There is not enough time in the day at the moment. The twins are both poorly with bronchiolitis, Jamie has just been discharged from hospital, Louis has been admitted. Just when things are starting to look up with good news about the health concerns surrounding Louis they both become ill. Daughter is exhausted, she is staying at the hospital with which ever babe is in, and what with them not settling due to their coughing and the alarms from the monitors, her sleep is averaging about an hour and a half per night. I have been looking after Amy, fighting off a cold and had a 24 hour sickness bug so I'm rather low on the energy stakes as well, life is rather like the weather today, dismal.
I have always said that my daughters having babies has given me a hugely increased insight into my job and the feelings of the women and their families, the twins being hospitalised has increased that insight even more. On the surface, certainly to the hospital staff, all is serene. Daughter stays at the hospital, partner goes in for a couple of hours, harmony. Under the veneer there are phonecalls, schedules for childcare, arrangements for collecting from nursery, cancelling other commitments, e-mailed shopping lists, bags of laundry being ferried around and at the end of every day there is a logistical puzzle being unravelled to ensure that every eventuality is covered for the next day. We are lucky as we all live very close to each other so there is a good support network, it must be hell if you are new to an area, away from family and friends and suddenly your ordered little life is disrupted by an illness.

Time has flown, again but here I am again. Still the same old midwife, the only new thing is that I now have 2 new Grandchildren. I am sooo greedy. First there was Jack, then Amy, then Izzy and now we have Jamie and Louis as well. Our little peas in a pod were born, by elective C-Section, on the 23rd August which was 4 weeks before their due date. Jamie came out first weighing 6lbs 2ozs, followed 1 minute later by Louis weighing 5lbs 15ozs. The first couple of days with little Lou were a bit worrying, he had to have CPAP as his breathing was not particularly effective, and then a careless nurse gave him an overdose of gentamycin (can cause deafness, we don't know yet if it has) but now both babies are thriving. They are freakily identical, Jamie has the distinction of wearing nail-varnish on one toe nail so we know which is which, ok unless he is dressed, then its a guessing game!
The Maternity Services are gradually disintigrating around us, but we are soldiering bravely on. My job-share partner left in the middle of August, she will be replaced at some point in October and so her replacement should be up and running by the beginning of November. Nice little cost-saving exercise, half a salary for 2 months but not especially good for my stress levels.

