SageFeminist

A Newly Qualified Midwife's blog on all things Pregnancy, Birth, Midwifery, Feminism and Student Midwifery.

Home Archive for July 2017

I'm extremely lucky. Every mentor I have worked with over my two years studying as a midwife has shaped my practice, taught me things in a new way and helped me develop into the midwife I'd like to qualify as.
I know sometimes it isn't that easy. Personalities clash, students feel intimidated by their mentors or asked too much of them. Mentors do not spend enough time with their student or use the age old line of 'I can't give you an A grade because you're only first year'.

I am very much an advocate for asking questions, in appropriate circumstances. There are no silly questions when you're learning. If your unsure how to word it ask them to 'clarify' a certain decision or event.

Take notes. I cannot advise this enough and I even know newly qualified midwives who still do this.
Write out how documentation should be laid out e.g. vaginal examination findings.
Note down the stages of labour, normal range limits for blood results, blood pressures and temperatures etc.

By knowing the basics and having them to hand you can use the 'normal' to help you identify the abnormal - and be able to read these off to your mentor should they question this.

Outline if something makes you uncomfortable. This week was the first time I helped during newborn resuscitation. I needed to let my mentor know how I felt during this so that next time she was aware of my strengths/challenges surrounding the task.

Mentors can make or break your training.
It is important that their goals line up with yours. Ask them how they usually treat first/second/third year students in relation to aspects of care.
If you are having issues with a mentor bring it to the attention of your charge midwife and university. Most issues are usually misunderstandings.

And remember they were students once too!


When developing a professional relationship with your mentor - remember you're both #InItTogether

Ruth x

twitter: @ruth_stmw


Infographic for this post can be found at http://sagefeminist.blogspot.co.uk/p/infographics-from-blogposts.html


Throughout my time at university we've always been told that communication is number one in maternity care. The use of verbal and non-verbal communication can help build a trusting relationship between the midwife and mother.  

Initially, during the booking appointment and antenatal period, midwives use communication to build up trust and rapport, and allow the woman to become comfortable answering questions surrounding her medical history and mental health.

In labour and birth we use non-verbal communication to establish whether the labouring woman is transitioning, involuntary pushing or even needing further verbal support.
Eye contact, mirroring, body language and even simple gestures such as nodding or smiling are all important when building and maintaining a trusting relationship especially in a situation whether the woman's verbal communication may be inhibited by use of entonox or strength of contraction. 

In midwifery education and discussion language is so much more important. Language used focuses more on what we are actually saying and the effect certain words have upon others feelings, perspective and understanding of a situation.

Many midwives actively loathe the word 'deliver' when discussing the birth of a child and much prefer 'catching' or 'birth'. For me I agree, childbirth is such a wonderful moment we should not be using language which assumes we are removing the empowerment and experience from the woman. 




But what about other words used in day to day midwifery discussion?
I recently wrote a post about resilience in maternity care this got some backlash due to the choice of the word 'resilience'. I still believe that I used the word which correctly fitted with my view of the midwives I experienced on labour ward that day - it was resilience.
But how can we communicate this to other midwives and student midwives without using controversial language? This is where we must understand that sometimes the use of terms can cause criticism, and be open to this. 

Other words I constantly see used in maternity care and believe that they do not belong include allow, fear, risk and failure. 

Allow denotes that we, as midwives, are letting a woman feel the way she does, do the things she needs to do, and have the baby on our terms. We should be following the woman. She should allow us into her space.

Fear. I never use the question 'what are you afraid of?' when a woman looks concerned. I ask them how they feel, and if the answer is 'fear' I use reassurance. Birth should not be feared. It should be celebrated.

Risk. Using the term 'risk' instantly increases the 'risk' or as I prefer to term it challenges or approach to maternity care. If you are supposed to be undertaking women-centred individualised care then why are we putting women into groups based on 'risk'? Not every woman with a high BMI/ Diabetes/ Previous C-section is a risk, so why are we labelling these women? 

Failure. What a horrible word to be told. You've 'failed to progress' or a 'failed forceps'. This makes the woman feel it was her fault. We need to use a better term to communicate that there may be need for an intervention and not just because of 'failure'.


But how can we change an established language culture which has been influenced by medical times over the years?
By educating. 
Using these new terms or preferred terms in placement, clinical practice and university can help build a new generation of student midwives whose usage of language is primarily based on physiological birth.

What are your thoughts. Leave your comments below or tweet me @ruth_stmw

Ruth x

twitter: @ruth_stmw



That is what it felt like a few days after the event. A dent in my armour. A dent in my belief pattern of childbirth being a happy and exciting experience for families and for myself as a student midwife.

