Born to Safe Hands: with a few battle cries

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Two exceptional midwives from Bolton, in NW England, decided to plan a conference after being inspired whilst attending MAMA conference in 2013. Joanne Camac and Annabel Nicholas wanted to hold an event to celebrate birth centres, and chose the name ‘Born to Safe Hands’  from their family experience/visitors book.  Jo told me ‘a lovely family that Annabel and I looked after wrote this and we felt it was just perfect for our conference‘.  So they set about inviting potential speakers, collaborators, film makers and researching venues. Last week the conference happened. From the moment I arrived, I knew I was part of something special. The wonderful Oli Armshaw (@Olvinda), a student midwife from the University of the West of England attended (see photo below), and has written a superb reflection of the day.

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Student Midwives Oli (left) Jude and Heather

When Sheena asked me to write a reflection on Friday’s Born to Safe Hands conference, I did what I always do, which is, a) instantly say yes without considering how on earth I’ll lever it in around family/full time placement/exam revision and, b) consult Twitter – and there it was, the whole marvelous day to be relived, one #B2SH tweet at a time!

On 28th March 2014, 180 midwives, mothers and a few doctors converged on the home of Bolton Wanderers football club for Born to Safe Hands: a conference to celebrate birth centres, beautifully brought to life by Bolton Birth Centre midwives, Joanne Camac and Annabel Nicholas. I’m still buzzing from the vibrantly positive atmosphere and sense of building a community, a living network – not just within the walls of the Reebok stadium conference room, but as far afield as Perth, Rio de Janeiro, Edinburgh, wherever Twitter stretches. The midwifery ecosystem keeps growing, inspiring us to keep up the fight for women’s rights to informed choice and dignity in childbirth, and to keep looking for ways to be ‘with woman’ – for all women, not just those who fit admission criteria.

 

Certain battle cries stood out from the day:

 

‘Put on your leadership hat and fight for women!’ Cathy Warwick incited every single midwife to be innovative, imaginative and creative about the woman-centred agenda, do research, challenge practice and use emerging evidence. As we all know, it’s not just the birth rate putting midwifery under pressure, but the complexity of the women we are looking after, and we need to keep this complexity in perspective, as it’s not always a problem. Cathy highlighted the need to adapt our care and policies to the over 40s mothers, who are the most rapidly increasing group, and to learn from each other about keeping the numbers up for birth centres and freestanding midwifery units.

 

‘Why can’t labour wards look like birth centres?’ Denis Walsh demanded, as he enthused about normalizing birth for older mothers, women with high BMIs and other complexities. He calls for a change in how we assess risk, and to make the point that change can and does happen, told us about the ACOG’s game changing revised active labour thresholds: “Cervical dilation of 6 cm should be considered the threshold for the active phase of most women in labor. Thus, before 6 cm of dilation is achieved, standards of active phase progress should not be applied.” and “A prolonged latent phase (eg, greater than 20 hours in nulliparous women and greater than 14 hours in multiparous women) should not be an indication for cesarean delivery.”

 

It’s the baby’s blood anyway! cried obstetrician, David Hutchon confronting the misnomer ‘placental transfusion’. No one can still be in the dark about the benefits of timely cord clamping to prevent neonatal hypovolaemia, though third stage practice is slow to change.

 

Love or fear?’ Soo Downe, made it very simple, binary even: Love or fear. Which one are we working from? Which drives our decisions and actions? I enjoyed her every word about belief and salutogenesis: the fundamental belief that birth is salutogenic – ie seen from a perspective of wellness.

 

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To illustrate the effects of being watched, and the power of belief, Soo showed us this chilling image of Jeremy Bentham’s Panoptican penitentiary (1791). The concept of the design is to allow a single watchman to observe (-opticon) all (pan-) inmates of an institution without them being able to tell whether they are being watched or not. Although it is physically impossible for the single watchman to observe all cells at once, the fact that the inmates cannot know when they are being watched means that all inmates must act as though they are watched at all times, effectively controlling their own behaviour constantly. It reminded me of the main office on delivery suite where 8 women’s CTG traces can be viewed at once on a huge screen – not exactly the ‘private, safe and unobserved’ conditions recommended by Dr Sarah Buckley as the optimum environment for undisturbed, physiological birth.

