Archives
Mad as a termite
Boy, I'm seething. That **** tax man. New tax coding but reduced. Why? Something about car use. What the hell are they on? Of course I use my car for work, I'm a community midwife. No. The trust do not pay my mileage for going to and from work, where did they get that idea from? I work for the NHS. You know, those people who say we will pay you this and everything else you do you do for nothing cos you love the job. Oh yes, we know you are supposed to have a pay rise but - we'll give it to you in so many parts and spread over a couple of years, and during that time you will get another pay rise, and by the end of all their machinations everyone has completely lost track of how much and when so you just give up and trust you got it. Then you find the Inland Revenue also want a piece of you so you might just as well work for sweet fanny adams and be grateful for having the job. I'm PAYE, how do they work out that I have underpaid tax as well as the car thingy. I can't underpay tax, I have no choice, I never see the money in the first place.
Whilst I'm whinging I read some blogs yesterday that included comments about community midwives. All bad comments. Grumpy, fat, unsympathetic, out dated hairstyles. Well I'm sorry. I try my hardest. I give my job my all. I visit in heatwaves, gale force winds, blizzards etc. People grumble if my clinic is running 10 minutes late, but then expect to talk to me for half an hour when they know the system allows for a 15 minute appointment. Thats why I run late. Sometimes they will have to see another midwife, I do have holidays, I do deliver babies. I can't say to someone having a baby 'sorry, I'm off now, got a clinic to do'. If I've been up all day working and then all night delivering a baby, or working in the hospital because they're short-staffed, do people really think that I should be out and about the next day making judgements about their pregnancys or babies?
I'm not normally so negative. Please don't give up on me. I can be quite lovable (even if I am fat with an out-dated hairstyle)!
Smiling again
Sorry about the tirade before. All sorted now. Poor old taxman. Not his fault but my pay department, silly sausages.
Did I mention that I am soon to become a grandma? This has hit me very hard, I'm not mentally prepared for it. I tell people about it, look at pushcahairs ebay.co.uk, do my cross-stitch www.ohbotherpooh.com etc, but the reality only occasionally dawns on me. You would think that since I'm a midwife I would be experienced in these matters, well this is just out of my experience. It's my youngest daughter who is about to shift me up a generation. When she told me she asked that I be her midwife. How can I say no. I've looked after any friends who've asked me so I can hardly refuse my own flesh and blood. The other day I was doing an antenatal checkup for her and was feeling her tummy when suddenly I connected. What I was feeling was my grandchild.What I was listening to was his (or hers) heartbeat. I'm overwhelmed. I say to my patients all the time what a miracle pregnancy and birth is, I've had three babies myself, I've delivered hundreds, but this unborn grandchild has opened yet another perspective and the magic of my job has gone mega.
I'm off to watch my secret, and soon ending, vice. Kerry to win.
In control?
Whats 20 inches long, is much admired, photographed ad infinitum, eagerly waited for and anticipated like nothing else? A baby. So when this baby comes home what happens? All anyone wants it to do is sleep, or if not sleep just lie quietly. Why would baby do this? When being grown it has been in a constant environment closely surrounded by the womb, fed constantly by the placenta, drinking fluid at will, rocked by Mums movements. If you were suddenly in what must seem a fairly hostile environment where the only way you got attention was to cry, what would you do. I would certainly let my feelings known. Now lets look at the other side. If you were someone who is used to doing virtually what you want as and when, how are you going to adapt to this? Will you try and control the situation? I suggest many will ( and do ), expecting this baby to immediately understand that by regulating its feeding you have its best interests at heart. So, what happens? Baby cries, and cries. Mum attempts to pacify, Dad attemps to pacify, baby continues to sob, she may even fall asleep, for half an hour. Then awake again. This time with renewed vigour, hungry. Mum consents to feed little one. Bliss. Baby only has a short feed, she's tired from all that crying. She falls asleep, only to wake again half an hour later, didn't take enough milk before 'cos she was so tired, also she's got tummy ache. All that screaming gave her wind and when she was fed she gulped quickly because she was desperate. Stuff and nonsense? Make up your own mind. My comment would be that in countries where babies are carried around in slings all day by Mum, and feed at will don't cry as often and 'colic' is unknown.
