tag:blogger.com,1999:blog-45897094149767310772024-02-20T11:41:28.493-08:00Born StroppyCampaigning for the maternity services we deserve, particularly one mother one midwife care,homebirth service, and independent midwifery. The blog's author is Ruth Weston, of Aquabirths, pool specialists (www.aquabirths.co.uk and www.aquabirthsathome.co.uk). She runs the monthly choices newsletter which can be subscribed to on www.aquabirthsathome.co.uk. The aim of Aquabirths is to make waterbirth specifically but normal birth generally accessible to all birthing women.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.comBlogger39125tag:blogger.com,1999:blog-4589709414976731077.post-26198067570939668682011-10-06T02:58:00.000-07:002011-10-06T02:58:35.890-07:00Is a 37% Induction rate for healthy women normal?<span class="Apple-style-span" style="font-family: Georgia, 'Times New Roman', 'Bitstream Charter', Times, serif; font-size: 13px; line-height: 19px;"></span><br />
<a data-mce-href="http://bornstroppy.files.wordpress.com/2011/09/iol-audit.ppt" href="http://bornstroppy.files.wordpress.com/2011/09/iol-audit.ppt">Induction of Labour Audit, Power Point Presentation 2011</a> <br />
Airedale Maternity Services did an audit on various aspects of their Induction of Labour practice and presented it to the local MSLC. Key statistics included:<br />
<br />
Parity 24% nul par, 19% 1 par ( the majority of women induced are first time mums, or with one previous pregnancy that was 'viable' whether or not the baby lived beyond 20 weeks gestation). <br />
<br />
45% of those induced are 41 weeks gestation and 37% of the women induced are for postdates only. This means that nearly half the women are being induced within the recognised normal range for gestation, and<br />
<br />
37% of those induced are entirely healthy and normal, the arbitary line of induction policy is the only reason for this intervention. <br />
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The other shocking thing is that in this Trust 73% of women induced are put on Electronic Foetal Monitoring, not intermittent auscultation. The reasons we were told are 'historical' ie not evidence based. <br />
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Comment: As women and midwves we need to ask whether we have got our sums right on length of pregnancy if 37% of healthy women need to be induced for postdates alone. A Stats textbook called Supercrunchers by Ian Ayres demonstrates how our clinicians have got their sums WRONG in calculating the length of preganncy. Also check out Ann Frye' fantastic textbook of Holistic Midwifery. She quotes Professor Carol Woods method of calculating length of pregnancy - based on research into the actual lengths of pregnancy groups of women have. We should not accept high induction rates of health women for postdates as normal and acceptable maternity care.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com1tag:blogger.com,1999:blog-4589709414976731077.post-64851984726618252722011-07-28T14:45:00.000-07:002011-07-28T14:45:55.508-07:00I sparkle like a diamondOnce upon a time a long time ago yesterday, there was a young woman who sat on her bed looking very sad :<br />
<br />
She was so sad her hair was lank and grey, her face was grey, her clothes were grey. She was sad and grey.<br />
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She was so sad and grey that her bed was grey, her bedroom walls were grey, and as she looked at the people around her they were drab and grey.<br />
<br />
In the morning she went into her workplace and it was grey and sad and unappealing.<br />
<br />
So she went out into the garden. And there she found a rose, beautiful and crimson. She said to the rose, "Why have you so much beauty and colour when I am so sad and grey? The rose replied, "I am being just who I am."<br />
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She came to some phlox standing tall and white and full of scent. "Why are are you so white and beautiful, when I am so grey?" the girl asked the flowers. "Because we are being just who we are." Came the reply.<br />
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Then she came across a cluster of sweet peas. They were lilac, and blue and purple, swaying in the breeze. "Why have you so much colour when I am so grey?" she asked the Sweet Peas. "We are just being who we are." The Sweet Peas responded.<br />
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The girl walked on and came to a Hawthorn tree where she sat down and began to think. And she reached down inside herself and brought out a beautiful sapphire, sparkling and glittering in the sunlight and in its prisms she saw pinks and blues, purples and greens, yellows and golds. The world was filled with colour and so was she, the girl was no longer grey but sparkled with colour and life.<br />
<br />
The girl held the prism for a while and laughter sparkled on her lips: she was being just who she was. She placed the sapphire carefully back in her soul and continued on her way sparkling like a diamond, full of colour and life.<br />
<br />
Radical mother, cake maker, born stroppy I was tired and worn out, discouraged and depressed. Today I told myself this story and remembered who I was.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-5804784629733292572011-07-01T05:45:00.000-07:002011-07-01T05:45:59.947-07:00Carrying the Courage of Conviction<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if !mso]><img src="http://img2.blogblog.com/img/video_object.png" style="background-color: #b2b2b2; " class="BLOGGER-object-element tr_noresize tr_placeholder" id="ieooui" data-original-id="ieooui" /> <style>
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<span style="font-size: small;"><strong>"We do not have to take our troubles lying down – the most effective way of birthing new life as we all know is standing up!"</strong></span><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><span style="font-family: Gautami;">This begins as a report on the opening of ABL’s Carlisle Business Centre Conference Suite on Wednesday 30th June 2011- but Oh there is always more to it than that . . .</span></span></div><span style="font-size: small;"> </span><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><span style="font-family: Gautami;">Steve Wyler OBE was the ketnote speaker.<span> </span>He is a Big cheese in the new organisation </span><strong>Locality</strong><span style="font-family: Gautami;"> which is an amalgamation of the Development Trust Association with </span><strong>Settlements and Social Action Centres.<span> </span></strong></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong>Steve commended the courage of ABL to take risks to invest in the local community in the middle of a recession and talked about the commitment of ABL and other development trusts to enABLing their communities.</strong></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong>He then went on to talk about the bigger strategy which he and his colleagues at national level are working on, to support the courage and commitment of local communites like Manningham seeking to invest in their people.<span> </span>This is what we are asking for, he said – and sometimes getting:<span> </span></strong></span></div><div class="MsoNormal"><br />
</div><ol start="1" style="margin-top: 0cm;" type="1"><li class="MsoNormal"><span style="font-size: small;"><strong><u>Asking for a pause</u> in the ‘slash and burn’ cuts which fall most heavily on the poorest communities.<span> </span>Giving time for communities to<span> </span>co-design local alternatives, taking the chance to do things a different way.<span> </span>They have got 3 months moratorium to do this.</strong></span></li>
</ol><div class="MsoNormal" style="margin-left: 18pt;"><br />
</div><ol start="2" style="margin-top: 0cm;" type="1"><li class="MsoNormal"><span style="font-size: small;"><strong><u>Community Right to Buy</u> – this is now in the Localism bill but there is opposition from the Lords and from landowners who see that they may lose out.<span> </span>In Scotland there is a stronger law which has enabled the inhabitants of many of the Western Isles to own the land they live on.</strong></span></li>
</ol><div class="MsoNormal"><br />
</div><ol start="3" style="margin-top: 0cm;" type="1"><li class="MsoNormal"><span style="font-size: small;"><strong><u>Community Allowance</u> – to enable people on benefits to do short terms sessional paid work for community organisations without effecting their benefits.</strong></span></li>
</ol><div class="MsoNormal"><br />
</div><ol start="4" style="margin-top: 0cm;" type="1"><li class="MsoNormal"><span style="font-size: small;"><strong><u>Community Rights Act.</u><span> </span>This puts a requirement on banks to be transparent about lending activities in poor communities; where they are found to be wanting it puts a requirement on them to put remedial measures in place ( eg supporting local business, partnership/support for credit unions etc).<span> </span>This law is effective in the US and communties are using it.<span> </span>Steve said: “We think it is a scandal not to have this here.”</strong></span></li>
</ol><div class="MsoNormal"><br />
</div><ol start="5" style="margin-top: 0cm;" type="1"><li class="MsoNormal"><span style="font-size: small;"><strong><u>To have a large team of Communtiy Organisers</u> working within communities.<span> </span>They will listen to people, find out what they want and see if they can come together to effect change – often this is about taking down the barriers those in<span> </span>power have put up preventing people helping themselves – positive solutions run on our terms not yours.<span> </span>The Government is up for this.</strong></span></li>
</ol><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong>Steve said that: We are about working to do thing differently, working with local people’s hopes and dreams and helping to make them happen.</strong></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong>Here clearly was a can do man in a can do organisation where poor local communties are able to build and invest in their own future.<span> </span>This takes courage and conviction.</strong></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong><u>Mothers and Midwives</u> let us carry that courage and conviction to build birth care and communities on our human terms, let us start challenging the barriers to us claiming our birthrites - <span> </span>and those who put them there.<span> </span>Let us invest in our children and in our futures together.</strong></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong>In the evening it was my local church’s Church Meeting: a difficult one as the financial situation is bad – but it comes down to the same issues of courage and conviction: who we are, why we are here, what are we going to do with the resources we have to fulfil our aims and why we are here?<span> </span>And in partnership with fantastic organisations like Locality we can turn around whole communities not just individual churches.</strong></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-size: small;"><strong>Who has the courage and the conviction? We do not have to take our troubles lying down – the most effective way of birthing new life as we all know is standing up!</strong></span></div>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-81250972223037706392011-06-24T08:20:00.000-07:002011-06-24T08:20:23.259-07:00The Mother magazine: Around the campfire<a href="http://themothermagazine.blogspot.com/2011/06/around-campfire.html">The Mother magazine: Around the campfire</a>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-63566949198544816002010-12-23T02:07:00.000-08:002010-12-23T02:07:01.440-08:00Of Birthdays and Government White Papers<!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style>
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<div class="MsoNormal"><span style="font-family: Arial;">This is an odd day.<span> </span>My eldest child is 16 today, and it is therefore, the sixteenth anniversary of becoming a mother to a term baby: bittersweet memories vie with the present day realities leaving me feeling somewhat disorientated and bewildered.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">At 8.20 16 years ago after 24 hours labour, being transferred into hospital, having labour augmented, suffering agonies without anaesthesia with those synthetic contractions, giving birthing yelling in animal agony as I birthed my baby in fear and pain facing a blank hospital wall and a drip machine because I was not important enough to be faced.<span> </span>That memory haunted me for many years and my body remembers even if the joys of subsequent births have healed the wounds.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">And yet despite this my baby was born miraculously calm and cheerful, she fed right away and easily and we both took to breastfeeding as ducks to water.<span> </span>This was the joy of motherhood for me, and it continues to be.<span> </span></span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">And then the weeks of challenge, nursing a baby learning the art of motherhood alone with a husband working away, building a new life outside of employment which had been the centre of my life up until then.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">And as winter turned to spring and then to summer, I would sit in our tiny garden overlooking the park, with my tiny daughter playing at my feet, and as she grew older how I loved to sing and to read to her.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">These memories partially suppressed bubbled to the surface through this day 16 years on.<span> </span>Sixteen years old, my child was woken by her four siblings, being sixteen years old she curled her lip at our practical present, being sixteen she had already got her birthday money out of us some days earlier, being sixteen she wanted to spend her birthday not with us but with her friends at a sleepover.<span> </span>And I realised I was clinging to a daughter I no longer had.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">“How do you mother a teenager?” I ask the memory of a mother struggling to come to terms with her new role 16 years earlier.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">And today I went to a meeting where CS rates were discussed and professionals talked of women as ‘them’ as opposed to ‘us’ the professionals. <span> </span>I thought this does not feel right – ‘should it not just be ‘us’?’<span> </span>Was this the attitude underyling my experience of becoming an object in the hospital system 16 years ago?</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">And this afternoon, in another meeting I learnt that the Government has changed its mind and Maternity Services will be commissioned by GP’s.<span> </span>And I wanted to cry with frustration and fear.<span> </span>16 years ago I had to change GPs twice to find a GP who would cover my homebirth (despite the evidence even then that supported my choice). Dr Eisner (now retired) and her practice were the only ones to really specialise in maternity care in the area.<span> </span>Certainly Dr Eisner was the only GP who ever turned up to one of my births – and 16 years ago she turned out at 4am and stayed with me until her surgery began – so just missing the triumph over adversity which was my first birth.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">I so fear <span> </span>GP’s who have no interest and no committment for good birth, whose knowledge is limited and partial, taking control of the budgets and purse strings, using their power to stop the progressive investment in normality, not understanding the importance of ensuring a good start to motherhood and a good start to those little lives.<span> </span>GPs who care but don’t understand because in the last 20 years they have progressively handed over all the work and knowledge and experience to midwives and centralised maternity services based in hospitals.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">I was so looking forward to midwives as independent professionals in partnership with their medical colleagues and service users having the chance to be part of the commissioning of the care they see as necessary for the wellbeing of women, and now we have GPs – General Practitioners being given the role – who asked for that?</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><b><span style="font-family: Arial;">I feel tonight that if we all pull together, work hard and campaign well, we might just stave off the worst</span></b><span style="font-family: Arial;"><span> </span>- but that is no where near good enough!<span> </span>I want the best, the best for my daughter<span> </span>- my daughter who is sixteen today - not the make-do, not the maybe if we have enough staff, but the world class services that have been abolished in the new terminology of the new Government.<span> </span>I want my daughter to have world class midwifery and maternity care – because she deserves it and so do I!</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">And so today past and present collide. The personal is so painfully the political.<span> </span>And with bitter sweet memories, and anger borne of experience and determination borne of love, I pull on my boots, roll up my sleeves, paint my placard and light my candle in the dark.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><span style="font-family: Arial;">Sisters I hope you may join me, I cannot do this alone. And tonight I feel as alone as I did all those years ago staring into the abyss of a blank hospital wall.</span></div><div class="MsoNormal"><br />
