Telegraph News Mothers and babies 'at risk' on wards
We know this. When is something going to be done about it?

I'm here to have a right moan, about some of my esteemed colleagues in the medical profession, especially those who comment on www.nhsblogdoc.blogspot.com. I enjoy reading this blog, Doctor Crippen often has very pertinent observations to make about the way the NHS is going, and the majority of the time I agree with him. He frequently has a swipe at nurses, particularly nurse practitioners, or 'quacktitioners' as he comically (tongue in cheek) refers to them and I am always cringing at the venom he, and many of his commentators, will aim at this section of the caring profession. If I dare to leave a comment, and it is rare, it is to attempt to pour oil on troubled waters, what is the point of all this animosity, letting off steam perhaps? When he 'goes off on one' about midwives my comments are made with the intention of informing about the midwife's role, I start off trying to stick to the point and explaining why a particular action has been taken.
I have now come to a sad realisation though, medical doctors may be highly trained individuals who have doubtless excelled in exams and at uni, but they are so bigoted that they cannot interpret the written word correctly. Obviously this is a fairly sweeping statement, far too much of a generalisation, but certainly the majority of those who comment on NHS Blog Doc read what they want to read and not what is actually written down. If you continue to try and explain rationally what you meant, without resorting to crass statements about Doctors, you are met with a pile of verbal garbage. A prime example of how blinkered the commentators can be are the 250 odd comments left for Nurse Ratchet, I was absolutely horrified by the frankly pathetic insults left by many of the readers.
Considering the behaviour of these pillars of the medical profession I have decided that they are feeling threatened. How are they feeling threatened? They are worried that their pillars are being lowered and that we may discover they have feet of clay. You see their role is being eroded by all sorts of pretenders to their throne; nurse practitioners, souped-up paramedics, etc. This is, possibly, why medics have always traditionally hated midwives. We are not quite nurses and definitely not doctors but we are autonomous practitioners so we will attempt to discuss cases with them, and may even disagree and refuse to do what they want if we consider their proposed actions to be wrong.
If they are up in arms because they really believe that training non-medics to take on a few of roles is a dangerous step, then more power to their elbow, but when you study some of the responses to posts it is often intelligence, ability to pass exams, years spent studying that is given as the objection or the reason why others should not be trained for the roles. Sorry, but I believe that those are spurious reasons, just because a person has a first class honours degree that does not indicate that they have any common-sense or special aptitudes for a job.
I do generally work well with doctors. I have respect for them, the same as I have respect for anyone who has not not given me a reason to doubt them, or their abilities. I am horrified though at how vitriolic they can be, basically how 'up their own arses' some of them have shown themselves to be.
Happier blogging. Daughter is now 29 weeks pregnant, all is going well. Grandchildren are a constant source of pleasure to me, I'm sure I enjoy them more than I did my own children!

Daughter had her scan, and all was well. Baby 'Poppy' was lying there with his/her legs wide open so they know what sex baby is, I don't want to know, but Jack keeps telling me!
'Poppy's' Daddy has just had a bowel resection performed for acute diverticulitis, apparently it all went well but he will be off work for 2 months, gulp.

