Understanding more about birth and story…

I often hear midwives and birth folk lamenting the way that one-sided, fear-based, sometimes mysogynistic and frequently inaccurate depictions and representations of birth permeate modern culture, and I share their concerns. Participants in my workshops and online courses note the…

Pondering Domesticity…

My grandmother gave birth to all of her babies at home. There were simply no other options (Lee and Wickham 2000). But by the time her daughters were ready to birth, just a couple of decades later, they were offered…

The words we use…

Midwives have done a lot of reflecting on their language over the last few years. While visible changes in practice inevitably take a while to evolve, there is a clear movement in the progressive midwifery literature from use of words…

Vaginal seeding – more data required?

A review article written by Danish doctors and published in the British Journal of Obstetrics and Gynaecology has stated that the benefits of vaginal seeding “do not outweigh the risks”. This paper and the inevitable news stories which have been…

What’s in a word?

‘Language is important and influential. I request that the Journal stop using (and letting authors use) the term obstetric when talking about midwifery care. Obstetrics is what obstetricians do, midwifery is what midwives do, and maternity care is what we…

Antibiotics and operative vaginal birth

The authors of an updated Cochrane review entitled ‘Antibiotic prophylaxis for operative vaginal delivery’ have drawn the same conclusion as in previous versions of the review: that routinely giving antibiotics to women who have forceps or ventouse births leads to…

Birth outcomes and women of size

Another study has suggested that the differences in birth outcomes experienced by women of size may be due as much to provider attitudes and biases as to any intrinsic difference or disadvantage. Ellekjaer et al’s (2017) research, carried out in…

More evidence on targeting anti-D

A study carried out in Finland has provided more evidence of how we can use fetal rhesus group testing in order to offer anti-D prophylaxis only to those rhesus negative women who are carring rhesus positive babies and thus reduce…

On birth trauma…

“Whilst for many women pregnancy and birth is a wonderful, life affirming experience, the findings from this study have highlighted how birth trauma can be experienced by women as a culmination of previous life events, pregnancy and birth trauma and…

Group B Strep: the realm of mysteries

“To study neonatal Streptococcal B infection is to enter the realm of mysteries… How to explain that microbes from maternal origin may be pathogenic for the baby? Several decades ago, we learned that, compared with the placenta of other mammals,…

The true midwives…

“Being with someone, murmuring along with their heartbeat, breathing with them, is a lost art. The true midwives of birth and death, those who keep vigil at the bedposts, are rare. They are the people whose eyes are accustomed to…

When even simple tools can harm…

A case study shared in this month’s International Journal of Obstetric Anesthesia carries an important warning message for women choosing to (and, almost more importantly, those supporting or working with women choosing to) use epidural or other forms of regional…

Informed consent – a redundancy?

“Informed consent is a redundancy, because being properly informed is a precondition of consent. Without being properly informed, a patient or client cannot give any legitimate, binding consent. Therefore, it is imperative that all professionals withhold any request for agreement…

Closeness after birth

A Finnish study exploring parent-infant closeness and separation has thrown more light on how hospital practices both promote closeness and cause separation in the first couple of hours after birth. And it’s kind of paradoxical, because the researchers discovered that,…

Exploring the Exceptions

Last month (Wickham 2016), I wrote about a principle that I was taught and have subsequently shared with many other midwives. It involves asking oneself whether offering a screening test would change one’s management, or what one would offer to…

Labour progress resources

As this post goes live, I’ll be in Queenstown, New Zealand, running my Labour Progress Workshop, and it seemed like a good opportunity to offer a summary of labour and progress related resources that are right here and freely available…

Another set of risks…

“Much, though by no means all, of what has been written and spoken around childbirth revolves around fear. Policies and practice at both national government level and local hospital level have frequently been based on the idea of ‘risk assessment’.…

We’re headed down under!

Suitcases are packed, liquids are corralled in the obligatory ziplock bag and – perhaps most importantly of all for me – my craft case is full to bursting with projects for me to make on the plane and while I’m…

Nobody is normal

“In short, normality is all about context. What is normal for one individual could be insufferable for another, and the same individual could be normal in one environment yet not in another. Just take a look at inborn differences in…

A woman’s decision…

I find it really sad that midwifery regulators don’t seem to understand the enormous value that there is in continuity of care, which has been described as central to gold standard midwifery care. Nor is there much recognition that the…

Is this going to change your management?

I have found, over quite a few years of teaching midwifery, that people who are learning midwifery and similar arts often like to have building blocks in the form of rules, lists and principles that they can learn and explore…

Help Save Independent Midwifery!

A few weeks ago, I posted about the worrying situation in the UK, where the actions of midwifery regulator the NMC have led to midwives in the UK not being able to practice independently. “The impact of this ruling extends…

Defining active labour

An article published in Birth has added to the debate about the different guidelines relating to the diagnosis* of active labour, considering which of them leads to the highest number of caesareans. *Before I move on, I’d like to quickly…

Celebrating the Albany Practice Outcomes

This week, an important paper has been published (currently in draft form) in Midwifery. Titled ‘Midwifery continuity of carer in an area of high socio-economic disadvantage in London: a retrospective analysis of Albany Midwifery Practice outcomes using routine data (1997–2009)’,…