</div><div class="MsoNormal"><br />
</div>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com1tag:blogger.com,1999:blog-4589709414976731077.post-85142396723868125312010-09-13T05:52:00.000-07:002010-09-13T05:52:37.323-07:00Sir Ken Morrison, former chairman of the Morrison's supermarket chain and native of my adpted city Bradford. He started with a market stall and ended his working life with anational supermarket chain. He is now developing his interest in farming.<br />
<br />
I found this little bit of advice in an article I found today. I think it is worth keeping these thoughts in your head whatever you want to succeed in - from supermarkets to birth resource centres to any social enterprise or project. It takes and heart and soul to achieve anything worht achieving. Heart and soul.<br />
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Over to you Ken:<br />
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1. Have confidence in what you do<br />
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2. Do your research <br />
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3. Respect your competitors<br />
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4. Expect to work hard <br />
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5. Expect to work continuously <br />
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5. No one person has all the good ideas, there are still plenty of good ideas around<br />
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6. You can learn from others - seek them out<br />
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7. Look at other industries for tips that could help your business<br />
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8. There are no short cuts <br />
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9. Application, dedication and hard work – no substitutes<br />
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10. Success is hard wonRadical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-90282244910883601602010-09-06T02:02:00.000-07:002010-09-06T02:03:37.980-07:00Kes: a metaphor for an ambitionWe went to watch Kes at the Oldham Coliseum on Friday night. It was a fabulous production and it has disturbed and gripped me ever since.<br />
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Kes, the feral boy. Father left home when he was six, neglected by mother, bullied by big brother. The food he eats is largely stolen from others. Picked on by anyone who feels like it. In trouble with the police.<br />
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And then he finds a baby Kestrel and becomes absorbed in training the bird. It takes patience and skill. A boy who never reads, reads voraciously in order to learn. <br />
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A teacher is able to pull this out of him and he is transformed into a lad full of enthusiasm, respect and joy as he talks about his Kes. A person with purpose.<br />
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But the story is a tragedy. Because in revenge for not putting a bet on a winning horse (Billy spent it on chips for himself) and he because he could not find and beat him up his bullying brother kills the bird.<br />
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All this was played out on stage and in my soul. The playright Lawrance Till says: “The bird is a metaphor of his ambition – what he delights in, what he is reaching for, what he runs towards.” The tragedy is the destruction of a young boys ambition, which with life so stacked against him, was as fragile and as vulnerable as himself - and as beautiful.<br />
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Lawrence continues: “We may not have the extreme events happen to us as happen to Billy Casper, but we all have ambitions, we all have passion, invest in something and, unless we are very lucky, we all have a sense of loss in our lives – divorced parents or the loss of a pet or maybe something more tragic than that.”<br />
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What are my dreams, my ambitions, what do I run towards, what do I invest so much of myself in? Do not allow the bully destructiveness of the bullying big brother to kill it, nurture and protect it – do not show the indifference and neglect of this story’s mother. Be the English teacher, empowering, enabling, interested, mentoring, listening respecting – so that your dream might with patience be tamed and trained and one day take flight but always come back to you.<br />
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For it occurred to me last night that each character in this story could be an aspect of oneself – if the kestrel was a metaphor for a boy’s ambition then the mother should have been nurturing it.<br />
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And I wonder, for myself and others whether if we treat our own ambitions with such violence. If we do, then whether we also treat the dreams, ambitions, delights of others with similar violence - even without realising it. <br />
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And it reminded me of growing up in a Lancashire industrial town in the 1980ies with the miners strike, the decimation of manufacturing industry in the area. The state, Government and policy of the time did not care how this crushed and destroyed the communities, the families, and above all the kids of our town - the kids I went to school with. Let us never forget the Billy’s of this nation when we make policy and investment, when we make swinging cuts and take austerity measures. Let us not be a state that kills Billy’s Kes.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-24724986517750376282010-07-21T06:41:00.000-07:002010-07-21T06:41:13.212-07:00The chime of the anniversary bellWhy is it that when the hot summer weather comes and everything in the garden is in full and healthy spate, I begin to mourn. There is that heavy feeling. I don’t know what it is, for a while, and then I remember: it is 2 weeks away from the 4th August - again. The 4 th of August, the death day for all my lost babies. Why did I always lose them on the same day? the same time? What is it about this time of year? I don’t know.<br />
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What I do know is that as the seasons turns from winter to spring from spring to summer, each year I have a moment when I must turn and remember, remember my little lost loved ones, speak to their souls, and speak to mine too.<br />
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And I have to do it. My body compels me, even in my busy happy life, it compels me with gentle but firm tug, to turn aside, be still and remember. My friend tells me her African friends would say I need to visit my bush spirit. It is not to be morbid, not to drag up the past, but in a sense to ensure that it stays in the past. Acknowledged, remembered, and given its place, the losses of the past need not spoil the future or dominate the present. Except today of course, when the call comes. It is to stay well that I need to pay attention when my body chimes the anniversary bell.<br />
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I reflect that it keeps me human too. Working on a strategic level, campaigning and lobbying, running a business, I can lose touch with Real Life, Real Things – that is, where humanity touches humanity, where mother reaches to mother, woman to woman. These days, these special days when my bush spirit calls me to sit down with my dead loved ones, keep me human, keep me listening, keep me whole.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-20745031149931910762010-07-05T02:00:00.000-07:002010-07-05T02:00:57.059-07:00We cannot lose our precious progress to normality!<strong>I am really concerned about what is going to happen next.</strong> We have just had the budget and all the rhetoric is about cuts, cuts, cuts. It is the rhetoric that worries me in some ways because it is about pushing the boundaries of what cuts are acceptable. We have no choice they say but to tighten our belts – but they do not specifiy what they mean. And in the post budget rhetoric it is to slam the poor and the sick rather than taxing the rich and the bankers, to cut spending rather than raise taxes to protect services. To be a fair budget and to be fair rhetoric we need to hear both. <br />
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<strong>Of course cuts are not just about benefits it is about our public services.</strong> Services are used disproportionately by the poor and disadvantaged. This is where my greatest concerns lie and this is not being highlighted in the media or in political speeches. I know that Bradford Maternity Services have been asked to cut about a million and half pounds from its budget. With a rising birth rate, investing in midwives and normality – I wonder where the cuts are going to be made? The Birth centre is not happening because, I am told, maternity services have made only half the cuts that they need to make – and the ‘stick’ for compliance is the money not being released for the birth centre. <br />
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And reader, you must understand that these cuts are made from UN-RINGFENCED budgets, that is from budgets that can be reduced by the acute Trust anyway because it gets a lump sum of money for all the hospital (and community) services in its care and then it divides it out between the departments. The PCT may give the Hospital say £100 for maternity services but the Trust is not obliged to give that money to maternity services – it can give £70 to maternity services and spend £30 elsewhere. And then ask the Maternity Services to cut their budget from £70 to £50. I don’t know yet whether this is what is happening in Bradford – but it could be.<br />
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<strong>What worries me most in this situation is that what will be cut, what will be lost, is our precious progress to normality</strong>, increasing and welcoming homebirth, supporting breastfeeding in communities, reducing CS rates and other interventions, increasing the numbers of midwives to meet national recommendations on woman to midwife ratios. Readers, it is my fear that progress here will be lost when we are only just beginning to feel the benefits. I fear a return to the bad old days of me knowing personally anyone who has a home waterbirth in Bradford, of CS rates of 30%, of decreasing breastfeeding rates, of midwives burning out or battening down the hatches because of the immense pressure they are under. <br />
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<strong>The thing is, that cutting investment in normality, quality midwifery led care, breastfeeding will actually increase costs in the short medium and long term</strong>: Lower breastfeeding rates raises re-admission rates for babies and young children (Eg. gastro problems, excema) and has an impact on health and wellbeing stretching for decades afterwards; CS costs about 4 times as much as a home birth (tariff), research shows that more doctors mean higher intervention rates ( which costs more money, source Denis Walsh’s excellent presentation at ARM conference Oct 2009), quality midwifery reduces the need for analgesia, raises breastfeeding rates and lowers postnatal depression rates to name but a few. Midwives save money whilst saving lives<br />
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<strong>So this is a call to arms. Albany for All! We want good quality maternity care, which means continuity of care from midwives. But folks, if we have any chance of getting this or even retaining the progress we have now made, we need to get out there NOW and start making a noise, waving the shroud, reminding Governments, MPs, PCTs and Hospital Trusts what cutting investment in quality care and progressive normality for birth will cost in terms of money and unnecessary suffering.</strong><br />
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<strong>It is time to organise, strategise and get those dandelions growing!</strong>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-13831718066962053072010-06-22T14:45:00.000-07:002010-06-22T14:49:03.665-07:00A blessing on Midsummer night (21st June 2010)<span style="font-size: large;">And did the Great Mother pass my house this evening? Did her skirts not brush my cheek? And did I not catch her scent? Surely it was Her who touched my soul as I watered the garden in the dusk of the day, bringing me to a standstill, gazing into the copper heart of the buckthorn, wrapt, amazed. Awed by beauty, blessing, wholeness; being part of the whole yet having a unique place in it. For a few precious minutes of eternity I lived in paradise and the cares and fetters of my life did not bind or bother me; like paper streamers they fluttered weakly in the wind. I gazed upon my garden lit in the subdued hues of midsummer night, so new, so young, yet so vibrant with the birth of a dream, and I saw her hand scattering her seeds of life and love. I gazed once more into the buckthorn and saw her smiling face. And I smiled. </span><br />
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<span style="font-size: large;">And there I would have stayed for ever and become a tree myself, but the door opened and a voice of love called me back into my world (‘Aren’t you coming to bed?’). Could he not see her? I turned slowly and came in.</span><br />
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<span style="font-size: large;">The great Mother passed my home tonight and her skirts brushed my face, and she turned and smiled upon me and I carry her blessing in my soul.</span><br />
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<span style="font-size: large;">Thankyou.</span>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-49143636710548906952010-06-12T14:39:00.000-07:002010-06-12T14:40:40.297-07:00The Midwife, the Prophet and the Broom Tree<span style="background-color: magenta;">Funny how you send out a cry for help into the universe and the answer comes back to you. I found this article written as a speech for the ARM Conference Oct 2009. I needed to learn the lessons again, so I share it with you.</span><br />
