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Friday, 16 June 2017

"There's a Fire at London..."

Duckling, like many three-year-olds is completely obsessed by fire engines, police cars and all things "memergency". I have lost count of the number of times I've been pulled into his emergency rescue games with cries of "Quick Mummy, there's a fire at London!" (I think this is his interpretation of Fireman Sam's catchphrase "Great Fires of London").

It is a very hard thing to explain to a three-year-old that fires are more than just 'exciting'. I tried a few months ago, when some neighbours down the road had a minor issue with a singed bedroom carpet, prompting the arrival of two fire engines in our street. He sort of understood, but mostly he just wanted to wave to the fire fighters.

Yesterday, the explanation of what had happened at Grenfell Tower was infinitely harder. He saw the pictures on TV as I watched the news. "Wow Mummy! That's a big building on fire! And lots of fire engines!" I explained that this was a genuine 'Fire at London', and after some confusion about it being in the building where I worked (London and my office seem to be largely synonymous in Duckling's mind) he grasped the concept that this was a building where people lived. He wanted to see more pictures. He wanted to see the fire and the fire fighters and the sad people. I showed him some pictures on my phone, then told him I couldn't show him any more as I was very sad too. He asked me why.

What I wanted to say was I was sad because so many people had died in the most horrific circumstances imaginable, leaving behind desperate parents, children, siblings and friends. I was sad that mothers had been compelled to throw their babies out of windows, or had faced the agony of losing their children in the choking smoke as they ran for their lives. That those who survived had just had all their earthly possessions taken from them, and would never, ever be able to return to their homes. And above all, I was sad that this tragedy had happened, today, in 2017, in a wealthy developed nation, not because of an unpredictable freak event, but because the prescient concerns of residents were ignored and safety was forgone for the sake of a few thousand pounds. That this whole awful, horrible disaster was so fucking avoidable.

You can't say all that to a three-year-old though. So I just explained that people's homes had burnt down, and some had lost their friends and family and that made me very sad because I could imagine how scared and upset they must be. "Oh." he said. "What if our house goes on fire? Would we be burned and trapped like the people?" I reassured him that our house was very unlikely to burn down, but if it did catch on fire, we could escape out of a window or down the stairs. "No Mummy. I would put out the fire with my fire stingsquisher! Ne naw ne naw!" he cried and zoomed off to build a towerblock and a fire station out of Duplo.

Three is hard. Old enough to understand and be scared, but not yet quite able to fully empathise and grasp the gravity of what a fire - particularly one on the scale of Grenfell Tower - really means. In a year, he will get it. Right now, I'm kind of glad that he doesn't.

Tuesday, 6 June 2017

Things to remember when parenting articles make you feel crap

I read one of those articles today that begins, "There is a silent tragedy occurring amongst... our children," and proceeds to explain how an ever increasing number of kids are growing up with terrible mental health issues, unable to cope with life's challenges because their parents are basically rubbish.

I'm sure you recognise the type. They are the bread and butter of many websites and publications aimed at parents, and while they may make very salient points, and in some cases be based on good evidence (of the problem, if not always the cause or the solution) they can also make perfectly decent parents feel like crap for occasionally looking at Facebook rather than actively engaging in little Calendula's colouring in sessions. I know, I've beaten myself up more times than I care to mention for similar crimes.

As I've become more au fait with motherhood however, and particularly since I've had my second child, the levels of guilt I feel after reading these articles have lessened. I still have moments of regret when Paw Patrol or Pom Bears have featured too heavily in Duckling's day, but the feeling that "I'm obviously just not doing this right" has definitely declined. Why? Partly my confidence has grown, but also, I have come to realise a number of important things about articles that critique "parents" en masse:

1) Generalisations about modern parenting habits are just that: generalisations. They are not directly targeted at you or your child, even if it sometimes feels like it. For example, many articles bemoan digital distraction, and parents who look at their phone while in the company of their kids. I am guilty of this. I am thus, apparently, contributing to the downfall of the next generation. Except I don't think I am. I'm an intelligent adult and like most other Mums I know, I understand the concept of balance. I use my phone, of course, just not all the time (mainly because I'm forever losing it). Phones are banned at meal times, while we're out and about, and when I'm actively playing with Duckling. And if he's playing on his own and I am looking at Twitter, he just has to ask and I will put my phone down and speak to him. You know, like our parents would have done while reading the newspaper, or a book, or watching TV. If we were lucky...