For confidentiality purposes I will be changing some facts of the events but remaining honest in my feelings and opinions.

At my university before you head into second year you are taught the theory of obstetric emergencies. What to do if a woman has a spontaneous rupture of membranes and the cord prolapses, the positions and techniques to use for a shoulder dystocia, the medications used to treat an eclamptic fit.
Theory.
Unfortunately in my opinion only a small section of that really prepares you when you encounter with an obstetric emergency in real life.
I completely understand why obstetric emergencies are not discussed in depth during first year training, we need to understand normal to identify abnormal, but labour ward and childbirth doesn't discriminate based on your experience and for some, seeing these emergencies can impact upon their emotional resilience and training for the rest of their career.

I was prompted to write about this after being on my labour ward placement and experiencing second hand the emergencies we had been taught. I was not looking after these women but was on shift during the events.
For me, just being in the labour ward when a woman had a cord prolapse, diagnosis of an IUD, placental abruption and an eclampic fit occurred really opened my eyes to management of obstetric emergencies and the resilience of the labour ward midwives. Especially when it came to managing their own emotions and actions before and after the event.

The one event that made me question my own emotional resilience was a stillbirth. Again, I was not looking after the woman but was on shift. The emotions within the entire labour ward were hard to ignore, yet an air of extreme professionalism remained.

An article shared by Hannah Dahlen on twitter (@hannahdahlen) by Rakime Elmir, Jackie Pangas, Hannah Dahlen and Virginia Schmied 'A meta-ethnographic synthesis of midwives’ and nurses’ experiences of adverse labour and birth event' highlights a few important areas of focus for midwives after a obstetric emergency. I would advise reading it.

In the article midwives and nurses noted feeling relatively unprepared due to the rapid unfolding of the event. They themed this as 'Feeling the chaos' - having to respond quickly both practically but also emotionally. Facing different emotions including, fear, disbelief, shock and anxiety. 

Many midwives noted that they are continually learning from these experience and I believe this is where the resilience grows.They see it as part of becoming a midwife, professional growth and understanding emergencies better. By using positive debriefing and reflection, continually developing skills and practice for any future events.

But I also think it is important that the culture in which midwives practice in is support after events. Debriefing is used, reflection is championed, for example writing a statement, to ensure midwives are not left with emotional trauma.

Unfortunately some events can cause midwives to change their view of midwifery, to start practising defensively, increase risk management and even vigilance which sometimes can be downfall for promoting normal physiological birth. 

The resilience of midwives should be highlighted as an important skill as this can impact upon the core belief of a midwife to build a caring relationship with the mother and family and then when an emergency occurs, how to deal with this both personally and professionally.

I agree with a lot of the finding of this article and believe it is important for midwifery services to be aware of midwives experiences of adverse labour and birth outcomes. This will effect different aspects of staff moral, and needs to be highlighted as an important area for compassion and care within maternity services and to provide midwives with the emotional support needed after these events. 

Training courses such as PROMPT can help reduce that emotional burden, by practising emergency routines in a safe environment with colleagues. I myself have contributed to PROMPT training by acting as a woman having an obstetric emergency (PPH) and it was invaluable to see how midwives reacted honestly to an emergency situation outwith their control.

But for me I still wasn't prepared for the feelings of sorrow, fear, anxiety and doubt I had surrounding labour and childbirth after being secondary to an emergency. But by reflecting, writing this post and discussing it with my mentor I feel this experience is only a small dent in my midwifery armour, and will make me a better midwife for emotionally facing it.


Midwives need support within the work place as well as outside of it. RCM Campaign 'Caring for You' aims to support midwives health, safety and well-being at work. More information can be found at https://www.rcm.org.uk/caring-for-you-campaign

I hope this has helped, and give you a little more insight into a student midwife's perspective on midwifery resilience in obstetric emergencies.

Until next time,
Ruth x

twitter: @ruth_stmw


References
Elmir, R., Pangas, J., Dahlen, H. and Schmied, V., 2017. A meta‐ethnographic synthesis of midwives’ and nurses’ experiences of adverse labour and birth events. Journal of Clinical Nursing.


This week I received my final placement allocations for my BMidwifery course.
My map of third year.
My last year all planned out in front of me in 2/3/4/7 week blocks.

Honestly moving into third year and practising independently is daunting. I remember first opening my placement book and looking at all of the competencies I needed signed off, the skills clusters I needed to pass and the grades I needed to achieve to move onto my second year.
Confidently I thought I would be fine practising supervised, and even sometimes supported, but independently definitely brings the nerves of applying right back to me.