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Let me tell you a story. It is a story from the Jewish and Christian traditions – it is not feminist, it is not PC but in the tradition of Estes the Jungian psychologist and writer of Women who run with the Wolves, a psychological reading can give us food for thought and tips to help us take the things we have learnt today into our real lives.<br />
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I am calling it restoring the burnout midwife<br />
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For refreshment and recreation the man in my life enjoys choral singing. The corollary of this creativity is that his good wife must attend a variety of choral concerts. This is the concert season and last weekend I attended at the performance of Elijah. I like music of all kinds thankfully but most of all I love stories. And as I listened, I began to think and as I began to think I got out the original tale – I can really use this I thought. <br />
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The Elijah cycle are a series of traditional tales from the Jewish and subsequently also the Christian traditions. They are macho tales of daring-do really, formulated and written in an ancient patriarchal tradition, but in these tales, as I have discovered, are some real gems for women and men of the 21st century trying to transform the birthing world.<br />
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A bit of context before telling the tale and pulling it apart. Elijah was one of the old prophets of the North of Israel post partition. Unlike later prophets who wrote books or certainly caused their words to be written down, what Elijah left was a collection of stories and historical encounters - a bit like Robin Hood or King Arthur and his knights - I guess, but in his context it had such an impact on the history of the state that they were chronicled in the history books of the Kingdom and so we come to have them today. Elijah comes over as an archetypal figure striding across the country, telling off Kings and countrymen alike before having to flee for his life and then returning again to cause more political havoc – a sort of prophetic gorilla. <br />
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Now I don’t want anyone here to think that I am trying to bring religion into midwifery because this is not how I want to use the story. I want to delve into it in the way Estes does, Blue Beard and the girl with the red shoes or the crescent moon bear – using the ancient tale to teach us good lessons to be effective in our lives – whoever we are and whatever faith we do or don’t have. So if you are Christian or Jewish, please forgive the unorthodox treatment of this piece of scripture<br />
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The story that that I want to use today is one of those in-between tales. Elijah has just had the big show down with the priests of Baal imported by the wicked Queen Jezebel (who performs the function of the wicked Step Mother of English fairy tales). He lone prophet of God challenges all the priests of Baal to meet him on a holy mountain for a holy dual. They each build an altar to their God, set up a sacrifice and then must call down fire from their respective deity to burn the sacrifice. The Baal prophets go first and call and wave and shout, but nothing happens. Elijah one imagines, arms folded, mocks them – maybe he’s gone to toilet, maybe he is asleep, maybe he is on holiday? The prophets get more and more frantic using every trick in the book to arouse their deity, until Elijah says – enough! It is my turn. He restores the ancient altar of Yahweh, digs a trench, pours water all over the altar and sacrifice until the trench is full, then calls on God to answer his prayer. Fire comes down from heaven, the people of Israel are called back to their faith, and Elijah orders and oversees the execution of all 450 Baal prophets.<br />
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Needless to say Jezebel is unhappy with this outcome and in her fury puts a price on his head and sending a message to him says “May the gods deal with me ever so severely if by this time tomorrow I have not ended your life like theirs!” And here is where our tale begins. Elijah is fleeing for his life – this is not that unusual, as a gorilla prophet he is used to appearing and disappearing from the public scene for personal health reasons shall we say. But in this story it is different because Elijah has (in the words of one translation) “had enough”, he is tired, he feels old and alone and wants to die – and tells his Lord so. <br />
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Elijah, flees for a day, leaves his servant behind and carries on alone. Finally exhausted he sits under a lone broom tree. “I have had enough, I want to die” he tells his Lord and then falls asleep. - AS I hear these words my heart aches. Anyone here tonight who has birthed a babe, brought a babe to birth as a midwife, worked, campaigned, negotiated to make the world a better place, surely we have all sat under the broom tree at one time or another and said “I have had enough, I want to die”. - It is enough! I want to die! All is vanity!<br />
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Burnout. I have had enough. I want to die. All is vanity. We work and work, we give everything of ourselves, we may win, we may lose, we take the knocks we may get a heavy knock, we may see things change for the better or not as the case may be. But there comes a day when we go to the barrel and it is empty, there is nothing left, we have used up all our resources. Burnout. And then we may want to flee or maybe we want to shut ourselves in, but we sit under the broom tree and say “I have had enough . . . . .<br />
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This story is about first aid for burnt out midwives/activists but I also want us to take that further because prevention is better than cure - and think about how to keep our energy and passion flowing in the joys and challenges of bringing babes and mothers to birth. So let us return to Elijah asleep under the broom tree and see what happens next:<br />
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“All at once an angel touched him and said “Get up and eat”. Elijah looked around and there was a bread cake warm and ready to eat, with a jar of water. He ate and drank and went back to sleep. Then again, later, he was roused “Get up and eat, the journey is too much for you.” So he got up and ate and drank once more. <br />
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What was Elijah’s first aid? Food, drink, sleep. When we get sucked into our mission we can forget the essentials of keeping healthy, balanced and well. And in a crisis, in our dark night, when we want to die, we forget the building blocks of life: food, drink and sleep. When the journey has been too much for us we need to feed the body in order to restore the soul. I know it is basic stuff but make sure that in a busy challenging life you take the trouble to eat and drink well, to stay well. Beware of too much fasting on the one hand and comfort glutton on the other. And in a crisis, in despair eating and drinking properly is an essential and sometimes comforting focus.<br />
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But under the broom tree Elijah was not just offered food he was given friendship – the food and drink was a gift, a gift of compassion.<br />
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I often wonder who this angel was. Was it a golden figure with wings and halo? Or could it have been his manservant, unable to abandon his master, secretly following him so he could minister to his needs. Or, since the angel was clearly a stranger to Elijah, could she have been a woman, learning of Elijah’s distress, a woman who took 2 days leave of her family to provide for his basic needs. She could not heal this tortured soul but she could cook a meal to restore an exhausted body and provide sustenance for the journey ahead of him, she could light a fire to keep him warm and watch over him while he slept. Surely these are the skills and duties of a mother, a midwife and nurturer?<br />
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In the big sweep of the traditional tale telling and the drama of Mount Carmel and Mount Horeb this detail is missed – as the role of mother, midwife and nurturer is often missed amongst the high drama of clinical action. But if you want to understand a mothers lasting gratitude to the good midwife, the child’s loyalty to a mother then here you have it: the glass of water brought to your lips, the believing you can do it when you have given up hope, the food set beside you where you can reach it, the kind face that appears when you open your eyes. And if you think back to your darkest hour, was it an angel who helped you through? Or was it the figure or figures in your life, who listened and loved, who gave you food and drink, who believed in you when you did not, who watched over you until you had the strength to carry on? <br />
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This is the sisterhood, the communion of saints, the comradeship, the team spirit – whatever you want to call it and it is essential to effective midwifery within and without the NHS and essential to any mother, midwife or other who wishes to be a changemaker in the world. We need to nurture, and support one another in fostering good births whether in the birthing room, in the management meeting or in the parliamentary lobby, whether we are mothers, midwives or full time activists. One night we may be sat under the broom tree with an angel ministering to us, another day we may be that angel. That is the way it is and the way it should be. And by being angels to one another we can prevent burnout and help restore those who suffer it.<br />
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Two short angel tales for midwives. One: a midwife told me how after an adverse outcome as they seem to be termed these days she tortured herself for weeks as to whether she might have spotted something earlier, that she could have done something different. At last one day a more senior midwife, quite a brusque character, talked to her about it and said “ Years ago I made a mistake that caused the death of a baby. You live with it for the rest of your life. But you have to carry on; there are more babies to birth. It is the risk we take in doing what we do.” The midwife who told me this tales said that it was not just her words that picked her up but the courage of this midwife both to carry on after that awful experience and to be willing to tell her story to encourage another midwife. Second. New birthing pool, the first midwife takes the plunge and - agh! -A third degree tear. And Oh! How it travelled about the unit – “ooh, hear you had a third degree tear in the pool”; you put a lady in the pool and had a third degree tear.” You know the stuff – natter, natter, natter. : The stuff that kills innovation in a birthing unit. One midwife said we should not be doing this so she went up to the midwife and said – “Hear you had a third degree tear in the pool – that’s tough but I heard you spotted it and dealt with it really well. Well done!” Angels. Sisters. Sweet tea, listening ear, homemade bread, words of encouragement, believing in someone when they don’t. This is first aid for burnout and prevents long term damage.<br />
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And the story continues. Strengthened by this sustenance he journeys on – forty days and forty nights – that old term for a long time – to the holy mountain of Horeb, where Moses received the stone tablets centuries before. There on the mountain side he finds a cave and sits in it all night. A lone figure returning to his roots, to the source of his faith . . . and he has a complaint to make.<br />
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There are a few things to learn here for the prevention and cure of burnout.<br />
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First of all, he could not sit under the broom tree for ever - in order to sort himself out he had to move on. Years ago, after 10 years of giving my all to a particular life and vocation it came to an abrupt and bitter end; a full stop. I was utterly devastated and spent some weeks and months in despair, broken. And then I heard a story about a man lost in the desert and suddenly in his wanderings he came across a beautiful desert flower blooming large and red, where there is a flower there must be a little water, and there was. And there he sat sustained by a little water, gazing at this beautiful flower. And it was such a beautiful flower, large and lustrous, deep red with a black centre. But the water could not sustain him and this beautiful flower and the flower began to wilt and he had to choose whether to stay and die with the flower or to journey on to the nearest city where he could find sustainable life. I remember realising that if I stayed gazing at the beautiful flower of my loss I would die there, and so I got up and started to make the long journey (500 miles) through my desert to find a new and sustainable life. We cannot sit under the broom tree for ever - we have to deal with the challenges we face one way or another.<br />
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Elijah’s solution was to retreat to his God’s holy mountain and to make a complaint. Retreat! - is the cry of an army losing a battle. It is no failure, faced with something that overwhelms you to retreat to a safe place where you can regroup, and redeploy your resources. It is a necessity of survival and if you don’t do it often your body will call time and shut down on your behalf. And this can be the cause of much illness and debility in some of us – it is the way we get a break. First Aid for burnout then is retreat, shut down, get away to gain some time to be refreshed, sort yourself out, work out a new plan.<br />
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If you recognise this in yourself as I did then a solution is to book your retreats in advance so you can miss out on the misery of being ill. Twenty or thirty years ago when the Basic Communities were in full action in Latin America, empowering peasants to gain justice over land, water and pollution as well as political emancipation, the leaders of these communities faced immense pressure and persecution. The sisters and religious that supported them in one area, taught and practiced regular ‘retreat’ or withdrawal to ensure the activists did not burn out. It was something like this – one hour in the day, half a day in the week, one day in the month, three days in the quarter, one or two weeks in the year. <br />
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I think this is a brilliant strategy to stay sane under pressure, it provides space at different levels and different intensities and in chunks that an ordinary person can manage. So much of monastic tradition in all religions is pretty aspirational for us ordinary folk but here is something we all can do – and indeed must do if we are changemakers wanting to avoid burnout.<br />
