SageFeminist

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

Home Archive for September 2017


The beginning of a new semester or module has always been a particular challenge for me. Starting something brand new. Re-organising notes, getting in a new routine and dusting off the cobwebs of my brain since being on annual leave.
This week is my first week of teaching after introductions to my third year modules. I'm to choose an essay and report topic, start reading for my essay and begin planning my accommodation for my placement in November/December.
Phew.
Not to mention my twin sister is getting married in England in 11 days and I'm her Maid of Honour!

At 22 I was diagnosed with depression and anxiety disorders which have fluctuated my mood over the last 8 years, but which, I say with trepidation, are now stable. I am very open about my depression and anxiety as I feel there is too much stigma attached to young women and men who experience it. Especially university students.

Breaking down the stigma of getting stressed, being diagnosed with depression or anxiety can actually help people get the support they/you need.

I've thrown together a little self care info-graphic that I'd love student midwives to download and keep on them when they feel like they've run out of options or don't know where to start.

It can be found in my info-graphics tab and includes:


  • Keeping track of your sleep - using an app or diary. Getting the right amount of sleep is vital to brain and body health.
  • Eating well, at the right times of day - no carb loading at night, no coffee at 9pm! :/
  • Mindfulness / meditation - again phone apps are great for these, also using the moments before you sleep to clear your mind and relax.
  • Reflection - can release thoughts and feelings from your day, help you work through experiences.
  • Not criticising yourself - it's okay to feel how you do. And if you want to watch Netflix instead, do it. You need to work when you feel productive. Promise yourself you'll wake up earlier the next day and start fresh.
  • Accepting your mood and working to the best of your ability - don't overload yourself with tasks and responsibilities. Say NO, it's OK to change your mind if you don't want to go to that party, meet up or dinner.

I hope this helps.
I've found my practising a few things on the list I can help centre myself, accept my feelings, validate them, and work to the best of my ability.
Even if that means incorporating naps into my schedule!

Ruth x
twitter: @ruth_stmw
Not all feedback is positive. 
Some can cause you to get that tight knot in your stomach and make you feel ashamed as embarrassed. 

Criticism/ Feedback can be mean. Especially when it comes out of the blue, or is assuming something about you as a person. Sometimes it makes us want to stop what we are doing and pack the whole thing in. It can be demotivating and dis-empowering. 

Managing criticism is difficult. 
It needs to be given in a supportive manner and take in with a open mind. 
Especially if it is from a peer or mentor. 

Tips to help include:
Asking why the criticism or feedback was given.
Ask to discuss it later when you have thought it through.
Asking for constructive feedback or criticism to give you ideas for approaching the task again.

Overall try not to take it to heart. 
We are all learning, everyday, brand new things. 

Ruth
twitter:@ruth_stmw




If you receive the wonderful Sunday Summaries email newsletter from Byrom & Byrom you will know that this weeks theme is Sepsis awareness month which falls each September.




A few days ago I created a info-graphic for student midwives to help remember the Sepsis 6 framework in order to diagnose and treat the signs and symptoms of Sepsis.

Maternal Sepsis affects women in the antenatal, intrapartum and postnatal period.
Sepsis 6 is a tool most commonly used during intrapartum care.

After a lecture at University I now use the easy memory technique of thinking 'give 3, take 3'.

As always documentation of times need to be correct. If Sepsis is suspected then the Sepsis 6 protocol needs to be initiated within an hour.

Info-graphic is available under 'Infographic' page on the right hand side of my blog.
Please use and share.

Ruth
twitter:ruth_stmw
On the 12th September 2017, the RCM introduced into the Parliament a series of short films and images related to the illegal practice of FGM, or Female Genital Mutilation. This is being put forward to help highlight misconceptions about FGM and the UK, cultural practices and awareness of the consequences of FGM.

My first experience with FGM was at a Midwifery conference held by my University the year before I started studying there. I had accepted my place and was keen to visit, so attended their student run International Day of the Midwife conference. There during the second half of the day was a lecture on FGM.
This was the first time I had seen first hand images of FGM. The first time I had really connected the practice with Midwifery. However it was not going to be the last time I heard about it, or encountered it.



In July 2017 new statistics showed that there had been 5391 new cases of FGM in England alone.
112 of these were Women and Girls born in the UK, and of then 57 procedures we actually performed in the UK. 
The RCM remain concerned that there is a lack of access to FGM community support, lack of resources and lack of education by health professionals surrounding FGM.

As a future midwife I am not as naive to think that I may not one day met a woman or girl who has suffered FGM. In fact my plan is to mentally and educationally prepare for that day.

FGM, also known as female cutting or female circumcision is usually performed by a traditional cutting practitioner usually a family member, with a blade. Usually a razor blade.
It is conducted from birth, to puberty and beyond and is prevalent in countries in Africa, Asia and the Middle East.
FGM is culturally practised to ensure a woman or girls maintain their 'innocence' or 'purity' in an attempt to control their sexuality. Many families see it as an honour, with fear that if their daughter is not 'cut' she will be socially excluded.

