It’s my time for a blog post now!
I have a little rambling/reflection about continuity of care that I just wanted to share with you all…
As midwives it is so important that we are able to reflect on our actions (or inactions!) so that we are able to continually improve the quality of care that we provide to women and babies. Ange, Marnie and I often discuss our experiences over coffee – this is why we drink so much! It is important to debrief, to deeply reflect and to move forward and improve.
I recently cared for a woman in labour – this in its self is not unusual, it’s my job, I do it most days (I know I am very lucky!!) but this was no ordinary woman. This was a woman who I knew very well, I had provided care for her at The Nest during this pregnancy from very early on. The first time we had met was during her first labour many years ago. By the time she went in to labour, after many hours together during her pregnancy, I knew her well. But she also knew me!
I knew that this beautiful woman was anxious about birth and breastfeeding, I knew what books she read and what exercises she did during her pregnancy. I also knew that she wanted minimal birth intervention and that she was gaining in confidence with every pregnancy visit that we had! I knew that she loved a Cherry Ripe, that her husband was an amazingly supportive fellow and that her daughter had a dolly named Rachel!
As I mentioned earlier though, this was not a one sided relationship. This women knew me very well, she knew that I had every confidence in her and her body, that I would do everything in my power to advocate for her choices, that I had exceptional taste in T-shirts and an odd obsession with my rabbit! She knew that I would be there in whatever capacity she needed during her labour and in the long days and weeks after her baby was born.
So other than everyone knowing each other intimately, what is my point?? – my point can be found in my own personal reflection of her birth. This may be mostly of interest to other midwives, but I feel that it is important to share, becausewhen we are discussing pregnancy care, we can never over emphasise the importance of continuity on outcomes and wellness for both women and midwives.
This amazing woman went in to labour, she laboured gently at home for most of the day and came in to the hospital when she felt the time was right. I was at the door when she arrived, she laboured quietly, so quietly in fact that I was questioning if her labour was progressing! She was lying down and appeared to be sleeping, she made very little noise and needed nothing physical from me. In hindsight of course, she was in ‘labourland’ – that beautiful place that Michel Odent speaks about, the place where women need to get to to allow their primal instincts to take over from their thinking brains and allow their babies to be born.
Remember that I knew her… I knew what she wanted and didn’t want during labour, I knew what she was afraid of, allergic to and excited about. It was because of this knowledge that I did nothing (that sound’s terrible I know!), I did the important things of course, I ensured that both her and her baby were safe and well, but beyond that I watched and listened. Even as I watched her sleep and every cell in my body was questioning if her labour was progressing or stalling, even as I considered encouraging her to change positions or offering her an internal examination ‘just to check’ – I did nothing, I continued to watch, wait and listen because I knew that both her and her baby were well and that she didn’t want any of that.
Guess what?? After less than two hours of being in that room I could hear the instinctive sounds of a woman who was ready to meet her baby. Under the shower, without coaching, instruction or intervention, she birthed her baby girlpowerfully in to the waiting hands of her husband. She had done an amazing job, and by knowing her well, protecting and respecting her choices and birthing space I had done mine. What an absolute privilege continuity of care is.
The physical pain had been bad enough, but it was nothing compared to the shame, disappointment and utter uselessness I felt at not being able to breastfeed my baby. Not only had I not been able to birth her properly (I’d laboured for what felt like years only to end with a caesarean section for ‘failure to progress’ past 4cm) but I was useless enough to be bad at feeding my baby too. She was constantly crying, hungry I assumed and after a lot of soul searching, I put her on formula. No big deal, right? At least she was being fed…..?
Baby number two and, after being told that I needed another caesarean because of the first, was determined to breastfeed this one – no matter what. This baby was more obliging, (or was it because I was more comfortable?), and for the most part, fed well. The pain was tolerable but still there. When she came off looking like an infant vampire, with blood mixed with milk trickling out of the side of her mouth, she too was put on formula. I’d failed again.
The overriding reason I did not continue to breastfeed my babies was that I had little to no support. We were living in Darwin in the early nineties, far away from family and friends who may have been able to help, or at least been there with a cuppa and a shoulder to cry on when things felt they were going south. I had no idea where to go for help other than the child health nurses who, while lovely, were too busy to give the time needed to sit with me and guide me. I knew of the, then, Nursing Mothers Association (now Australian Breastfeeding Association), but no idea they had meetings, if indeed they did.
Consequently, it came as a huge revelation to me when, 14 years after the birth of my first child, sitting in a lecture hall during a midwifery lecture, that I sat, open mouthed, at presentation on breastfeeding. ‘Was THAT all I had to do?’ ‘Could it have been THAT easy?’ I cried all the way from Wagga Wagga to Bungendore at what could have been if only I had been given the right support.
I distinctly remember the moment and place I was when I was hit with an epiphany. I was driving down Smiths Gap into Bungendore and decided that no, I was not going to have another baby in my fourties to prove I could now breastfeed, but I would make it my mission to make sure no other woman felt the way I did those fourteen years ago.
So, with a lot, and I really mean heaps, of study, seminars, discussions, exams and finally lactation certification and the unwavering support of my friends, family and my fabulous Nest partners in crime, Ange & Clare, The Lactation Lounge at The Nest was born.
The Lounge is meant to be a place for women to gather and chat about all things baby, including feeding. It is not an exclusive place for breastfeeding mothers, but FEEDING mothers, with a Lactation Consultant available if needed. Although my main mission is to assist breastfeeding mothers, I totally understand the feelings that can come when deciding to formula feed your baby, as well as the need for all women to support each other, especially in those early weeks and months.
So, if you're having any trouble with, or questions about, breastfeeding or just need somewhere comfy and safe to feed your baby, HOWEVER you feed your baby, want to have a chat & meet other parents, please feel free to come in and enjoy a lovely cuppa and biscuit. The Lactation Lounge is on every Thursday morning from 10am-1pm at The Nest, 77 Campbell St Moruya. If you are not comfortable asking me about feeding in front of a group, I am more than happy to have a chat to you, in private, on the day.
Above all remember: YOU'VE GOT THIS
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