Thursday 20 May 2010

BBC News - Post-natal depression in fathers 'often undiagnosed'

Modern day pressures on men have escalated in the last couple of decades as men seek to find relevance in a world that is rapidly changing their role in society and the family.

At last researchers are turning their attention to men's experiences of birth and early parenting. Researchers from the Eastern Virginia Medical School team looked at 43 studies involving 28,004 parents from 16 different countries. The countries included the UK and the US. In a news item in the BBC news, the researchers were quoted as saying:
"One in 10 new fathers may have the baby blues, US researchers believe - based on their trawl of medical literature. While this rate is lower than in new mothers, it is more than currently recognised, they told the Journal of the American Medical Association. Lack of sleep and new responsibilities, or supporting a wife with post-natal depression can be triggers, they say".
Childbearing and early parenting are stressful experiences.  New roles, new experiences and general unfamiliarity with babies provide a catalogue of changes that both women and men are having to deal with and integrate. A new reality for many along with smaller family sizes and the nuclear family phenomenon is that a vast majority of young parents have never even held a baby before they hold their own. Many men are inadequately prepared for being present at the birth of their baby and parenting.



Midwives have a real role in including fathers-to-be in their work with childbearing women. Many men feel left out and sidelined during antenatal visits and during the birth process. Feedback from women on their experiences of midwifery student follow through often contain comments about how the student included their partner. The women always say how grateful they are that their partner was included and made to feel important by the student. The fact that the women feel a need to comment on this aspect of the student's involvement in their childbearing experience indicates to me that partners are not generally included in the care given by midwives and doctors.

Midwives and other health professionals have to recognise that childbearing is an emotional experience for men too. Working with women across the continuum of childbearing is enhanced when their partners are included in the woman centred focus of the midwife. Respect, kindness, inclusion and relationship building are core attributes of midwifery practice and set the foundation for women's feelings of being well cared for and valued during their experience of maternity care. Engaging fathers in the same way obviously has implications for how men emerge from their experience of maternity care too.

John Heron (born 1928) , a wonderful man who pioneered a participatory research method called cooperative inquiry, provided (for me) the first clear understanding about the importance of emotions in human interactions and wellbeing. John Heron identified three core emotional needs:

1. To love and be loved
2. To choose and be chosen
3. To understand and be understood

Heron said when these core emotional needs were not met, people develop defense mechanisms. Defense mechanisms are often counter productive to optimal relationships; optimal interactions on both cellular and social levels and overall mental and physical health and wellbeing.

If midwives and other health practitioners make a clear goal to ensure the emotional needs of women and their partners are met in their work with them through the childbearing year and beyond, many of the ills that plague new parents may be 'headed off at the pass'.

BBC News - Post-natal depression in fathers 'often undiagnosed'

Why midwives and women have to stay upbeat about birth: The wisdom of herds: How social mood moves the world - 19 May 2010 - New Scientist

In the latest New Scientist (19th May 2010), an article by John Casti, Senior Research Scholar and a futurist (castiwien@cs.com) based at the International Institute for Applied Systems Analysis in Laxenburg, Austria who is developing early-warning indicators for extreme events in society, informs us that

"No collective human activities or actions, such as globalisation or, for that matter, trends in popular culture such as fashions in films, books or haute couture, can be understood without recognising that it is how a group or population sees the future that shapes events. Feelings, not rational calculations, are what matter. To see what our world might be like tomorrow, next year or next decade, we need to spend time and money investigating "social mood". Put simply, the mood of a group - an institution, state, continent or even the world - is how that group, as a group, feels about the future".
How would we, as a group of people who care about what happens to women and babies during the childbearing year, be described as feeling about the future?

Are we optimistic or pessimistic? "

According to John Casti, how we feel and how we see the future, does much to create it. In the Selfish Gene, British scientist, Richard Dawkins coined the word 'meme' as a concept to enable discussion about these collective social, cultural moods/orientations and behaviours as evolutionary principles in explaining the spread of ideas and cultural phenomena.

What's our meme? What do we want it to be?

Casti's essay is based on his new book Mood Matters: From rising skirt lengths to the collapse of world powers.