My tutors and mentors were not lying when they said to all of us at the beginning of the course that the three years passes quickly. I can't believe in a short number of weeks I will be introducing myself to new first year cohort as a third year midwifery student.

My last two years have been wonderful. Yes, I have had times when I thought the job might be a bit too emotionally tiring for me, especially with my depression and anxiety, but overall every single placement has made me grow in confidence and made me recognise how much passion I have for midwifery and learning.

As I mentioned in one of my tweets I have grown to have a passion for certain areas of midwifery care and I definitely feel my third year will be used to develop these passions amongst new student midwives, the midwife community in my trust and the amazing midwifery community I have found on twitter. I am getting myself involved in more midwifery community events, chats and conferences. I plan to develop and build the student midwifery society at my university (@RGUMidSoc) and practice as independently as possible. Keep proving to myself everyday that I deserve this positive change in my career.

Making the decision to do midwifery wasn't difficult and honestly neither was the process. The challenges I've faced have all been around believing in myself and my skills to make decisions at the right time and speaking up in the right situations.

Bring on third year and the end of my training / beginning of my new career.

Ruth

twitter: @ruth_stmw


The final episode of the three part documentary on Scottish rural midwifery finished this week and it was another great episode. We were introduced to another three mothers to be and their wants and wishes for their birth and feelings about midwifery care they received throughout pregnancy.

As in my two previous posts my reviews usually focus on the three stories and the key points I take from them as a student midwife studying in Scotland.

First I'd like to talk about Sian's journey to an induction and long (in regards to time) birth process. Induction is always one of those things talked about quite lightly and for some women seen as a normal process to give birth. In my experience inducing labour should not be promoted unless for some medical reason, as shown here. The mother's Graves disease increased the challenges of pregnancy and birth on her body and on the baby and it was important that this was monitored and a plan put into place. By discussing this with the woman it can include them in the discussion and ensure they still have a feeling of control and empowerment when it comes to birth planning.
Inductions can take a long time. Inductions can be unsuccessful (I hate the term 'failed induction' - like it was someones fault!). As shown by the show once a induction is termed favourable, an artificial rupture of the membranes (ARM) can be undertaken. I though the explanation to the women about all procedures undertaken during the show were excellent. Communication is paramount when any type of intervention is undertaken in a woman's labour. The use of the hormone drip, and FSE were explained and overall the introduction of the medical staff to assist the birth was all explained to mum and undertaken in good time.

In my experience the process of induction can be controversial, but I'll save that for another blog post, or twitter chat!

Meeting Carrie and her experiences with Morven as a midwife was an absolute delight also. Not being able to feel contractions was certainly a new situation I haven't heard of. I've heard of people labouring in their back or sides, or only feeling contractions in latter stages of labour, but not feeling any contractions and dilating also silently was new to me! Absolutely the right path of care was again undertaken for Carrie, extra precautions when she felt tightenings and referral to the CLU was important due again to her remote locality. In the end her labour progressed well, again after an ARM, and baby girl was born quickly thereafter. I have experienced quick labours myself undertaking an ARM at 6cm dilation only to have the baby born 2 minutes later. Second time mums who have experience of quick first births will be monitored closely after ARM as it usually isn't too long until baby arrives.

Finally to Claire and her homebirth transfer. I felt inspired by every point of her story. Being supported to have the homebirth she requested after feeling a loss of control after her first birth was empowering. The care undertaken by her midwife Hazel was also empowering. Hazel's explanation of the homebirth kit, inducing labour naturally and cervical sweep was fantastic. The communication between midwife and mother was informative, honest and individualised.
My only annoyance was the use of language by the narration when discussing mum's choices. 'Risk' of homebirth could have been 'challenges' of homebirth. The homebirth being 'judged as dangerous' and so transferred could have been put that 'Claire needed further medical intervention'. It didn't help paint a positive light of homebirth. It also showed the reality that labour can be a long and tiring process and that transfer for pain relief is also sometimes needed.
Nevertheless the decision to transfer to hospital was 100% correct, especially after the diagnosis of a shoulder dystocia at the birth. Although this can be managed at home, in my opinion, it is best to be in a place with the resources to hand should the situation grow critical and intervention be needed. I am glad Hazel made the call and that Claire, after labouring brilliantly at home, was in the right place at the right time.

Birth is unpredictable and it just shows that every mother to be needs individualised care based on their preferences, previous experiences, underlying medical conditions and family requests.

The show has put Highland midwifery in a wonderful light. Shown the reality of rural midwifery and the challenges faced day to day by midwives in Scotland.
I hope it returns for another series and I hope you've enjoyed my little comments!