Time for some reflection on an experience I had at work when I was the on-call midwife.
A woman, having her first baby, booked for a homebirth, had been asked to go into hospital for induction of labour as she was now 11 days past her EDD, expected date of delivery. Previously she had been seen at home and undergone two 'stretch and sweeps', on neither occasion was it possible to complete the process as the cervix was long and closed. J had refused to go in to be induced. Her pregnancy had been uneventful and she had no existing medical conditions.
This morning I had gone into the office and was told that J was in early labour. The evening before she had called out the on-call who had attended, examined her and found that the cervix was 1 cm dilated, baby's head was still high and J was having irregular tightenings. The on-call felt that this was very early labour and that it could still be several hours until J was in active labour so having explained this to J and her partner she left. At 1am the on-call was asked by J to attend as the contractions were now more frequent. When the on-call arrived J was in the birthing pool and was experiencing more frequent contractions but they were still quite irregular and short. Eventually J agreed to leave the pool, 1) So the on-call could see how labour was progressing 2) As the midwife felt that J may be using the pool too early and this may be slowing her labour. On palpation the contractions were extremely mild and the baby's head was still high. An internal examination was performed again and the cervix was found to have thinned and to now be 3 cms dilated but as the head was still so high, and the membranes were bulging it was impossible to determine the position. The midwife was concerned. There had been no descent of the head and this could present a problem in that if the waters break the cord can slip down in front of the head, a cord prolapse. As is usual when a midwife is called out labour ward was contacted, and the shift co-ordinator was briefed on the situation. After involving the obstetric registrar it was decided that J should be 'invited' to go in, have the baby monitored and a scan be performed to ascertain why the baby was failing to enter the pelvis. J refused. The on-call midwife was then left sitting downstairs, where the birthing pool was, whilst J and her partner went upstairs to bed, and to sleep. After a couple of hours the on-call advised J that she was going to go into the unit, 5 minutes drive away, catch up with some paperwork, and that J should call when she needed her. 4 am and the call was received, so the on-call returned to their house. Nothing had changed, an examination at 7am revealed that the baby's head was still high and that the cervix was now 4 cms dilated. J and her partner went back to bed having once again refused to go into the unit and the on-call returned to the hospital to pass care over to me. By now the Consultant was involved, 'Get her in' was the message given to me. I phoned J, checked that all was well, labour was still in the early stages and so told her that I would be there in an hour after I had dealt with any outstanding phonecalls and handed my visits over to a helpful colleague. I had a clinic scheduled to start at 1.30pm but I was hopeful I would be able to fulfill that commitment.
I arrived at 10 am. J and her partner seemed quite calm. They were not overly communicative but I suspected that this may be because they were feeling defensive so I avoided all talk of 'invitations' and just spent an hour chatting and observing how the labour seemed to be progressing. Gradually I suggested that as it was now 4 hours since the last examination, and the contractions seemed to be sporadic it might be wise to examine J and see how much further along things were. They both agreed, actually seemed quite eager, so I performed an internal examination. I already knew from palpating the abdomen that baby's head was still high but even so I was surprised by how high it really was. Trying to assess how dilated the cervix was now proved to be quite difficult as it had no firm surface behind it and so with any pressure it moved around, I estimated that it was about 5 cms open. Throughout baby's heartbeat was textbook at 128-148 bpm, at least baby was a happy chappy. I told the couple what I had found and discussed with them what the findings indicated to me. To me it meant that labour was progressing slowly, but, to be fair, I thought that active labour was only just starting so perhaps a re-examination in a couple of hours to discover if faster progress, and descent, were happening would be the favoured course of action. I explained why the baby's head remaining high caused us anxiety, why it could be happening and what J could try to encourage descent. J wanted to get back into the pool, I discouraged her from this, the contractions were still quite weak and only coming once in 10 minutes and the pool could slow them down even more. I suggested that J spend some time marching up and down the stairs as this movement sometimes helps an awkwardly positioned baby to 'sort itself out' and if we could get baby to move down and press against the cervix this would help dilatation and also improve the 'feed back' mechanism encouraging closer and stronger contractions. As J marched up and down the stairs I sat at the bottom and suggested to her that when I re-examined, if there had been little progress, and especially if there had been no descent by baby, then it may be wise to go into the hospital as the best course of action may be to break her waters but that there was no way that I would do that at home with baby's head bobbing around at the top of her pelvis. J and partner appeared to take this on board and so I went and phoned labour ward to update them on my findings and the agreed plan. 'Get her in' was the repeated advise, Hmmm, easier said than done! I looked at my watch, it was now after 12, there was no way I could make the start of my clinic so I asked labour ward to find someone to cover it, difficult request as community were now 2 midwives down, last nights on-call was in bed catching up her sleep and I was stuck in my own personal nightmare. Nightmare? Yes. In someone's home feeling that I was in a lose, lose situation. I was fairly certain that the next examination would reveal little change, J's contractions were hardly bothering her at all so she would be quite happy just to carry on, baby was oblivious to everything and really happy, but with every minute I could imagine those membranes bulging more and more and just waiting to pop, with a possible disastrous result.
At last. The marching upstairs had beefed up the contractions, J wanted her TEN's machine on, she had stopped talking through her contractions, perhaps the next examination would reveal good news, hopefully baby moving in the right direction. 1pm, cervix probably slightly more dilated, but baby's head still high and not moving down even slightly with the contractions. I went off to the bathroom and allowed the couple to ponder the next move, hopefully they would elect to go to the hospital. J was starting to look tired and I was now starting to worry that she would not have enough energy on to cope with the hard work ahead. No. The decision was that we would all carry on and we would re-assess in another 2 hours. I rang labour ward with the glad tidings and then spoke to my manager for support, life was beginning to feel very lonely. I returned to the labouring couple. J was starting to feel she needed gas and air as the contractions were becoming stronger, I positively skipped to my car to get the gas cylinders, hopefully this was progress. The first cylinder was hissing around the tubing, obviously there was some gas escaping, we fiddled around but it still continued. Not good, it would mean that it would run out very quickly, and it did. The next one was fine but knowing they only last for about half an hour I phoned the unit and asked that the 2nd on-call bring some more cylinders out, she couldn't as she was in the middle of a clinic! My manger promised me that she would get someone to bring more gas. J then decided that she would get back into the pool. I advised against it for the same reason as before but ultimately had to support their decision as this was her choice. She had the information and, if I hadn't already told her, she should have read it in the 'Waterbirth' book lying on the sofa.
The gas and air ran out but it wasn't really a problem as the pool had worked it's 'magic', the contractions were back down to 1 every 10 minutes and J was dozing through them. Just after 3pm we discussed the repeat examination, J was eager to find out if there had been any progress, I emphasised to them that if there had been no progress, mainly descent, then I felt that the best option now really was to go into hospital. J was very tired now, baby was still a happy little chappy but I was running out of ideas as to how to keep J out of the pool and maintain adequate contractions. The examination that followed revealed baby's head still as high, the cervix still 'floppy' and ?? 6cms dilated, and the bag of waters bulging (such a temptation to break them). Finally, at 4pm J and her partner agreed to come into the hospital. I phoned Labour Ward and gave them the glad tidings. At 4.30pm I handed their care over to another midwife, said my farewells and breathed a sigh of relief.
Throughout this visit to J's home I remained as positive as possible. Having facilitated Active Birth classes for several years now I am well aware of the importance of a positive, relaxed approach and it's effect on the labour hormones. I was finding it difficult in this case as I felt that we were reaching, had reached a point where I should be more directive. The loop playing constantly in my brain was 'get those contractions going', if we could just do that I believed baby's head would descend and labour would progress better. I/we had tried all the methods within my sphere of practice to encourage stronger contractions, J had an oil for labour which contained Clary Sage, she had used her birthing ball, knelt in all-fours, marched up the stairs, snacked on energy rich nibbles, nipple stimulation had been suggested, there had been limited response to these but ultimately, whether due to pool use, baby's position, or something I still haven't thought about, it was to no avail.
All was well in the end. The waters were broken, a syntocinon drip was started and at 8.30 pm J gave birth naturally to a little boy. Not the birth experience she wanted but a safe outcome.
What have I learned from this? That even a well-educated, well-informed woman may need to have a directive approach. I was left with the distinct feeling that I was being tolerated and just used as a safety net until they wanted to go into hospital. My feeling was that I might just as well not be there but from what happened with the previous on-call Midwife I knew that, even if I felt I could leave them, they would call me back after about an hour. Anyway, I didn't feel that I could leave them because of the 'what if'. What if the waters did break and the cord did come down and I had gone off to do my clinic, I could imagine the backlash, and I believe it would be right. I am pleased that all was well in the end. Perhaps if we had stayed at home we would have got to the same point, eventually. I have my doubts though. J was getting tired, baby's head was still high and even if we had reached a point where J was feeling the urge to push I believe that I would have taken so long to get there, and then it would have taken so long to push baby out that we would have ended up with an emergency transfer to the hospital rather than the calm drive and arrival that we did have.
At all times I shared my thought processes with the couple, told them the options and allowed them to make the decisions. We were lucky as baby never gave any cause for concern, if I had become worried at any point I would have called in my manager but my feelings were that 'kid gloves' were the best way to handle this situation.
J and her partner were pleased they had been able to stay at home for so long, they believe that this enabled them to have a normal birth. They are right, but I do question the use of midwifery resources. It would be wonderful to offer every woman in labour the advantage of staying at home with their own personal midwife keeping them company but with the configuration of the service at the present time it is unrealistic and places strain on the day-to-day service, taking midwifery time from other women and babies.
Would I act differently if this situation arose again. Probably not. Women do have choice in their care. Midwives are often seen as 'the bad guys' and complaints about us being non-supportive are rife. What would I have done if J had demanded that I break her waters? I would have refused and if she became insistent I would have called my manager and a Supervisor of Midwives.
What emotion am I left with after this? Dissatisfaction.
P.S The gas and air never arrived!

