The Independent Midwife

07/01/2022

So very beautifully written. Grateful we are helping to make positive memories for bereaved parents.

Our middle child was 72 minutes old when the midwife listened for his heartbeat and heard no sound. His peaceful death was the long-anticipated conclusion of a pregnancy fraught with inconclusive scans and tests, and eventually a diagnosis of anhydramnios that put all ambiguity to an end. With no mo...

17/05/2021

What we have all known, all along. The ARRIVE trial needs to be exposed for its faults and binned. Please never let me hear you quoting it.

A new study has reinforced our knowledge that, in real world settings, healthy women are more likely to end up having a caesarean if they have induction of labour than if they go into labour on their own.
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The study will be published in the European Journal of Obstetrics & Gynecology and Reproductive Biology.
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The authors conclude that, “Awaiting the natural onset of labor, if there are no maternal or fetal reasons to intervene, may yield no worse a perinatal outcome than an earlier induction of labor. The consequences of a cesarean delivery are known to be associated with immediate and longer-term maternal morbidity, and this may be potentially avoided, if elective inductions of labor can be minimized.” (Levine et al 2021).
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This result, which echoes that of a number of similar studies, is in contrast to the findings of the often cited ARRIVE trial.
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So why is that?
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One reason is that the participants in the ARRIVE trial were not representative of all women. Another is that women in the ARRIVE trial had very medicalised care. And, as Levine et al (2021) note, there’s a difference between what happens in the setting of a trial, and in the real world. I’ve written lots on this, so here are some resources if you’d like to know more.
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You can read Levine et al’s study at https://www.sciencedirect.com/science/article/pii/S0301211521002463
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If you’re wondering whether induction is right for you or wanting to read more about the evidence, check out the resources on my website or my book, “Inducing Labour: making informed decisions.” www.sarawickham.com/iol
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And if you’re a midwife or birth worker and you’d like to better understand the issues and develop your confidence with research, we’re looking at a number of aspects of induction in Gathering in the Knowledge 2021. See https://app.ruzuku.com/courses/66197/about
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05/05/2021

💞A very Happy International Day of the Midwife💞

Literature from around the world shows that women who have midwife-led care have better outcomes, a higher chance of a live, healthy baby, less unwanted intervention and are more satisfied with their experience.
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There are no known downsides to midwifery-led care.
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Midwives can make a huge difference but, as the World Health Organization points out, socio-cultural, economic and professional barriers must be overcome to allow midwives to practice to their full potential.
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Today is International Day of the Midwife.
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Happy Midwives Day!
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And a huge thank you to midwives everywhere. (We'll be saying thank you to midwives in a more concrete way later this morning with an Insta giveaway, so if you're on Instagram, watch our tiles! We're )
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If you'd like to find out more about midwifery, birth options or midwifery-led care, there's lots of information available at www.sarawickham.com
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01/05/2021

Love this!

24/04/2021

"Compared with other types of fetal surveillance, intermittent auscultation seems to reduce emergency cesarean deliveries in labour without increasing adverse neonatal and maternal outcomes. New fetal surveillance methods did not improve neonatal outcomes or reduce unnecessary maternal interventions. Further evidence is needed to evaluate the effects of fetal pulse oximetry and fetal heart electrocardiography in labour."
https://www.cmaj.ca/content/193/14/E468?fbclid=IwAR3C91m-vgvMk7weMIc5u5IqH59lxpa3vt-ZHWzEUlHDYj7PEyDSZxSPaQc

BACKGROUND: Cesarean delivery is the most common surgical procedure worldwide. Intrapartum fetal surveillance is routinely offered to improve neonatal outcomes, but the effects of different methods on the risk of emergency cesarean deliveries remains uncertain. We conducted a systematic review and n...

06/03/2021

Sharon GamonHome Birth Group UK
Yesterday at 14:06 ·
"Good morning to my lovely colleagues. My name is Sharon and I am the Practice Development Midwife for Privatemidwives.com. We are a fully indemnified and CQC registered company looking after women in all settings in collaboration with the NHS.
I wanted to introduce myself and let you know a bit about us. Our number is growing all the time and we have midwives all across the UK and ROI. We come into contact with many of our NHS colleagues on a regular basis, and whilst many of you express an interest in how we work, there is also some uncertainty about who we are, how we are regulated, what we can do, and some confusion about the difference between us and our Independent midwifery colleagues.
In the spirit of facilitating better understanding of how we work in your settings, and to promote good working relationships we would like to offer the opportunity to get together via a number of virtual coffee mornings / workshops. We hope that we can create better understanding and enable good working relationships so we can all support women and families well together.
This pandemic has hit us all very hard and our workload at Private Midwives this past year has more than doubled. We are all getting through this together and we would love to meet you.
If any of you are interested please do private message me and I will let you know when the events are happening.
Thank you for reading this far, and I hope to be meeting some of you soon"
Private Midwives https://privatemidwives.com/?fbclid=IwAR05KQrfwRqI0GThxyWrx-a2_R2yhm5bnqj1SVKhrAp7xtxOuIlWFr-c0-Y

Private Midwives offer private midwifery services to offer you choices for your pregnancy and birth from home births to hospital births. Contact us today

06/02/2021

Please sign !

A group of mothers and midwives who care about quality maternity care have come together to start this petition. Last week, the major newspapers all ran high profile stories saying that Midwives were no longer supporting 'normal' birth, portraying it as a climb down. Midwives were attacked for 'push...

24/01/2021

This study has really annoyed me! There has never been any evidence that the use of CTG improves neonatal outcomes but it does increase the cesarean section rate and morbidity for women, short term and long term. Recent studies have shown that the use of CTG may actually increase the cerebral palsy rate. So this study seems to be suggesting that the reason why CTG does not improve neonatal outcome and decrease C section is because the training of professionals is poor. CTG has been around since the 70's...over 50 years. Seriously, if we cannot interpret CTG after 50 years of use as well as trying to get computers to interpret then maybe it is not the training that has a problem maybe CTG is just not a useful tool for improving morbidity and mortality of babies? Maybe we need to really look at the evidence and be brave and bin all those lovely shiny machines?

Training in fetal monitoring: systematic review finds little evidence of impact on neonatal outcomes.