Until next time,
Ruth

twitter:@ruth_stmw
#TheHighlandMidwife
#GetYourTweetOn




Sorry for the delay in posting this blog, but I've been on a run of shifts on placement, not to mention living my non-student midwife life!

I finally managed to catch up with The Highland Midwife before my last night shift and I have to say it was another fantastic, moving and educational episode.

This weeks episode focused on a lovely couple keen to have a large family (6! I can't even imagine 1 at the moment!), a woman having her third c-section and another woman having a rainbow baby.
This week really brought the tears out again as I listened to how the women felt their midwives impacted upon their pregnancy and maternity care.

Local midwives really are important, which was highlighted by Morven (who is slowly become a bit of an idol to me) 'bumping into' Mum Karen in a car park who was complaining of constant headache and visual disturbances. A quick check of her blood pressure and she was on the list for a visit the next day, which uncovered her blood pressure was still high, causing a trip to the hospital, induction for pre-eclampsia and a baby!

Midwife Morven with Mum Karen and Rainbow baby Katy
(Channel 5)

This episode also made me shed a tear. This year in labour ward I have been exposed to more obstetric emergencies and difficult situations. Listening to Mum Karen discuss her son who died due to Edwards Syndrome struck a nerve. It made me grateful for my experiences and my role as a midwife with families. Listening to the family discuss their upcoming rainbow baby was beautiful. You can really see how the relationship between midwife and mother is so important when looking at previous obstetric history. the care provided and the understanding the midwife had for the mothers worries really made the care individualised.
I really think looking at all women's influencing factors such as, social, physical, emotional health can help provide tailored care for her. Which, as shown, is appreciated.

Gone are the days when people in the village or town knew who the local midwife was.
Nowadays people tend to use the internet to diagnose themselves or think they'll be fine, but it just shows how important it is to contact the midwife if symptoms outwith the normal pregnancy symptoms occur. Even over excessive sickness can require a trip to hospital.

Talking about trips to hospital, yet again I find myself frustrated that these women have to travel 3+ hours to get to their 'local' tertiary unit. The woman who travelled to have her c-section then had a 3 hour journey home with her newborn and after surgery.

I was pleased that the show didn't hide the fact that having multiple c-sections does not come with consequences. Unfortunately the uterus and abdominal muscles are affected each time and repeat c-sections are not recommended, yet we often see indication for cesarean section as being previous c-section. This has made me want to research reasons surrounding repeat c-sections and VBAC (vaginal birth after cesarean).

Finally, the show showed a beautiful Midwife-Led Unit waterbirth. Seeing the beautiful labour of this woman made me appreciate what we get to witness and be a part of everyday. I was also really happy to see water being promoted as a pain relief as this was all the woman used. A lot of women wish for a pool birth and due to one thing or another this doesn't always happen, but it was lovely to see facilities at midwife led units being used, and promoting waterbirth.


Can't wait for next week, bit sad that it's only a three part series and the next one is the finale!
Again would recommend highly to anyone interested in seeing Scottish midwifery and rural midwifery.


Until next time,
Ruth

twitter: @ruth_stmw
#GetYourTweetOn

I use reflection daily. Whether I am at clinical placement, classes, or in my everyday life.
It helps you analyse, recharge and readjust to positive and negative experiences.

Reflecting on clinical practice is now a part of the NMC Revalidation for Nurses and Midwives - to help them continue their professional development and lifelong learning.
But reflecting as a student is much more valuable. It can help students to adjust to placement cultures, atmospheres and staff. It can realign beliefs and thoughts regarding models of care. It can even pin point areas of research that need further study, or areas of interest.

Tools
Reflecting using a model is the best structure to start with. Gibbs (1988) Reflective cycle is the most common, however I tend to use the much simpler Rolfe et al's 3 question model (2011) to structure my personal, non academic reflections; What? So what? Now what?
It can be that simple.

The 'What?' is merely an explanation, in your own words of the day/situation's events
'So what?' is how this made you feel, why do you think it made you feel that way and why was that important?
'Now what?' How has this impacted upon you as a person/student/midwife?

More recently we undertook an assignment asking use to write a reflection - for that I used MacDonalds model of reflection (2014).  There are plenty of books to help with choosing the right model for you when reflecting.

Tips
Reflect as soon as possible after the event - use a diary, notebook or your phone to make notes. I sometimes record myself explaining the situation to better understand it.

One of my favourite student midwife blogs by Alison Brindle (alisonbrindle.wordpress.com) uses poetry to reflect on different situations along with blog posts. Check it out and other student midwife blogs to help with exploring reflecting styles.