Oh my goodness, it has been a long time. Loads has happened, including my third Grandchild being born. Yes, after giving everyone several causes for concern, prem labour at 34 weeks whilst our local SCBU was closed to admissions, footling breech at 37 weeks, with daughter insisting that she was not having having a caesarian, and then refusing to be turned at the first attempt at ECV (external cephalic version), baby finally gave in and allowed the turning to be successful. Meanwhile I was turning even greyer than I was before, what with the stress of what was happening with daughter and the amount of pressure that was being put upon me by the 'powers that be'. Yes, once again I was public enemy number one for caring for my daughter, at her request. They decided that the way to really pressurise me would be to also find as much fault as they could with the care I had given two colleagues/friends I had also looked after and helped birth their babies. They pointed out that clinically there were no problems, however I had not informed one of the G.P's that I was caring for their patient, her midwife had and so had she but courtesy demanded that I told him and also I had used equipment issued by the hospital when I conducted the antenatal examinations, this could be construed as misuse of Trust equipment. How they worked this one out I can't imagine since I was not being paid by the two women and they were having their babies at the hospital I work for! If I wasn't so upset that they called my professionalism into doubt I would have laughed, however the way they went about it made me feel truly abject.
Daughter was planning a homebirth and wanted me to be second midwife, I was told no. A Supervisor of Midwives was sent round to interview daughter and partner, not sure why, coercion was mentioned, we all started to feel under seige. Daughter then went to see the Head of Midwifery and an extremely heated discussion took place, I could go into detail, horror stories about severely damaged babies, scenarios involving daughter and/or baby dying, the end result though was a victory for daughter in that I was allowed to be second midwife.
At 9pm on 31st January daughter phoned, she growled down the phone that her waters had gone, the contractions were fierce, and I was to get there NOW with the gas and air. At 11.30pm Isabel Corrinne cruised into the world, a dinky little 6lbs 14ozs who, unlike her brother knew immediately what to do and went to the breast like an angel.
So, everyone was happy but the 'powers that be' still held a grudge, and also they held the power so just after little Izzy entered our lives I was summoned to the lair of the beast and was told that I was being 'rotated' to the other hospital within the Trust and would be covering an entirely different area, and all this in 3 weeks time. So that's where I am now, and all is very different, hence some of the stress. If I could afford to give up work I wouldn't think twice, I would be gone.
Anyway, a couple of weeks after Izzy arrives other daughter, Amy's Mummy, announces that she is pregnant. Yippee, last time it took them nearly a year to conceive, this time it took 2 days! At 12 weeks they went for their nuchal scan, I was in the middle of a clinic when my phone rang, I feared the worst as they all know not to phone me at work unless it's urgent.
'We've had the scan.'
'How did it go, is everything okay?'
'Hmm, sort of..........the babies are fine!'
'What?'
'It's twins, identical twins'.
I continued with my clinic in a state of shock and also desperate to see my daughter. When I did get to see her she and her partner were still in a state of shock, and terribly concerned. The scan report was positive about how the babies were at that time but then went on to quote the risks for twin to twin transfusion, a condition my sister had lost twins to at 28 weeks pregnant, and the likelihood of severly preterm delivery. The scan photos were amazing though, several of them were 3D and so you could see two tiny babies, it is very exciting but tinged with more than a little worry. She is now 17 weeks. Last week she saw the Consultant who outlined the plan of care, 2 weekly scans checking growth and blood flow through the placenta, plus a detailed cardiac scan at 20 weeks and her routine anomaly scan, with delivery of the babies by caesarian section planned for 34-36 weeks.
Gosh I started this year with 2 Grandchildren and it looks as if I will end it with 5. Whose a lucky Grandmother then?

