Royal Derby Maternity Unit Receives Midwifery Led Make-Over

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The Royal Derby Hospital where I did my Midwifery training in England, is leading the way in Midwifery led care after receiving a £224,000 make-over in order to create a ‘home from home’ environment within the birthing unit. The maternity ward now homes an in-hospital birthing center where low risk moms can choose to give birth with minimal intervention, in a homely environment. It is well document that the environment in which women give birth, has a huge impact on the progression of labor and a woman’s overall childbirth experience. Staff within the unit wanted to create an environment where families could receive one-to-one care from a midwife in a “private and friendly” setting, without emphasis on medical intervention.

RDH Pic2Last year, the Government announced it was awarding the Derby hospital a grant of £224,000 to make improvements to its maternity department. The money has been used to install a second birthing tub. The second birth pool will be used by women considered ‘high risk’ in the hope that this will bring a sense of normality back to their pregnancies. A separate entrance to the birthing center has also been created, along with the addition of a kitchenette for families to use during labor. Improvements have also been made to the overall decor, adding mood lighting and murals to the rooms. Floor mats, colourful lights, birthing chairs, birth balls, music and aromatherapy treatments will also be available to help create an “atmosphere of tranquillity”.

RDH Pic3Lets hope hospitals across the pond can follow in the same footsteps in the near future to help support moms to give birth naturally. Not everyone is suited to an out of hospital birth, and therefore may need or want to give birth in the hospital. These women should still be able to receive care in an environment which is welcoming, relaxing, and conducive to natural birth.  As Midwife Sue explains, ‘ultimately, this is about giving women more choice when it comes to how they want to give birth. The birth rate is going up and we think it is really positive that we can offer this atmosphere of normality – with the option of medical support if mums need it.”

Goodbye, Breastfeeding

Goodbye, Breastfeeding

2014-03-05 20.41.12This is such a beautiful post about weaning, taken from the blog ‘The Single Crunch‘, written by Kimberly, a work at home mama to two girls. This beautiful story had me welling up as I fast approach this place in my life also. I felt the need to share this story as it is so touching, and I am sure may people can relate to it. This is a topic that is not talked about enough. There is so much focus placed upon the actual act of breastfeeding, and the duration of breastfeeding, but not a lot of attention to what happens afterwards. I would love to hear more about other people’s weaning stories and experiences.

Design for Life

Despite what we are led to believe, our bodies work pretty well. They work in the same way they have done for millions of years. Our bodies have the same innate level of wisdom and survival features that they always have. The same ones that have allowed our species to successfully exist on this planet for hundreds of generations. When you really think about it, Mother Nature came up with a pretty fantastic design (although it may not always seem like it) for pregnancy, labor, birth and breastfeeding. When it all unfolds naturally, the concoction of hormones, emotions, reflexes and innate behaviors that evolve from both the mother and the baby, paint the most perfect picture.

photo (10)In the last 3 weeks I have ‘midwifed’ and witnessed some of the most beautiful and inspiring births I have ever attended as a midwife, which have touched my heart in a number of ways. Sometimes as midwives we get so weighed down with the logistics and politics of our job, that it takes the shine away from the magical moments we have the privilege to share with our clients. 2013 has given me the strength and the opportunity to grow and really fly as a midwife, and I’m sure 2014 will be no different. I want to thank the families who have welcomed me in to their birth experience, I am grateful to you for allowing me the opportunity to spread my wings a little further. I love the lessens I get to learn through my work-it makes me feel humbled every day. I am entering 2014 with a new energy and passion for the work that I do.

#birth #midwife #GraceFull #lessonslifeteaches

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Pregnant Cross Fit Controversy

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I love how this one photo has sparked so much debate. What started off as an edgy alternative to the typical cutesy pregnancy pics, has gone viral across the globe! From LA to London, to China, Germany and New Zealand. It seems like everyone has something to say on the matter. Cross Fit’s Facebook page, where the photo was originally posted, has received over 16.5K ‘likes’ and 1.7K comments! Lea-Ann Ellison is now at the center of a media frenzy. She is being interviewed for newspapers and magazines (such as the Huffington Post, In Touch magazine, the London Metro and the Daily Mail to name a few) all over to tell her story and to give her thoughts on exercising whilst pregnant. She hopes that all this hype will bring attention to an important health issue. In her own words, “I can’t believe this photo has caused this much stir, but it makes me hopeful that it will inspire other strong healthy moms to continue on doing what they love.” (And, her midwives concur)!!