 

Sheena Byrom’s whizzy Prezi explored the pitfalls of using guidelines-policies-protocols interchangeably, and linked the importance of supporting women to make autonomous decisions with human rights and the dignity agenda. @SagefemmmeSB is a massive advocate of Twitter, as her ‘I love you Twitter!’ video shows, eulogizing about the potential for getting and giving support; sharing ideas and news; building relationships, communities, networks and social capital; influencing change; starting or engaging in debate about practice. She implores all midwives to adopt Twitter, to respond to evidence and articles, to challenge what’s being said, to question and connect with each other. Bring the birth revolution!

 

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Twitter pals meet. What next?

 

‘Is hospital birth a riskier choice for healthy women and babies?’ It was the first time I’d heard Mary Stewart speak and I loved her ‘coming clean’ as a passionate advocate of homebirth. She tackled the knotty concept of risk, swapping the word risk for chance, when talking about out of obstetric unit (OU) birth and transfers to OU from home. Mary urged us to be responsible when talking to women about place of birth, providing balanced information about planned hospital birth as well as planned home birth.

 

What I found most stimulating about Born to Safe Hands, was the social bonding, and positive community building of it all, which Lesley Choucri, director of midwifery at Salford University, related to Cooperider’s work on ‘unleashing the positive revolution of conversations’. Thanks to Twitter, the potential reach of the normal birth conversation at Born to Safe Hands stretches way beyond the immediate 180 people present in the room. In fact, Twitter stats  suggested that 123,228 unique users saw #B2SH and the number of impacts was over 2 million, i.e. the potential number of times someone could have seen #B2SH. This is very exciting.

 

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Denis Walsh with Jo Carmac

 

Born to Safe Hands really was a celebration of the inspiring woman-led work going on in birth centres around the country – an antidote to fear and feeling disheartened, that we are losing our grip as birth becomes ever more medicalized, as women become more complex, and less curious and trusting of our bodies. Born to Safe Hands has revived my vigour and clarity about how to develop and nurture the new midwifery and bring to life the benefits of being truly ‘with woman’, for all women – the benefits of which span generations.

 

Oli Armshaw @olvinda

THANK YOU OLI!

A Storify from the conference is here, and a selection of comments:

‘best study day ever! Thank you – it’s been wonderful’

‘Best conference I’ve been to in years (and I go to a lot!). Well done. Make it annual! Make available on DVD for sale!’

‘Wonderful, wonderful day, loads of evidence and positive stories to take into my practice, thank you so much for organising’

‘Had a fabulous time, brilliant speakers. Feel ready to return fully invigorated’

‘Lovely to her what committed, expert birth centre midwives are doing in Bolton and around the UK’

‘More than exceeded my expectations, totally fantastic day, will look forward to the next one’

‘I came today to be uplifted and inspired as my unit feels very negative and de-motivated. I feel much more confident, have learnt something and feel so inspired and enthusiastic’

 

 

So Annabel and Jo, we hope you will start to plan next year’s conference soon, and make it a annual event. As Jacque Gerrard said ‘This could be the North West’s answer to MAMA!’

 

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What Twitter did, and what student midwives say!

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It’s been a while since I started using Twitter. It was my daughter, @abglyph and her lovely chappy @gazcook who stirred my interest. I don’t know how it all happened, but now most of my days involve ‘tweeting’ or ‘chirping’, and the result is I am increasingly connected with like minded folks across the globe.  Not only am I in touch with inspirational leaders from nursing and midwifery,  but NHS CEO’s such as Lisa Rodrigues @LisaSaysThis  and Mark Newbold @drmarknewbold always have great information to share. I communicate with local GPs, and Stuart Berry @StuartBerry1 is one of them. Stuart and I have never met, but we have some similar interest and can promote each others’ work through Twitter channels. Amazing. Interestingly, Stuart posted this  about the use of Twitter this morning. Great stuff!

