Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Tuesday 3 June 2014

A midwife's personal journey into supporting birth honestly


Elly Copp is a guest blogger today.



 Photo: Elly Copp

Elly is a hospital midwife working in a birth centre in the south-west of the UK.  She is also an integrative therapist in private practice in Bristol and where she lives, in Somerset.  I first 'met' Elly on twitter over a year ago and liked her approach to midwifery, women and birth. I was interested in Elly's many 'hats' and how she managed to work within the system with her approach to women and their families. I invited Elly to write a piece for this blog to share her rich understanding and experience and here it is.

Enjoy!

Elly writes:

"I recently attended a conference on “Attachment, Loss and Significant Change” which taught me such rich and relevant information that I have been able to synchronise all my learning for the first time. This experience feels like a culmination of years of process which has made a direct and immediate improvement to my work as a midwife and mentor.

The two presenters, experts in their fields, shared their knowledge with us:

Sir Richard Bowlby, spoke about his father, Sir John Bowlby and his work on attachment theory. He identified the key needs we all have in order to survive our life, which begins as early as birth. By the third trimester, a baby is equipped with senses, feelings, reflexes and a personality. We are born ready to make contact with our parents. Attachment is a core need and initiates in us a sense of belonging and feeling ok in the world.
Conversely, the effects of not having our needs met in the early days and not being ‘seen’ just as we are, is likely to have long lasting effects on health and relationships. Considering the impact on a baby when she loses her mother temporarily or permanently will have us all unsettled as we don't like the idea of it or how it felt when that was our experience. As midwives we are in a prime position to assist at these moments of a person’s life: mother, father and new baby, the evidence is there and now our challenge is to bring it into our daily work. The rewards for us as individuals will fuel more courage, compassion and love we have for ourselves and the women we meet.

The second speaker, Dr Una Mccluskey, talked about the roles of care seeking and care giving and the dynamic between the two. In our world these are the roles of ‘mothers’ and ‘midwives’. Midwives with good attunement antenna will pick up the ‘state’ a mother is in and will consider the next appropriate step. Dr Mccluskey says it's what the care giver does with that knowledge which is important. In order that she does that effectively, a midwife has to be aware of her own state, her own ability to regulate her internal system. This ability to self-regulate takes attention, commitment and support.

When fear diminishes, the ability to explore and be curious expands. That is true for midwives and the women they care for.  When we model our own state we see it mirrored and replicated. In her book “Why Love Matters" Sue Gerhardt looked at effects of being and feeling loved. When young people experienced no or poor attachment the consequence on their internal regulatory system was an inability to find equilibrium and resulted in negative, anti-social behaviours. What is known is that we do not manage so well in life if we have not felt the feeling of being loved and cared for, cherished, touched and cuddled by our mother or a mother like figure, a person who will stay with us long enough to understand us and regulate our internal state, and will keep coming back to us, again and again.

Watching film clips of mothers and their babies interacting and learning the theories behind this brings to life vividly the need for a secure attachment from the start, as well as feeling empathy for the newborn, the impact of a secure attachment for the baby on lifelong health is absolutely clear.
I consider myself very lucky , because I have been involved in some very profound births .I am often moved to tears and have the sense that I have been appreciated at a very deep level of the mothers'  being. These spiritual births where I feel a connection with the mother often come after she has experienced a traumatic time in a previous labour and birth .My understanding is that these women had been holding their trauma in mind and body and are very relieved to be able to let it go and feel pleasure, happiness and wonder in a birthing environment. It is my quest to remain open, available, curious and exploratory and I offer these mothers the same, and work very hard not to move myself or be manoeuvred or coerced by others into a fear state. The ability to translate that knowledge into practice is transformational and meaningful for the mother, the father the baby, the midwife and the student midwife.

As a midwife of 20 years, I am familiar with the realm of labour and birth and work in a birth centre where the environment is spacious. I learn here, and carry that knowledge to other places I go to, such as the delivery suite or ante /post natal ward for example. Even in a different environment I bring with me the assumption that this doesn't have to change a woman’s ability to birth and bond, and the baby to attach. When the environment is out of our control, we can still make it work, as everyone needs a supportive and companionable attachment system wherever they are.

