Hospital Midwives Making A Difference

This mother, a member of my own private Facebook group for mums, has shared some of her experiences with us before (see Pregnancy After Birth Trauma).  Here she discusses her experience of establishing breastfeeding after a major post-partum haemorrhage.

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It was only when I trained to be a breastfeeding peer supporter and learnt more about initiating supply that I truly appreciated the actions of the hospital midwives after the birth of my first daughter nearly two and a half years ago.

Following a reasonably easy pregnancy and near text-book birth, I tried my first breastfeed in the birthing pool in an attempt to help delivery of the placenta.  She latched then came off straight away but I wasn’t worried and resolved to try again once on dry land.  However that first feed never happened as in delivering the placenta I suffered a major obstetric haemorrhage losing 4l of blood.  Once I’d come round from the general anaesthetic and was safely installed in ICU the nurse asked if I would consent to my daughter being given formula.  Naturally I gave my consent and then after ringing through to maternity she came over with another question; would I like to see my husband and daughter and if I felt up to it did I fancy giving breastfeeding a go?  I can’t remember what my exact words were but it was something along the lines of ‘yeah go on, why not’ – rather nonchalant given the circumstances!

I can distinctly remember wondering why the midwife hadn’t just given my daughter formula and it was only after talking to my husband and reading through my notes that I found out my midwife had made the effort to make contact with the infant feeding specialist to find out the maximum time that they could leave my daughter without a feed before her blood sugar levels were affected.  She hadn’t needed to, in my absence I am sure my husband would have consented to formula being given but by holding out she was giving me a glimmer of hope to get breastfeeding started – thank goodness I’d written it in my birth plan!

I don’t remember the exact timescales but am pretty sure we were close to the end of the feeding window when my midwife, husband and daughter arrived at my bedside.  It was rather a surreal experience, hooked up to all kinds if monitors, drips and goodness knows what else I finally held my daughter properly and tried to feed.  Murphy’s law inevitably happened…after waiting so long for a feed she promptly fell asleep so with the midwife’s help we stripped her down to her nappy and tickled her toes to get her to latch and have her first feed.  It wasn’t a long one, she soon fell asleep again and so the midwife asked if she could hand express to give it via syringe when my daughter woke up.  She was extremely encouraging (and I think genuinely surprised) that some colostrum (aka gold dust) started to drip out…I have no idea if it was a good amount or not but her words gave me faith that I could still breastfeed.  In fact at that point I was still so numb to what had happened that I don’t think it even occurred to me that I might not be able to feed my daughter how I intended.

Throughout the night the midwives were fantastic; bar the one time when they were dealing with an emergency delivery of twins they would either bring up my daughter or come to hand express colostrum from me every few hours.  We exchanged blankets so that my daughter could get used to the smell of my milk although of course now I know that the exchange was 2-way to try and encourage the flow of oxytocin for myself.  The situation wasn’t ideal but I know that the easiest solution would have been to just give formula and have my husband feed her through the night.  By making the extra effort they were giving me a chance.  It’s not just the physical side of it that helped, being hugged at 2am by a midwife, told that you’re amazing and that she’s proud of you really does make a difference; at the time I didn’t really think I was doing anything amazing (in all honesty I was still in shock) but those words told me that the midwives wanted me to do this as much as I did and stopped me worrying about being too much of a pain when asking for help.

Once I was back on the maternity unit I was finally reunited with my daughter.  After a short while the feeding marathon commenced.  I knew that it’s normal for babies to feed frequently in order to bring your milk supply in, so perhaps I thought the incessant feeling was par for the course but my daughter once started hardly stopped feeding.  I have no idea how many times I rang the call bell to ask for the latch to be checked but it was a lot – I was never met with any grumpiness or suggestion to switch to formula.

