notes for the Biology exam, starting early meant I was re-covering things rather than learning things for the first time.

An unexpected pain

Anyone who has lost someone they love will know what I mean when I talk about the occasions where it hits you smack in the chest with a reminder of who you have lost, completely unexpectedly. There are of course the days that you know will be more difficult; the anniversaries, the birthdays, special occasions. You also know sometimes from the moment you wake up, that today is going to be a bad day, where the ache of missing them is as bad as the day you lost them. People tell you it gets better with time and that is both true and a lie. It's true that the fog lifts, and you are more able to function with every day that passes. However it's a lie that the pain lessens....at least that is the case for me.

I feel like I've started this post a little back to front as I am sure I have readers that don't know my history. My brother died in May 2006. He had a brain tumour that he just couldn't beat, despite his very best efforts. In spite of the fact that he'd been ill for some time, and we'd been told there was no more they could do, it still hit like a sledge hammer when he died. His wife had given birth to their son just two days previously, whom he sadly never met and it felt incredibly unfair. At the time, my eldest daughter was just 10 weeks old, and my sister's youngest son was just 8 months old so I don't know whether or not that made it feel worse to us, that he never got to meet his son. I have a very treasured photo of my brother holding my daughter but at the same time I almost feel guilty about having it at all. I could talk on and on about my brother - about his qualities and his faults but suffice to say I miss him just as much today as I did on the day he died.

Today at Uni I had one of those sledgehammer moments where the pain hit me hard in the chest completely unexpectedly. We were sat in our Ethics seminar talking about ethical decisions and one of the topics under debate was the case of Diane Blood who went to court to fight for the right to use her deceased husband's frozen sperm in order to conceive. The issue of consent was discussed and the fact that her late husband had not given consent for his sperm to be used if he should die but he also hasn't specified that he wouldn't want it to be used. When my brother was first diagnosed with a brain tumour and he and his wife knew that he was going to have chemotherapy, they made the decision to freeze some of his sperm knowing that they were planning to have a family. It is now an automatic part of the "service" to ask whether or not consent is given for the sperm to be used in the event that they pass away. My brother has given permission for it to be used so my sister-in-law will never have to fight for her rights there. However there are still a number of issues surrounding her actually using it so I know that it will never be an easy nor straightforward decision for her.

Anyway sitting in class today and listening to these debates going on around me on this topic; the rights of the deceased husband's parents, the rights of the children, the rights of Diane Blood. It hit me bang in the chest, that it could easily have been a conversation about my brother and his wife. Due to the fact that I didn't know my fellow students before beginning the course, they of course had no idea about my brother. Actually come to think of it, I don't think many people know about his frozen sperm....and why would they? Is it anything to do with anyone else?

It's made me think about my brother obviously but it's also made me think about the fact that we all bring our own histories and it isn't always obvious what someone has experienced. I believe that no-one should be taken at face value and that our experiences shape us and our opinions on things. Sometimes it is good to challenge yourself and think about why you think what you do? Where has it come from? If you explore it more deeply, is it what you truly think? Just to put this into perspective; I grew up believing that all terminations were wrong. I had never really thought about why I felt like this - was it my upbringing, my religion, how I really felt? Ultimately of course, I can only make a decision about what is right for me, and as a midwife, I need to be able to support women in their decisions without judgement. Therefore how I feel is somewhat irrelevant, providing it doesn't affect the care that I give. And that goes for anything not just terminations.

I feel a little like I have rambled my way through this post but I would like to share this very precious photo of my brother David, holding my daughter.

Attitude and Stereotypes

Today we had a lecture about attitude and stereotypes and it really made me think about myself and the kind of person I am. I tend to think I don't conform to the norm and like to be a bit different. However as a female who is more than "cuddly" I certainly think I conform to the traditional image of a midwife. When my eldest daughter was born, I did tend to dress her in pink clothing; though it has to be said, I partially did that so that people would know she was a girl and this continued as she hadn't much hair until she was 2 years old.