A recent birth demonstrated to me how it is possible for a mother to change her physiology and emotional state when the people she has supporting her are present, being in the now, mindful and observant. I wish to share this with the intention that midwives reading this will be motivated to make their own deliberate but subtle and invisible switch in their own understanding and response. All the names have been changed to maintain confidentiality.

As a hypnotherapist, I am familiar with the mind and how it works, the limbic system, the cognitive brain and how the two are affected by each other and the environment. Dr Stephen Porges describes the neurophysiological foundations of attachment, emotions, communication and self-regulation so well in his book “The Polyvagal Theory ". It is quite manageable to digest and process the theory, the difficulty is making theory useful practically in such a busy environment where risk is calculated and expectations and therefore stress is high.

"Help for the Helper" by Babette Rothschild discusses how roles can get confused when boundaries are not maintained, the mirror neurones in our brain mean that before we realise it, care seekers are mirroring and mimicking the care givers own state.

It is significant that working in a fear state a lot of the time is not helpful or healthy for us, and has a part to play in burnout. We have a real vested interest to self-care and ensure we regulate our systems frequently to maintain our health. This is extra difficult when we are working a shift pattern which is pre-arranged for us. Add to that the variety of work needing to be attended to, which can be acute and immediate for a short or prolonged time, plus no breaks and the situation for the midwife can become untenable.

When a midwife is in fright / flight mode herself she needs to become aware and notice it quickly so she can shift it. Her brain will prevent any connectivity or attunement as long as it it is focused on anxiety. In such a situation the midwife cannot create a safe birthing environment; instead she becomes distracted and loses focus. No one is grounded, no one is self-regulating. 

Dr Mccluskey stated that in supportive relationships, a genuine response must match the depth of the other person’s situation; Women will know it if we show mixed messages. The words need to match our actions for us to be seen and trusted by the women in our care to have faith in us She states: " we are all hard wired to care for other people, to seek care for ourselves and to pursue interests " As midwives in a work environment where the care we give is increasingly scrutinised and critiqued retrospectively, seeking care for ourselves and pursuing interests can be the aspects where we are not so successful, and therefore less able to self-care. In addition our workload becomes greater and visibility around each other is reduced.
For a mother, when the fright /flight brain is in ascendance, dissociation from the self, the body and the baby will result (as a survival technique), it will not be easy for her to experience an empowered birth. I believe that when doctors, midwives, anaesthetists and health care assistants operate collectively from this place of flight/fright, disconnect is a constant presence.

When women can be in a calm and regulated state there is sufficient capacity for them to utilise internal resources, to stay exploratory and look for ways to cope. Ultimately they give birth in an engaged and connected way.

When a midwife successfully regulates her own internal state, the woman she is with can be in touch with her own skills necessary to deal with any upset. We are facilitating an environment within which a woman can build her own competence in the world, which is what she will simultaneously be passing on to her baby. Having worked in a birth centre since 2008, I have found my own ability to problem solve and find solutions has expanded and that is apparent in the confidence I have and pass to the parents I meet.

I am also a Bowen technique practitioner (Bowen is a way of working with the fascia and muscle spindles which rebalances the body via the vestibular system). During a Bowen session, a body can restore health and vitality to the best of its ability. There are clear parallels between Bowen and birth, because the same environmental conditions are required for best outcome. Michel Odent commented " an ideal situation for a mother to birth in is where there is as little interference to the mother’s natural process as possible: speaking, feeling cold, feeling unsafe and bright lights are stimulation which is not conducive to giving birth."

What seems to be happening during a Bowen session is that the body is allowed to re-orient to a memory of a previously healthy state or an original blue print of health. Many of the moves are made on areas significant during embryological development (John Wilks, The Bowen Technique). Like the mind and its ability to move from a fear state into a calm state, the body can do too, physiological changes occur when liquid crystals in the cells which hold memory and have the capacity to register a new experience which are highly receptive to change are touched.
Sheila Kitzinger writes about birth crises and the effects on bonding with the baby as well as any future births. Where a woman has experienced a shocking birth experience and felt helpless and out of control, that memory of helplessness stays with her. If she does some work to recover from her trauma, restore her self-esteem and confidence, she can experience healing in advance of her next birth. If she's doesn't, her bonding and attachment with her next baby will be negatively affected
Sir Richard says:
“If she doesn't recognise that state and therefore remains static she cannot release the dynamic energy needed to give birth to her next baby. She becomes stuck in her thoughts and in her muscles. This is visible in the way a mother uses her body in labour, during and in-between contractions, her posture, her eye contact and how she expresses herself and receives support”.