There isn’t a week goes by when I’m not contacted by individuals asking me for help and support, or inviting me to speak at study days an other events. I am particularly happy with this, as it helps me to share expertise gained by working in the NHS for 35 years.

Last week was a particularly busy week, and almost everything that I did was either initiated or organised via Twitter! I happened to be in London, for some ‘away time’ with the Trustees of the Iolanthe Midwifery Trust on Saturday…and then the fun started.

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Posing with Alison Baum, outside Best Beginnings office!

On Monday  morning I met with the wonderful Alison Baum from Best Beginnings, to see how I could help her with the amazing new smartphone app for new parents. This all came about when I retweeted a short film about the app, and Alison asked to see me. I visited Alison’s office and we didn’t pause for breath for two hours. Lots of ideas and plans…including a small package to be sent to the Duchess of Cambridge! Take a look at this film to learn more about the Bump Buddy app….

I then scurried to St Pancras to meet Murray Chick (yes that’s his real name). Murray is the owner and brainchild of Britain’s Nurses, and I LOVE the site. Again, this opportunity was made via Twitter, I found the site there, and made some enquiries. Incredibly easy, and so effective! Previous to this meeting, and through Twitter, @Britainsnurses picked up two of my blogs to share with nurses for International Nurses Day! Sorry about that @gbutcher17!

The day after I went to Kings College London again to meet a group of wonderfully enthusiastic and very smily  positive student midwives, organised via Twitter following a lovely invite by student midwife Natalie Buschman @Birthsandmore. It wasn’t the first time Natalie and I connected and made a plan via Twitter; she also took up the challenge to do the Prudential Ride London, in aid of the  Iolanthe Midwifery Trust, after seeing me advertise the opportunity on Twitter! Great work Natalie! If you want to sponsor Natalie, and thereby support the Iolanthe Midwifery Trust, you can do so here!

After being with the students I ran round the corner to enjoy lunch with three formidably inspirational women: Maggie Howell @MaggieHowell from Natal Hypnotherapy , Independent Midwife extraordinaire Pam Wild @Pamoneuk  and journalist Beverley Turner @BeverleyTurner . What a treat. Again…lot’s to chat about and plan in limited time…and it all started with Twitter!

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L-R Maggie, Me, Beverley and Pam

And then a couple of weeks ago Dean Beaumont @DaddyNatal from Daddy Natal, invited me to review his book…’The Expectant Dad’s Handbook’  on Twitter. We exchanged contact details through the direct message function, and voila! The book plopped through my letterbox and was avidly devoured within a few days. The book, by the way, is spot on. Sensible and sensitive…with great advice for all Dads-to be. I will be writing a review Dean!

I have the feeling that my Twitter support of StudentMidwife.Net went some way to their decision to invite me to be their Patron. Whoop! What a privilege and an opportunity. Also, through Twitter I saw an chance to be involved with @WeNurses, by running regular @WeMidwives chats…which has been a steep learning curve! This has really given a new voice to Midwifery.

And then there’s the fabulous Doulas. I ‘met’ many of them through Twitter, and we connect so regularly I feel like I know some of them well, even though I have never seen them in person.  There are too many Doula friends to mention here, but you know who you are! (I’ll probably cause offence if I miss anyone out!). Through Twitter, I have come to know and appreciate your valuable contribution to childbirth.

And of course this isn’t just all about me. I couldn’t ask many, but these two student midwives have had opportunities too, through using Twitter:

Student Midwife @Li33ieBee said -‘Via Twitter I have had articles proofread by experts and been sent hard to find research papers’.

Sarah Tuke @sazzletastic told me- I have become a more compassionate ‘put hands on’ midwife after reading quotes from Sheila Kitzinger at a conference to put hands on to reassure to increase oxytocin. It works! Wouldn’t have known about what she said without tweeting from that conference as I couldn’t make it 🙂

HOW GOOD IS THAT?