At work we just had a really difficult/sad case. One of the G.P's I work with called me in and showed me a letter he had just received from a specialist unit regarding a 16 year old patient the practice had referred to them. This teenager had presented at the surgery on numerous occasions with lethargy and headaches, she had been prescribed ibuprofen and amitriptyline, but to no effect. The G.P had referred her to the local hospital's paediatric department who had done every test imaginable, including an MRI scan, but they admitted defeat and suggested referral to the tertiary unit. At the specialist unit they had reviewed all her test results and decided to start the consultation with a complete physical. Chest exam, nothing but the abdominal examination had revealed a 30+ week pregnancy. When questioned the teenager had maintained that she was having regular periods, no one had thought to do a pregnancy test! Anyway, she was scanned and the gestation was estimated at being 36 weeks but she denied having had sex. The Doc told me that he had informed Social Services about her as she wanted to put the baby up for adoption at birth, he had also told them that I would be getting in touch, her Mother knew everything. I phoned the girl the next day, but Mother answered the phone and the entire conversation had to be conducted through her. Yes, I was welcome to call round, but I must park round the corner as everyone knows my car, and I must put my equipment in a carrier bag so that no one thinks that I am there professionally! I complied. I left there certain that the adoption decision was the Mother's, as far as she is concerned this is a huge inconvenience, at first she was demanding a section so that it was over and done with this week. After a long chat I managed to talk her out of that one but all she was worried about was her daughter having 'it' in time for her to be able to go back to school when the new term starts. I am so worried about this young girl, she is now saying that the pregnancy is a result of a rape following her drink being spiked, apparently she is gradually remembering the 'attack'. The support she is receiving, at the moment, from her family is fantastic, but she is having to do everything their way. She is not allowed to tell her friends about this, the attack, the pregnancy, the birth, the baby, nothing, she is expected to give birth and give away a baby with only the people in her house to talk to. If any other person knows, me, Social Services, the G.P, Mum is always there as well so she can never really express her emotions. I really fear for her emotional health.

Back again, the intermittent blogger.
Quick update on my life goes as follows:-
Jack is now 2 and Amy is 1.
Jacks speech is starting to improve. He still tends to be monosyllabic, but his vocabulary is huge. Nappies ceased to be a feature of his life a few months ago, days are problem free, nights are not quite as reliable. He is a joy to have around, except when he wakes from his daytime sleep, then he is horrid for about half an hour, even ignoring him doesn't lessen the bad-temperedness. Thankfully he is unbelievably tolerant of his cousin as she expresses herself in a very physical way, hitting and biting. Her Mummy maintains that she doesn't understand that she is hurting people, I'm sure that she does it's just lucky that she is a little extrovert and really entertaining, a big girl with a big personality!
Jack's Mummy is pregnant again and we are keeping our fingers crossed that her scan next week, when she will be 16 weeks, is a happy event. Certainly 'poppy' is an active little bump who takes exception to Nanny listening to her heartbeat, I can feel 'her' kick the sonicaid.
Son and DIL have moved from their flat to a house and DIL is starting to make noises about starting a family, when that happens I hope that she will want me to be as involved as my daughters do. I'll have to wait and see.
We are in negotiations at the moment with a property developer. He has bought the house next door and after several bargaining episodes has agreed to pay us a good price for ours. Obviously it is all subject to planning consent so I'm trying hard not to think about it too much. I shall be really sad to leave this house, it has been a wonderful family home and holds a lifetime of memories for us all. The garden is my domain, it started off as a wilderness and has gradually turned into an outside living area and retreat for when I want to escape the frenetic activity in the house. It's strange how you suddenly see things differently when circumstances change. After the initial approach by the developer we had a valuation done on the house by a local Estate Agent. We've lived here for 15 years and have never had it valued, plus, when we bought it it was derelict so we have have made massive changes to it so we had no idea what it would be worth. After the Agent finished waxing lyrical about everything we were pleasantly surprised by his guide price but also saw it through a strangers eyes, it really made me think hard about moving on. We've always known that this house was our 'pension', it's all just a bit earlier than we had anticipated.
Work is going from bad to worse, not just for our Trust but Nationwide. Something has got to be done but I fear that it is already too late to save many of our services. It is really depressing to see the disintegration of something which wasn't perfect but was there. The statistics and tables may say that things are improving, but down on the ground they are being held together by that perennial plaster, goodwill, and that is slowly becoming unstuck by that solvent that solves nothing, bureaucracy.

Medline Plus video of caesarian section.

Not for those of a squeamish nature. Link lasts an hour.

On Tuesday my daughter lost the baby she was growing. We don't know why, baby just died. We don't know when, just sometime between 13 and 16 weeks. She had some bleeding and so she had a scan, baby's heart had stopped beating. The photo shows a perfect little baby, it doesn't show a why. She had the operation that afternoon and went home that evening. Questions, so many questions, but answers....none. Oh, I'm full of platitudes, they trip lightly off my tongue, and I'm strong, so strong, but inside I'm aching. Crying for that lost little baby, that Grandchild I'll never hold, but mostly sobbing for a hurt my daughter is suffering that I can never heal, for her hopes and dreams that disappeared when they looked at a screen and didn't see a fluttering, for a few gray photos that have been put in a box and hidden in a drawer.