Putting all this into practice is sometimes straight forward and sometimes very complex. The woman I met called Suzy* and her husband John* seemed initially to be quite a simple care in labour, part of my daily work, but moved into a more complicated area as she moved through her labour and some details emerged.

Two years ago. Suzy had been in labour with her first baby in the pool, and out of the blue, the midwife became worried about the baby's heart rate. Suzy was rushed and hurried along a long corridor to the obstetric theatre where her daughter Imogen was born by forceps. It happened fast. Suzy and John were handed Imogen after a while when she was dressed. There were no other concerns about her health; the perceived concerns about her wellbeing during labour had not affected her wellbeing at birth. This aspect was never discussed though, and the couple were not given any more information about what had happened.

Suzy and John decided to have another baby a year later, but Suzy was very worried about how the birth would go during the second pregnancy. She only told John about this, he was as supportive and kind as he could be. He couldn't see they had any choices.  Suzy started her labour in the early hours and they drove to the birth centre, she wanted to use the pool again but was plagued by lack of confidence, worry and fear about it. She questioned herself so much that she couldn't actually think any more. It was a busy night and the couple met 4 different midwives over 4 hours. Suzy began to panic that her contraction pattern was spacing out. She started to think that this was an impossible situation for her. She was kneeling and closing her eyes a lot of the time.

I entered the room and saw a lovely and supportive man talking gently to his wife and introduced myself and my student who is gentle and kind and softly spoken.

My colleague who was leaving thought that the birth was imminent so we waited for some signs; it was 07:30 am.

We watched and attuned to Suzy and through John we learned about their experience with Imogen. Suzy said it was awful, she had been worrying about it, she didn't want that to happen again but she was frightened it was heading the same way.

I am very careful about discussing previous births with couples because my experience is that it can detract from this baby, but on this occasion, the nature of Imogen's birth needed to be spoken about out loud because the residual fear seemed to be stopping Suzy from giving birth. It felt like an elephant in the room.

My thinking is always how do I give the woman my full and complete attention, my whole person support without judgement or a set of conditions - as well as give her free reign to find her own path to birth her baby. I wonder and worry that I may be perceived as unsupportive, disinterested or lazy. In "Birthing Normally” Gayle Petersen details birth stories where she has attuned herself to women’s fears and needs and in doing this, has enabled the mother to birth her baby herself without any interventions. Whilst Gayle knows the women she describes, I am unfamiliar with the women I meet and not knowing them I cannot know their preoccupations and concerns.

Nine o'clock now and I observe Suzy in a pickle, she is wanting it to be over, saying she can't do it and becoming increasingly negative, defeatist and a little self-centred; rejecting Johns loving support. In my calm state I am wondering how to move Suzy out of her fear state and back into exploratory without being dictatorial or overbearing.

Where is that internal space for her to connect with herself, find her resilience and prepare to meet her baby? Dr Mcclusky says we are moving inside ourselves with other people all the time, and that self-regulation goes on as background music. "We are born with the expectation of being met as a person” resonates within me, and I want that for Suzy so that her baby receives that meeting.

Meanwhile Suzy is becoming more despondent and closer to giving birth (9cm dilated). Is analgesia the right thing to offer? Is that kind and appropriate I ask myself? Maybe, but I think not is my internal answer.
After another of Suzy's desperate outbursts that "she cannot do it", I realise she is overwhelmed and I ask her 3 questions very carefully.

What does she need right now - she answers “not to feel any of this”

What does her baby need right now - “to be born quickly”

How can the two align?  A pause and then - “I had better get a grip", said with a sense of authority and humour.

John smiles at me, as if we have made a breakthrough, it feels like she has moved from her fear state to her maternal and problem solving state.

That is the moment the labour changes, because 30 minutes later and without any pushing at all her baby's head is born in the pool, the membranes are intact and still over his face when Suzy brings Harry to the surface.

We were all in tears, moved by her capacity to change and in how by releasing something negative from her past she became free to move energetically and give birth so smoothly.