But there aren’t many midwives using Twitter, and there are still a considerable number of individuals and organisations that are fearful of using social media.  I know that several health professionals have lost their jobs or places at University, due to inappropriate postings. But this is a pity. There’s lots of guidance out there, and with common sense you really can avoid the pitfalls.

SoMe

Tips for Social Media found at http://topnonprofits.com/posting-guide/

Need help?

Check out the Nursing and Midwifery Council guidance on the use of social media 

The NHS Social Media site has lots of useful tips

Guidance for NHS Caremakers is useful for all health care professionals

Here are some great folks to follow or connect with:

Sarah Stewart- Midwife Educator and Professional Development Officer with Australian College of Midwives @SarahStewart (and quite a whizz with social media matters)

Jacque Gerrard -Director for England Royal College of Midwives @jacquegerrard

Mark Newbold -Chief Executive of Heart of Birmingham FT @drmarknewbold

Anne Cooper -Nurse working in informatics interested in leadership @anniecoops

Teresa Chinn-Nurse and social media specialist @AgencyNurse

And if you are unsure about what Twitter is, and why or how it would be useful to you, @pam007nelmes is a social media expert, AND she believes kindness is magic which for me, is the best. Pam is worth following as she has lots of tips! Here is one of Pam’s presentations-Social Media for Nurses Oct 2012

For me, Twitter brings fabulous worthwhile interactions with others, the sharing of current and interesting news or information, and unique and exciting opportunities. And every now and then, there’ll be a gem that pops up, such as Molly Case’s inspirational poem, read by her at the RCN Congress 2013.

So, last night I asked several student midwives who are already engaged with Twitter, what benefits they felt it brought them…and here are a few of their ‘tweet responses’ back to me!

@dawn_t12‘Twitter for me is invaluable as a student. It keeps me updated on news/new research/study days, but more than that it’s another form of support. I love that through twitter I’ve made friends with people at different unis in different towns and we help each other through the bad days and celebrate the good. It’s just sad some students & midwives are missing out on this world!’

@Beetrooter‘Twitter brings fellowship with ppl passionate about midwifery from across the world & across spectrum of professional roles. Its my inspiration for learning, gives evidence to inform my practice, rolemodels for me to aspire. Instant access to womens’ experience jubilant/ anguish. Twitter is conversations. It’s life squished beautifully into 140 characters’.

@Birthsandmore -‘great way to broaden mind, horizon and tweet with like minded people you otherwise would not have met. t lifts my spirit to read and hear from so many passionate people, especially after a tough day ‘at the office’!

@Josie_jo_F-‘from a v.small Uni, twitter gives me a chance to find out what happens in other trusts, have contact with other SMs, learn from MWs, lecturers&other inspirational ppl I’d never meet in my isolated neck o’the woods.glad to have found this community’

@sazzletastic-People on twitter have been an amazing support to me throughout my 3rd yr studying giving me encouragement and reassurance to keep going and have confidence in my knowledge and abilities. Having access to organisations and big names in the field that actually reply to you is brilliant! I’ve learnt so much via twitter, I only wish I’d had it for the first 2yrs of study too!

So, come on midwives and student midwives….Twitter has so much to offer. Facebook keeps you in touch with friends, but Twitter helps you find those you would never have met, who hold the potential to open up a new world for you! As student midwife Hana Ruth Abel  @Hana_Studentmid so eloquently puts it:
Twitter is the thread that binds me across the globe, weaving me into the fabric of international midwifery & making me a piece of the puzzle that builds up a global voice, I am an equal part of that voice. Ever changing and pushing myself to grow with a community of individuals who share my philosophy and question practice. Twitter shines a light on every end of the spectrum. United we stand on our virtual platform- Speaking up and stepping forward, one tweet at a time’. 
Wow Hana!

Social Media Posting Guide