In personality I think I am fairly atypical of female traits. I am sensitive, cry easily and wear my heart on my sleeve. I have a tendency to react first and think later - this can be both a benefit and a fault of course. In general I think I have a "good attitude". I mostly look on the positive side of life and am an optimist. However at other times I have a definite tendency towards a negative, pessimistic attitude. My self-confidence is not great and people don't always know this about me as I put on a face to hide it so I would say that is the more negative side of my personality. However when it comes to situations and life in general I am fairly optimistic. I also tend to try and turn situations around and find the positives in them where I can. I also like to think that I always try to see the best in everyone. This is probably because I don't believe that anyone is all bad and that circumstance, upbringing, finances etc. all contribute to who we are; not to forget that everyone is entitled to a bad day.

When I consider my home life I think I am a little less stereotypical. I have a house husband for example - that's definitely not stereotypical. My husband is responsible for the majority of the childcare, the cooking, the washing, and  the housework. My husband is not the type of man to be concerned with how people view him though.  I had however been a stay at home Mum for 4 years before I started the course. I don't think that is unusual, although it's not unusual for women to return to work either. Perhaps slightly more unusual is the fact that I used cloth nappies and a sling which which to carry them. Whilst these are growing in popularity, they are still the more unusual option.

When I was at school Take That were around for the first time and many of my friends were really into them. Me - nope I didn't like them at all! I was into Guns n' Roses and Pink Floyd. I liked to wear Doctor Martens and a leather jacket. So although I wasn't the stereotypical teenager in some ways, I was still conforming to an image of what a Guns n' Roses fan should look like. Not quite so much of an individual after all. These days I listen to what I like and if it's in the charts then great because they'll be playing it on the radio.

So what benefit is this to me in my training as a midwife? I don't fit into a "box". I am not stereotypical because no-one really is. Everyone is unique and an individual and as such the care provided to them needs to be tailored individually as well. As a midwife being able to see the good in everyone should only advantage me I think? Understanding that attitude can be affected by others is essential as well. If I am positive with a woman, in both my language and demeanour, then that can transfer to her and help her to be more positive too. It's important not to be judgemental as a midwife but we all make snap judgements on a daily basis. We make assumptions about what people are like based on their clothes, their appearance, their job. This shouldn't impact on how I look after women. I am most definitely not a saint or an angel, as midwives are sometimes portrayed,  but I do try my best to treat people equally already.

A week at Uni

I began the week feeling very nervous about my exam. I was glad to have no lectures on the Monday so I could spend the whole day studying. My husband dropped me off at the library straight after we dropped our eldest off at school and I got straight down to work. The first thing I decided to do was my drugs calculation test; as I wasn't concerned about it, I thought I'd get it out of the way. I was more nervous doing it, than  I expected to be so I made sure to take my time, read every question twice and double checked each answer. Thankfully I passed it first time so I could then forget about it.

Tuesday we had a full day of lectures and meetings which none of us really wanted, as we'd rather have been preparing for the exam. In fact there were quite a few empty chairs. We began the day with a cohort meeting although it was meant to be a skills lecture, we ended up switching the two around. The cohort meeting gave us an opportunity to raise any issues that had come up over placement, problems we'd come up against and also to celebrate our successes. It seems that the difficulties were things that had come up time and time before. There were quite a few girls that had had problems having their books signed off - that their mentors would repeatedly put it off, and then it would be too late. There also seemed to be a huge variation in the marks we'd been given. There is a mark guide and we'd been advised to explain that the mark scheme was based on us as first years and therefore we'd possibly need to push for higher marks if we felt we deserved it. Unfortunately some mentors would mark us as first years assuming the marking criteria would remain the same over the three years and wouldn't listen to any opinion given by the student. It certainly made me realise how lucky I had been with my mentor and how I'd been marked for my placement.

There was also some discussion about the attitude towards students from some of the midwives. It's very obvious those that are happy to work with students and those that aren't. Simply put it is an essential part of their job but like any job I guess, everyone has parts they don't want to do....doesn't make it easy for us as students however. We talked quite a lot about the different ways we had handled it and hopefully it will help us for our future placements.

We then had our skills lecture, personal tutor group meeting and finally a psycho-social lecture. It would have been far better to have had the psycho-social lecture at the beginning of the day as many people left by the end of the day, and I found it hard to concentrate by that point. Once we'd finished for the day I went straight to the library to squeeze in some final study for the exam. I must confess it wasn't very successful as I was very tired by then.