A few hours later, we chatted it over and she said last time her birth had been taken away from her, she felt she had lost a part of herself which she hadn't realised until this birth. I told her what had been going through my mind about analgesia, and she agreed she had been thinking that too - I reflected how we had synchronised. She loved having so much skin to skin with her baby because that had not been included last time, and she valued us as helpers and enablers whilst we saluted her for her courage and commitment to her baby.

To conclude, I do not say that having this understanding will mean all births are going to be smooth or straightforward, but I do believe that seeing a woman for who she is gives her choices and with those choices she can make the best decisions for herself and her baby.
 
The approaches I use incorporate my knowledge of hypnosis and Bowen technique, directly and indirectly. Sometimes I use touch, and sometimes calm and reassuring suggestions. The midwifery training itself did not give me a good enough education to understand the minutiae and nuance of what birth entails. I was shocked when I was in labour with my first baby that my training had not prepared me for the realities of birth and what resources I needed. It has taken years of work and application, critique and evaluation to reflect on what holistic means and how to see women holistically. It is a journey not encouraged within the hospital system and finding my own identity has been a hard slog but one I could not avoid. My passion has stemmed from a mixture of sources and is maintained by the appreciation I receive from women and their families as well as colleagues and students. When a mentee says "all we are told about is litigation and self-protection" I worry a little bit more about the lack of self-awareness and acknowledgement these fledging midwives are being trained in.

The other motivation is personal: as a daughter, wife and mother of four, I have to keep working at all my relationships - and in trying, my efforts will be seen, and I will be met as a person. 

You can contact Elly via her email eleanorcopp@me.com and she tweets as @EleanorCopp

REFERENCES

Bowlby,EJM. (1997) Attachment: Volume 1 of the attachment and loss trilogy. (1st ed) UK:Vintage publishing. 

Gerhardt,S.(2004). Why love matters: how affection shapes a baby's brain.(1st ed.)UK:Brunner-Routledge.

Kitzinger,S.(2006). Birth Crises. (1st ed.).UK: Routledge.

McCluskey,U.(2005).To be met as a person: The dynamics of attachment in professional encounters.(1st ed) UK:Karnac. 

Peterson, G. (1984). Birthing Normally: a personal growth approach to childbirth (2nd ed.). USA: Shadow and Light.

Porges, S (2011) The Polyvagal Theory: Neurophysical foundations of emotions attachment communication self-regulation. (1st ed) USA: W.W.Norton and company.

Rothschild,B.(2006) Help for the Helper: self care strategies for managing burnout and stress.(1st ed ) USA:W.W Norton and company.


Wilks,J (2007)The Bowen Technique: The inside story (1st ed) UK:CYMA LTD.

Sunday 12 August 2012

Australian Government acts to give women greater access to midwives and improve care!

An important update on the outcome of the Standing Committee on Health in regards to midwifery care.  So exciting to see this sensible development.  I know many people have been working tirelessly on getting the government to understand the issues.  My deepest gratitude to you all.

MEDIA RELEASE: 11 August 2012
Contact: Liz Wilkes 0423 580 585

Standing Committee on Health Decision will give women greater access to Midwives and improve Care.

Today’s decision by the Standing Committee on Health to enable midwives to collaborate with hospitals rather than individual doctors provides a welcome relief to Medicare provider midwives struggling to provide Medicare funded care to women.

“Until now government policy designed to provide women with Medicare access to private midwifery care has been to date severely restricted by obstetricians not wanting to be involved” said Liz Wilkes President of Midwives Australia.

“The recognition from every Health Minister across the country that midwives work collaboratively with doctors in hospitals and do not need individual doctor sign off is entirely appropriate. We applaud the sense they have shown” said Ms Wilkes

Midwives Australia has seen the legislation requiring midwives to collaborate with individual doctors has created unnecessary administrative burden and has created opportunity for medical veto over women’s access to Medicare rebates.

“What we are seeing here is the opportunity for midwives to develop license agreements and contracts with hospitals which enable true collaborative practice to continue”

“The whole hospital system relies on obstetricians being in the right place to deal with referrals of women. It is not a change in safe practice.”

“Midwifery care should not and does not require the presence of an individual doctor at a tertiary hospital when many other doctors are on staff, what matters is that there is a doctor present who is able to accept referral and transfer as doctors are employed to do this on a daily basis.”

“This week a Melbourne study found the care of a known midwife reduced the need for a caesarean section and actually improved outcomes. It is comforting to know that all Health Ministers agree on the need to make the care of a known midwife more accessible to Australian women.” said Ms Wilkes.