The history of a Midwife

There was once a girl who had a dream, nothing amazing, just a yearning that one day she would be a midwife. She knew what it was all about, her Mother had been a midwife and she had accompanied her in her daily work sitting in a metal seat on the back of her Mum's bike. Sometimes it was pretty boring, she would have to sit in some strangers front room for ages, if she was lucky she would have a glass of juice and a biscuit and the radio would be on, there might even be another child there, but after a while her Mum would come in to the room, her face would be flushed, her hair damp but she would be smiling in a way her Mum hardly ever smiled. Then she would be taken upstairs, into a bedroom, where a lady would be sitting in a bed holding a beautiful, tiny pink baby in her arms. Most of the time she would be allowed to peep at this special present her Mummy had bought the lady, and if the lady knew her she could stroke it's soft, warm face and watch as the baby turned its head to her careful fingers, sometimes it would try and catch her fingers in it's mouth, then everyone would laugh and say they hoped her hands were clean. When the girl started school she couldn't go with her Mum anymore, but she always remembered those special times, and when other children said they were going to be ballerinas or singers, or gymnasts, she knew that one day she would go to peoples houses and make them happy, all the other things were good to dream about, but her job would be special, and she knew that she could do it.

To be continued

One of my daughters is expecting again. We've had a couple of upsets in that she decided to have a couple of quite heavy bleeds earlier on, but a scan following the first one was reassuring so we all got back on track and recommenced the waiting game. A couple of weeks ago she asked me to have a listen to see if baby would let us hear its heart-beat, and sure enough, there it was, bounding away. Two days after that she had a nuchal scan, and thats when the worry began, three and a half hours they scanned for, by the time they finished she had, literally, a bruised tummy. The risks were good though, low-risk for Down's syndrome but, they were concerned about baby's size. Her previous scans scans had put her at 13 weeks, her dates put her at 12 weeks, but they were estimating 11 weeks. They recommended rescanning in 2 weeks. I played it down, in the back of my mind I thought there may have been a chance that originally she had been carrying twins but that she had lost one when she had the bleeds, baby would therefore be slightly small, but would catch up. This week though she asked me to listen in to baby again, and I couldn't hear baby. Plenty of maternal circulation, a good sign, but no racing baby. Friday she asked me to try again, still nothing. I have remained, outwardly, positive, berating baby for hiding from Mummy and Nanny, but inside I'm frantically flicking through possibilities. I have spoken to the hospital, who are hopefully arranging a scan to 'check baby's growth', and I am remaining positive when questioned by daughter. There are good signs, dislike of certain foods, tiredness, breast growth etc, but her womb is smaller than I would expect, especially with second baby. Just think, if she hadn't have had the nuchal scan, we would all be blissfully ignorant, we wouldn't be concerned, just eagerly anticipating 'Peanuts' eventual arrival. We are in some strange limbo like world now though, waiting to see what happens. No one is really discussing it, I havn't started my cross-stitch, and I can't blog about it on my other blog as daughter knows about it and might read it. Not a good time. I want to flick a switch and skip to the next bit, what a shame life isn't like that.