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I am always one for taking a good recipe as a guide and then making the rest up as I go along and so taking that structure as a guide I have found a way of structuring ‘retreat’ time, soulspace into my hectic life. I share this as an example; you will have to find your own way. So every day I try and do a couple of rows of knitting or crochet – I find this works better than meditation because it keeps my hands and chattering brain busy on the one hand and I look busy to the children so they don’t tend to interrupt! For years my daily retreat was listening to the Archers! I go to yoga on a Thursday and a meditation on a Sunday evening. Recently the pressure in my life has increased and I am finding that I need to make an hour’s knitting at a knitting group on a Wednesday morning also a priority. Notice the busier you get the greater the stress, the more breaks you need to keep a balance. Once a month I visit a therapist for massage or acupuncture or such like. I may not need to see her each month but I would need to see her if I didn’t go – if you know what I mean. I also spend an evening a month with some good nurturing friends where we consciously talk about deeper things. Every eight weeks we try to get away as a family for a either a weekend or 5 days depending on the seasonal nature of our business. Very recently we have had the courage to shut down the business entirely for two weeks in August and spend two weeks away together as a family – part of the retreat plan!. <br />
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This is no great shakes – this is survival rations for a mother of five children who runs a business, chairs an MSLC and is trying to change the world! It prevents burnout, prevents ill health, and manages stressors. And if something overwhelming does happen a restorative retreat is rarely too far away. Retreating isn’t failure it is the key to successfully maintaining our campaign for good birth.<br />
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But back on Mount Horeb, things still aren’t good for Elijah. He has retreated, back to his roots, back to the faith roots of his nation. This is then a physical and emotional journey to a Holy place - to the source of his strength and courage and his powerful and effective work. And in this special place, at the root of his soul he pours out his troubles: I have been very zealous for the Lord Almighty he declares, I have done all the right things, – but look my countryman have given up on their heritage and persecuted those who have tried to maintain it – and I am the only one left.<br />
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When we are overwhelmed, when we have lost our sense of purpose and vocation, when we are pulled in too many directions, when we do not feel we can cope any longer we need to return to the roots of our belief, what makes us who we are, whatever or whoever that may be - for some of us that includes a physical journey to a special place or person, for some of us it just takes time and space. But we all have roots and when we have had enough we need to go back to that place to find the answer to what we need. An answer we shall surely find, but as Elijah finds out the manner and the content of the answer may be unexpected and unlooked for.<br />
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Elijah says he has done his bit for God and some and for his pains he sees his brethren killed and has to flee yet again for his life. And he can’t do it anymore. And maybe he was looking for big show from his Almighty God, maybe he expected a dramatic vision, a proof of power and strength - but his God was not in the earthquake or the fire, his God was found in a gentle whisper. In A still small voice Elijah converses with his soul and finds his needs supplied, – a new mission, a friend and successor and a message to take to the King. And then once more Elijah bestrides the nation and his dramatic tale continues.<br />
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We need to return to our roots from time to time but when we do so at the point of despair I find that what I get is reassurance of my calling and a new mission. I am not retired - but empowered to carry on! I am not given laurels to rest on but walking boots for the next journey – and amazingly it works!<br />
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Some of you here today maybe be suffering burnout or be close to ‘jacking it all in’ because you have ‘had enough or maybe you have a friend who is going through it at the moment. So using the story of Elijah as a tool, here are some first aid tips to tackle and prevent burnout so you can survive and thrive amongst the challenges of today’s world:<br />
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<span style="color: magenta;">Pay attention to the basics – food drink sleep</span><br />
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<span style="color: magenta;">The care of an angel – be an angel receive and angle</span><br />
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<span style="color: magenta;">Do not sit under the broom tree and die – get up and look for a way out</span><br />
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<span style="color: magenta;">Retreat! Ensure times and places for recovery and refreshment in your busy life</span><br />
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<span style="color: magenta;">Go back to your roots – the roots of your soul, strength, or vocation whatever it may be</span><br />
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<span style="color: magenta;">The answer may come to you in unexpected ways from unexpected places</span><br />
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<span style="color: magenta;">And you won’t be given laurels to rest on but a new journey, a new mission, a new task, a new inspiration.</span><br />
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I hope that this helps other burntout activists as it helped me - let us apply the lessons of Elijah of the lonely Broom Tree.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-53726587924530174982010-06-08T14:57:00.000-07:002010-06-08T14:57:01.822-07:00Fragments of SoulWhat has happened? Where did April and May go? They flashed past in a flurry of activity and chaos. Our busiest Easter followed by our busiest Whitsun. Every pool out. Working flat out. The birth resource centre planning and action dropped and lost in the overgrowth of the business. Where do the days go? Another day and I have not read stories to the children. Another day and the consititution is unfinished, the funding bids unwritten, another day another week and the blog goes unwritten. Yoga class missed, meditation missed, lunch with hubby missed.<br />
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And slowly slowly inexorably I am worn down, pared away until I wake up one morning and there is nothing left, nothing left to give, creativity dried up, sense of humour abandoned, fragmented unfocussed.<br />
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Time to pay attention. Time to read the story of Elijah - and how to deal with burnt out activists. Time to go into the garden, time to sit on the bed with the children, time, time there is no time. And yet if there is no time for the soul - there really is no time for everything else. Soul time spins the yarn of time, it is how you find time, time for what is important.<br />
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And we who are mothers at home, we who are mothers dividing ourselves between outside work and the home, we who live lives of interruption and fragmentation, we will not grasp the bigger picture, we will not stay focussed on what is our true visions, we will not keep our balence and perspective, unless we learn the art of soul time.<br />
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Soultime is time in the garden, reading a good story with a child, a cup of tea stood by the open back door, a 2 hour slot doing an art class or a yoga class or a singing class, breastfeeding, listening to muisc, meditating, lighting a candle, gazing into an open fire. Soul time is what nurtures and heals the bumps and bruises of the day and that is what I need, you need, we need - or else we will spend our time without really Living - and that would be a tragedy.<br />
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Tonight, was Choices, where several women and men got together and shared our knowledge of birth, and our visiting Independent Midwife, for the first time talked and talked about birth, everything everything and we all left at ease with the gift we have been given, the gift to birth. And I thought this is really living,, this is the soul of birth, this is why I do what I do, and this is why I need soul time - so that these soul things can happen.<br />
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The birth of a birth centre needs SOUL.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-61810679450719709552010-03-22T15:00:00.000-07:002010-03-22T15:08:50.658-07:00Of Fatigue and Foundation BuildingAnd tonight I am tired. So tired.<br />
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Life maybe a roller coaster sometimes but with a roller coaster it stops at each end and there is an end – this is a roller coaster that just keeps going.<br />
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As I lie in bed and listen to the generator of the road works outside, I sometimes think – is this what we have signed up for? a life of constant change, of crises queuing for attention, of juggling too many responsibilities?<br />
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It is the 17th March when I write this. Three months to our first day in our new home, dream now fully launched and the snow began to fall. And we have survived the coldest winter for thirty years in a Victorian edifice without central heating, and double glazing. <br />
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We move into an area with four primary schools but with no school places at all for my reception and year 2 children and so end up with one at home and one being educated on the other side of Bradford for all that means in terms of time and fuel and his unsettlement. Meanwhile the bath leaks (not the plumbing – though that leaked as well but we could fix that – a hole in the bath on the other hand . . . .) so we have to remove it because we found the cable for the lights of the bathroom below run under it. Hmmm. <br />
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So now we have a house with no central heating, lacking double glazing at the majority of windows and a house without a bath and with a rather disgusting shower. And then Balfour Beaty, bless ‘em, are laying siege to two sides of our house so you can only gain access to the side entrance and we get phone calls from firms saying they tried to deliver the package but could not locate an entrance due to the roadworks . . . good for business then! <br />
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Meanwhile because they have dug a long stretch of road for electrical work the water pipes are on the surface on the ground and in the coldest winter for thirty years we find our water is frozen many mornings in the week. So not only are we cold we can’t warm ourselves either with a shower or a cup fo tea. <br />
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And then there was the generator situated outside out bedroom window which would rumble into action at 3am each morning waking us up as its vibration shake the house. I know I have done the 3 am feed as a breastfeeding Mum but I no longer have the hormones or the lifestyle to withstand chronic sleep deprivation. At the end of a week of this I am desparate and my sense of humour has ebbed. After two weeks of this . . . .I take to ringing Balfour Beaty at 3am in the morning to inform them of the noise. They finally move it away so we can hear the noise but are not disturbed by the vibrations. But some other poor sod must get it instead – hopefully they have double glazing. <br />
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And of course there is the saga of the electrical meter . . . . and so the list goes on, and these are the things I can remember – I can’t remember week by week the litany of disasters to be overcome. And this does not include the challenges posed by the business which have not been inconsiderable especially not having staff for six weeks over Christmas due to the big freeze. I would wake at 6am to get the children off to school ready to start work and by 8.30am all the schools would have closed and I had to re arrange my day to accommodate it. I could do this for a couple of days but it went on for 2-3 weeks. And to wake up to that and the water frozen in the taps – it gets wearing.<br />
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I know I am moaning but I am not really complaining. Writing it down gets it out of my system and I feel less tired and worn down. Yes it has been very tough and still is tough. We are coming up to Easter and the pressure is on to deliver umpteen baptisteries and get them back over the next three weeks whilst holding down the rest of our chaotic life. <br />
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But . . . . but . . . . , today the sun shone, the roadworks have moved down the road and people began to walk past us and they were curious at what or who is happening to this house. The daffodils in the pots have come out and cheer me with hope, and my sons went to play in the park. Yesterday I was told that the PCT are reconsidering their policy regarding funding the MSLC and its chair – until the fat lady sings - I won’t say it is sorted - but at least it is a positive move forward. And I am begining to get my joy for cooking and baking back – the mental siege is lifting - I feel able to invite people to lunch or dinner confident that we can give them ‘a good do’ as my grandparents would say. Choices met at 89 this month and it was not a disaster – though 20 people rather touched the capacity of the room! My to do list includes setting date for a meeting to take forward the birth resource centre theme as a steeringing group. We are getting there, we are moving forward, this dream can be earthed in reality.<br />
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<strong><span style="background-color: white; color: magenta;">Henry David Thoreau in Walden or Life in the Woods says in his concluding chapter:</span></strong><br />
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<span style="background-color: white; color: magenta;"></span></strong><br />
<strong><span style="background-color: white; color: magenta;">“If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them”</span></strong><br />
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Yes, I am digging the foundations to earth the castle in the air. And to you my readers I hope you too have a castle in the air and a spade to dig the foundations under them. And I wish you well.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com2tag:blogger.com,1999:blog-4589709414976731077.post-67802581394267171972010-02-11T13:58:00.000-08:002010-02-11T14:01:04.862-08:00Green shoots in the winter earth.<span style="color: lime; font-size: large;"><strong>Another step forward. Green shoots in the winter earth.</strong></span><br />
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This weekend we had a painting polishing and planting weekend. We invited friends and family to come along and help us reduce the mountain of little jobs - hanging curtains, moving a bed, building a desk, rehanging a couple of doors, polishing the stairs, staining the wood work, stripping and painting the therapy room etc etc. We offered food and drink and good company in return.<br />
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And they came, on their own, as a couple, with babies and children. Some stayed for 2 hours some the whole day. Some could do loads of practical work others could barely move to make a cup of tea such were the demands of their children. One couple took all day to arrive with their 2 week old baby - but what a joy! What a gift to receive them! And how important for us that they came.<br />
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And it was wonderful, wonderful. And yes nearly all the jobs got done but that is not why it was wonderful. The house came alive to the sound of children's laughter and adults chatter, the walls echoed to feet and hands doing creative work and the place was filled with love and joy and fun and real people and real stories.<br />