 We hope you will find it informative.

Best regards,
Midwives Australia

Thanks Liz Wilkes for this update! 

Monday 12 December 2011

Quotes for Midwives

My last meeting with the lovely midwifery students I've been working with in Papua New Guinea is this morning.

 Pacific Adventist University Midwifery Students PNG
I've been surfing the net, looking for quotes that relate to midwifery, women and birth that I thought would inspire them.   I've come across the following and thought I'd share them with you.
"You are a midwife, assisting at someone else’s birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must take the lead, lead so that the mother is helped, yet still free and in charge. When the baby is born, the mother will rightly say: “We did it ourselves!”  - From The Tao Te Ching
Speak tenderly to them. Let there be kindness in your face, in your eyes, in your smile, in the warmth of our greeting. Always have a cheerful smile. Don’t only give your care, but give your heart as well. ~ Mother Teresa
Ask me for strength and I will lend not only my hand, but also my heart. ~ Unknown
If you lay down, the baby will never come out! ~ Native American saying
Offer hugs, not drugs ~ Adina Lebowitz
Someday, after mastering the winds, the waves, the tides and gravity, we shall harness for God the energies of love, and then, for a second time in the history of the world, man (sic) will have discovered fire. ~ Pierre Teilhard de Chardin
  Just as a woman's heart knows how and when to pump, her lungs to inhale, and her hand to pull back from fire, so she knows when and how to give birth. ~Virginia Di Orio
You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. ~ Eleanor Roosevelt

For God hath not give us the spirit of fear, but of power, and of love, and of a sound mind. ~2Timothy 1:7
If I had my life to live over, instead of wishing away nine months of pregnancy, I'd have cherished ever moment and realized that the wonderment growing inside me was the only chance in life to assist God in a miracle. ~Irma Bombeck

Making the decision to have a baby – it’s momentous. It is to decide forever to have your heart go walking around outside your body. ~Elizabeth Stone

What's done to children, they will do to society. ~Karl Menninger

A woman
in harmony
with her spirit
is like
a river flowing.
She goes
where she will
without pretense
and arrives
at her destination,
prepared
to be herself
and only herself.
~Maya Angelou


Sunday 10 October 2010

"Waking up is hard to do"

Following my blog post about the importance of sleep, a friend of mine, Maxine, posted a link to a blog post on Not Totally Rad, a blog that gives insight into medical imaging. Maxine said that

"Probably only the medical types with as equally sick sense of humour as I will find this funny, but what the heck... "


Well, of course I had to look at the link and I'm so glad I did. I'm still chuckling and thought you may find it delightful as I did and do! 


Born at a Christmas party in 1990, they are a group of practicing Certified Registered Nurse Anesthetists who call themselves the Laryngospasms. The larynx is the voice box and a laryngospasm is a spasm of the larynx that is a complication of anaesthesia. The group create and perform medical parodies for audiences throughout the United States.



More music by the Laryngospasms found here

I needed this laugh!  What about you, do you think this is funny or sick?  Is it only those of us who are socialised into hospital culture who find this humour funny?  I'm really interested in what you think.  I know that we can always talk comfortably about the most amazing, body oriented subjects at mealtimes, which other members of the family and non-health related friends think is really 'off'.

Saturday 25 September 2010

Sleep, glorious sleep!

Sleeping is something I've tended to put on hold. As I seek to cram more into my day, I find the hours in the middle of the night are those that are most able to be contracted.

I used to wonder about sleep and whether we could learn to do without it. Sleeping seemed like such a  waste of time to me. All those hours just lying around, doing nothing. Especially wasteful when there is so much to do!  I've discovered that reducing the amount of time I sleep is not a good idea.

According to current understanding about sleep and its functions, sleep is essential to psychological and physical wellbeing and is neuro-protective. According to John Axelsson from the Karolinska Institute in Sweden, a good night's sleep is a very important component of looking attractive and healthy. Those ideas that my grandmother had about the hours spent sleeping before midnight being important are very likely to be true, much as I'd love to ignore that fact. She was right about a lot of things, my grandmother.

 I've found to my horror that sleep poverty is associated with obesity.  Apparently those of us who struggle with middle age (or any age) 'spread' or 'spare tyres' - polite terms for enlarged girth would be well advised to ensure that we regularly get a good night's sleep as good sleep patterns help to keep obesity related genes switched off!

