I (Sheena) was recently speaking to a head of midwifery from a local maternity unit, and she happened to mention ‘an inspirational student midwife’ who was positively influencing practice. It was Ali, Ali Brindle – featured in this post. I asked Ali if she would tell me what she was doing to receive such praise, so that we could SHINE THE LIGHT ON her, quite rightly! Thank you Ali – your passion, dedication and humanity really makes a difference. I am so so proud of what you are doing in Lancashire, that will hopefully influence the world. I hope we can help you! Sheena and Anna
Ali told us:
One of the unique things about being a student midwife, is the ability to view practice from an outside perspective. We can question ‘why?’ and ‘how come?’ with explorative expression and the innocence of the inquisitive mind. It is this which gives my position of being the student a sense of power, as my questioning of why things are done a certain way is not seen as being confrontational or undermining or to anyone.
During my first year as a student midwife, the questioning of things I saw or witnessed usually stayed within my mind, as having the courage to speak up was not something I felt comfortable with. However, going through second year, I found the courage to question and the passion to want to find better ways to improve maternity services for women, babies and families.
Earlier this year, while undertaking a placement on delivery suite I was caring for a woman in labour. Everything was fine except she spiked a temperature over 38 degrees which initiated the septic pathway for her and her baby. Nothing unusual, as I have cared for lots of women and babies where this was needed, both on delivery suite and on the postnatal ward. As usual, the doctor was called to come and cannulate the woman for IV antibiotics, and the neonatal doctors alerted to prepare for cannulation of the baby. Having done this so many times without question, it was the woman’s angst at having her newborn removed from her for this which sparked my inquisitive mind. It is usually normal practice within many maternity services to take babies to the neonatal unit (NNU) for the cannulation procedure, and administration of the first dose of antibiotics, which can take anything up to 2 hours. It was at this moment that I questioned why the cannulation of the baby couldn’t be done in the room with mum. Suddenly, the practice of separating women and babies so soon after birth hit me, and remembering all the times I had taken babies from women on the postnatal ward to NNU for the same reason made me feel very uncomfortable. I began to question the whole reasoning behind why we were separating babies in this way, and not only that, I decided to do a little research into the damage caused, if any, as a result of this practice. I soon discovered the true nature of the potential harm this seemingly innocent practice could have on both mum and baby, not to mention the damaging effect it could have on the chances of establishing breastfeeding. After doing a little background reading and research, I made it my mission to raise awareness of the harm caused by this separation and to help promote togetherness of all mums and babies where ever possible.
After some thought, I could not see any reason why equipment could be set up on both the delivery suite and postnatal ward to enable neonatal cannulation to take place with mum, or at the very least facilitate the choice for mum and family to stay together during this procedure, and while I was familiar with the work of Dr Nils Bergman and the benefits of kangaroo care for premature babies, it was his work on zero separation of mums and premature babies which inspired me to campaign for the zero separation of mums and babies in my hospital. I was motivated by the realisation of the potential damage caused both physically and psychologically from the practice of separation and short term NNU admission.
#ZeroSeparation is the Twitter campaign I am using to champion changes in practice where avoidable NNU admissions take place which can be prevented with interventions and promote togetherness of mums and babies in the postnatal period. The campaign which first started with the championing #ZeroSeparation for neonatal cannulation is now being promoted at Lancashire Teaching Hospitals Trust (LTHT). I designed posters to highlight guidelines and recommendations to promote #ZeroSeparation and there is currently a display championing this on the delivery suite. I was recently excited and pleased to see the Chief Executive of the Trust, Karen Partington, with the display on a recent visit to the unit.
CEO Karen Partington
This work has now inspired me to champion and campaign for #ZeroSeparation for other situations. I am now working on expanding my campaign to include other avoidable situations where mums and babies are separated such as for treatment and prevention of transient hypoglycaemia of the newborn, especially in women with diabetes or other conditions where there is a higher risk neonatal hypoglycaemia.
Ali Brindle is a student midwife at the University of Central Lancashire.