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.

I blog so intermittently here that it wasn't until I had mail from Rosellen I remembered about being an 'expectant Grandmother'. Since my last post I have been an expectant Grandmother again, different daughter this time, and entirely different outcome. This pregnancy started off well but from 32 weeks on went downhill. I was sharing her care with a friend/colleague so had really not laid my hands on much, observation was causing me concerns though, she looked 'large for dates'. Eventually I could restrain myself no longer and asked her if we could have a listen to baby, this gave me an excuse to have a feel of her lump. Sure enough, at 32 weeks she was the size I would expect at 36, and when I tapped the side of her lump I could feel vibrations in the hand I had placed the other side, whoops, polyhydramnios, this is when there is an excess of fluid surrounding the baby. Baby also felt quite large and was super active. I immediately referred her to a consultant, when she palpated she disagreed with my findings, to the extent that she also felt baby was breech, I requested that we scan to make sure. Suffice to say that I was right, fluid ++, large baby and head down. With these findings they then conducted a detailed scan to rule out problems with baby, luckily they didn't find any, but they did estimate that baby's weight was above the 90th centile. Her care was now with the medics, and they let her so 12 days past her due date before they induced labour. Everything was against this being a success, small Mum, large baby, head not engaged, thick meconium liqour when they broke her waters (baby had had it's bowels open), 14 hours on the drip with strong contractions and no progress, yes, it was an emergency section. I now have a beautiful Grand-daughter though, 9lbs 12ozs at birth and has never looked back.

