Homebirth Midwife

Look what Deborah Neiger has just brought onto the market! It’s your very own homebirth midwife doll and accessories!!

Ha ha, not really. This IS homebirth midwife Deborah Neiger, plus all her kit laid out in all its glory. So, if you’ve ever wondered what’s in a homebirth midwife’s magic toolkit – here it is. We’ve come on a bit since the days of Call The Midwife!

Or maybe not! In reality, Deborah says that at most births all she uses is the Doppler (14), the incontinence pads (3), the scissors (31), the gauze (6), the scales (20) & baby weighing sling (12) – plus the wonderful midwife (1), obviously!

Homebirth Midwife and kit -Deborah Neiger

Second thing to note is that Deborah says the list isn’t exhaustive, and it’s not listed in order of importance.

The Kit

  1. A kind and sensitive *known to you* midwife
  2. Rebozo for comfort measures or to help fetal positioning
  3. Lots of incontinence pads to soak up birth goo
  4. Catheter if passing urine is difficult or a full bladder is causing excessive bleeding
  5. Cord tie
  6. Gauze Swabs, mostly used to check the perineum for damage after birth if desired, or for microbiome seeding
  7. Placenta bag if parents want it disposing of
  8. Fetoscope
  9. Penguin suction, NEVER used as routine, only as part of resuscitation should it become necessary
  10. Gloves
  11. Pinard
  12. Baby weighing sling
  13. Stainless steel mirror for pool use
  14. Doppler
  15. Transducer gel for doppler
  16. Birth pack, only carry it for the unlikely possibility we ever need the Spencer Wells clamps and super sharp episiotomy scissors in it, though it actually has never happened
  17. Some needles and syringes to administer emergency drugs or vitamin K to the baby, if needed/wanted
  18. Cord Clamp
  19. Lube in case of vaginal examination, also not routine ever
  20. Hanging scales
  21. Sphygmomanometer to take blood pressures
  22. Giving set and tubing for Entonox
  23. Vomit/emesis bags (or as Deborah likes to call them – puke tubes!)
  24. Stethoscope
  25. Entonox tank
  26. Urinalysis sticks
  27. Infrared thermometer
  28. Emergency drugs to control excessive bloodloss (Syntometrine, Syntocinon, Ergometrine) and vitamin K if desired by parents
  29. Tongue depressor, for use during insertion of Guedel airway during baby resuscitation if necessary
  30. Bag and Mask for baby resuscitation
  31. Sterile scissors to cord eventually once fully white or placenta birthed, unless Lotusing
  32. Sharps bin

Addendum, not in photo!

  1. Phone! This is useful when you need to look up things, if ever in doubt, and to summon help.
  2. Torch. To huddle and write notes when in a dark room, check heads emerging in darkness if there are concerns, check perineums.

Thanks for sharing, Deborah! I had no idea my lovely homebirth midwife most likely had all this stuff nearby when I gave birth to my second!

If you’re interested to find out more about Deborah and her work, you can follow the link to her original Facebook post here.

You can also find support at the Big Birthas Facebook Group here.

Birth in a time of Covid-19

I think most people are a bit anxious right now. There’s a lot going on and a lot to get your head around. But if you’re pregnant, it must be especially worrying. Particularly if it’s your first and you already don’t know what to expect. Pregnancy and birth keeps you on your toes at the best of times, but birth in a time of Covid-19 comes with further considerations.

You can read the Royal College of Obstetricians & Gynaecologists advice on coronavirus infection and pregnancy here.

We’ve had a couple of recent births in the BigBirthas Facebook Group. With permission, here’s a birth story from someone who just did it four days ago! Hopefully this will give a bit of information and reassurance on what to expect if you’re nearing your due date:

Kay’s birth story

I gave birth to my little legend on Friday 27th March.

newborn wearing a hat and clutching a finger -
birth in a time of Covid-19

I was induced at 37+5 due to obstetric cholestasis. (OC is a liver condition which affects 1 in 140 pregnancies in the UK. It is characterised by excessive itchiness, often on the palms of your hands and/or soles of your feet. A bit of itchiness in pregnancy is normal, particularly on a stretching tummy, but always worth getting checked out. – Big Birtha)

He came at 38+1. They kept me in hospital due being high risk with OC and high BMI and the midwives were absolutely amazing. They really put my mind at rest. The consultant and the anaesthetist were pushing for a c-section because of my size, but I rejected and carried on. I knew that I could do it.

In the end I managed all but the last hour without any pain relief at all and the last hour I allowed myself some gas and air. He was born at 2.10am on the 27th weighing 7lbs 14oz and is perfect.