My way of learning is enhanced by de-briefing. This is where the 'So what?' comes into it. 'Why do I feel the way I do?' and 'Why were decisions made?' are often the two questions I ask myself. If you find it hard to reflect writing down feelings is a good place to start.

Write down single words to express your feelings. Doubt, confidence, encouragement- explore why you feel this later on.

Use voice recording apps to describe the situation you're reflecting. Later on when transcribing you can reflect on how your voice sounded, the impact upon this. What you might do differently next time.

Frame reflections in question format. Use these to start conversations with mentors or other students and gain different knowledge and experience on situations you may be unsure of how to act in.

It's important to reflect on both the good and the bad. Counter balance. Remember that change can happen and by reflecting can pin point areas YOU can influence change.

Use twitter to engage with other students and midwives. #GetYourTweetOn.
(@RCM_SMF Campaign)



What are your tips for reflecting? How often do you use reflection? Share some experiences below in the comments or on twitter with #studentreflectiontips

Thanks,

Ruth x

twitter: @ruth_stmw
#GetYourTweetOn




I'm taking a little diversion away from the midwifery stuff to let you all know I. AM. A. FEMINIST.
I've never ever seen the word as 'dirty', as 'man-hating' or even 'unequal'. I was brought up in a household where feminism was an empowering word.
My first experience with feminism was with my mother. A working mother with five children and a husband away in the military. She is strong, educated and my female idol. We always had books in the house such as 'Fat is a feminist issue' and we were encouraged to think about how we as women were going to influence the world - I am one of four girls, one of them being my identical twin sister.

Midwifery, to me, is the most feminist job a woman could possibly hold. For the purpose of this post, I'm looking at female feminist midwives, although I am aware there are plenty of fantastic male feminist midwives in the world.

For women, we have always been pigeon-holed into working in more of a 'caring' profession, and certainly midwifery can be seen as this. Unfortunately many people (read: men) have the disadvantage of not being in this amazing secret woman club of being a feminist midwife.

We empower, advocate, actively promote healthcare policies that benefit women, support the normal physiology of the female body and support women in a life changing moment of their lives. We are in an extremely powerful position.

As a feminist speaking out and advocating is a core characteristic of who we are as women in today's patriarchal society. Not just in our country and culture but across the world, as childbirth isn't limited to one group of women.

So if you've ever questioned if you are a feminist ask yourself:
Do I care about the woman I'm caring for? Especially her legal and ethical rights?
Do I as a woman, respect the decision this woman is making about HER body?
Do I understand that women across the world are still having decisions made for them by men?
Do I want to be paid the same as men doing the same job as me?
Do I want to be respected the same as a man who works in healthcare?

Then, yes. You are a feminist.

Now go put it on your twitter bio.

Further Reading on Feminism

Article:
Why Midwives should be Feminists
Walsh, D., Christianson, M. and Stewart, M., 2015. Why midwives should be feminists. MIDIRS Midwifery Digest, 25(2), pp.154-160.

Blogs:
Feminist Midwife - feministmidwife.com
Everyday Feminism - everydayfeminism.com
Adios Barbie - adiosbarbie.com
The F Word - thefword.org.uk/blog/

Books:
How to be a Woman - Caitlin Moran
Bad Feminist - Roxane Gay
We Should All Be Feminists - Chimamanda Ngozi Adichie
Men explain things to me... and other essays. - Rebeeca Solnit


Please suggest others... lets share!

Ruth x

twitter: @ruth_stmw
#GetYourTweetOn
#FeministAndMidwife



Recently I've been loving reading, whether it be fiction or non-fiction and I thought I'd share some of my favourite books involving midwifery, childbirth and strong women.
Here are some of my favourites and also what is on my summer reading list (while I'm on placement!)




1. Tales of a Midwife by Maria Anderson
I was bought this book when I received my unconditional offer to university by my best friend and it opened my eyes to training as a midwife and real life experiences of childbirth and midwifery. I absolutely loved it. It's a memoir, but inspiring for all midwives-to-be!

2. Call the Midwife by Jennifer Worth
I read the books after starting the television show. I love it. It captures real life midwifery in England and how it developed over the years. Love how well the TV adaptable took the story and ran with it. A 5 star recommendation.