The wisdom of herds: How social mood moves the world - 19 May 2010 - New Scientist

Sunday 9 May 2010

Where's the Placenta in Birth Films?

The placenta is an ignored organ in birth films. 


The following film is beautiful, but the cord is cut early and there is no placenta! I can't help but wonder why.



The way the woman gives birth so calmly and consciously in this video is a delight.  I love the way the tank enables the family, the midwife and the doctor to see what is happening without interfering or interrupting the woman's 'flow'. I also love the way the woman uses her hands to birth her baby's head and how she engages with the baby when the baby's head is born.  This woman was obviously well prepared for the birth of her baby.

BUT - where is the placenta???

The birth of the placenta is missing from most videos.  The fact that the placenta is missing from birth videos sends the wrong and incomplete message about birth.  Giving birth to the placenta is the third stage of labour. The third and fourth stage of labour, during which time the woman adjusts psychologically, physiologically and spiritually to the birth of the baby, are vitally important parts of the birth process. This period is a 'peak experience' time; one where women get surges of the 'love' hormone oxytocin if the environmental conditions are optimal. These surges in oxytocin are essential for optimal psychophysiological functioning for bonding with the baby, contraction of the woman's uterus, haemostasis and the initiation of lactation. 

The placenta is an awesome organ and needs to be given due respect and acknowledgment for the mighty role it plays in the beginning of life.

Many cultures have the Tree of Life symbol which is said to be a metaphor for the placenta; artworks across millenia demonstrate this potent recognition of the placenta's role in the life of a fetus and baby.  Not only is the symbolism missing in modern life, even the placenta itself is written out of the mainstream artform - that of videos.

Ignoring or dismissing the placenta comes at a cost.  Women don't know they have a placenta to birth; if they do know, they don't know the magnificence of it. What that means is they think birth is over when the baby is born. Unfortunately, thinking birth is over sends the wrong message to the neural networks and hormonal system.  Safe birth requires conscious engagement in the process.

A key lesson of modern neuroscience is that a change in the focus of our attention changes our brain firing patterns and changes the neurochemicals associated with the firing pattern. The practical application of this lesson is that our physiology responds to our thinking. The thought that birth is over when a woman doesn't realise that the birth of the placenta requires attention, especially when the feeling of relief is profound and/or the woman is disturbed/distracted from her baby and birth process can result in a blocking of the release of oxytocin.  A drop in the level of oxytocin can  predispose the woman to excessive blood loss because her uterus doesn't get the chemical messages it needs to contract well and seal off the placental site. The attentional network that I suggest is optimal in birthing the placenta and keeping safe in third and fourth stage of labour is the attentional neural network associated with fascination. When a woman is fascinated with her baby, she is safe and her physiology works as it ought. Disrupting, distracting or in any other way interrupting the fascinating network bodes trouble. Midwives have a duty of care to ensure the birth environment is conducive to women's fascination with their babies being enhanced and potentiated; a key aspect of midwifery guardianship. .

I've written a theoretical paper, with my colleague, Professor of Midwifery, Dr Kathleen Fahy,  on midwifery guardianship in the third stage of labour. You can access the abstract here

We also conducted a cohort study which showed that women who had active management of third stage were 7-8 times more likely to experience excessive blood loss in third and fourth stages of labour than women who were well prepared and, together with their families and midwives, had a mindful approach to the birth of the placenta.

The answer is: let's talk up the placenta, make sure women know that third and fourth stages are an integral and important part of labour and include the birth of the placenta as an integral part of any film about birth.
 
On this Mother's Day,  the recognition that knowledge is power and education about the placenta is lifesaving and helping women to stay safe in childbirth is a good thing to think about!

Friday 7 May 2010

What you don't say can hurt you!

The vital importance of speaking up and saying how you feel to your health and wellbeing is demonstrated in a post by this young woman, Fiona Hollis.


You can visit Fiona’s website and read more about her journey here: http://www.iloveraw.co.uk/

The post was part of an email newsletter I found in my in-box this morning from The Raw Divas, one of my favourite health and wellness sites.