Call The Midwife, the BBC drama about Midwives in 1960s portrayed FGM in their last season. The woman was pregnant and had been circumcised and then sewn, also known infibulation. This is where the vulva are joined and sometimes a small hole is left for urine or menstrual fluid to leak and for sexual penetration but no visible vaginal opening. The show portrayed sensitively the cultural aspect of FGM in the 1960s and also the difficulties and health problems that it causes women. Not just pregnant women.
Please watch it if you haven't and are more interested in FGM. (I am aware this is a dramatisation but it was a great source of awareness of FGM).

Since 1970s it has been of great effort to try and persuade practitioners to stop performing FGM. Many countries made it illegal, but rules were not enforced. In countries like the UK - women and girls are flown back to countries where the practice is not illegal to have the procedure.

The procedure, as mentioned is performed by non-medical practitioner, often using the same blade for many girls. Infections and sometimes urinary issues arose, haematoma and considerable pain for the women and girls.

In regards to women's rights, it was only in 1993 that the United Nations added FGM to the Deceleration on the Elimination of Violence to Women. In 2003 it joined and sponsored the International Day of Zero Tolerance for Female Genital Mutilation. 
But how and why did we wait so long?

Practising of FGM has been known since the 1960/70s yet organisations such as the UN have not declared zero tolerance to FGM until 1990s.

Perhaps because FGM was not seen as prevalent in UK or Western society that many healthcare practitioners and organisations felt it was not an issue to deal with. Perhaps it is just another case of female health being ignored for other health matters. (My own Opinion)

I have read a few pieces on the opposition of making FGM illegal on the basis of cultural significance, potential social exclusion, women's choice and hygiene. 
In one article a pro-FGM supporter noted that female circumcision is carried out to avoid bacteria and clitoral adhesion occurring due to having extra labia and not being able to clean themselves properly. 

I will one hundred percent admit that as a white woman in a western society this does not make sense to me, but perhaps through traditions women are taught to see circumcision as beautiful and 'clean'. 
Perhaps also however, we should also be focusing on hygiene education in these countries. 
In the UK I cannot see the same issue arising except for social cultural acceptance.
This particular author also noted how the term 'mutilation' is offensive and demeaning. But surely having to have parts of your genitals cut with a razor blade with no pain relief is more demeaning to that woman than not allowing herself to have the right to choose.

As a feminist and future midwife I am encouraged to educate, bring awareness to and #EndFGM

Follow the RCM's Campaign on Facebook and Twitter - if tweeting use hashtag #EndFGM

Ruth x
twitter: @ruth_stmw




As the news has broken that the Duchess of Cambridge (or the Countess of Strathearn as she is known in Scotland) is pregnant with her third child she is yet again being treated for Hyperemesis Gravidarum (HG).

As noted in the news, they often refer to HG as 'extreme morning sickness' however it is far more complicated than that. As a student midwife you learn about HG in your pregnancy complications classes - so not exactly classed as a usual side effect of pregnancy.

So what is Hyperemesis Gravidarum or HG. HG is diagnosed by ruling out other pregnancy related complications such as UTI's or increased thyroid levels.

Signs and symptoms often include:
Vomiting more than 3x a day, all day
Nausea
Fainting
Weight loss +5% of body weight
Ketoneuria
Dehydration
Reduction in Vitamin B1, B6, B12 levels

Reasons are often unknown but women are at a higher risk if they have experienced HG in a previous pregnancy, have a family history of HG, are obese, it is their first baby or they are carrying twins or triplets.

HG is usually treated by dietary control - eating bland foods and drinking electrolyte replacement drinks such as Lucozade sport.
Many women however will need hospitalisation, with a IV Fluid regime and anti-emetics.

HG is not just 'extreme morning sickness' - for a start HG occurs all day, throughout the entire pregnancy. HG can be debilitating, reducing woman's energy levels by affecting how much she consumes for fear of vomiting and can effect mood. Time off work should be sort by women suffering from HG to help maintain healthy energy levels for the mother and baby.
HG affects between 0.3-2% of pregnant women.

The effects on the fetus for women with HG can be increased risk of low birth weight, and small for gestational age baby and potential to be born before 37 weeks gestation.

So if you have a mother coming to you antenatally complaining of continued sickness and feeling faint, has a small or low diet and ketones in her urine - guidelines state she should be managed in the community with anti-emetics first before admission to hospital for monitoring and an IV fluid regime (RCOG 2016)

And don't believe the old wives tale that 'morning sickness is a good sign' and 'it means you're having a boy!'.
Hopefully with the media attraction to Kate Middleton more information on HG will be widespread in the community and women suffering from HG can seek advice and support.

Here are some support lines:
1. Call your midwife!
2. Pregnancy Sickness Support 
3. NHS Choices - HG


How much have you read on complications on pregnancy? Or have you met anyone with HG?
Tweet me @ruth_stmw

Ruth x

Infographics to go with blog can be found at http://sagefeminist.blogspot.co.uk/p/infographics-from-blogposts.html

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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.


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