3.Catching Babies by Sheena Byrom
Sheena is an inspiration to me. I didn't read this one until I was a year into my training and I'd already devoured ROAR! a few times. Reading about Sheena's life training as a nurse and then midwife was inspiring. Follow her on twitter @sagefemmeSB and @byromandbyrom and her website with her midwife daughter, Anna at byromandbyrom.com

4. The Handmaids Tale - Margaret Atwood
If you have been watching this on C4, then the book (which obviously came first) is also amazing. I have to admit I had not read this before becoming a student midwife, but now with the world being what it is (read: USA politics) this is far too close to comfort. 

5. The book of the Unnamed Midwife by Meg Elison
This is on my to read amazon wishlist. I've heard great things about it. Here is the blurb: In the wake of a fever that decimated the earth’s population—killing women and children and making childbirth deadly for the mother and infant—the midwife must pick her way through the bones of the world she once knew to find her place in this dangerous new one. Sounds epic!

6. The Power by Naomi Alderman (Winner of Baileys Women's Prize for Fiction 2017)
This is a strong feminist novel. I'm just starting it. Women rule the world and can inflict pain at the flick of a finger - men find they've lost control. How does a women-controlled world function? I can't wait to find out.

7. Small Great Things by Jodi Picoult
Another book on my summer reading list - a story focusing on a newborn baby who dies after a routine hospital procedure. Its about prejudice and power in American society. (Soon to be a movie starring Viola Davis and Julia Roberts!) Non-fiction but poignant looking at roles and responsibilities of midwives in society.

So those are a few of my summer reads and favourite books. Would you add any?

 Ruth x

twitter: @ruth_stmw
#GetYourTweetOn 




Channel 5 have a new mini documentary series on midwifery and the first episode aired this Wednesday 5th July at 8pm. It is call 'The Highland Midwife' and follows a group of community and continuity of care midwives in rural Scotland.

On the show we meet midwives, mothers and families going through the last few weeks of pregnancy and labour and birth. Each woman discusses her past history and relationship with the midwife.
Honestly, it made me very teary. It was fantastic for the media to show this honest portray of the midwife-mother relationship in communities in Scotland.

Midwife Morven Fioretti from Channel 5's 'The Highland Midwife' 

A few things I noticed during the episode and wanted to discuss will make up this blog post but if you haven't already seen the show I would highly recommend it. It can be found on my5.tv catch up and the next episode airs next Wednesday 12th July at 8pm on channel 5.

Continuity of Carer - What an absolutely fantastic way to introduce to mothers the standard of maternity care that Scotland is working towards. One of the main topics of the maternity review 'The Best Start' by the Scottish Government (2017) outlines the move towards case-loading midwives and continuity of carer. You can just see how this makes a different to each of the women. How they discuss the midwives as being parts of their family, how the woman having a cesarean section is missing the support of her antenatal midwife and  the trust the women have in the midwife when they are referred to hospital for review.
It is inspiring as a student to see this practice when sometimes you are faced with the reality of hospital midwifery as the only experience of midwifery in your city/town. Rural midwifery is different. The passion of midwifery shines through these midwives as they discuss the job and their role in these families lives. Still getting excited seeing a baby be born after 20 years of being a midwife? Incredible, and I hope that's how I'll feel in 20 years time.

Reality of limits of Rural Midwifery - This show does not gloss over the reality that sometimes birth at a midwife-led unit isn't possible and also the restrictions that living in a rural area can have on maternity services. For me this makes the best argument for having highly resourced midwifery-led units in rural communities to bring the services to the women, rather than have them drive 4 hours to have a midwife-led 'low risk' (yes I hate the term 'risk' but it fits here) birth.

Breech birth - I hope this show raises questions regarding why we go straight to cesarean section for breech birth, and honestly I think it should be questioned in this day and age. Lack of skilled breech birth attendants and resources is the only thing holding these women back from having vaginal birth - something which hopefully will be focused upon as maternity services head back to midwifery care but who knows. The power of the Hannah Report (2000) still seems to control breech birth. We need to start a conversation to change it.

Breastfeeding - SO MUCH ACTUAL BREASTFEEDING ON SCREEN. Yes I know all caps can seem like I'm shouting and believe me I almost did - with enthusiasm! Seeing mothers putting baby to breast soon after birth was beautiful not to mention the uninterrupted...

Skin to skin - Passing the baby straight to the mothers chest, initiating bonding and feeding and showing this as the norm is encouraging. Babies covered in vernex and blood and being cuddled by their mothers was an honest representation of birth. As a student I was so happy to see actual reality being shown on screen. But can I also mention the skin to skin after c-section?! Absolutely thrilled and I hope this opens up mothers minds to having uninterrupted skin to skin even if a c-section is planned.

Language - The praise for the midwives was wonderful but to see midwives praising the mothers during birth made me realise how important the power of words can be. I'm not sure if everyone picked up on it, but even the narration (Pam Ferris!) even said the mother had 'given birth' after the c-section. So important to use that language to empower the mother and family.

