The madness of modern measurement

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Cassie, who has given me permission to tell her story and who chose her own pseudonym, became pregnant via IVF. She was thus one of those women who know the exact date when they conceived, and she and her midwife…

Research on breech birth in an upright position

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A new and groundbreaking research study has found that, “Upright vaginal breech delivery was associated with reductions in duration of the second stage of labor, maneuvers required, maternal/neonatal injuries, and cesarean rate when compared with vaginal delivery in the dorsal…

To feel, or not to feel?

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I’ve had a few requests recently for an article that I wrote several years ago about the practice of feeling whether or not the baby’s cord is around its neck during birth. Here’s the text of that article, in the…

On burnout…

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“Health-care organisations should move beyond a culture of endurance, which overvalues stoicism and dismisses complaints as signs of weakness, and help clinicians be better at self-care than they are at present. 21st-century patients demand more than in the past, rightfully…

Midwives matter more than monitors

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I had only been a midwifery student for a few months when I first heard the late, great Marsden Wagner speak about the lack of evidence for electronic fetal heart monitoring (EFM). At the time, he told us, more than…

A much needed revolution

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“Centralisation, standardisation and market economics have been the dominant concepts in maternity care over recent years. Organisationally, NHS maternity care has been centralised into large units based on an industrial model where care is highly fragmented. Standardisation of services is…

Birth in Focus

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I get sent lots of books, because of what I do. I always tell people who ask me, you’re welcome to send me your book, but regardless of whether I know you or any other factor, the independence of my…

EFM and conflicts of interest

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“So the question is why would the BRPOs* of the world ignore obvious evidence of EFM harm, ignore informed consent, ignore the violation of mothers’ bioethical autonomy, and ignore the reality that most of the birth profession is lying daily…

The importance of everyday birth wisdom

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I love research papers that tell me things I already know. I especially love those that tell me things I already know about everyday midwifery practice that I don’t think about on a daily basis but which, when I read…

Let there be mood lighting…

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There can’t be many midwives or birth supporters who don’t already know about the advantages of low lighting for labour and birth. While we are still learning about whether and how darkness and light relate to the release of oxytocin…

More on consuming placenta…

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A few weeks ago, I shared a two-part article that I had written about the practice of consuming the placenta (you can read part one here and part two here) and the lively discussion that followed highlighted one key thing:…

The ALTE mysteries

Thinking Outside the Box

“Last month, I shared my frustration regarding the bias against normal birth and the ability of women’s bodies to grow, carry, birth and feed their babies. As is often the case when one starts to pay attention to an area,…

Risk: what is to be done?

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“[R]isk has come to be defined as narrowly as possible, while there is a real and growing sense of concrete risks which overwhelm the poorer and more vulnerable on a daily basis. Within what Nicolas Rose, another sociologist calls the…

Jeg kommer til Norge!

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I’m coming to Norway! I’m delighted to tell you that I have agreed to speak at the upcoming Jordmorteamets konferanse at Høgskolen i Drammen, Norway on October 3rd, 2016. “The conference will be about women’s rights during birth, specifically her rights…

Midwives, resilience and sustainability

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A discussion paper on sustainability and resilience in midwifery has highlighted the importance of self-care, self-determination, relationship and passion in midwifery (Crowther et al 2016). The research was led by a team of authors who have worked on past and…

A cautionary holiday tale

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I’m sharing a bit of holiday cheer today, and am thinking especially of my friends who are in the Southern hemisphere and heading towards their midwinter. The nice people at The Practising Midwife let me share my Thinking Outside the…

The risks of documentation

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“Documentation of care is at risk of overtaking the delivery of care in terms of time, clinician focus, and perceived importance. The medical record as currently used for documentation contributes to increased cognitive workload, strained clinician–patient relationships, and burnout. We…

Happy Midwives’ Day!

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Happy Midwives’ Day! I’m spending International Day of the Midwife in Reykjavik where I’m discussing Recipes for Normal Birth with lovely Icelandic midwives, but I wanted to send my happy midwives’ day wishes out to my friends all around the…

Pondering placentophagy – part 2

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“A recent systematic review, which looked at whether there are any benefits to placentophagy – the consumption of one’s placenta after birth – has concluded that there is no evidence of benefit or risk and that these require further investigation.…

The false economy of “busy-ness”

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“Place shapes the ability of midwives to “be with” women. In the labour ward, strong cultural norms press midwives to engage in “busy work” while they feel more able to sit quietly with women in primary birth settings. Midwives are…

A small ‘seeding’ rant

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May I jump into the microbiome/seeding debate really briefly, while acknowledging that the issues are much larger and more complex than I have room to discuss in one blog post? Because I have been watching several recent conversations in medical…