Stress is another culprit! Even if people get enough sleep, unless the causes of too much stress are managed or diminished, the problems compound.


 I read Katy's blog this morning and she was talking about sleep - Katy is a biomedical scientist and her blog is always informative. Amongst other things Katy said:
"Sleeping the correct amount (or at least longer than you typically do) is a good place to start when trying to get to the root of any health issue.  As for body postures, it’s best (does the least to shorten muscles and stiffen joints) to sleep flat on your back, no pillow, on a firm mattress.  Sleeping in his way (or just getting into this position on the floor when you’re awake) reveals a lot about your chronic joint position.  If you need something under your knees to be comfortable, your psoas is too short for your height.  If you need a pillow under your head to keep your chin from elevating, the cervical (neck) extensors are too short for the length of your spine.  If you take yoga, executing the supine savasana posture takes a good chunk of time to work up to.  You’ve been practicing chair-asana (the art of sitting long hours with your hips and knees at 90 degrees, head forward to the spine, and chin elevated) 10 hours a day, it’s no wonder you feel stiff getting into bed.  Do five minutes of light stretching followed by a “floor assessment” of your tension patterns.  Set the timer for 10 minutes and relax your parts to the floor, breathing quietly and thoroughly, before hopping into bed.  This should make getting into REM state that much easier".
 As someone who practices 'chair-asana' on a daily, hourly basis, I've taken her words to heart!

Making the change to ensure good quality sleep means changing habits and establishing new routines. Some random tips for healthy sound sleep I've picked up over time are:
  1. Avoid stimulating drinks, conversations, television and other similar activities immediately before bed. 
  2. Spend time winding down; that can include a relaxing bath (with or without candles and aromatherapy)
  3. Get regular physical movement - a good walk each day stimulates/coordinates our brain cells and the muscles leading to better functioning
  4. Sweet talk - with yourself and if you have one, your beloved - quality mutually rewarding intimacy and sexual expression
  5. Review your day and congratulate yourself for things well done
  6. Avoid focusing on the things you could have done better - write those down and tell your self that you will review them in the morning
  7. A warm drink before bed can be helpful
  8. Think of five things you are grateful for and feel the feelings associated with that gratitude
  9. Review the things you want to do the next day and imagine them done well
  10. Ensure you are warm enough/cool enough and comfortable in bed
  11. Clean, fresh linen and smooth sheets always feels good
  12. Keep electrical appliances away from your bedside
  13. Don't read newspapers or action books or watch television in bed
  14. Make your room as dark as possible (optimal hormone release at night requires darkness)
Sleep well!

Monday 19 July 2010

Stress, Telomeres and Health

Our chromosomes have protective sheaths and caps at their ends. These caps are known as telomeres and protect the ends of the chromosomes. An analogy is the little plastic ends on shoelaces. The length of these little caps has been found to indicate the health of our cells. Shortened caps are associated with advanced cellular aging.



Telomeres and the enzyme telomerase are responsible for protecting the chromosomes which take care of  the replication of our cells. Chromosomes which are unprotected are associated with cancer and other mutations of cells. Shortened or damaged telomeres have been found in women who are chronically stressed in caring roles (Epel, Blackburn & Lin 2004).

Researchers at University of California San Francisco (UCSF) were calling for volunteers to take part in a trial to look at the role of stress on telomere length and health. 

I volunteered, because I figured it would be a good thing to be part of this research looking at whether knowing the length of these cell replication protection units would be useful as a health  marker.  I got an email back today telling me they were fully subscribed for the study. Many women had responded to the newspaper article. I'm delighted that so many people saw the value in this research.  What really impressed me was the note the researcher included in her email.  She said and I quote:

"Just a side note --we can try to keep our telomeres healthy, without having to have them tested. To keep healthy  telomeres, it seems the same factors that protect the heart also protect the telomeres- regular vigorous activity, healthy diet with lots of fruit and vegetables (antioxidants from foods) and less processed meats, and to reduce stress, feeling socially connected and being mindful and relaxed when we can.  My own favorite stress buster is yoga.

With best regards,

Wanda Truong, Clinical Study Coordinator
Elissa Epel, PhD, Principal Investigator (head of the study)"
I was invited to reply if I was interested in being part of further studies and of course I am, so I replied and told them so.  I figure that if these researchers are suggesting ways to keep our telomeres healthy, then that's worth listening to!