Many generalisations assume us all to be extreme in our behaviours: permanently glued to our phones, never setting boundaries, only ever giving our children beige freezer tapas and Haribos... If you are on the extreme end of the spectrum about anything then sure, you probably are going to 'ruin' your kids a little bit, and potentially your other relationships too. Most of us are kind of in the middle though, adapting our approach to suit our kids' needs and personalities (and just as importantly, our own).

2) Many articles are riddled with contradictions. Either they contradict other articles, or there are contradictions in the article itself. So, you can never really be 100% sure what you're doing right is actually right, or what you're doing wrong is actually wrong. For instance, you must engage with your child at all times. But also step back and give them space to discover the world themselves and "be bored". Breast is allegedly best. Unless it makes you feel bad about not having breastfed in which case it's not. Because actually the evidence of benefit is overstated. Although it's also considered by many to be overwhelming and irrefutable. So you should breastfeed for at least 6 months. Or better still two years! But not more than three because that's just weird and there's no proof it's useful. Or maybe there is? You get the idea.

3) A lot of articles are written by child psychologists, pediatricians or similar professionals. Who do they see day in, day out? Children with physical or mental health issues. They see where parents are going 'wrong' (according to their particular pet theories). But they don't necessarily see all the parents who are getting it more or less right.

Claims about negative trends in childhood behaviour and experiences thus need to be carefully assessed. Is there longterm, objective evidence of a problem? The recent dramatic increase in autism diagnoses for example is most likely down to a change in how we diagnose the condition rather than environmental factors, or anything that we are doing differently as parents. In the case of childhood obesity, or anxiety and depression, there is however clear evidence of increase, as diagnosic criteria have remained identical for many years. What is less certain is exactly how we, as parents, are contributing to these issues beyond the obvious (feeding our children too much of the wrong thing, putting unreasonable amounts of pressure on them, or neglecting them). The problem is invariably more complex than some claim, and involves an interplay between shifting societal norms, current affairs, our children's innate personalities, their relationships with peers and our own relationships, parenting style, interactions and expectations. There is no one clear reason for rising mental and physical health issues, so no one clear solution - though having some common sense as parents and avoiding obviously damaging behaviour is a good start.

4) If the guilt trip article isn't written by a professional, it's probably written by a reformed "bad parent"; i.e.: "I used to shout at my kids all the time - then I discovered how to parent while sitting in the lotus position chanting 'ohm' and eating braised tofu. Now I'm practically perfect in every way!" Never trust anyone who claims to have all the answers. Their solution may suit them. It doesn't mean it will suit you.

5) There is always a cognitive bias towards both negativity and nostalgia, and many articles reflect this. I often pick up an underlying theme of "women have lost the basic skills of motherhood. They used to be better at it." Really? People used to routinely wallop their kids. Surely things are better now most don't? What about the modern children who are now benefiting from contemporary research findings relating to stress, love, nutrition, infant sleeping positions...?

6) Negative cognitive bias affects us as readers too. Parenthood is a thankless task, and praise is a rare commodity. It is easy to hear and dwell on criticism (even from generalised articles) and assume you're doing a terrible job because you once let your child watch twelve episodes of Peppa Pig in a row. Plus nobody ever says, "Wow, that was some awesome supermarket tantrum taming you did there!" or "Ha! Your Gruffalo voice is HILARIOUS!" so you often ignore all the times you got parenting right. If you love your kids and are thoughtful in the way you raise them (i.e. thoughtful enough to be reading parenting articles), you're probably doing just fine.