We are delighted to be sharing with you our edited book about spirituality in and around the start of life. The chapters highlight aspects of birth we often take for granted, qualities often ignored or left silenced and questions the art of birth and the meanings ascribed. The voices you hear in this book are from international practitioners, educators and researchers as well as those of women and those who care for them and are present at the birth of a new life. Spirituality means different things to different people yet what consistently is shown is that spirituality is concerned with meaning and purpose and each chapter draws our attention to new dimensions of understanding of what it means to be human in and around childbirth. The premise of our work is that spirituality at this stage of a life span has been ignored for too long. Though discussed and raised as significant and important at the end of life, at the start it has been hidden. We are honoured that Lesley Page has written the forward for the book and recognises the significance of the content. There are many contexts that are explored throughout the chapters, ranging from straightforward births to those that are complex or challenging; from the mother to the practitioners; to the unborn and born baby. This book raises many questions and suggests some practical suggestions to take this forward. We hope that this book will provoke discussion and debate over a topic that has long been subdued. We welcome you on this journey with us and look forward to engaging further.
Today we want to Shine the Light on Dr Roa Altaweli – an inspirational midwife from Saudi Arabia. Although Roa is well known to many, we wanted to tell the rest of the world about her amazing career, her creativity and her leadership. If you want to be inspired….then read on!
‘I love being a midwife and would like others to love this profession as much as I do’.
Dr Roa Altaweli is the first midwife from Saudi Arabia to obtain a PhD. Roa was born in Jeddah, she is a registered nurse and midwife, and has worked as a midwife at National Guard Hospital in Jeddah and as a teaching assistant at Dar Al Hekma University.
Roa decided to pursue a academic career and obtained a Postgraduate Certificate in Advanced Practice of Midwifery from King’s College London and then a Masters and PhD in Midwifery at City University, London.
Roa now works as a Clinical Director of Nursing at East Jeddah Hospital, Saudi Arabia. She is. a founding Board Member and Vice-Chairperson of the Saudi Midwifery Group and a member of a Saudi Ministry of Health initiative called the Optimizing Maternal Mortality and Healthcare Advisory Team.
I hope that midwifery education in Saudi Arabia can be as strong as in the UK
Roa says. “I love being a midwife and would like others to love this profession as much as I do. My aim is to empower women to have natural childbirth in Saudi Arabia and help in the development of direct-entry midwifery courses that prepare competent, qualified midwives.”
And Roa certainly takes ’empowering women’ seriously, by keeping connected to women and childbirth.
‘Due to the limited and trusted Arabic resources about natural childbirth I created ‘Rahmah Birth’ in April 2016 to increase the awareness of natural birth, for women in Saudi Arabia and around the world. Rahmah (my mother’s name who passed away January 2014) means Mercy in English. My mother always believed in natural childbirth and gave birth at home to my older brother Khalid who passed away in November, 2016. I dedicate this work to her and my brother.
‘I saw your Dad this morning walking William in his pram‘ – a regular call to Anna, as she skids into school to collect 4 year old Betsy. It seems much of the Ribble Valley spots this Grandad, as he treads the country lanes with the boy, And William is often in the arms of his Daddy too – as Anna and I work and plan for the exciting times ahead. My, we need all the help we can get! It’s been a few weeks since we launched our site, and the beginning of our journey working together as a mother-daughter midwife team. Bringing our experience and knowledge together has been a joy, lots of fun, and the whole family has rallied round to help with childcare, chauffeuring, and cooking! It’s all coming together, and we’re delighted.
Helping others to shine…
In short, our commitment and drive is to optimise maternity care so that mothers and babies have the best start to family life. We feel we can do this by supporting those who serve childbearing women, in their daily work. We want to be a conduit to help future and current midwives to shine, to succeed in their work and careers – to fulfil dreams, whatever they may be. As midwives we’ve both had enormous opportunities to develop, and we will always be thankful for that. We remember vividly those who guided and inspired us. We have also experienced difficult times, and we equally remember individuals who made our hearts sink. We have learnt from both experiences, and these are shaping our future plans.
In the meantime, we are keen to spotlight individuals who are trying to make a difference, or who have a story to tell, to help others. Check out our previous blog posts for ‘Shining the light on’ and ‘In conversation with’ features, and if you feel you’ve want to share your work or ideas, please get in touch, we would LOVE to hear from you…..
And Anna’s #SundaySummaries have been a HUGE success. Hmmmm…..so you may be wondering what all the fuss is about, and here’s an explanation. As busy mother and daughter midwives, we’ve often been left in the dark when it comes to keeping up to date at work, on general matters relating to maternity care and midwifery. As the editor of The Practising Midwife, Anna keeps reasonably well-informed on current national and international issues, so she decided to synthesise relevant topics into snappy,, bite-sized sections, and deliver them to all subscribers of this website.
The response has been overwhelming.
‘Congrats to you both. Another very current and interesting summary update of events. Love the format that you use, current info delivered in simple yet informative format, much easier to read than a journal, and very up to date…….’