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And this house which had felt so silent and sad when we moved in was full of light in the right places, and this house that had felt so very very cold glowed with warmth. I thank <strong>all</strong> my friends who came in body and spirit that day and gave their hands and heart to give our home soul.<br />
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This truly was the birth of a birthing centre, born in love, born into community.<br />
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This week, perhaps for the first time, it has felt like a gift and a privilege to live and work here.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com1tag:blogger.com,1999:blog-4589709414976731077.post-51337507981233757542010-01-26T09:16:00.000-08:002010-01-26T09:20:12.483-08:00Right Care, Right Place, Right TimeI attended a HSJ ( Health Service Journal) seminar on 26th January 2010. It was actually about using or selling a data tool called Interqual (registered trademark) and it was clearly aimed at A&E and acute illness scenarios (heart illness etc). However, applied to maternity services and birth its principles, I think, could be an eye-opener. If it was seriously and rigorously applied to maternity services and birth services I wonder if they would be structured very differently? AS Gary Lane said at the end of his presentation – short term pain for long term gain – restructuring services to give appropriate levels of care at the appropriate time will have long term benefits for patients and Trusts.<br />
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<strong>The seminar began with a quick overview of the financial situation of the NHS:</strong><br />
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• NHS nationally has a shortfall of £20billion. This amounts to a big cash crisis.<br />
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• Trusts and PCTs have been informed that they will only receive 30% of 2002 levels ( this needs to be checked as was not on the slide) of the money they received for Acute admissions.<br />
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• Just 10% of PCTs have managed to reduce A &E admissions accordingly<br />
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• There is a continuing demand for quality assurance through QIPP (Quality, Innovation, Productivity and Prevention) and CQUINN<br />
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<strong>The Solution </strong><br />
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<strong>Reduce acute level of care (ie in hospital, in patient care) and providing as much care as possible in patient’s locality and community.</strong><br />
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<strong>My comment</strong>: Surely this is the nub of the issue with regard to how maternity care is structured? The complaint of many women is that their care is inappropriately centralised and clinicalised, and not there at the right time, place and level that they really need. From maternity services point of view women are going into hospital for birth inappropriately – the system is set up for care only to be in this location. So, for example, women turn up to hospital and complain that they keep being returned home in early labour – why not assess women at home and keep them there until they wish to go in or give birth? Homebirth services are provided as optional extras by maternity services rather than being structured into the care pattern for all women as, for instance above. For many women this would be appropriate localised care at an appropriate level, and would reduce acute admissions to hospital – unnecessary acute admissions to hospital.<br />
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<strong>Postnatally,</strong> regular midwifery and social care visits to establish breastfeeding and general wellbeing of Mum and baby dyad in first 2 – 4 weeks post partum could reduce acute admissions (eg for gastroenteritis of baby) and post natal depression. The question being does saving in one departments budget offset the extra spend in another? Ie If investment in low level social care (to establish breastfeeding for instance) has big payoffs in the acute budget ( readmission of babies for instance for preventable illness) will this be acknowledged and supported within the NHS structure?<br />
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<strong>A case example given was Rotherham</strong> – this was not maternity services but hospital acute care generally – however, if read applying to maternity services it is thought provoking.<br />
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<strong>The key issue to be tackled in Rotherham: Patients in acute beds who do not need to be.</strong><br />
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The tool was the Interqual tool.<br />
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<strong>The objectives:</strong><br />
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• Right care, right place, right time<br />
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• Admission avoidance ( patients being admitted into hospital that do not need to be)<br />
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• Developing Alternative Levels of Care<br />
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• Better care with better value (for money)<br />
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• Building locally based care<br />
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<strong>Activity </strong><br />
<strong>(</strong>Taken from the HSJ Rotherham Case study PDF <a href="http://mediazone.brighttalk.com/comm/Emap/12ce4a01b3-16351-3188-12894">http://mediazone.brighttalk.com/comm/Emap/12ce4a01b3-16351-3188-12894</a># )<br />
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• Rotherham Partnership began implementing InterQual in February 2009 initially on three wards covering emergency admissions; trauma and orthopaedics; and healthcare for older people. It was also implemented in the community in a purpose built facility for people with chronic obstructive pulmonary disease. <br />
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• Case Managers assessed patients both on admission and throughout their hospital stay and where they identified that patients could be cared for more appropriately elsewhere, they worked to facilitate a supported discharge.<br />
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• All patients are reviewed against InterQual’s admission criteria and then against the continued stay criteria while they are on a ward using the system. In the first16 weeks (16 February 09 to 8 June 09), 3631 reviews were undertaken on 892 patients. <br />
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• .The hospital found that 49% of the admission reviews met the criteria for an acute admission; 45% did not. <br />
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• The continued stay [in hospital] reviews show that 15% met the acute criteria and 77% did not. <br />
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• This data shows that the 77% of continued stay reviews and the 45% of admission reviews which did not meet the criteria resulted in patients occupying an acute bed. This meant a total of 1574 days, when patients could have been cared for at a sub-acute level if that level of care had been available in Rotherham.<br />
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• InterQual has subsequently been rolled out in Rotherham across respiratory medicine, and plans are in place to use the criteria in a modified way on the Stroke Unit and obstetrics and gynaecology in order to undertake retrospective audits. <br />
• Case Managers report numerous examples where experience told them that a patient needed moving to a less acute environment but InterQual provided the evidence-based assessment to confirm this.<br />
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<strong>Long term objectives (from HSJ seminar)</strong><br />
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• Using Interqual data to identify the number and type of patients who are not meeting or requiring acute level of care to inform future commissioning.<br />
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• To commission the most appropriate service model location and resource structure to deliver this.<br />
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• Changing the culture of the organisation and clinical practices.<br />
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• Identifying bottlenecks (eg bed blocking or delivery room blocking)<br />
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• Ensuring medical intervention at appropriate times, levels, and places.<br />
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• Short term pain for long term – redesigning care system so that they are efficient in the long term so that care is provided when and where it needed says Gary Lane.<br />
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<span style="color: orange; font-size: large;"><strong>Right Care, Right Place, Right Time</strong></span><br />
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<span style="color: orange; font-size: large;"><strong>For Mums that means: One mother one midwife, at home, for the birth</strong></span>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com4tag:blogger.com,1999:blog-4589709414976731077.post-55294867824289998462010-01-20T06:55:00.000-08:002010-01-20T06:55:07.904-08:00Harsh reality and gritten teethThis week the snow finally cleared. The ice on the windows became condensation. I could get dressed without the heater being on for 40 minutes first! The coldest winter for thirty years and we move into the coldest house in Bradford!<br />
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But snow gives a beautiful dressing to everything, ice stops people coming to see you; huddled around the fire you don't venture into the rest of the house to see what needs doing. This week the snow cleared and out of my office window I can now see the builders rubble, the plaster, the discarded cardboard boxes. The over-grown lilac has lost its sparkling dressing and looks leggy and messy. Without the Victorian Christmas look the porch looks less Dickens and more tatty tenement. What will people think as they come to the door I fret? - They won't want to come to a birth resource centre looking like this?<br />
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And though the hall has beautiful pannelling it needs touching up and a polish, and as fast as I clear it up another lot of stuff is dumped by the front door on its journey up, down, in or out of the house. The living room needs half a dozen boxes removed and just needs tidying up - and one of those Belgium-sized sofas removed. Could anyone come here and believe this was a place to learn about birth and be nurtured in it?<br />
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And the therapy room - the fridge as the family call it - because that is what it is. A gaping doorway into a once lovely Edwardian glass and wood extension makes this the coldest room in the house. And so it has become the repositiory of all boxes and items without a home and not essential for immediate use. And it feels empty and sad and in need of a coat of paint. Could this be a therapy room where women are nurtured and loved, and where healing is offered? Could you see it and believe it?<br />
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I believe it, I know it . . .but will others see it and believe it too? People who I need to come to the groups, facilitate the groups, provide the therapies, provide the funding? Can they see it? Could they come to a place with a scruffy garden with daffodils peeping through as scouts for the beautiful garden we will make - could you? Could you come and sit and learn in a big room that is beautiful but not finished - like when you wear a suit and then sturdy boots for the weather? Or your pretty dress has the stripes of a sickly baby? Could people feel comfortable with cosy but not yet posh? Could you?<br />
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And could a therapist see a beautiful but cold drab room and believe that this in 4 weeks could look pretty good and feel wonderful and 12 months be perfect? Could they? Could you?<br />
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This week I have faltered because the snow has cleared and the harsh reality on a dull wet day is that there is alot to do. The house IS tatty and you can't replace all the windows of a Victorian Edifice for under £10 thousand pounds and we spent that on getting the roof weather proof and the cellar damp proof. And my wild roses won't flower until June and we won't be cutting the trees until later in spring. <br />
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And my kind and honest friends - are they being really honest when they share my enthusiasm and say how lovely the house is and capture my vision and say everything will be OK? And that all it needs here is a coat of paint and there a sort out?<br />
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Sometimes realising a vision means holding on to your vision with gritten teeth, believing when the reality tells a different story, and just working task by task. Sometimes only your friends can see the progress. Sometimes you need a holiday.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com1tag:blogger.com,1999:blog-4589709414976731077.post-76551625622253496142010-01-07T09:43:00.000-08:002010-01-07T09:43:41.438-08:00I am a believer.<strong>"If I count how many steps it would take to climb this mountain I would go no further: I would sit down and cry. But I have decided to be a believer."</strong> <br />
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I have not blogged for a good while. And I am sorry for that but let me tell you something of why. We had this dream, this plan. It started off as a plan to put work and home together, to simplify our lives so we did not spend 2 hours and 20 miles a day in a car taking children to school and us to work. We wanted a more sustainable lifestyle. But then we looked around some houses homes, premises – all kinds of things, all over the north of England and Wales. Mind you, there seemed to be a theme, as our favourites tended to be old doctors surgeries. <br />
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And so another dream began to emerge. “What a lovely big room” we thought. “It could work for classes, courses, training etc. And look at this room! This would be so fab as a therapy room.” Basically, we realised that we might be able to have an office, a pool storage and a Birth Resource Centre. That phrase was given us by a doula moving down from Edinbugh who had worked with Nadine Edward’s set up. She gave me the concept I was looking for: A resource to parents, midwives practitioners for maternity birth and beyond. A place to be informed, nurtured and massaged as well. A network hub for birth.<br />
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That was the dream. Now the reality. A large family a small income, a small but expanding business, a credit crunch. After 18 months of arguing with banks (No, the Royal Bank of Scotland does not lend to small businesses any more) and vendors (What? You want to knock another £10 thousand off for the tree in the cellar?”), we finally purchased 89 Bradford Road, known to the children as 89 Zoo Lane ( Do you remember ’64 Zoo Lane' on TV?) and to David as Gormanghast. <br />