So Wednesday came and the nerves were fluttering. We were due to have a lecture for Values at 9 but I confess I skipped it in favour of some more last minute study. At 12 I made my way over to the room along with some of my colleagues. The exam was two hours long and afterwards there was the typical postmortem. I found it much harder than I'd expected in some parts and other parts were ok. I simply hope I have done enough to pass it!

The next couple of days were far nicer without the exam hanging over us, though we'll all be grateful in about 6 weeks when we get the results. We're already thinking ahead to our next assignment and also our next placement. And we're also beginning to think about our transition time when we can choose what we'd like to do for 3 weeks; well 100 hours. I've got a few ideas and it's a case of deciding which one to go for. Next year I think I would like to go and learn about fertility treatment and then potentially use that experience to follow through with my final dissertation.

Bagian Otak yang Mengendalikan Gerak Kita

"Ketahuilah, sungguh jika dia tidak berhenti (berbuat demikian) niscaya Kami tarik ubun-ubunnya, (yaitu) ubun-ubun orang yang mendustakan lagi durhaka." (Al Qur'an, 96:15-16)

Ungkapan "ubun-ubun orang yang mendustakan lagi durhaka" dalam ayat di atas sungguh menarik. Penelitian yang dilakukan di tahun-tahun belakangan mengungkapkan bahwa bagian prefrontal, yang bertugas mengatur fungsi-fungsi khusus otak, terletak pada bagian depan tulang tengkorak. Para ilmuwan hanya mampu menemukan fungsi bagian ini selama kurun waktu 60 tahun terakhir, sedangkan Al Qur'an telah menyebutkannya 1400 tahun lalu. Jika kita lihat bagian dalam tulang tengkorak, di bagian depan kepala, akan kita temukan daerah frontal cerebrum (otak besar). Buku berjudul Essentials of Anatomy and Physiology, yang berisi temuan-temuan terakhir hasil penelitian tentang fungsi bagian ini, menyatakan:
Dorongan dan hasrat untuk merencanakan dan memulai gerakan terjadi di bagian depan lobi frontal, dan bagian prefrontal. Ini adalah daerah korteks asosiasi…(Seeley, Rod R.; Trent D. Stephens; and Philip Tate, 1996, Essentials of Anatomy & Physiology, 2. edition, St. Louis, Mosby-Year Book Inc., s. 211; Noback, Charles R.; N. L. Strominger; and R. J. Demarest, 1991, The Human Nervous System, Introduction and Review, 4. edition, Philadelphia, Lea & Febiger , s. 410-411)
Buku tersebut juga mengatakan:
Berkaitan dengan keterlibatannya dalam membangkitkan dorongan, daerah prefrontal juga diyakini sebagai pusat fungsional bagi perilaku menyerang…(Seeley, Rod R.; Trent D. Stephens; and Philip Tate, 1996, Essentials of Anatomy & Physiology, 2. edition, St. Louis, Mosby-Year Book Inc., s. 211)
Jadi, daerah cerebrum ini juga bertugas merencanakan, memberi dorongan, dan memulai perilaku baik dan buruk, dan bertanggung jawab atas perkataan benar dan dusta.
Jelas bahwa ungkapan "ubun-ubun orang yang mendustakan lagi durhaka" benar-benar merujuk pada penjelasan di atas. Fakta yang hanya dapat diketahui para ilmuwan selama 60 tahun terakhir ini, telah dinyatakan Allah dalam Al Qur'an sejak dulu.

http://www.keajaibanalquran.com

Placement One - Done!

Tomorrow the first assignment is due in - thankfully I've already done mine and submitted it. I've since fretted over whether or not I've missed anything, whether or not I've submitted it correctly and so on. However all I can do now is wait and see so I am trying to put it out of my mind and concentrate on the other assessments I have coming up. I have begun on my next assignment already as it's a bit more challenging. I am grateful that I have until January to complete it.

The other thing I can do tomorrow is my online Drugs calculation test. The practice test has been open for a couple of weeks and I've done fine with it so I must confess to not being too worried. It is compulsory to get 100%  because in the real world when it comes to drugs, there can't be any errors. We get three attempts at the test, we can log in over the next two weeks to make our attempt and we get the result immediately....I think this is my kind of test!