Safe Practice
From reading my comments I have deduced that some readers may not hail from Great Britain so their experiences of care during pregnancy etc may differ from us Island folk. I'll just give those amongst you who are innocent of our system a quick run through. In G.B we have midwives everywhere. According to statistics midwives are the lead professionals in the majority of pregnancies, births and aftercare. Most midwives are employed directly by the local hospital, or Trust, as they are fondly known now. We do have some independant midwives ( I would love to be one but the insurance is too high ) on the whole though midwives refers to NHS employed people. When a woman finds out she is with child she choses where she wants to have her baby and the system swings into action. She is booked for that place, sees a hospital doctor if there are any probs, but the majority of care is by a midwife. Maternity units are mainly staffed by midwives but there are always doctors available if there are problems. We also have a few birth centres which only have midwives and are only for low-risk Mums. Hospital employed midwives also do homebirths, these are usually community midwives, of which I am one. We do all the antenatal care, homebirths and aftercare. Oh yes that's something different again. In the UK we care for women for up to 28 days after the birth. We visit at home and check that all is OK with Mum and baby and, if by day 10 everything is going normally, we discharge them from our care and someone called a Health Visitor takes over. Missed out loads, but basically that's a midwife. Apparently we are an endangered species as we are fleeing the profession in our droves, I shall comment on that another time. Be warned!
Anyway, safe practice. Midwives have to have a supervisory interview once a year. I've just had mine. All my women will be pleased to hear that I am safe to practice. Questions have been answered, updates completed and record keeping reviewed. The system considers me OK, the question is - do I consider the system is functioning well?(See the above.)
My pregnant daughter is in Italy at the moment. She is 29 weeks and has gone snowboarding with partner. They are due back tomorrow and from then on she is staying in England. Whilst she's been away I have bought two pushchairs and two baby chairs from that wonderful institution E-Bay, I'm really enjoying being an expectant grandmother! I think I will enjoy being a Grandmother, its just the birth I'm not looking forward to, so I think daughter and I probably have loads in common there.
Pregnant, with worries
The pregnant one is back. 10 weeks to go and the worries are surfacing. Labour isn't too much of a concern at the moment, the only comment was "if I ask for an epidural, just remind me about my lumbar puncture." When she first started work on labour ward she witnessed an epidural being sited, she passed out, but the staff present said that she fitted after she hit the floor face first. As a result she had every investigation possible, including a lumbar puncture. Very traumatic procedure for everyone in the hospital as she has a very loud scream, and used it repeatedly! The Doc involved took two attempts to do the lumbar puncture and left her with a dural tap.( I don't blame him, she had everyone rattled.) A dural tap means that some of the fluid surrounding the brain has been allowed to leak, and it leaves you with the worst headache imaginable, for at least a couple of days. It is one of the few side-effects that may happen following an epidural, its not that frequent. Anyway, she now knows that she really doesn't want an epidural. So, it's not labour causing the worries it's baby. Daughter had the nuchal scan so knows the risk of Down's is low, she had an anomaly scan, so knows that major physical abnormality is unlikely but is now worrying about everything else. Will baby be hermaphrodite, have Tourettes, be autistic, blind, have a speech impediment? I try to reassure but have nothing definite to quell her anxieties with. I point out that there is no history of anything in either family, then other daughter pipes up and reminds her that her aunt had dislocated hips, a 'bat ear', and a hole in the heart. Thankyou oh cherished one. It doesn't matter that none of these were life threatening or affected aunts life in any way, other than splints when a baby for her hips, which she has no recollection of, and an op when 4 for her ear, pregnant daughter is now adding these afflictions to her list. Anyway, if we really delved into the realms of possibilities, which I shall not do here, or to daughter, the list could be endless, and would not end at birth but continue as the baby develops into an adult. I have always had doubts about screening 'cos it is just that. It's not a Yes or No, just an odds for, or against. Now, if I was told my odds were 1:6 million I would be convinced that I was that 1 because I am a pessimist, so what use screening for me? If I then think further there are endless possibilities of illnesses, syndromes which could affect my baby, which I would doubtless cope with if they happened. Why? As I said to my daughter, 'we will love baby because he's yours and one of our family.' Everyone hopes for a baby who is well, and most alter their lifestyle with that in mind, but sometimes that doesn't happen, but hopefully love will grow regardless and, he's still your baby.
Pavlovian theory
A comment I received as a result about musing upon demand feeding mentioned Pavlov. I wasn't aware that Pavlov experimented with babies, his experiemts concerned classical conditioning and dogs. Classical conditioning and babies has been delved into, but that was with regard to conditioned blinking. However, by tracing along the theory of classical conditioning and reward for behaviour, in this case crying being the behaviour, and reward being fed, I can see that if the conditioned behaviour is not reinforced, baby isn't fed, then the behaviour will, according to the theory, become extinct. So, baby will not cry as it won't be rewarded. Deep concern, when do you feed the baby? I do agree with you, dear commentator, that a balance needs to be struck, but the question is on the timing of the conditioning. I was being the babies advocate in the muse in question. Never fear I have not forgotten Mum and will doubtless delve into her trials at some other date. Possibly, if my daughter turns up exhausted and tearful following sleepless days and nights, expecting me to have all the answers. Which I won't. Only suggestions and different perspectives.