 

Photo by Nick Stern

 

Spinach

Nutritional Window

I learnt something very interesting today, which I had never considered before. The window of opportunity for introducing new foods to infants is limited. It best time usually ranges from around 4-6 months to around 12-14 months. This, interestingly, corresponds to the time at which they begin to sit up with support to when the begin walking and running around freely on their own. This is an evolutionary protective mechanism so that once kids are up and running all over the place they become suspicious of unfamiliar fruits, vegetables and meats. This is a good thing because, lets face it-we can’t keep an eye on our kids every second of the day. This protective mechanism is designed so that if we were still ‘in the wild’, it would (hopefully) protect our kids from picking up and eating something which could potentially be poisonous. As this time frame is limited, it is so important to introduce infants to a wide range of colorful foods. According to Dr Greene, ‘if you let them sample something enough times…they can more easily acquire a taste for it than at any other period in life’. It is important to make the most of this nutritional window. Introducing infants to a rainbow of colorful tasty fruits and vegetables, whole grains and varied textures, rather than bland processed flavors, will set them on the right path for healthy eating through in to adult life.

Sugar Cubes

The Sweet Truth

 

Does anyone else think the traditional oral glucose tolerance test to screen for gestational diabetes, is enough to put anyone in to a diabetic coma? For regular healthy women who are conscious about what they eat, this test is highly inappropriate.

Let me explain why…

Firstly, let’s go over some basic physiology to understand how a healthy body deals with the breakdown of sugar (glucose). As glucose is ingested, blood glucose levels rise almost immediately. The pancreas responds by secreting insulin. Insulin helps the liver store excess glucose as glycogen until it is needed. As blood glucose levels begin to fall a few hours later, the stored glycogen is converted back to glucose to provide energy until more food can be eaten.

What many people don’t realize is that during pregnancy the placenta produces the hormones Lactogen, Estrogen and Progesterone, all of which counteract the function of insulin. The placenta also makes potent enzymes that destroy Insulin. Why would that be, I hear you ask. The body suppresses insulin purposely to allow more glucose to remain available in the mother’s bloodstream for longer periods of time. This is known as ‘glucose sparing’. Glucose sparing increases as pregnancy advances, peaking during the third trimester when the fetus gains most weight and needs more nourishment to grow. In other words, at 28 weeks (the time gestational diabetes screening is performed) the body actively creates higher levels of blood glucose (the very thing the test screens for) so that it is available for the baby to use to support its growth in the last trimester. In the medical field this is seen as a malfunction, a glucose ‘intolerance’, however this is normal pregnancy physiology.

For those of you who are not familiar, I will briefly explain the procedure of the oral glucose tolerance test (OGTT).

  1. A woman fasts for (at least) 8 hours before the test
  2. Her fasting glucose level is taken via a blood sample to gain a baseline result
  3. She is given a sugary drink containing 100g of glucose (often with artificial colors and additives too) within 5 minutes
  4. Blood is taken at 1, 2 and 3 hour intervals after the drink is consumed

The problem with this test in women who don’t ordinarily ingest such high levels of glucose, is that their body is not used to handling the overload. The pancreas cannot produce sufficient quantities of insulin fast enough to meet the demand. Therefore levels become temporarily elevated until the pancreas has chance to catch up. This decreased carbohydrate tolerance is known as starvation diabetes. When the pancreas catches up with the glucose overload, insulin surges, and glucose levels plummet. This is called the rebound effect. This shock reaction is not true diabetes. A woman with a diet with a low intake of refined carbohydrates is at high risk of starvation diabetes.