‘I just love the layout and content of your page. All I need now is a few hours to read through it all. Well done’
‘Needed to message you this week as I’ve been working nights and feel like I have been away from news and updates that I usually read . The adjustment of the body clock and finding the time to even look things up even on my beloved Twitter has escaped me this week. The opportunity to see all of the reports means I’m back in the loop!. I’m back to nights tonight and I’m planning to tell everyone about this great resource…’
Over the summer, we’ll be sharing some more exciting news with you. We’re BURSTING to tell you! We’ve been collaborating with student midwives, midwives, doulas, obstetricians, leaders and many more – so stay with us if you can!
We do like to celebrate midwife entrepreneurs. When Emma Cook got in touch to say she’d written a book, a guide for parents, we jumped at the chance to read it – and to ‘Shine the Light on’ Emma!
Emma Cook, Midwife
Emma qualified as a midwife in 1999, and has worked the majority of her career in the community, being privileged, she says, to attend many home births. In 2014, Emma won a national award for her ability to mentor student midwives (Congratulations Emma!) She has a thirteen-year-old son who features heavily in her book….
A Midwife in My Pocket: Midwife’s Heart-Warming New Book Guides Parents through Pregnancy, Birth and “New Baby” Life
This book is a 100% practical, 100% honest guide to the entire process of pregnancy and being a new parent. Based on my own experiences of motherhood, as well as my 15+ years as a midwife, the guide will help any parent prepare for the most amazing journey of their life.
‘After having a child of my own and meeting thousands of parents as a professional midwife, I was well aware that pregnancy and parenthood is fraught with many confusing questions, unknowns and anxieties. However I have learnt that information is power; and I try to offer reassuring words, allowing parents to settle back into their role and thrive with their new baby. I’ve been wanting to write a book for many years, particularly after giving birth to my own son and experiencing the struggles first-hand. My midwifery work is so rewarding, and I’m incredibly proud to now be sharing what I’ve learned with others.
I have written the book in such a way that I hope readers feel that I am chatting to them, addressing the subjects that pop into their minds between their visits to and from their own midwife. It is full of practical advice that readers can access whenever they want to. The chapters cover from the earliest part of pregnancy, through to birth, feeding, settling and enjoying their new baby. There are insights into how I felt during my pregnancy, and in the first few weeks with my new baby…. even midwives can feel vulnerable!It feels like a dream to actually have it published, and the response from colleagues and women has been really positive!’
Reviewers have said the book is:
‘Written with true warmth and dignity and there really is nothing else on the market quite like my book’.
‘This is a comprehensive and truly down-to-earth guide that walks parents through the entire process of pregnancy, birth and infant care’.
‘This book is like my pregnancy bible at the moment! There is no preaching like some pregnancy books, and doesn’t weigh you down with medical jargon! So well written, and easy to read! Thank you for making my pregnancy a whole lot easier to understand!!!!!’
Every day I meet anxious mothers whose babies are not breastfeeding properly, and they become riddled with worry. After explaining that what’s happening is completely normal, the resulting relief is immense.
I would like pregnant and new mothers (and fathers/partners) to use this book as their ‘best friend’, to read it, dip in and out of it, but most of all use it to guide them on their incredible journey.
Note from us:
Thank you Emma, for sharing a little about your fabulous book with us…we are delighted that it is so popular, and obviously a success!
We love your book. We especially like the fact that the information is to the point, not prescriptive, and very insightful. The ‘did you know’ facts and ‘top-tips’ are so useful, easy to digest and clear. It’s no wonder there’s been so many rave reviews. There are many excellent books and mobile apps (and some not so good!) for mothers, fathers and parents on the market right now, and this books is up there with the best. Congratulations Em, on using your knowledge and personal experience to help others, keep on going! Your work is greatly appreciated.
Thank you so much for being our special guest, and accepting this invitation for me to interview you for our ‘In conversation with’ series….what an honour! I was incredibly interested and excited to read about the subject you have chosen to study, as many years ago I worked as a consultant midwife, and one of my responsibilities was to support women to have the birth they wanted. I did this by working closely with women, and with midwives and obstetricians. Together we ‘pushed boundaries’ – which wasn’t easy, when ‘fear’ was (and still is) prevalent, and influenced the actions maternity care workers took on a daily basis.
So let’s here more!
I know you are studying for a Ph.D. at the moment, can you tell us about the topic have you chosen and why?