To me, this show was inspiring and although I know I am not working as a registered midwife just yet, I hope my passion for positive birth representation in the media doesn't make me sound naive.
I have a passion for midwifery, and I with application numbers dwindling I think we need to hold onto midwives with that passion with both hands to show women how maternity services should be.
And hopefully inspire a whole lot of future midwives too.

Leave me some comments below - I'd love to know your take on the tv show.

Ruth x

twitter: @ruth_stmw

Scottish Governments 'The Best Start' Maternity review can be found here: http://www.gov.scot/Publications/2017/01/3303 or by clicking link in paragraph above.

I have just recently started my final second year placement, which WOW is a slightly scary thought.
I remember starting the course and the other students and tutors mentioning how quickly the three years goes and I have to agree!
Placement really is my favourite thing about the course. The time spent in clinical practice is invaluable and I try to be as organised as I can during my placement blocks.

This block is seven weeks long and I'm spending it in one ward area. Before each placement I like to prepare a few bits and bobs to ensure I'm not over-stressed as well as tired during my placement weeks.

First thing I do as soon as possible is find out my shifts. Even if it's just the first week I like to be able to plan out when I'll be at the maternity hospital and what my shift pattern is. This week I have done 3 night shifts, and I was lucky to have been given 6 out of 7 weeks of shifts before I started so I have been super proactive.

I recently asked on twitter (@ruth_stmw) about shift / calendar apps for storing shifts. I used my iCal on my iPhone SE usually but I find having an actual diary so satisfying as I can tick off each shift, like a to do list! (I love lists!) I've not yet found one I really like without spending money but I'll maybe do a little tech post another time.

Other little organisational tasks I do include:
Ironing my uniforms - important to make an impression and to have this done way in advance.
Plan my meals according to my shifts - I usually eat less on night shift but I like to snack so I make sure I have food shop done the week before. Also meal prep is a life saver.
Buy black pens - I know many students / midwives joke, but really a good black pen is a life saver. I can't use pens with lids, I like to click down the nib so I buy a pack of the ones I like so I always have two on me, and two in my bag - just in case.
Find my hospital ID / Fob watch - I don't know if it's just me but I am ALWAYS misplacing my hospital ID and fob watch. This year I bought a cute box pencil case for 39p from home bargains to keep these in (along with my pens) so I know where they are in my bag, and I'm not hurriedly delving to the bottom of my bag just before handover.
Invest in a good mascara - I don't wear a lot of makeup on shift, foundation, eyebrows, powder, mascara, but the latter has to be good! Waterproof and smudge proof, so you can't tell I have a wee tear every time I see a baby born.
Pack my bag - I need it done before my first shift so why not now?
Write little reminders in the back of my placement notebook - I take a new little notebook for each placement and I write reminders in the back; medicine dosages, timings for observations, sepsis 6, obstetric emergency manoeuvres - so I can revise on down time.
My objectives for the placement - even just bullet pointed in my notebook. I like to know the numbers / skills I'd like to experience on placement. Sometimes knowing and asking can lead to you experiencing some amazing things - like the time I spent in scanning and I got to tell a woman and her partner they were expecting twins.


Any advice from current midwives for what they like student's to have prepared before hand? Or advice from other student midwives?
Or even now, topics you'd like to hear from me on?

Ruth x

twitter: @ruth_stmw
So now you know a little bit about my journey to midwifery, here is how I was inspired to apply for my course. Hope you enjoy!

I sometimes feel a little shame when I talk about how the Channel 4 TV show 'One Born Every Minute' encouraged me to begin my midwifery application.
But this was my only source of midwifery care that was readily available for most lay people.
Multiple Facebook statuses later about how I wished I could 'quit my job and become a midwife' followed by family and friends commenting how they thought I'd be great at it (again, their reality of midwifery care being OBEM) and I began researching courses in Scotland.

I now know that seeing midwifery in the media for the lay person can be empowering for future midwifery students. Yes, the reality portrayed on the show is not real. Yes, it is not a true reflection of working and training of a midwife BUT! the stories told by the women and families, the ability to be compassionate, the interest in the anatomy and physiology of labouring women DOES inspire future midwives to seek midwifery as a career, myself included.

Before applying I joined a well known chat site for potential student midwives, and even met girls on my course on there. I found the information invaluable, and daunting.