A little insight into the ineffectiveness of NHS managers, bearing in mind that this is Maternity Services and pregnancy is our speciality.
Last autumn, one after another, 9 midwives announced that they were pregnant and would be going on maternity leave, for at least 6 months, March/April time. Congratulations flowed, and then the impact on the service began to be anticipated and we began to mention to managers that we could be in trouble if something wasn't done about covering the departing midwives hours. They did.................nothing, except send round a questionaire as we had been identified as being the employees most at risk of stress.
Then, finally they acted. The antidote to the loss of 9 midwives, or 45 shifts per week, is to command the community midwives to each work a shift, per fortnight, in the unit. Brilliant solution, what genius came up with that, it's really going to help, 10 community midwives, that equals 5 shifts per week, only another 40 to cover. There is a problem with this, I cannot adequately cover my caseload as it is, I'm constantly working an extra 2 hours here, half a day there, doing my paperwork at home, in my own time, and now they want to take a day away from me, it's not them who receive the brunt of this from women complaining about not being able to see me. They have shifted the majority of the care into the community as it is, our women rarely see their G.P's about the pregnancy, consultant appointments are rare, women are discharged earlier from hospital following the birth, even section Mum's go home after 2 days, of course this has impacted on our workloads, if they are not in hospital, we are visiting them at home. We have increased the homebirth rate as well, it's gone from about 1% 3 years ago to 8% now, who do they imagine staff these events, and who they think covers the work the attending midwives cannot cover due to being at a homebirth? Both within and outside the unit the midwives are stretched to the limit at the moment, and the result, the women do not receive the care they are due. It's not dangerous, lives are not at risk, but corners are cut, and the staff hate it. For the majority of midwives it is the care they are able to give which is the most rewarding, most satisfying part of the job, if we feel we are not able to give this we become disheartened. If we are racing from one woman to another care suffers, the woman suffers, and ultimately the service suffers as we will leave.
So congratulations managers, a pat on the back to the trust board. You had time to act, we all knew a 'crisis' (their word) was imminent, but you did nothing, not a thing. Now you have a service approaching meltdown. As you sit in your gilded tower, watching us little ants chase around trying to patch-up and cover for your ineptitudes, congratulating yourselves on what good little workers you have, don't think you won't feel the repercussions. It will be to you the letters of complaint are addressed, we will make sure of that. It will be on your desks that the resignations, notifications of retirement, and sick-notes, citing stress as the cause, will land, I expect that you already have the excuses, but we will know the real reason, your failure to plan effectively. Why should that surprise me?

When I started this blog I was entering a new phase of my life, Grandparenthood, I was finding the whole concept truly daunting, and really had no one to share my apprehensions with. I didn't know anyone, female or close to me, who was anywhere near this monumentous transition. The blog was my way of expressing myself. I certainly had no idea, two years ago, that I would find myself almost constantly being an 'Expectant Grandmother'.
Well I'm a Grandmother now, and still feel just like I did before I was elevated a generation. I haven't stopped being immature, I'm still dying my hair whatever bright colour takes my fancy and I still leap-frog bollards with my sister. My life has changed though. My relationship with my daughters has blossomed into something so special that I feel I am the luckiest person on earth. Friends and colleagues berate me for the way I am always there for them, but I love the feeling that I am useful again. With my children I found that we reached a point, very gradually, where I was superfluous to requirements, I was their Mother, no more, no less. Now, once again I am 'needed'. This sounds very one-sided, it's not, we have evolved into an organism that functions symbiotically, we are all there for each other, physically and emotionally. In these days of the 'nuclear' family we are building our 'throwback' family, our house is the nest where everyone congregates, sisters gossip, cousins play, Father and Son discuss the footie, Mum and Daughter give each other facials, Grandad crawls round the floor pretending to be a horse, monster, whatever. Would I go back to how things were before? Never. I had always known that I wanted to be a Mother, I had thought, as the children grew up, that it would be good to be a Grandmother to have babies around again, I had never realised quite how much it would enrich my life and change relationships, I recommend it!

Yes, I'm back again. Firstly, can any kind blogger out there tell me, in simple, idiot proof language how to put links on to my page, hopefully without having to use >, < sort of things, just letting me type away happily. I don't mean in my entry, I mean at the side.
Still a midwife, still having a love/hate relationship with the job. If I could afford the insurance I would go independant, but I can't, £10,000 is a bit rich for my pocket, so I shall just have to carry on grumbling about the NHS etc.
Looks like I'm going to be a Grandmother, again, this year. One a year for three years, I'm super blessed. Grandson is being acquainted with the concept of using a potty, he appears to be catching on quite quickly, but insists on emptying it himself, can be quite messy. Grand-daughter is learning to crawl, just in time for me to start looking after her two days a week whilst her Mummy works, shall have to take the child-proofing more seriously.