My current study centres on exploring midwives who actively choose to facilitate women’s unconventional birth choices whilst working within the NHS. By unconventional, I mean women’s choices that perhaps are outside of guidelines or where women decline recommended care. Largely, this topic has been born out of my previous Master’s research that explored why women choose to freebirth. The findings in that study demonstrated many unfortunate examples of poor midwifery care, namely around women feeling their choices were restricted and some even experienced coercive and threatening practices such as unnecessary referrals to social services. Listening to the women, whilst also being a practicing midwife with a range of experiences (good and bad), I wanted to turn my research questions around and to actively seek out the midwives who are managing to facilitate true woman-centred choice, as I know they exist! I am particularly interested in the midwives practising this way whilst facing the tensions that all maternity professionals face; busyness, poor staffing, guideline-centric care etc. I felt that by exploring the experiences of midwives’ who are managing to facilitate women’s unconventional birth choices, it can be used for other’s to learn from to benefit women’s experience of maternity services.
Are you allowed to tell me any of the preliminary findings at all?
I can tell you that recruitment was a great success! I had over 80 inquiries, and have recruited 45 midwives to the study. The midwives are from all over the UK, working in a range of roles; community, hospital, specialist roles and they also range from Band 5-Band 8. This is particularly useful going forward as all midwives working in any part of the service will benefit from the findings, as they will be relevant to a wide scope of practice. The midwives were invited to write an account and/or be interviewed so that together, we could explore practice stories of caring and facilitating women’s unconventional birth choices. This was to ascertain what the midwives do, how they do and also why they practise in that way. The birth choices women made were hugely varied such as; declining inductions, actively pursuing home birth or access to birth centres whilst with medical or obstetric conditions or declining certain observations during labour. Consistently, throughout the interviews was the importance of relationship building between the midwives and women, where open, honest conversations were central to the care planning and caregiving. It was interesting to note that some midwives worked in continuity models of care and others did not which is also useful as it helps us learn how to practice woman-centred care even when continuity is not available. As you can imagine, the scope of the findings will facilitate a wide range of knowledge generation to learn about complex midwifery practice. But for me, what has been so exciting and inspiring is hearing the commitment of the midwives’ to woman-centred care even in very unusual situations, something I think we can agree will help us move forward on the Human Rights in Childbirth agenda. That is all I can say for now, as data collection is still ongoing!
What are your personal thoughts about women choosing ‘unconventional’ births?
My personal thoughts about women making ‘unconventional’ birth decisions are that arguably many of the decisions shouldn’t be deemed ‘unconventional’ in the first place! If choice is a true choice, then it is reasonable to consider that a number of women will decline our suggestions or recommendations. Evidence suggests that women are sometimes steered into compliance which I feel is unacceptable, I firmly believe and am committed to women making their own autonomous decisions. Unfortunately, I feel a side effect of increased maternity surveillance, fear of litigation and the overuse of guidelines means that women are increasingly categorised into simplistic notions of high or low risk, which are not always helpful for either women or maternity professionals. By women pushing our ever narrowing boundaries in maternity care, they are teaching as valuable lessons in birth physiology and birth psychology.
What are your plans for the future?
What a tricky question! Well, I feel that my work is only just beginning and there will be many unanswered questions following this particular study which means continuing my research path. I am passionate about exploring ways we can learn from our colleagues to create virtuous cycles of improved midwifery practice and woman-centred care. I hope to establish some future collaborations with other midwives and researchers to drive this work and that of others forward. I endeavor to maintain clinical practice as I love working with women and their families, I just hope there are enough hours in a day!
Do you have any suggestions for related reading material or video links/websites?
I also have to mention the fabulous Birthrights, a particular source of inspiration.
And finally……If you had the power to change 3 things in maternity services, what would they be?
I would employ more staff to reduce the relentless workloads midwives face, that way they will be able to provide appropriate, timely and compassionate care to ALL women, and not be on the brink of burn out. I would introduce a no blame compensation scheme immediately, the fear of litigation has caused many unintended negative consequences. I would want midwives to have their rota’s at least three months in advance, midwives need and deserve to have a work-life balance, manage childcare and other family commitments. Valuing and looking after midwives is an essential component to improving women’s birthing experiences.
Midwife and PhD student Claire Feeley
Well Claire, I loved reading about the inspirational and courageous midwifery practice, and I feel sure there’ll be a great response to your very important study. Your findings will be particularly important as we move from statutory supervision of midwives, to the new Professional Midwifery Advocate role, as I believe ALL midwives will need encouragement and support to be true advocates for women, and to facilitate the choices they make, safely.