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Our new home is a gargantuan Victorian edifice with no central heating system. After the TV programme ‘Victorian Farm’, we’re going for the spin off: ‘Victorian House’ complete with real TB. Spread over four floors there is ample opportunity to lose children, ladders, staircases and whole rooms. Visitors and workman have been known to appear in doorways looking puzzled and nonplussed asking “Where have the stairs gone?” “I thought they were around here somewhere”. And so our enchanted house casts its spell.<br />
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We got the keys to the focus of our dreams on 30th November. On 1st December the builders moved in to remove the tree from the basement wall, put the stairs back where they need to be for health and safety reasons as well as reaching the fourth floor, and to make other basic repairs – such as restoring the roof and chimney etc. <br />
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It was an exciting week when we moved in – and yes it took a week to move the Weston tribe with their goods and chattels plus expanding business into one set of premises – (and yes we do now have a tradesman’s entrance!). Unfortunately as we moved in, the central heating boiler moved out into the skip and we had the white Christmas we would never have contemplated otherwise. Ah the twists and turns of fate! Our children have now learnt that getting ready for bed means putting your pyjamas on top of your day clothes. And no one is allowed out with less than five layers of clothes. Tom says he prefers ‘windy Walney’ (our holiday home) with outside loo because it is warmer there. And it is.<br />
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The Scott of the Antarctic Memorial Society are holding their annual re-enactment at 89 Zoo Lane to which all who have the appropriate clothing are invited. Bring a penguin. Placement students from the British Antarctic Survey are also welcome. (None of this is true but its sounds good! - ed)<br />
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And so here I sit with large jumper retrieved from case of clothes from my student days and woolley hat (I may look silly but I feel warm!) writing my blog. IN four weeks time I want the embryo Birth Reosurce Centre to be ready for birth – I suspect, like every mother, I will have to learn the art of contented waiting. In the mean time there are boxes to empty, furniture to arrange, walls to paint, workmen to find and organise. And at the same time, meals to cook ( where is that pan it can’t be in a box), washing to do, children to take (or not) to school, customers to deal with, bills to pay. <br />
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<strong>If I count how many steps it would take to climb this mountain I would go no further: I would sit down and cry. But I have decided to be a believer. So instead I count the steps I have made and look back at how far I have travelled. With the courage this gives me I can turn my face forward. </strong><br />
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<strong>I know that in three years time we will hardly believe the distance we have covered. I am a believer.</strong>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com2tag:blogger.com,1999:blog-4589709414976731077.post-29743277671573113892009-07-07T01:18:00.000-07:002009-07-07T01:36:53.814-07:00Birthstory: The gift of a good midwifeThis story tells the world why we need professional independent midwves who are with woman and not with the medical systems. Read and be inspired! Then go to <a href="http://www.independentmidwives.org.uk/?node=8765">www.independentmidwives.org.uk/?node=8765</a> to find out what you can do to save them.<br /><br /><span style="color:#cc33cc;">"Having Michelle there gave me confidence and she did that through allowing me to birth my own way, to be the expert on my own body and not taking that body and not taking that power away from me. "</span><br /><br />Birth Story – Owen Conor<br /><br />Ok, some back story to my choices. My first son was a planned homebirth. He had been three weeks late and I had a real battle with the NHS. I had a really positive 1st stage but a difficult second stage due to him being back to back with the cord wrapped twice around him. I went into hospital afterwards as his apgars were low and it was the most horrendous experience and made me vow to never go in again!<br /><br />This time round I decided to take no chances with the NHS and booked an independent midwife. Michelle is the most amazing woman, experienced, knowledgeable, calm, confident and utterly convinced that women will labour instinctively and positively if allowed to do so.<br /><br />Michelle visited the day before Owen was born and we joked that I had decided to labour the next day, after breakfast, and be done before Niall’s bedtime so he could meet his baby brother.<br />The next morning was a beautiful sunny Saturday. We all got up, had breakfast together and began to potter. At around 10am I had a brief achy feeling in my lower back which made me stand up. I got a few more of these before starting to experience some random tightenings with mild cramps. This made me really hopeful, but I tried not to get too excited. Just after noon we went for a walk to the local shop and they became more frequent, between 5-7 minutes apart but not very intense. I phoned Michelle to let her know that things were starting and agreed to ring when they were more regular. Dermot began assembling and filling the pool and I put the TENS on.<br /><br />I then started reorganising my kitchen in between contractions! My friend Debbie popped over and joined in with me. Niall went over to a neighbour’s house to play. By 2pm the surges were becoming more intense and regular – every 5 minutes and by 3pm I was making low noises and concentrating with each one. I rang Michelle who said she’d be straight over and then put on some music. At this point I just started dancing. I had a playlist with lots of stuff like Faithless, Basement Jaxx, Chicane, Moby etc. It felt so right just to be dancing round the kitchen, swaying my hips. I had my clary sage oil burning on the work top and bent over that rotating my hips to each contraction, then carried on dancing. I would recommend this to anyone especially as I was later told that belly dancing was originally a birth dance! My system was flooded with endorphins and I felt so high. Both Debbie and Michelle had a dance with me before Debbie went home.<br /><br />At around 6pm the surges started to be felt more in my lower back and I was asking Michelle and Dermot to put counter pressure to the base of my spine – heaven! At 6.25pm I decided to get in the pool. The warm water was lovely and I got on all 4 fours swinging my hips and lowing with the surges. Both Michelle and Dermot continued with the counter pressure, putting their full weight into it. I’m surprised I’m not bruised back there! Derm told me at one point he released pressure to change position and I growled at him ‘BACK!’ It was the voice of command apparently.<br /><br />I soon began to feel mounting pressure as Owen began to descend, I stayed very relaxed and made positive noises, saying ‘yes’ and other words of encouragement. My waters eventually went in the pool at 6:55 and were clear. Over the next 15 minutes I could feel Owen’s head moving down and at 7:10 I could feel the top of his head with my hand. The contractions were now very strong expulsive ones and I knew with some help from me I could birth him quickly, however, I was conscious of not wanting to tear and took it very slowly. I talked to him all the way through, telling him what a good boy he was and how well he was doing and what I was doing. I went easy on the next few contractions, easing him out slowly and holding the top of his head. I pushed the sides of my labia over his head and felt him crown. I remember telling him over and over ‘it’s ok’ and I was also telling myself, reminding myself not to panic but to stay calm and relaxed. Two minutes later the next contraction moved his head out and with the next one he was born. He did a bit of a corkscrew and shot out. Michelle pushed him back between my legs and I lifted him out of the water for his first cuddle! Michelle and I blew on his face and talked to him as he cried and gasped a couple of times before breathing and pinking up.<br /><br />10 minutes later Niall came home and met his little brother for the first time. He seemed quite impressed! Owen and I stayed in the pool together for another hour. Owen latched onto my breast like a pro and had a good half hour feed. At around 8:30 I had still not birthed the placenta and was having lots of cramps. Dermot cut the cord once it had stopped pulsating and had his first skin to skin cuddle with his new son. I eventually turned onto my back and manually removed the placenta. It slid free with a little pressure on the cord. I then got out of the pool to be checked over by Michelle. Owen was weighed and surprised us all by being 9lb 6oz! We’d all guessed lower. Niall’s grandparents took him to theirs for the night and Dermot and Michelle emptied the pool whilst I had a well earned glass of fizz! We were then tucked up in bed together with our little treasure to spend the first of many sleepless nights.<br /><br />All in all I could not have wished for a better birth experience. I had one small 2nd degree tear but it’s healing nicely on its own. I felt happy and relaxed throughout and this is what made it so manageable. Having Michelle there gave me confidence and she did that through allowing me to birth my own way, to be the expert on my own body and not taking that power away from me. She checked Owen’s heart rate periodically but that was the extent of her intervention (besides the counter pressure).<br /><br />I would advise anyone wanting a natural birth to look at hiring an independent midwife, they are fantastic. I had great care from the team at Yorkshire Storks throughout my pregnancy, a wonderful birth experience and the post natal care has been outstanding. Michelle made me stay in bed for a week after the birth, and despite my initial reluctance I am so glad I listened. 3 Cheers for babymoons!<br /><br />Rhian<br /><br />Michelle can be contacted via Yorkshire Storks Midwifery Practice <a href="http://www.yorkstorks.co.uk/">http://www.yorkstorks.co.uk/</a> or telephone 01423 360 460Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com2tag:blogger.com,1999:blog-4589709414976731077.post-52642964962386141192009-07-07T00:04:00.000-07:002009-07-07T00:13:47.066-07:00Have your say! (Again)This is another consultation that the Government has put out about 'nursing and midwfery'. Don't fret, mothers, just put in your workbasket, get some needles and some brightly coloured wool and knit your response. We have until 10th Augst (and beyond) - so hit the link and say what you think! Love to you all!<br /><br />Ruth<br /><br />Commission on the Future of Nursing and Midwifery<br />Core Script - June<br /><br />The Prime Minister launched the Commission on March 10, 2009. It will report by March 2010. It covers England, and considers midwifery and all branches of nursing, in all settings, services and sectors. Partly in recognition of her previous experience in nursing practice, management and leadership, Ann Keen MP was asked to chair the Commission in her current role as Health Minister. The Commission is made up of 20 leaders in nursing and midwifery practice, management, education and research.<br /><br />Lord Darzi in High Quality Care for All rightly identified nurses and midwives as key to providing quality care. The Commission has been set up to ensure that frontline nurses and midwives have the support, skills, and competencies that they will need to design and deliver 21st century quality services for those that are in need of health and social care and to promote health and well-being.<br /><br />The Commission has been asked by the Prime Minister to:<br /><br />· identify the competencies, skills and support that frontline nurses and midwives need to take a central role in the design and delivery of 21st century services for those that are sick and to promote health and well-being. In particular, to identify any barriers that impede the pivotal role that wards sisters/charge nurses/community team leaders provide.<br />· identify the potential and benefits for nurses and midwives, particularly in primary and community care, of leading and managing their own services.<br />· engage with the professions, patients and the public in an interactive and robust dialogue which will identify challenges and opportunities for nurses and midwives.<br /><br />Commissioners will also receive advice from expert advisors in relation to specific aspects of their work including independent sector, workforce planning, regulation and international perspectives on human resources issues.<br /><br />The Commission met for the first time on the 28th April and considered how the NHS Constitution linked to the role of nurses and midwives, identified their priorities for the coming months and agreed that the first phase of their work would be to kickstart a process of listening to the views of the NHS, patients, public and wider stakeholders.<br /><br />The Commission met for the second time on 2nd June and discussed patients’ views of nursing and degree-level nursing registration.<br /><br />Commissioners agreed to form five workstreams to take their discussions forward. Workstreams, which will be led by Commissioners will focus on: quality and innovation, the vision and image of nursing and midwifery, the socioeconomic case for nursing and midwifery, helping and hindering forces, and workforce and leadership issues. (The attached table shows which Commissioner will be leading and working on each workstream.)<br /><br />The first phase of the Commission’s work is to engage with the public, patients, professions and organisations to hear their views on the what the challenges and opportunities will be for nurses and midwives in the 21st Century.<br /><br />The Commission will work with an external agency (Opinion Leader Research) to shape the engagement process, which will include national events, events hosted by the NHS/organisations, to engage patients, the public and voices from seldom heard groups.<br />As a first strand of this engagement the Commission has launched a call for the views of patients, the public, staff and organisations.<br /><br /><span style="color:#993399;">Questions centre on:<br />1. What are the knowledge, skills and attributes that nurses / midwives require to take a central role in the design and delivery of 21st century services?<br />2. What would you like to see nurses and midwives doing more of and/or doing differently in the future - whether in people’s own homes, in the community or in hospital?<br />3. What might be preventing nurses and midwives from doing this now?<br />4. How can these barriers be overcome?<br />Members of the multidisciplinary team or those who have particular expertise are also being asked their views on:<br />5. What is the potential for, and benefits of, nurses and midwives leading and managing their own services and the framework and support that would be needed to for this in the context of the multi-disciplinary team?<br /></span>People are encouraged to submit their views via the website at: <a href="http://www.cnm.independent.gov.uk/">http://www.cnm.independent.gov.uk/</a> although views can also be submitted via email to <a href="mailto:contact@cnm.independent.gov.uk">contact@cnm.independent.gov.uk</a> or by post to the Commission on the Future of Nursing and Midwifery, Room 159, Department of Health, 79 Whitehall, London, SW1A 2 NS. Views are sought by the 10th August.<br /><br />This date will not be the end of dialogue, however. All responses will be studied and will inform the Commission’s key messages. We will check these messages back through the website, public events and the media to see whether we have got them right, which in turn will shape our final recommendations to the Prime Minister.