By the way, Dr Elizabeth Blackburn has been seeking to find ways to enhance life as we age and her efforts led to her winning, along with two of her colleagues the 2009 Nobel prize in physiology or medicine for the discovery of “how chromosomes are protected by telomeres and the enzyme telomerase.”


Accelerated telomere shortening in response to life stress. by E. S. Epel, E. H. Blackburn & J. Lin, et al. Proceedings of the National Academy of Science (PNAS), 2004, 101(49)

Sunday 4 July 2010

Birth and Bugs

Note: for some reason the links aren't showing up in this post. Just run your cursor over the words and they will show as a purple colour. I can't fix this glitch, not sure why! Sorry.




Some interesting posts about the importance of the way babies are born and the bacteria they are exposed to through the birth process are emerging in cyberspace. The information is not only interesting, it helps to inform our practice as midwives and enables parents to understand one of the many reasons why there is a concerted move in both midwifery circles and government agencies to turn the tide more towards normal birth. Concerns are being raised that environmentally triggered changes to immune cells of babies born by caesarean section are predisposing those babies to be susceptible to immunological diseases such as diabetes and asthma in later life.

A blogger has explained the importance of our exposure to bugs at birth this way.

and a teacher of molecular biology at Princeton University, Bonnie Bassler, explains how bacteria talk to each other chemically. Bonnie informs us that we are composed of 10x more bacteria cells than human cells!

This information is a powerful addition to the accumulating evidence about normal, natural, unhindered, supported birth being best for mother and baby.

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.










Sunday 25 April 2010

Flu vaccination ban goes national after fever, convulsions in children

More than 60 children around WA have had adverse reactions to the flu vaccine, Fluvax. This vaccine contains three different flu components, including swine flu. If a child has already been exposed to swine flu, experts suggest that some children may be reacting badly to receiving a second exposure. Reactions have included febrile convulsions leaving one child in a critical condition. Doctors have been advised by the department of health to stop giving the vaccine to children under five years of age.

Photo from WA News 23rd April 2010

The official response to the adverse reactions has been remarkably slow.

Chris Thompson reported in WA News that
"WA's chief public health officer Tarun Weeramanthri has defended the response time in closing down the state's juvenile flu vaccine program amid revelations that children were presenting with convulsions more than two weeks ago".

The ABC said on Friday, 23rd April, 2010, that authorities in SA and Queensland have also acknowledged a number of adverse reactions to the vaccine in young children. The AMA have agreed with the ban on Fluvax to young children, however they caution parents not to lose confidence in immunisation.

In the ABC news story on Friday, Professor Peter Collignon, from the Australian National University, whose expertise is in infectious diseases, voiced concern about wide scale vaccination with Fluvax. Professory Collignon doesn't think that we have enough data to roll out a population wide vaccination program because it might cause more harm that good.

I'm wondering if the delayed reaction to the widespread reaction to the Fluvax is the result of an inability to truly perceive what was happening because the phenomenon is so outside the belief system that has been created about vaccination.

While the authorities claim they were monitoring the situation, the reality appears otherwise. They appear to have been rationalising.

The pro- vaccination lobby has been virulent in the way that open debate and discussion about the value of vaccination has been squashed until now. Dissent has been forbidden, thought patterns about vaccination have been dictated. I was told at an immunisation nurses' update session to leave the room if I didn't agree with newborn babies being given Hep B immunisation. I was seeking honest, open discussion and information. I was told "you have to believe!!" in very strong tones. Well, I don't agree to 'just believe' I want to keep my thinking open, curious and able to critique events if and when they occur.

The cult like behaviour that accompanies the pro-vaccination stance reminds me of
fundamentalism.

Fundamentalism in any context is dangerous. Slavish following of 'science' is no different to slavish following of 'religion'. Slavishness removes the ability to discern, debate and think clearly.

The delayed response to the childrens' vaccine reactions can be seen as a symptom of a fundamentalist, non thinking bio-behavioural state.

The Term Breech Trial and Catholic Priests paedophilia are both examples of slavishness; also recognised as cult like behaviour - (no independent thinking encouraged or allowed) with dreadful sequelae that continues to reverberate.