My advice to everyone is to not let them put time pressure on you. If you choose a c-section, that of course is your choice and I am fully supportive, but I am so glad I didn’t let them hound me into one. The ward they put me on (postnatal) I was the only one that had a natural birth. It was so hard watching everyone else struggle even picking up their newborns, whereas I was up and walking about straight away.

Birth in a time of Covid-19 – Kay’s experience

They are taking the upmost care due to current situations, and I am generally a bit of a worrier. If you’re like me don’t let it get you down, I cannot express how safe they made me feel!

The midwifes were only allowed in that section of the hospital. Birthing partners were limited to one and had to take their own food etc. Once they were on the ward they couldn’t leave and come back again. It’s reduced the risk and made everyone feel more comfortable. We all washed so much too, mums, dads, and staff.

All in all it was a very positive experience, even in the circumstances.

Good luck everyone, from one very happy mumma. 💜

*****

Thanks for taking the time out to share that Kay, and congratulations!

Birth in a time of Covid-19 – highlights from the RCOG guidance

The Royal College of Obstetricians & Gynaecologists is carefully monitoring all evidence as it’s released. So for up to date information, it is definitely best to read the advice on their page. The below is current as of 31st March 2020:

Generally, pregnant women do not appear to be more likely to be seriously unwell than other healthy adults if they develop the new coronavirus.

Based on the evidence we have so far, pregnant women are still no more likely to contract coronavirus than the general population.

What has driven the decisions made by officials to place pregnant women in the vulnerable category is caution.

It is expected the large majority of pregnant women will experience only mild or moderate cold/flu like symptoms.

If you think you may have symptoms of COVID-19 you should use the NHS 111 online service for information, or NHS 24 if in Scotland.

Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service / NHS 24 for further information and advice.

The most important thing to do is to follow government guidance [to reduce the risk of catching coronavirus].

It is really important that you continue to attend your scheduled routine care when you are well.

If you have any concerns, you will still be able to contact your maternity team but please note they may take longer to get back to you

There is a long FAQ section in the Royal College of Obstetricians & Gynaecologists advice so it’s likely most questions you have may be covered there.

Stay safe, and look after yourselves.

x

Big Birtha

Birth Confidence Summit

Do you have an urge to listen to BigBirthas.co.uk founder Amber Marshall talk about high BMI birth for 50 minutes? Surely you’re keen to marvel at how much I waggle my hands around when I talk (because it’s a LOT)!? Well, I’m pleased to tell you your wait is over! I recently took part in a free online Birth Confidence Summit, organised by Birth Confidence Mentor and founder of BirthEssence.co.uk Charlotte Kanyi.

Screenshot of Amber Marshall - founder of BigBirthas talking to Charlotte Kanyi of BirthEssence at the Birth Confidence Summit
Amber Marshall – founder of BigBirthas – talking to Charlotte Kanyi of BirthEssence

Charlotte has interviewed 27 ‘experts’ (her title, not mine) over Skype about many different aspects of birth. Talk titles include Healing from a traumatic birth, Exploring Induction Choices, Dropping the Nice Girl Conditioning – Make Birth Better (which links with) Visibility, Birth and freeing yourself from the Good Girl Archetype, Hypnobirthing for Confidence and more.

It’s a great idea and you can access all the talks for the bargain price of free!

I talk about why I set up the site, research, the difference between absolute and relative risk, looking positively at pregnancy vs the self-fulfilling prophecy, the media, blaming and scapegoating, and a bit about my two pregnancies and births and how I felt about them.

TL:DR?

In my interview I discuss how our bodies are designed for making and birthing babies. That we’re no longer in the minority and therefore shouldn’t be treated as ‘exceptional’ or ‘problematic’, in fact, we should have the same options as anyone else! Yes, carers should monitor the risks and act accordingly, but until something negative arises (and odds are it won’t) we should stay positive! Do your research and don’t expect your doctor to know everything about your personal circumstances and what is best for you. You decide, and you can use the BRAIN acronym to help you ask the right questions.