7) Many articles forget that we are human and our kids need to see us as such too. We should of course try keep our less desirable traits (short temper, bitchiness, nose picking etc.) in check, as kids are little spongey mirrors (and I know that's not a thing...) who both absorb and reflect. But children also need to see what to do when someone messes up - i.e. apologise and make things right.

8) In a similar vein, I am now wary of any article that suggests I entirely overhaul the way I speak to my kids. You know the sort: "Frangipane, I can see you are very upset with your sister. I understand you are feeling very angry but shall we think of better way to express that anger than ramming cheesy puffs in her ear?" The sentiment is great, but by the time you've got through that all, poor little Frangipane's sister has probably had a cheesy puff lobotomy.

I read an article about evaluative praise a while back, that suggested saying things like "Good Boy/Girl" and "Well Done" was actually terribly detrimental to our children as it cuts off further discussion and makes us, as adults, the determiners of their worth, rather than the child having an innate sense of where they'd got things right, tried hard or done well. I understood the point and tried not to 'praise' for a few weeks. I changed my speech patterns, and the things I said. I got the concept, but it just felt wrong, and Duckling (and Drake) kept looking at me like I was a bit bonkers every time I squeezed out an awkward "Gosh, that scribble is very, um, wiggly and, um, blue. You must have thought really hard about how to hold that crayon," rather than "What a great picture! What's this bit meant to be?". Sometimes I had to try so hard not to "pass judgement", I found I couldn't say anything at all, which is surely worse? I'm all for speaking to your children at an appropriate level for their understanding, remaining authoritative and reigning in the criticism, but I wonder how beneficial it is to constantly converse like an awkward robot stuck on "linguistic programming" mode. Your child will likely notice that you're not being genuine, and besides, second guessing and censoring everything you say sucks much of the joy out of the simple act of chatting with your child, which is almost as important as what you actually say sometimes.

___________

The purpose of this minor rant is not to pretend all parents are brilliant and free of blame or to excuse us from any sense of responsibility for helping our kids to be kind, happy and healthy individuals. This is surely our most important job as Mums and Dads, and we should always strive to hone our technique and scale the inevitable obstacles we encounter along the way as our children develop and change. Whether it's discipline, healthy eating, confidence building or potty training, by all means identify the issue, search out good advice - even professional help - and make some consistent, realistic changes. Just don't feel guilty about getting it 'wrong' previously. Furthermore, any changes you make should be based on what will benefit you and your child at the present moment, and not on a sense that you need to fix every long term trend, societal problem or 'behavioural issue of the month' that you read about. It's only by recognising this that I have at last learned not to worry about the baggage I have saddled Duckling (and now Ducklingette) with due to my ignorance of a problem I only learned about five minutes previously on HuffPost Parents. I have enough issues to address - I definitely don't need to imagine new ones...

Friday, 5 May 2017

What your second baby makes you realise about your first

Today I took my two children to soft play. It feels strange writing that. Not the soft play thing (though really, anyone who takes a three-year-old and three-week-old to soft play hell is certifiable), the TWO children bit. I am a Mum of two. It feels impossibly grown up. One child could just have been an accident. Two is deliberate. Planned. A proper family. I have a proper little family.

Ducklingette is a sweetheart. She has her moments, and an impressive set of lungs on her when hungry (which is quite a lot of the time), but mostly she just sleeps or feeds or gazes at your face / a shadow on the wall / the curtain pole / the oven timer (everything must be pretty remarkable when you're less than a month and can't really see clearly). She clearly got my note.  The contrast with Duckling at the same age is stark. For the first year or so, Duckling didn't really sleep unless he was latched on to the breast. He wouldn't take a dummy or a bottle (unless truly starving), and despite endless attempts, I couldn't reliably put him down for more than a few seconds without him howling as though I'd plonked him on a sacrificial alter. He wouldn't go in a pram or pushchair without having a meltdown, and even in the baby carrier, I would often have to resort to surreptitious breastfeeding as we walked. Car journeys were a nightmare - I'm amazed I never crashed. Consequently, every outing, even a quick pop to the shops, was an endurance event. With Drake abroad most of the week, I got very little respite from my somewhat demanding infant, and even when Drake was back, Duckling made his preference for being surgically attached to me exceedingly clear.