Wednesday 24 March 2010

Flashmob: Pregnant women breakdancing in London






"If you think this is dangerous, try giving birth in poor countries without a midwife,  hospitals or medicine. This flashmob is one of a series that is happening in Paris, Berlin..."  Oxfam
700,000 more midwives are needed globally. When a trained midwife is in attendance, a woman's chances of surviving childbirth dramatically increase.

Midwives create a clean environment for the delivery and deal with complications during birth. Midwives must be supported with decent, well-equipped hospitals nearby for emergency care.

Oxfam

Saturday 20 March 2010

Optimistic Expectancies and Cell-Mediated Immunity — Psychological Science

Having positive expectations is good for your immune system functioning and therefore good for your health.

"These results provide the first evidence that changes in optimistic expectancies are accompanied by changes in immunity, as well as the first evidence for a mechanism by which this effect occurs. Changes in expectancies about law school predicted changes in cellular immune function, and this relationship could be partially accounted for by positive but not negative affect. The results support the validity of psychological interventions to improve immunity and health (e.g., Andersen et al., 2007) and suggest that efforts to correct irrationally pessimistic expectancies may be warranted, particularly if these efforts also increase positive affect".

Interestingly, the authors conclude:

"Although optimistic expectancies are associated with both increased positive affect and decreased negative affect, it may be as important for immunological health for people to be happy as it is for them to lack anxiety".

That song "Don't worry, be happy" was on the mark!

Of course, childbearing women do have 'worries' and their anxieties can be alleviated by having a midwife to journey through their experience with.  Midwives can provide a sounding board and provide information and a safe space where worries and fears can be explored; strategies for self management developed and worries dissipated.  In such a supportive environment, women's cell-mediated immunity is obviously improved, which would 'fit' with the reduced numbers of women experiencing pre-eclampsia, gestational diabetes and premature labour that is associated with 1-2-1 midwifery care.


Optimistic Expectancies and Cell-Mediated Immunity — Psychological Science

Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring

The way that our physiology switches genes on or off in response to environmental circumstances/triggers/cues, a process now studied as 'epigenetics' or 'above the genes' is becoming increasingly understood. The way that stressors impact our lives, our genetic expression and our immune system is becoming more and more recognised and obvious as scientists seek to understand the role of the environment in disease profiles. The significance of the prenatal experience in setting the foundations for health and wellness or disease is now recognised as a reality for humans as well as other animal species.

What scientists are discovering as they study the role of the prenatal environment in health and disease, is that high levels of maternal stress during the prenatal period is associated with impaired immune modulation. This study gives further credence to the Barker hypothesis that the prenatal experience is programming the infant's physiology, including the immune system to respond to the environment it will be born into. In the case of children whose mothers experience chronic and high stress levels, they have immune systems that are more vulnerable and more highly triggered by adverse environmental factors.

"In the Urban Environment and Childhood Asthma Study, the investigators evaluated associations among prenatal maternal stress and cord blood mononuclear cell (CBMC) cytokine responses among 557 families in Boston; Baltimore, Maryland; New York City; St. Louis, Missouri, and other cities. Each child had a parent with history of asthma or allergy".
Cytokines are messenger molecules with a complex range of interweaving, intersecting pro inflammatory and anti inflammatory functions.

"This is the first study in humans to show that increased stress experienced during pregnancy in these urban, largely minority women, is associated with different patterns of cord blood cytokine production to various environmental stimuli, relative to babies born to lower-stressed mothers," lead author Rosalind Wright, MD, MPH, associate physician at Brigham and Women's Hospital in Boston, Massachusetts, said in a news release.

The obvious answer is take care of pregnant women. Reduce the environmental stressors that pregnant women have to negotiate on a day to day basis. Poverty, violence, poor nutrition, unwanted pregnancies, lack of preconceptual care, lack of meaningful, supportive care during pregnancy and birth etc are all environmental risk factors with huge implications for the health and wellbeing of mothers and their babies.

Midwifery care that is provided in a one to one relationship is very beneficial for helping a woman defuse her stress levels. As a woman feels safe with her midwife and as trust builds, discusses her fears, problems and life circumstances, emotional stress is releases and solution generating can begin. Our government needs to heed these studies and provide better care for pregnant women if they truly want better and healthier societies.



Stress During Pregnancy Linked to Higher Risk for Asthma in Offspring