Honestly, I had no idea what 'holistic' care was, why people talking about a 'fundus' and not to mention where the hell was I going to get work experience with a full-time managerial job?
After a mad google search I decided my best bet to get started was to buy an anatomy and physiology textbook for midwives (this one from amazon) and to log into as many midwifery groups on Facebook and twitter that I could (I'll be doing a separate post on these).

One thing I knew would make or break it was my UCAS personal statement, and one bit of advice I pass onto those who wish to apply is; if you are applying for a Midwifery degree, talk a lot about midwifery in your personal statement, about how YOU have a passion for the profession.

My added bonus was my previous degree and job which meant I was offered an unconditional place at my chosen university first time round (after an interview), but I understand for some it can take a few attempts to get accepted. I didn't get into the other two universities I applied too (I limited myself to the three in Scotland) but I made sure I discussed my skills in relation to midwifery in the interview I was asked to attend.

An interview can be daunting no matter what it is for, and I found I felt very nervous before hand, even though my previous job had me interviewing others. I just hadn't sat on the other side of the table in a while. I knew above all else, I had to be myself. I really thought about why I was there, and what skills I already had to bring to the profession. This is a good starting point for those who have an interview ahead - how do you already fit the 'job' criteria? And focus on that.
For example:
Team work
Communication
Working in busy environments
Coping with stress
Asking for help
Thirst for knowledge
Ability to adapt and change

Hopefully some people will recognise these characteristics in themselves and realise work experience is not always how people get university places. Experience is invaluable and try to get this if you can, whether it be shadowing a midwife or working part time in a service profession e.g. care home.
I adapted my full time job to show how I can be versatile and use these skills in healthcare context, experience doesn't have to be in maternity services.

I think I've waffled on enough for today's post. Please ask questions and comment below, I love feedback!

Until next time,

Ruth x

twitter: @ruth_stmw
#GetYourTweetOn
Hello! I best start with a little introduction. I'm Ruth, a student midwife and a feminist. To me the two are synonymous and you can't be one without the other, which is why I've named my blog Sagefeminist. 'Sagefemme' being the french for midwife or 'wise/with woman' and a play on words with femme/feminist.
I like to think I have a little literary creativity in me. You can decide.

Right now I've just passed my 30th birthday and I'm in my second year training as a student midwife. But my story didn't begin two years ago.
Aged 16 I was asked to decide what I wanted to do as a career. Imagine that, just about working out who I am as a person and I have to start deciding WHAT I will label my 'job self' as well. I chose midwifery - at 16. It influenced my A-level decisions and I started my journey planning to study midwifery at university.
Sixth form college is never what people except and I changed some courses and didn't do well enough in others. One being my Biology A-level (which I eventually passed with a C). My tutor discussed with me that she didn't think midwifery would be a good fit for me and maybe I should look at a more structured university course. I was persuaded and in my second year of sixth form college my application for UCAS went in for a Marketing degree. Polar opposites.

I graduated the University of Stirling with a 2:1 BA (Hons) in Marketing in 2009 and promptly went to into management in service industry. I felt uncomfortable. I didn't enjoy my job. I didn't enjoy the profit focused aim of the business. However, I didn't know any midwives, only the birth stories I'd heard were from my mother and older sisters.
I always believed that I would return to University to study again, originally I was focused on women's studies but eventually my passion for midwifery couldn't be hidden. Inspired my my Father, who changed careers to Para-medicine when he left the Royal Marines, my Mother who did her MSc the year before I began my midwifery course, and my Nanny who did went and studied women's studies in her 60s. I guess changing careers is a familial trait!

Luckily, the universe answered my thoughts and I won some money in a TV prize draw (who knew people actually win those!), so I left my job and applied to study Midwifery at the age of 28.

I haven't looked back.

I've moved cities, found out who my real friends are, moved flat for the first time in 10 years and redirected my skills towards a more caring, supportive and fulfilling career.

So that's where my journey started. I'll be sharing reflective pieces, comments on articles/news pieces/inspirational posts and general feminist and midwifery chit chat as I cover the last placement of my second year into my third and and final year as a future midwife.


I hope you enjoy.

Ruth x

twitter: @ruth_stmw
#GetYourTweetOn

((Disclaimer: All opinions are my own and I will be respecting NMC social media policies on confidentiality at all times. If you have specific comments I cannot respond to due to this, please respect that this is why. Thank you))

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About

Ruth. 33. English girl in Scotland.

BMidwifery with Distinction - September 2018

Robert Gordon University, Aberdeen, Scotland.

Previous degree 2:1 BA (Hons) Marketing 2009 at University of Stirling.

Interests include: coffee shop trips, reading fiction, true crime podcasts, social media, blogging and walking.


@Ruth_Midwife

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