<br /><br /><br /><br />Composition of Workstream Groups<br /><br />Title<br />Lead Comm<br />Other Comm<br />1 Quality and Innovation<br /><br />Janice Sigsworth<br />Peter Carter, Claire Rayner, Tamar Thompson<br /><br />2 Vision & image<br /><br />Eileen Sills<br />Dawn Chapman, Anne-Marie Rafferty, Laura Serrant-Green<br /><br />3 Socio-economic case<br /><br />Ray Walker<br />Judith Griffin, Heather Lawrence, Kathy Warwick<br />4 Helping and hindering forces<br /><br />Gail Adams<br />Liz Fradd, Donna Kinnair, Jo Pritchard<br />5 Workforce and Leadership<br />Audrey Emerton<br />Chris Beasley, Sue Bernhauser, Kuldip Bharj<br /><br /><br /><br /><strong>Lines to take written by the sender not by me:<br /><br /></strong>We’ve just had High Quality Care for All, why do we need another review?<br />Lord Darzi rightly identified nurses and midwives as being key to providing quality care, and the Commission has a timely opportunity to take a longer-term view on how we can ensure that the nurses and midwives of the future will be trained, and supported by the whole healthcare system to continue to provide quality care in the future.<br /><br /><span style="color:#cc6600;">How can I get involved?</span><br />We want to hear your experiences of nursing and midwifery. We want to hear your views on what makes a good nurse/midwife. We want to hear your thoughts about how the role or nurses and midwives should change in the future. Please go to <a href="http://www.cnm.independent.gov.uk/">www.cnm.independent.gov.uk</a> today to get involved.<br /><br /><span style="color:#990000;">What will it achieve/what difference will it make to nurses?<br /></span>The Commission will ensure that frontline nurses and midwives in the future continue to have the support, skills, and competencies that they will need to design and deliver 21st century services for those that are sick and to promote health and well-being.<br />What difference will it make to patients?<br />As set out in the new NHS Constitution, patients have a right to be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality. The Commission will look to the future to ensure that in the future the NHS fulfils this right to patients by ensuring nurses continue to have the support, skills, and competencies that they will need to design and deliver 21st century services for those that are sick and to promote health and well-being.<br /><br />For more about this see the July choices mailing at <a href="http://www.aquabirthsathome.co.uk/">http://www.aquabirthsathome.co.uk/</a>. You can also sign up for the monthly Choices e-newletterRadical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-78758901922173917942009-06-03T14:44:00.000-07:002009-06-03T15:12:11.211-07:00Because of those hands . . .<em>Birth Matters</em> made by Dr Nadine Edwards is an immensely moving montage of pictures, quotations and music which communicates the importance of treating birth with care and compassion. As I watched the film I read the words:<br /><br />"Birth is not just about making babies<br />but about making mothers<br />strong competent mothers"<br /><br />And I heard and saw no more as I was caught up in the powerful memory of the birth of my second child and the photograph I have of those hands - my midwife's hands. And then I wrote:<br /><br /><strong><span style="color:#cc33cc;">Because of those Hands</span></strong><br /><br /><span style="color:#6633ff;">Dear Madge,</span><br /><span style="color:#6633ff;"></span><br /><span style="color:#6633ff;">I will never forget you taking me by the hands, looking me straight in the eyes and saying, "We are going to do this, woman to woman!" And we did. You will never know how much strength and confidence you gave me to birth my first son. And what a healing birth that was.</span><br /><span style="color:#6633ff;"></span><br /><span style="color:#cc66cc;">I do what I do now because of your hands.</span><br /><span style="color:#6633ff;"></span><br /><span style="color:#6633ff;">Thank you Madge Boyle.</span><br /><br /><br />To find out more about 'Birth Matters' or contact Nadine Edwards see her website: <a href="http://www.nadineedwards.org.uk/">http://www.nadineedwards.org.uk</a> or visit <a href="http://www.aims.org/">www.aims.org</a><br /><br />AsRadical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com1tag:blogger.com,1999:blog-4589709414976731077.post-76196142641911143592009-05-22T06:41:00.000-07:002009-05-22T07:43:27.946-07:00Questioning Nick CleggJust a quick missive to the world and my friends out there!<br /><br />I managed it! I took my work basket to Idle Parish Church, BRADFORD, today, where, I learned, Nick Clegg, Leader of the Liberal Democrats was going to have a question and answer session. And I challenged him to do something for maternity services in this country.<br /><br />I wanted my question to be well delivered and have maximum impact so I wrote out my question in advance. My question was the last one and I got a round of applause for asking it. the text is below.<br /><br />And because questions at a public meeting like that are less about the response and more about raising an issue I have followed up our exchange with a letter reiterating the question. And for your interest and inspiration here it is!<br /><br />If anyone out there is a Labour or Conservative Party supporter/member. Please go out there and do the same. It is not about changing the men in suits at the top of our country, it is about changing the way the political wind blows!<br /><br /><span style="color:#006600;">Ruth Weston<br />c/o Aquabirths<br />Unit 3, Carlisle Business Centre<br />Carlisle Road, BRADFORD<br />BD8 8BD<br /></span><a href="mailto:ruth@aquabirths.co.uk"><span style="color:#006600;">ruth@aquabirths.co.uk</span></a><br /><span style="color:#006600;">07 824 990 345<br /><br />Dear Nick,<br /><br />I am writing to follow up on the question that I raised today regarding maternity issues at Idle’s Parish Church 22nd May 2009 (I was the woman with a purple cardigan!). <br /><br />First of all, thank you for your time and discussion. I was most impressed. I wished I had brought my 14 year old daughter along who is talking of going into politics and would have enjoyed the exchanges. Another time.<br /><br /> In these sort of settings it is much more about asking the question rather than getting an answer and so I wanted to re-iterate my question so that I might have a fuller response from you (and the party) and that there might be a more comprehensive discussion of the matter.<br /><br /><strong><span style="color:#cc33cc;">My question is this:<br /></span></strong><br /><span style="color:#cc33cc;">Although the World Health Organisation recommends an 8-10% Ceaserean Section rate for 1st World countries, the UK figure as I saw it on Monday of this week, was 25% nationally.<br /><br />Although Ceaserean Sections cost around five times more than a Homebirth, and research ( in UK of 5000 births) shows that a woman is HALF as likely to have a CS if she books for a homebirth (even if she subsequently births in hospital), homebirths are actively discouraged in many parts of the country and women give birth in high risk, high intervention obstetric units.<br /><br />Although research shows One Mother One Midwife Care reduces length of labour, pain experienced by women, intervention rates, Postnatal Depression, and increases normal birth rates and the likelihood of a woman breastfeeding; midwifery care has deteriorated so much that women in Bradford for instance can see a different midwife at each appointment and receive conveyor belt care in hospital.<br /><br />Although the only alternative to accepting this kind of care is employing an Independent Midwife (we hired one for our fifth child, the cost was 15% of our small income and worth every penny!) this Government is outlawing them by the back door by insisting they have insurance but not providing the means to obtain it.<br /><br />Birth and maternity issues are not just a woman’s issue but an issue that effects the whole community – a good or bad birth and good and bad maternity care can have profound effects on the wellbeing of mother and baby, her husband and family. Through the knock on effects of community mental and physical health service provision and social security this issue affects us all.<br /><br />I am therefore asking what you, Nick, and the Liberal Democrats of which I am a member, are going to do about this.<br /><br /></span>Obviously this was a complex question for you to answer at the time but I just want to pick up on a couple of points you made to feed into your more considered response:<br /><br /><strong>I do advocate homebirth but the point I am making is not really about homebirth per se but the lack of healthy choices women have when giving birth.</strong> It is less healthy for healthy women to give birth in an obstetric unit than to give birth in a stand alone birth centre or at home. Yet most healthy women in our PCT area as well as many parts of the country do not have (in reality) the choice of having either a homebirth or a birth in a midwifery-led or independent ( from the obstetric unit) birthing centre.<br /><br /><strong>You spoke the system not being set up for homebirths – and this will take time to sort. I agree but there are two immediate actions that can take place</strong>:<br />1) <strong> The current ‘tariff’ system rewards high CS rates</strong> as it is based on the cost of the procedures – rather than being paid on population risk and rewarding higher normal birth rates. This means that Trusts who do fewer CS and more homebirths get paid less, although the Trust is saving us a lot of money and sparing hundreds of women and babies the trauma of an unnecessary major operation. We need to reward Trusts for promoting normal birth.<br />2) <strong>The Independent Midwives Association have put forward the Community Midwifery Model (cf.<a href="http://www.independentmidwives.org.uk/?node=8766">http://www.independentmidwives.org.uk/?node=8766</a>) </strong>as a model that can run alongside current NHS provision which enables women to choose midwifery-led, low intervention care from a known midwife. As a user this system is particularly attractive because the money follows the woman – not the procedure putting her at the centre of care rather than where she is now – at the bottom of the hierarchy. I would commend this model to become a central plank of Lib Dem maternity policy. It is not as radical as changing to election by proportional representation!<br /><br />You spoke of the dangers of homebirths being advocated where the system and training is not in place and implied ‘it would be dangerous to advocate homebirths until the system can bear it’. <strong>I would warn that as the system deteriorates further and the option to engage an Independent Midwife is closed, women will take the matter into their own hands and will opt out of the system altogether and free birth (birthing without a trained professional present). </strong> The movement is growing in the US and is already in evidence in the UK, masked by I suspect (but I do not have the evidence as yet) a rising rate of ‘Born Before Arrival’s’ where the midwife is called ‘too late’. I know this is happening now. If women cannot choose to have the birth and care they want within the NHS a small but growing number WILL free birth – this is the danger of not providing low tech compassionate care for birthing women where they need/want it.<br /><br /><strong>Finally, in the light of the above, we urgently need YOU to take action to save my fabulous Independent Midwives from being outlawed by a crazy policy</strong> which insists they have insurance but makes no provision for it. The current insurance system for midwifery is a mess as it is mixed up with obstetrics (the care of abnormal births) where the highest claims are made. Independent Midwives are poorly paid, highly committed, highly competent professionals and I find it immensely upsetting to see them once again treated in this way whilst consultants continue to work privately and lucratively with NHS insurance. Patriarchy and discrimination are therefore, still in evidence in our maternity services. With this point in particular I would like your urgent attention.<br /><br />I speak as a mother of five children born in Bradford, and a user of maternity services. I speak also as someone who lives and is active amongst our diverse community in Bradford, is a Bradford Breastfeeding Peer Supporter and Trainer and the Acting Chair of the Maternity Services Liaison Committee. I want answers to my questions (and I raise these regularly with the local Trust and PCT) but I also want to be part of the solution – and offer that to you as someone with an interest and expertise in the subject.<br /><br />With every good wish and looking forward to being in contact<br /><br /><br />Ruth Weston<br /></span><a href="mailto:ruth@aquabirths.co.uk"><span style="color:#006600;">ruth@aquabirths.co.uk</span></a><br /><span style="color:#993300;"><span style="color:#006600;">07 824 990 345<br />Unit 3, Carlisle Business Centre, Carlisle Road, BRADFORD, BD8 8 BD</span><br /></span>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com2tag:blogger.com,1999:blog-4589709414976731077.post-47427105429943768652009-04-30T06:32:00.000-07:002009-04-30T07:01:09.409-07:00A patchwork of political lobbyingThe other week I got hold of the Green Party's policy on Maternity Care. I quite like it. however, I am actually a member of the Liberal Democrat Party - well on the very edges of it. Hmmm me thinks "I wonder what the Lib Dems are saying on the subject. And somewhat reluctantly (as I really have nothing else to do at all!) I must set about finding out what my party says, with a view to scrutiny, comment and lobbying for change. <br /><br />Seeking change within political party structures is not something all of us can or want to do - but some of us need to do it. It is part of the strategy for change. We need to build a patchwork banner, mother led, midwife empowered, created from the experience of us all, sewn with love and compassion for ourselves and our families. And it needs to be so large and enveloping that wherever our country's leaders turn they will see another segment of our calls for care and compassion to our birthing sisters and daughters.<br /><br />Writing letters, sending emails, asking questions, reading policy documents all felt so drab until a minute ago when I began to weave in womanly terms the work we need to do. It takes it from my crowded desk and puts it in my work basket overflowing with yarn and potential! <br /><br />the lobbying of political parties needs to be done to keep our births safe after the next election. And to do it and do with it creatvity energy love and flair we need to think of this work in different terms: <em>I</em> need to think of it in different terms: not another policy document to read but a patten weaved, not a letter written but a piece of fabric linked in.<br /><br />And so, with renewed vigour, I invite you to read the Green Party maternity care policy below with a view to using it as a lever to lobby for better maternity services in the political landscape you are situated whether from within or without a political party or pressure group, whether it be locally or nationally. Let us use all the tools in our work basket to change the patten of birth.<br /><br />Green Party Policy:<br /> <br /><span style="color:#009900;">SYNOPSIS<br />In 25% of NHS trusts, intervention rates are double the targeted<br />level. Lack of continuity of care, a shortage of midwives and<br />consultants and beds contribute to high death rates and threaten<br />mothers' and babies' health. About 11 million UK women have suffered<br />post-birth trauma.<br /></span><br />MOTION<br />Insert a new section after H302, titled "Maternity Services" and<br />subsequently renumber.<br /><span style="color:#ff6666;">H303: All women should be entitled to the highest standards of care<br />during pregnancy and birth, and post-natally. We will ensure that<br />women are given the information they need to make appropriate choices<br />about how they wish to give birth, and that a full range of options,<br />including home birth and a range of styles of hospital delivery, is<br />made available to all women.