After leaving hospital I certainly needed support.  The cluster feeding didn’t end in hospital and she would feed for hours and hours both in the day and even more at night and this went on for months and months.  I know that cluster feeding is ‘normal’ but speaking to lactation consultants it does sound as if mine was on the upper extremes.  So often we hear of women saying that they couldn’t feed due to a low milk supply and as a peer supporter I know that generally this isn’t the case;  however for me, and I’ve recently reflected on this with a lactation consultant, I do genuinely believe that this was the case.  And it’s not surprising, statistically I shouldn’t have been able to breastfeed and the fact that I was able to exclusively breastfeed is almost a miracle.

But I was also fortunate.  There was no tongue tie, the latch was just fine (soreness was only due to the sheer number of feeds I was doing), and no thrush or mastitis.  If I’d had to feed in constant pain I know that would have been the final straw.  I was also fortunate that we have some really inspiring and compassionate peer supporters where I live who, when the easiest answer would have been to combi-feed, helped me believe in myself and turn a feeling of failure into a sense of achievement.

I am still breastfeeding my daughter now, nearly two and a half years after the event and am doing so alongside her newborn sister.  We’ve had a hard journey at times but it’s been worth it and I honestly don’t think we’d have achieved what we have without those early interventions from the midwives.  If my daughter had been given formula at the start rather than waiting would she have been hungry enough to stimulate my supply?  If we’d not continued to try feeding/expressing through the night would I have given up?  If the postnatal midwives had been curt and unhelpful would I have persevered?  When the long nights drew on and she was going into the 9th, 10th, 11th hour of non stop feeding, I felt I owed it to those midwives (and of course the peer supporters too) to keep on going, to make their efforts worthwhile and to make that midwife ‘proud’ again.

 

Bringing It All Together

My projects and the work I do have been a lot like the TV series Game Of Thrones this last 12 months.  Just when you think you have got a handle on what on earth is going on, and what might happen next, something else crops up, new people come along, and you’re hurtling down another path filled with excitement and confusion!  Due to the themes and content of the show I don’t want to stretch this analogy too far (!) but just as with characters in Game Of Thrones, it’s great when some of my projects come together again and a few strands can once more be interwoven.

So I am really excited about the #MatExp project “Nobody’s Patient”.  Dubbed “#MatExp 2” it’s less of a sequel and more of a spin off.  This video from Florence Wilcock and Gill Phillips explains what Nobody’s Patient is all about.  The project will be focusing on groups and individuals who traditionally fall through the cracks.  The three key groups are:

1. Families with babies in neonatal or with newborns on paediatrics
2. Women who are unexpectedly severely ill postnatally and are being cared for elsewhere in a hospital, such as on intensive care, on a surgical ward or in A&E
3. Women who lose their baby in the middle of pregnancy, and who often fall between maternity and gynaecology

The project aims to find ways of “wrapping services around women and their families rather than them trying to work their way through our systems”.  The video explains how you can get involved and add your voice – everyone is welcome to join in, have their say and help to create better services for families.

This is full circle to where I joined #MatExp in the first place, as I joined what was then the NHS Change Day campaign as one of two “breastfeeding champions” due to my work on breastfeeding support in paediatric units.  My “hospital breastfeeding” campaign has since expanded to also look at breastfeeding support for lactating women who are themselves inpatients, and this also fits in nicely with Nobody’s Patient.  You can read here my thoughts about hospital breastfeeding when mum goes into hospital, and the information that peer supporter Asha Crocker has been gathering for the campaign.

It is so exciting to me that the two strands of hospital breastfeeding – paediatrics and adult wards – can now be brought under the umbrella of the #MatExp campaign as part of this brilliant new initiative.  In conversations I have been having with clinicians and family supporters at Alder Hey Hospital it is clear that breastfeeding support on paediatrics is just one of a range of services that are needed to adequately support the health and emotional wellbeing of babies and their families.  I am making connections with paediatricians and paediatric nurses all over the country who see the importance of these issues, and I hope that they will lend their voices and experience to Nobody’s Patient.

