It's back! The Channel 5 docu-series following a group of Midwives from the Highlands of Scotland undertaking rural midwifery at it's best.
This season they've introduced new group of midwives working in North East of Scotland in Peterhead - which is where I had my third year community placement!

So maybe, slightly biased review coming up. Especially as I working with some of the midwives and involved in the setting up of the renovated Midwife-Led Unit.

For that reason I'm going to do a slightly shorter review of the first three episodes with a little pros and cons list.

PRO's

• It is so great to visit each of these women's unique story and see their choices and requests being discussed in an open and honest way with the midwife
• The midwife-mother relationship remains a strong theme in the series
• Midwives praising the continuity of carer they can experience
• Showing elective c-sections as a CHOICE for women and no shaming
• Outlines the geographical issues women have in the Highlands of Scotland

I'd love to hear people's views on the how as I have had positive feedback from friends of mine who have experienced maternity care in Scotland. Also, perhaps how this show compares to One Born Every Minute?

Tweet me @ruth_stmw

Ruth x

Here's a picture of me in the Peterhead birth room, Moonlight.

Since May 2018 I have been on placement at two wonderful wards in my local Maternity hospital, the same hospital I will be working at when I qualify!

I'm currently putting together two pieces on my experiences there and especially my experience working with women who have experienced miscarriage and pregnancy loss as one of my placements was on the early pregnancy ward.

I am also looking to write an updated piece on resilience in workplace as more and more I have heard this term and 'sustainability' be used to describe self care for midwives and how clinical supervision is aiming to build these traits in midwives in Scotland.

As well, last week I attended a fantastic student-led Learning Disabilities conference at my uni, Robert Gordon University - which opened my eyes and ears to the treatment and language we use when caring for women and families who have learning difficulties.
My main interest in the conference was around the discussion we have with parents undergoing screening for Down Syndrome.

Finally - the new series of The Highland Midwife is out! So you know I will be blogging away about that. I am slightly biased this time as the unit shown at Peterhead was my last community placement and I worked with Ruth (the other Ruth) at my first year placement in Fraserburgh. For those who have seen it, believe me those ambulance transfers to Aberdeen are interesting!!

Hope everyone is well, and I'll get back to blogging now I'm on a break from placement.

Follow me on twitter: @ruth_stmw

Ruth x

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

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.