<br /></span><span style="color:#009900;">H304: The incidence of medical intervention in childbirth has<br />escalated in recent years, particularly the rate of caesarean<br />sections, which are expensive and, when not medically required, risky.<br />We will work to reduce the number of interventions in childbirth, and<br />change the culture of the NHS so that birth is treated as a normal and<br />non-medical event, in which mothers are empowered and able to be in<br />control.<br /></span><span style="color:#993399;">H305 All women will be entitled to the care of a single midwife<br />through prenatal care, birth and the first month of post-natal care,<br />in line with the model of care currently provided by independent<br />midwives. This will be made possible by initiatives to improve the<br />recruitment and retention of midwives.<br /></span><span style="color:#333399;">H306 We will ensure that the NHS embraces the current quality and style of care as offered by Independent Midwives so that they are able to work within the NHS system and offer this type of care to all women in a single tier system. We shall ensure that midwifery training places are increased to meet medium and long term needs. This will be achieved by: ensuring that terms and conditions for midwives are improved, increasing investment in midwifery services to ensure that these policies are delivered, specific funding for midwife training along with targeted recruitment drives, and ensuring that the culture of midwifery services is supportive for both mothers and midwives.<br /></span><span style="color:#993300;">H307: All women and their partners will be offered a full range of<br />psychological support after birth to help deal with trauma and<br />post-natal depression. The party will ensure that baby clinics are<br />open for adequate hours, so that women can get access to health<br />visitors and take their babies for regular check-ups at a location<br />that is convenient for them.<br /></span><span style="color:#330099;">H308: Maternity units should be sufficient in number and located so<br />that all women are within reasonable reach of one. Special Care Baby<br />units will be expanded in line with the increasing number of babies<br />that need intensive care, but special attention will also be given to<br />preventative efforts to reduce the number of low birth weight and other<br />problems that contribute to this need. Funds allocated for maternity<br />services should be ring-fenced to ensure that they are used for the<br />intended purpose.<br /></span><span style="color:#993399;">H309: Throughout maternity services the focus will be on compassion<br />and on providing a safe, supportive environment. Complaints will be<br />treated with sympathy, and systems arranged to ensure that complaints<br />can be registered easily and are investigated properly, challenging<br />the 'conspiracy of silence' that discourages women from speaking about<br />their traumatic experiences for fear of frightening other women.<br />ENDS</span>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com0tag:blogger.com,1999:blog-4589709414976731077.post-7875388541918967462009-02-09T14:26:00.000-08:002009-02-09T14:31:05.826-08:00"It was like a hotel!"<strong>“It was like a hotel!” said my (Aquabirths at Home) York agent Lis, describing the relatively small Swiss hospital she stayed in after breaking her leg on her ski-in holiday. And being an assessor for British maternity units and the maternity unit being just opposite her ward . . . she could not help hobbling across and asking if she could have a look around!<br /></strong><br />Her report was this. <br /><br /><strong>70% water birth rate in this small 2 room suite</strong>. The birthing pool is at the centre of the room and the bed is tucked away in the corner. The rooms are beautiful with a lovely bedspread on the (hospital) bed and ordinary curtains and net curtains in subtle pink and blue stripes (!) at the window. Not costly or adding to infection risk but looked lovely. The floors were bare but there were tables and chairs and an easy chair for relaxing or for partner. The medical kit was around but seemed very much in the background.<br /><br /><strong>There is just a 2% homebirth rate</strong> (this is nonetheless greater than Bradford’s where needless to say the water birth rate is much lower also). My agent said that she did not blame women for having a hospital birth in the circumstances with such stats. <em>and</em> 5 days of first class care in hospital <em>and</em> no quibbles about staying longer if the woman needed more support with breastfeeding. Post natal accommodation was mainly 2 bed rooms with babies in with the Mums. <br /><br />Lis was told that they never induced prior to 42 weeks without a real medical reason. Induced women were still allowed to use the pool. Access to the pool was just a simple step. They didn't worry about hoists or fancy kit for lifting women out of water: Everything kept very low tech. Seemed much less of a culture of claims if anything went wrong.<br /><br />Generally CS rates are low both here & in general through Switzerland. If women had high blood pressure or just a few minor problems they still stayed in this local hospital. They were just monitored more closely or moved down to a room in a different area of the hospital to be monitored. If they knew that baby might have problems then had to be moved to different hospital as didn't have intensive cots for newborns at Frutigen hospital.<br /><br />In terms of staffing the head midwife there said that they enjoyed their work and had a good relationship with the doctors who took a great deal more interest in normal birthing than do our doctors but tended to interfere less. The doctors would see women on admission and pop down later to check how things were going but unless called in would otherwise leave the midwives to it. Needless to say it is ‘one mother one midwife care’ during labour. Women could, in this unit, even choose the MW who they wanted to have for the birth prior to the birth - though this is not true of all Swiss units<br /><br /><br />Midwives only care for women in the intrapartum period (birth). General nursing staff admit the women and care for the mother and baby dyad during their 5 day stay. Nurses who looked after new Mums & babies saw it as their role to get the new dyad/partnership established well prior to departure - for best start in life. Breastfeeding rates: Lis does not know the figures but they were good and breastfeeding seemed to be accepted normal more than in UK.<br /><br /><br />The health insurance support is generous with 5 days full accommodation with excellent food and care (my agent said the staff were amused that she kept referring to the hospital as a hotel – she responded to them that the care and food etc were more akin to hotel quality and she had never seen anything like it at any hospital in uk she had visited). However, the monthly statutory health levy for this care is substantial for say the average family. (Well, don’t we say: ‘You get what you pay for?’)<br /><br />I leave with you this picture of how one small hospital in Switzerland cares for birthing women. Liz, asked many questions about what happened elsewhere to which she got relatively general or vague answers, as although midwives may have worked elsewhere before coming to this maternity unit turn over was low, and there seemed to be no plans to leave. Nevertheless, the impression she got was that things were not all that different in other parts of this region.<br /><br /><strong>My motto is</strong>: Ask for the moon – you can always settle for Doncaster. Here is one very down-to-earth example of the moon - that is to say the care mothers deserve in the UK. Why not ask for what we deserve? And is it not worth paying for?<br /><br /><strong>Post Script.</strong> Lis (being the canny lass that she is) says that she has an email address for the hospital and the MW she spoke to. So if you have more questions then you can contact Lis through me: <a href="mailto:ruth@aquabirths.co.uk">ruth@aquabirths.co.uk</a>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com2tag:blogger.com,1999:blog-4589709414976731077.post-44988593494453271932009-02-01T15:35:00.000-08:002009-02-01T15:44:26.302-08:00Super woman business tycoon meets hassled Mum!It was 16th January and it had been a good week for super woman and business tycoon – I felt like I was really going to change the world!<br /><br />Monday a big invoice had finally been paid so our cashflow could flow again.<br /><br />Wednesday I led a seminar with third year student midwives. With hubby’s help I had restructured the whole thing and I was rather nervous – but it went so well – they were such a brilliant class and I learnt so much. These midwives are questioning practice, questioning evidence, reflecting on their practice and that of their mentors, Passionate about good birthing and good care. I left Huddersfield inspired and proud!<br /><br />On Thursday, four of us met to plot the expansion of the Choices network (to subscribe go to <a href="http://www.aquabirthsathome.com/">www.aquabirthsathome.com</a> ). How fab! To finally be planning what I have dreamed of for years - to take Choices to the next level. We made plans and took minutes.<br /><br />Friday, at short notice I was asked, and accepted, a place on the interview panel for a Consultant Midwife in Normality for Bradford, to take place on Monday. How fabulous is that – a Consultant Midwife in Normality! And to be privileged to be part of the selection process. And if that was not enough I had an interesting and fruitful conversation with Huddersfield University again.<br /><br />At the end of this conversation, however, I looked at the time and the mother in me gasped in horror – 3.30pm – I was late collecting the children from school <strong>again</strong>! My super woman cloak was exchanged for <em>harassed mother hat</em> and I abandoned office, swearing at the rush hour traffic. I begged apologies yet again at one school as I collected one child and crept quietly into the second to collect the rest, trying to avoid the frosty gaze of the staff member in the office.<br /><br />I returned home in a turbulence of triumph and chaos for the weekend, to be met by my matronly neighbour: “ You daft *****! Did you know you left your front door wide open this morning?” 'No I had not', being the honest answer, since I am not into open invitations to burglars. “You never came back, so we shut the door in the end and have had to keep an eye on your house all day!” It never ceases to amuse my neighbours that this business woman and mother of five can be so scatty.<br /><br />And so that was the end of the triumph of super woman and business tycoon, Ruth the harassed mother of five, Ruth the modern embodiment of the old woman in the shoe – was home for the weekend. Throw your laptop in the cupboard and tie on your apron!<br /><br />But I want to shout from the roof tops – I want it all! I want a career, I want to run my own business, I want to have a large and happy family, I want a happy marriage, I want to save the world. And I am so proud that I am having a fair stab at it all! And so what if I can’t keep all the plates spinning! So what if I leave my door open by a mistake (the delivery man kindly left the parcel in our living room!), so what if I am late picking up the kids! (This is not the 1950ies – most women work now so we need schooling that caters for real life work) If that is what it takes to make the whole thing happen then so be it. I am proud of what I achieve and proud that I try. And I am just glad that I have a loving patient husband and five fab kids who think my antics are very funny and love the fact that as my hubby put on a ‘welcome home’ poster years ago: ‘Ruth, about to save the world, as soon as she finds her bus pass.’ We all need clay feet I say. It keeps us humble.Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com2tag:blogger.com,1999:blog-4589709414976731077.post-65328990135079957982008-12-23T16:01:00.000-08:002008-12-23T16:45:32.458-08:00The reality checkIt is the eve of Christmas Eve and I am back on form writing after midnight. I have delivered all the cardboard houses (a mad idea which is it's own story!), wrapped nearly all the presents, its just the butcher, the baker, the Asian supermarket and the co-op for David's whisky tomorrow and I am done for Christmas. I have tied up the loose ends I can at work and the rest will just have to wait until after Christmas. <br /><br />And I finally got our Christmas letter (the special Christmas edition of the Allerton Bugle) ready for publication. And then I sat there and read 3 journals: - one the local 'Streets Ahead' newsletter - which made me feel guilty that I am not more involved in my local community, the second, the Christian Socialist Movement's Christmas edition of Common Purpose - which made me feel guilty about not being more involved in national and party politics to change things! Finally the November edition of the AIMS journal. And there I found my speech at the Sheffield Homebirth Conference in print! I had forgotton about that. Well yes, I am doing something I thought - but of what real worth is that? And I read some of the fantastic articles and stories there of women doing so much where they are - and women who know so much as well. Oh how I wish I had read the NICE guidelines, Maternity Matters, Maternity Doesn't Matter, the local tPCT strategy - I really want to, I really should.<br /><br />At this point I took a reality check. I have five children between 14 and 4 years, I have no parents or relatives nearby to share regular childcare, just a fantastic hubby. Not do I/we have the luxury of a private income or a hubby who goes out to work leaving me relatively free to pursue my mission - we both work really hard, fulltime, on our small business building it up. I do 40 plus hours on the business and then there are the children.<br /><br />This is not a get out, this is not an excuse - it is a hard look at the reality - the gifts and limitations of my current position. It is about saying 'I am doing what I can, where I can. I am making a difference and doing it on a limited budget of time and resource. And that is OK.'<br /><br />And for anyone out there reading this, my litany of limitations and achievement is not a stick to beat yourself up with. It is a reflection on the limitations and gifts we bring. I reckon there are women out there with the time and knowledge to read NICE guidelines etc when I can't and decant them into manageable bite-sized pieces for people like me - if this is your gift please contact me! But maybe speaking at events, asking questions at meetings, running a social enterprise is not. It is about doing what we can, when we can; not doing (or worrying about) what we can't.<br /><br />And of course the best we bring to this campaign is passion and enthusiasm and the love of life, life in all its fulness. And as mothers we have bags of that - you can see it in our children.<br /><br />Have a wonderful yuletide if you can - and celebrate the life we have given birth to.<br /><br />Ruth<br /><br />p.s. thankyou to those lovely people who have sent comments. Technology is one of my limitations (or rather the time to spend on understanding it, I suppose) and I have not yet worked how to respond to them successfully. But thank you and keep them coming, sisters!<br /><br />The journal contacts are as follows:<br /><br />Streets Ahead in Allerton has been read and used for kindling by my hubby, so can give no more info!<br /><a href="http://www.thecommongoodmagazine.org.uk/">www.Thecommongoodmagazine.org.uk</a><br /><a href="http://www.aims.org.uk/">www.aims.org.uk</a>Radical Mum and Cakemakerhttp://www.blogger.com/profile/13040382873311975912noreply@blogger.com1