Giving a woman a concentrated refined sugar load before testing is not recommended. She can have a physiological reaction to the glucose overload which can mimic diabetes. When the pancreas is presented with such high levels of glucose, not enough insulin can be produced fast enough to compensate. A temporary peudo-diabetes results, making results abnormally high. When the pancreas catches up insulin surges and blood glucose levels crash. This rebound effect actually mimics hypoglycemia. The period of time for this to occur varies, but often the 1-3 hour OGTT is not long enough to allow levels to come down to a normal baseline.

This test is bad enough to put the mother through, but think what effects this has on her unborn baby. Think carefully before willingly undergoing this seeming ‘harmless’ procedure.

Ask your health care provider for alternative screening methods.

 

The (Post) Pregnancy Waterworks

Out of all the embarrassing pregnancy, birth and post partum issues women love to talk about – gas, excess sweating, varicosities, pooping while pushing, leaky boobs, this one hardly ever makes it to the coffee table. Incontinence is a huge issue that affects more women that you think. Around 25% in fact. That’s 1 out of every 4 of your mommy friends. While we all sit around forgetting to do our kegels and hoping it will never happen to us. For many women this is a very real reality.

When I was approached by the Public Outreach Department at DrugWatch.com to see if I was interested in hosting a guest blog regarding this issue, I was happy to accept. Below is their post. Whilst doing my own research on the topic, I came across another fantastic blog post from fellow blogger CrapAtPregnancy, ‘Nobody wants to be ThatWoman‘.

Childbirth is a joy in many ways, as any mother knows, but some of the effects it can have on the body aren’t always quite so joyful, such as incontinence. If you are one of the many women who feel the need to keep the incontinence pads just as handy as the Kleenex when cold and flu season arrives, joy probably isn’t the term you’d use to describe that particular problem. The good news is you probably won’t have to live with the threat of flash flooding when you cough or sneeze forever, since most women can reduce or eliminate incontinence with treatment.

If you have a tendency to get a little moist “down there” when you laugh or sneeze, what you have going on is a common condition called stress urinary incontinence, or SUI, which often has its roots in the strain that pregnancy and childbirth place on the pelvic floor muscles. It affects about 25 percent of women at one time or another — during pregnancy, soon after childbirth or around the time of menopause.

Causes

SUI happens when the pelvic floor has been weakened or stretched to the point that it lacks the strength to hold back urine flow when pressure is placed on the bladder, resulting in that annoying dribble that can happen when you laugh or cough. Pelvic floor weakness is most often caused by pregnancy and childbirth, but there are other factors that can contribute, such as obesity, heavy lifting, chronic coughing or frequent straining due to constipation.

Treatment

Physical therapy is the first line of treatment for SUI and has helped many women. Since the pelvic floor muscles are the ones at that are at the root of the problem, therapy typically involves Kegel exercises to strengthen and tone the pelvic floor, often with the addition of biofeedback to monitor muscle function and specialized weights and other tools to enhance results. Many therapists also use other exercise techniques in SUI therapy, such as yoga and Pilates, which aid in strengthening core muscles as well as the pelvic floor.

If you’re carrying around a few extra pounds, losing weight can help, since that extra weight puts pressure on your bladder and pelvic floor. Adjustments to your daily diet can help control your moisture problem too, such as limiting foods and beverages that can irritate the bladder. So cut back on coffee, tea and soft drinks that contain caffeine, and avoid spicy and fried foods. Constipation can worsen SUI symptoms, so make sure you have plenty of fiber in your diet, and make sure you’re getting enough vitamins and minerals every day to support muscle function and healing.

Surgery

If non-invasive treatments don’t help, surgery is an option that has helped many women. However, you should know that procedures that use vaginal mesh implants, such as bladder slings, to treat SUI are riskier than traditional surgeries. The Food and Drug Administration (FDA) has released safety alerts on these products due to a drastic increase in reports of serious complications over the past few years, such as mesh erosion, organ perforation, mesh shrinkage and infection. These complications have caused many women severe pain. Thousands have sought justice through the filing of a transvaginal mesh lawsuit. Since most SUI cases can be resolved without mesh, talking to your doctor about procedures that don’t use mesh is probably your safest bet.

Elizabeth Carrollton writes to inform the general public about defective medical
devices and dangerous drugs for Drugwatch.com.