The Raw Divas are entertaining and informative and I always enjoy their take on life and food. Their articles are often enlightening and I have fun with their recipes. Their approach suits my interests and understanding because my move to a vegetarian way of life, as a result of being employed as a nurse in an abattoir in the early 70's, has lead to an increasing interest in the power of food, especially raw food, to function as medicine for all sorts of ailments.


Fiona writes:

"My name is Fiona, and I wanted to share with you how raw greens have helped transform my health. January was my one year anniversary of healthy thyroid function. Woohooo!

In December 2008, I was diagnosed with hyperthyroidism. To my horror, I was told by my GP that surgery would probably be needed to remove 3/4 of my thyroid gland, leaving me dependent on medication for the rest of my life. This didn’t feel like a road I wanted to go down at all".
Having a baby had been life transforming for Fiona. Her birthing experience caused her to think differently about life and health. Fiona now believes that:

"... all illness or dis-ease is caused by energy blockages within our bodies where emotions get trapped and repressed. I have not always thought this way - but since having my son my eyes have opened to the magical possibilities that are open to us if we dare to believe and see for ourselves"
She explained her belief that our bodies are able to heal themselves when they are working properly and how she:
"... knew deep down the goiter in my neck was blocked expression - clearly affecting my throat chakra. There was a key issue that had been bubbling to the surface of my mind for the last few months and the fear of expressing it to those around me was too great. I denied the need to confront it. The ‘thing’ I least wanted to say - had now backed me into a corner and was testing how much I was willing to stay in denial.

I now had no choice - and I could feel it in every painful cell. The emotions surrounding this admission were HUGE. The waves of shame, self-hatred, and despair I experienced as I spoke my truth was clearly what I had been avoiding. The day after I spoke my truth my goiter went down & I started my healing - and believe me it was the biggest thing that’s ever happened to me".
According to Fiona, her remarkable healing and overnight reduction in her goitre occurred when she 'spoke her truth' and dealt with difficulties that she had been suppressing.

Fiona's experience resonates with what happens for childbearing women having one to one midwifery care. Anyone who observes the results of one to one midwifery care for childbearing women will find that among that cohort of women, more births are normal, more women and babies are well and breastfeeding successfully, there are less occasions of preterm labour and birth, pre-eclampsia and gestational diabetes compared to what happens for women who access the standard, run of the mill maternity 'care'.   

Midwives who work in a genuine continuity, one to one, relationship based model of care provide a safe place and develop a relationship of trust with the woman within which the pregnant woman can feel heard and respected and able to discuss concerns, fears and troubles. Putting words to troublesome feelings enables emotional release. The role of unrelieved and unexpressed stress on inflammatory processes and the involvement of inflammatory processes in the aetiology of disease is becoming more widely recognised.

As stress is expressed and released, health and wellbeing go up.

Awareness is so crucial to living a full, healthy and happy life. The importance of paying attention and acknowledging how you feel cannot be overemphasised. Midwives have a real role in supporting women to become aware of and express their feelings. Asking 'how are you today' in a meaningful way and waiting for a genuine answer, being present and acknowledging any discomfort for the woman, enables her to feel heard and cared about - the ultimate stress reduction exercise.

Not saying how you feel, as Fiona's experience demonstrates, can be toxic to the bodymind.

Another important point to note in Fiona's remarkable story is that she also embraced a nutritional approach to improving her health and used raw food to suppress thyroxine release.










Wednesday 5 May 2010

Happy International Midwives Day!

Happy International Midwives Day! 

All over the world, midwives and women, their partners and anyone who cares about how women are cared for during childbirth,  are celebrating midwifery today, the International Day of the Midwife. 


The 24 Hour Virtual International Day of the Midwife is an online event aimed at bringing midwives together from all over the world. The event is being facilitated by Sarah Stewart and Deborah Davis. For more info: click this link here

Remember to come and enjoy the different sessions. You can find the program here. 


A gallery of photos of Global mothers, midwives and nurses can be found here

Talking about the importance of baby's birth experiences at the Mother of all rallies, PH Canberra 2009

I happened upon this video when I was searching for some information on Google! What a rally that was. I was interviewed at the rally for the upcoming film 'Face of Birth' and this is the result of that interview:



There are other snippets of the film in the making on the site.

Carolyn Hastie - Mother of all rallies, PH Canberra 2009