So here I am preparing to go away on a last minute break. Hubby and I were not going to have a holiday this year due to the expense, yes it is expensive, of our first Grandchild. We are still not going away, but I am! How mean is that? It's my sisters 30 + 10 birthday and she asked me to go away with her, how could I refuse? We are off to Minorca for 5 days, my favourite Balearic, just us. I am so excited. Now don't do feeling too sorry for Hubby, he goes on two golfing holidays per year so he's not exactly hard-done-by.
The best thing is though, no work. I know I love my job but that doesn't mean that it is not stressful. It is. People expect so much of you. We now have to give everyone our mobile numbers so they are always calling. If it's important, that's fine, but sometimes it is so trivial, and often not connected to their pregnancy at all and then it is really difficult not to sound irritated. They also expect you to be on-call for them around the clock, I have a life as well. If my caseload were smaller, at the moment it's 180 women, then it may be possible, but as it is there are not enough days in the week, on-call as well would be impossible. Two 24 hour on-calls per week are enough I think.
Grandson is growing daily. He's 12 weeks old now and has more than doubled his birth weight, he is still totally breastfed so daughter obviously has some good stuff there.
I'm off now to give the grass it's final cut before I go away.

Really having problems navigating this new look blog-fest.
Since I last blogged one of my daughters has achieved the ripe old age of 21. In celebration of this we had a BBQ. 30 close friends and family attended, and one monster 6 year old, he is an advertisement for family planning, don't plan to have him in your family! He is a fine example of where relaxed parenting shows it's short-comings.
I have been filling my sparetime watching Big Brother. My viewing has certainly escalated since the major trouble between that bully Jason and twinkle-toes Marco, and that devious, overweight, liar Slick Vic and pea-brained Emma. My opinion of Michelle has changed considerably since I watched her cope admirably with Emma during their time in the bedsit, the patience she has in incredible. I can't imagine that BB will get any more interesting - never know though.

I have been away - now I'm back! While I have been away I have become a Grandmother. He was born in April, didn't have the homebirth that was planned, baby showed his displeasure at labour progressing quickly by dropping his heart rate so in went daughter to local hospital where, one hour later, she presented Jack to the world. Text book birth and, so far, a text book new baby. At birth he weighed in at 6lbs 5ozs and last week he weighed 8lbs 6ozs, Mum's milk is obviously suiting him!
I have another blog hence my absence from Bloggers.I defected due to easier blogging and a cameradarie built up through commenting. Passing through I decided to checkout my good old blogger and noted that things had changed, I'll give it a go.
I'm still the often angry middle-aged woman that I was so if you are hoping to read lovely happy little entries involving chubby-cheeked infants, log-out now. I need somewhere to vent my frustrations, especially concerning the health service, and this is going to be the place

Havn't posted for a while. I've been trying to work out how to put/allow comments on my blog. Now, I've found different sites that host this but it involves doing things to my template, and I'm not brave enough! Usually when things like this happen I call for help to BIL who is a whizz with computers, writes programmes, lectures etc. but I can't ask him. Why? Cos then he would know my blog. He knows I have a blog but I won't tell him the address or anything else about it and he is trying to find it and so far it has defeated him, wonderful.
Anyway. Pregnant daughter is now 32 weeks and blooming. Everything has been purchased for the unborn one and now the waiting game really begins. My career as a midwife is fast losing its appeal. The paper work is breeding faster than a pair of rabbits and I am getting to the point where patient contact is becoming something I have to 'fit in'. I think I might retrain, data input or something. Please someone save the Health Service.