However on Wednesday I have my first exam. I've been studying hard but I feel like each time I leave the library I know less than when I went in. I just keep hoping that some of it sticks. This is fortunately the only exam we'll sit this year and it's on Biology - probably my weakest area. The paper is split into two parts - the first part is 25 multiple choice questions; and the second part is the Midwifery specific question with a diagram to label and 4 long answer questions worth 10 points each. In order to pass we have to get 40% but obviously I'd like to get a better mark than that. This week I have been studying the pelvis - when I am in the car, I'm reciting the names of the bones and picturing the diagram in my head trying to match up the names with the image. I've also been studying fetal circulation before and after birth and the changes that occur. I've been looking at all the hormones and their effects during pregnancy. Tomorrow I am glad that I have no lectures so I can spend the day in the library studying hard although I worry that I don't have time to read up on everything that I want to. It's definitely a learning experience for the future....start earlier - yet I thought I started fairly early already.

I really enjoyed placement but I must confess to looking forward to going back into Uni now. I am looking forward to catching up with my cohort and hearing about their placement. I am particularly looking forward to talking with those who worked in the same area as me and with some of the same people. I am almost certain now that I am the only one in my cohort that hasn't made a "catch" of my own. I am trying hard to concentrate on the fact that it doesn't matter at this stage and next placement I will certainly do it, and plenty of times I am sure. Also I have had no problems in the end with getting my book signed off and I am thrilled with the result and feedback I have been given. However I cannot deny being slightly envious that everyone else has had their first delivery.

So now I am looking forward to Thursday - the exam over, the drugs calculation test hopefully passed. Of course we'll be back into the thick of lectures and seminars but with the next deadline a while away, it feels a little less pressured. Wish me luck for Wednesday - I have no doubt I shall post to let you know how I felt it went.

The miracle of birth

Love is...., originally uploaded by stephalie1977.

When I was in my late teens and early twenties I was terrified of falling pregnant. It wasn't that I was scared of pregnancy but I certainly wasn't ready to be a Mum. The other thing that terrified me was the thought of having to tell my Mum that I was pregnant, knowing I wasn't ready nor old enough.

When I was 28, married and felt very ready to have a baby; it was still a nerve wracking experience telling my Mum that I was pregnant. She was of course thrilled to hear she was going to be a Grandma again (she already had three (and a half) grandchildren at that time). For me it was quite a scary experience....I almost felt like I was saying "Hey Mum, I've been having sex". The second time I fell pregnant was a far more enjoyable experience.

I've already told you about my friends sad experiences of loss but I've not mentioned the friends I have that struggle to fall pregnant in the first place. Couples with no fertility problems at all can find it hard to fall pregnant. Why? There are a variety of reasons.

One egg is released each month and sperm have only a limited life span. Also a woman's uterus is not very welcoming to sperm...in fact it downright does all it can to make the sperm fail. Also when a man ejaculates, some of the sperm he releases are defective and the number of "good" sperm varies from man to man.

So the very first barrier is timing intercourse correctly for the release of the egg; then there is the hurdle for the sperm to reach the egg; then there has to be a good quality sperm able to infiltrate the egg and fertilize it and then just when you think you are on the home straight....you have to hope that the egg then implants and not only that but that it implants in the right place.

So you can see that pregnancy truly is a miracle even when everything is working correctly. As young girls you prevent against pregnancy but then one day we hope, dream, live for new life. It becomes an all consuming thought and you are hyper aware where you see babies and pregnant women everywhere. At the base of it all you hope that your body won't fail you. Of course not every woman feels such strong urges about becoming a mother but I certainly know plenty of women that do and it is how I felt.

Of course there are women who seem to fall pregnant at the drop of a hat, that only have to look at their partner and they are pregnant....if you've had fertility problems, you'll have heard these phrases before. And then there are the anecdotes "ooh I knew someone who'd been trying for a baby for 5 years, was just about to start IVF and she fell pregnant naturally". Or the useful advice "you just need to relax and stop thinking about it". Of course this follows the "so when are you going to start a family then?" from the second you get married. The thing is people mean well but it hurts. So if you ever find yourself in the situation that you might say something like this.....don't! Bite your tongue and don't.

I confess I don't know much about infertility treatment but it is an area I am interested in and I hope to spend some time at a fertility clinic during my transition period in University.

To all those friends that I have that do have fertility difficulties, I hope that someday soon your dreams come true and the miracle of pregnancy blesses you.