The Birth Confidence Summit Speakers

It’s a formidable line-up! There are some great speakers here:

Charlotte Kanyi, Confidence Mentor at BirthEssence

Natalie Meddings, Author, doula and birth yoga teacher

Debs Neiger, Independent midwife at Yorkshire Storks

Rebecca Schiller, Writer, Doula and Co Founder of BirthRights Charity

Alexia Leachman, Therapeutic Coach and Host of the award winning Fear Free ChildBirth Podcast

Kemi Johnson, Independent midwife,  KG Hypnobirthing Teacher and Positive Birth Movement Facilitator

Liz Stanford, Owner of the Calm Birth School of hypnobirthing

Clare Ford, Birth Coach and Master Reiki Healer at Beautiful Souls

Mandy Rees,   Pregnancy and Postnatal Yoga Teacher

Mars Lord, Award winning Doula, Doula Trainer at Abuela Doulas and Birth Activist

Phoebe Pallotti, Practicing Midwife and Associate Professor of Midwifery

Dr. Amali Lokugamage, Consultant Obstetrician and Gynaecologist and Author

Samantha Nolan-Smith, Writer, Feminist and Founder and CEO of The School of Visibility

Simone Surgeoner, Mother of four and Journey Practitioner

Jo Bolden, Mother of one and Co founder and professional dancer at One Dance Epic

Emma Svanberg, Clinical Psychologist specialising in pregnancy birth and parenting

Dr. Rebecca Moore, Clinical Psychotherapist in Birth Trauma

Naraya Naserian, Mother of two and Journey Practitioner

Zoe Challenor, Professional Singer and Co Founder of B’Opera and Mother of Two

Lorna Phillip, ​Doula and Mizan Therapist at Birmingham Doula

Jennie Harrison, Energy Healer, Mindset Coach and Birth Trauma Specialist

Joy Horner, Independent Midwife, and facilitator of Positive Birth Movement Group

Kati Edwards, KG Hypnobirthing instructor and Doula at Birth You in Love

Nicola Goodall, Author, Founder of Red Tent Doulas and director of Wysewoman Workshops

Maddie McMahon, Breast Feeding Counsellor, Doula and Doula Trainer at Developing Doulas

Rachel Elizabeth, Mother of four and Doula at Creative Birth

Take a look and big thanks to Charlotte for organising and facilitating!

How To Submit an FOI Request for Maternity BMI Policies

If you’re pregnant or trying to conceive, you might want to know how to submit an FOI request (Freedom of Information) to your local maternity providers. It’s worth finding out as much as possible about your likely treatment beforehand, and it’s pretty simple to do.

How to Submit an FOI Request

  1. Find out which NHS Trusts cover your local area

    Quickest way to do this is to use the postcode location service on the NHS website. This will list all the local services, sorted by distance. https://www.nhs.uk/service-search/Maternity-services/LocationSearch/1802

  2. Check out the Trust websites you’re interested in.

    Mostly clicking through to the individual pages will display the website at the top under the name, if not, just Google it.

  3. Find the page on Freedom of Information requests.

    There always is one. Easiest way is to type “FOI” into the search box, usually found somewhere near the top. Somewhere on that page will list the email address you need to send queries to.

  4. Send your questions/request for relevant policies to the FOI email address.

    If you don’t want to write your own, feel free to use/adapt mine:

    “I would like to know with regard to your fertility, maternity, childbirth and post-natal services:
    1. Do you have a policy for the management of larger women? If so, what is the BMI cut off (or other criteria) where this policy comes into use?
    2. Please attach a copy of the above policy.
    3. Please could you attach any other policies/guidelines/protocols relating to fertility, maternity, childbirth and post-natal which address the management of higher BMI women. This could include (but not be limited to):

    Inclusion/exclusion criteria for use of midwife led unit, hospital birthing pool, home birth, IVF etc.
    Glucose Tolerance Testing and Gestational Diabetes,
    Clexane prophylaxis
    Pre-Birth Anaesthetist referral
    Additional growth scans

    Digital copies/pdfs preferred.

    Kind regards”

  5. Wait for a response

    The authority must reply to you within 20 working days.

    Anyone has a right to request information from a public authority. For your request to be dealt with according to the Freedom of Information Act, you must:

    Contact the relevant authority directly
    Make the request in writing, for example in a letter or an email
    Give your real name; and
    Give an address to which the authority can reply (postal or email)

    You do not have to:
    Mention the Freedom of Information Act
    Say why you want the information

    They can charge you for the costs of sending the information, such as photocopying and postage if you request a copy by mail, but not if you request copies by email. They must let you know any cost beforehand.

    By law they must provide the information unless there is good reason not to; e.g. if in the interests of public safety or security to withhold the information or they do not record that information. See the Information Commissioner’s Office page for more info.

  6. Send the documents to Big Birthas for inclusion on the website!

    If you do get copies of your local policies, please contact me via the form on https://bigbirthas.co.uk/about-big-birtha/contact-big-birtha/ to let me know, and I’ll email back (stops me being inundated with spam!). Then you can send me the documents so I can add them/update them here for the benefit of all.