Gathering Stories

Florence Wilcock, Gill Phillips and the Nobody’s Patient team are asking for input on key areas in order that they can craft the workshops that will bring together all of the stakeholders for the project.  Getting women’s stories has always been easy for me due to the 2,000 or so members of my own private Facebook group for mothers, and again it was a desire to share these stories that initially led me to #MatExp.  Having shared lots of birth stories and experiences from my group with the #MatExp team it is wonderful to now be able to share stories of neonatal and paediatric experiences for the new workshops.  If you have a story to share please let me know, tweet to #MatExp, contribute to the #MatExp Facebook group or contact another member of the team.

Making Connections

Connecting with people, and connecting people with each other, has always been a passion of mine.  It is such a thrill to have that ‘I know exactly the right person for you to talk to’ moment, as Maddie McMahon puts it, and this is really at the heart of what I do.  New people are joining and leaving the web all of the time, some staying to draw others in, some finding their connections and pulling off in a different direction, weaving their own webs and strands.  And when you think you are in the middle of one particular web it turns out you are making connections for something else entirely….

A midwife on my own Facebook group has an interest in gathering information on women’s experiences of having a baby in NICU…… Well those stories are perfect for Nobody’s Patient!  I attended a brilliant study day at Wrightington Hospital to talk about hospital breastfeeding….. and found wonderful work being done in Wigan that corresponds to the Growing Families conference I am organising.  I met up with a health visitor friend of mine to catch up on work I have been doing around improving HV services….. and it turns out she is now working with Alder Hey Children’s Hospital to improve patient experience!  Connections everywhere, amazing projects being put together by passionate people, people who “get it” and want to make a difference.  This is what it’s all about.

This is why I am in the process of pulling everything together and building heartmummy connection, which will be going live within the next month.  I want to be able to bring together parents and professionals, knowledge and experience; those who can help with those who need support; those with something to say with those who have the time to listen; new ideas and established practice.  Watch this space – and if you have a project to share and I have not already been in touch about adding it to the site then please give me a shout!

JFDI

Just F***ing Do It has been the motto of the #MatExp campaign from the start, and it was in this spirit that Vanessa Aparicio-Hancox and I decided to put on the Growing Families conference.  We had dinner one night and I said I’d been toying around with an idea for an event.  She prized my rough notes from me and declared “yes, we’re doing it, we’ll do it next year.”  That was in 2015.  The wonderful Emma Jane Sasaru and Elena Abell joined the team, and this October the Growing Families conference will go ahead in Manchester.

Our mission is to tackle the postnatal information that desperately needs covering for new families. To explore expectations and evidence around the early days with baby. To keep ticket prices low, with no expectation of making a profit, in order to open up the event to as many people as we can. To ensure that support for the event comes from ethical organisations and those who share our interest in evidence based information and family wellbeing. To give new families the confidence to face the challenges ahead.

And as part of the event, we have a breakout session on Parenting Under Pressure.  This session will be led by me, Catriona Ogilvy of The Smallest Things, and Lynne Barton of Entrust Care Partnership.  We didn’t want Growing Families to be another parenting conference where those facing a different parenting experience felt left out or unwelcome.  Prematurity, disability, ill health – these are things that families face every day and it is no less of a parenting journey just because it doesn’t look like the images in the magazines.  These parents still need to know about attachment and bonding.  They still need to know about infant feeding and understanding baby’s behaviour.  They need to know how to face the challenges to their relationships that come from having a child, and they need to know about perinatal mental health.  Protecting emotional wellbeing.  What support is out there for their growing family?  In fact these messages are perhaps even more crucial for those facing a more pressurised parenting path.

And this of course brings us back to Nobody’s Patient.  No family should feel as though they don’t “fit in” to maternity or postnatal services.  No family should feel as though parenting information and support and social interaction is “not for them”.  No family should feel as though they are on the outside, looking in on the idyllic experiences of others.  We all need support.  We are all capable of offering support.  So let’s bring it all together.  And let nobody be Nobody’s Patient.