Compared to her brother therefore, looking after Ducklingette feels like a doddle. She's a pretty average newborn I suspect - but to me she's some sort of heaven-sent angel child. I may come to regret saying this when she suddenly develops colic or decides sleeping is no longer her thing. I know she will not always be this way, and there are moments, when she kicks off in the car or we get to hour five of her evening cluster feed session, where I panic that she's turned into Duckling. But she mostly just goes with the flow of our lives.

In the few weeks since her birth, I have regularly wondered what it would have been like had I had Ducklingette first. Would I have been tempted to have my second sooner? Would I have concluded, as I did a week or so after Duckling was born, that parenthood was "really fucking hard", a lingering sentiment that continues to make me feel daunted by Mum duty most mornings? I want to find mothering a joy, and there are moments - sometimes whole days or weeks - when I absolutely do because, now he has language, Duckling can be an utter delight. Provided other children and coveted emergency vehicle toys aren't added to the mix. But the hangover from his first year remains with me. Much of my pregnancy with Ducklingette was spent fretting. I wanted another child, but I was terrified of what would happen when she arrived. How would I cope with the constant cortisol bombardment created by a belligerently disobedient pre-schooler, and a perpetually screaming baby? I kept having flashbacks of various visits from friends and family where I would cheerily explain that a grizzling Duckling was just "a bit hungry / grumpy today, but we're doing fine" even though he was apparently famished and viciously grumpy every single day and I wanted to curl up in a ball and sob a fair amount of the time.

Essentially, I think I was a bit traumatised by Duckling's early days. I loved him unconditionally, but I was convinced I was a total pathetic wuss for finding everything so hard. My child was healthy, bright and alert. He didn't have any disability or illness that would give me legitimate cause to find parenthood difficult (my hat off to those who care for children who do), so I was clearly just not parenting right. Either I was focusing too much on the negative (because he DID sleep, smile, and occasionally even laugh sometimes), or I had made the proverbial rod for my own back by indulging him too much, and not 'training' him to accept being put down / sleep in his own cot / go more than 10 minutes without feeding.

Now Ducklingette is here, I know for certain that's bollocks. Duckling was just Duckling, and for whatever reason he was a genuinely difficult baby. I always suspected he was harder than most, but not being with other people's babies 24/7, I never had definitive proof.  Now I do. I was traumatised because I was a new, slightly clueless Mum, who was parenting largely on her own and my body was constantly flooded with stress hormones (there is NOTHING you can do to prevent a stress response when your baby cries - it's a very necessary product of evolution). I didn't make Duckling that way, and it wasn't my fault.  In fact, I did a pretty bloody amazing job in the circumstances, and it's only now that I can fully recognise that.

Furthermore, Duckling toughed me up. I can deal with most things Ducklingette can throw my way now. I already know how to drive through a 'why-have-you-abandoned-me-in-this-infernal-car-seat-mother?' sobbing fit (loud music), change a nappy on my lap (carefully) and breastfeed while standing on a moving train (anchor yourself with your knee and foot), and for that I am very grateful. Unexpectedly, even with an additional rambunctious three-year-old to keep in check, I am enjoying the newborn phase this time therefore. Really, truly - it's lovely. I just hope she remains as placid as a teenager...

Friday, 7 April 2017

The waiting game - 8 days overdue and counting

I am STILL pregnant. Fourty one weeks yesterday and no real signs of the baby making an appearance any time soon. I am massive because the baby is likely massive. If my little baby bun bakes any more I'm actually not sure I'm going to be able to get her out of the oven. I genuinely had a nightmare about someone in a giant pair of oven mitts attacking me with kitchen tongs last night.

I should be relaxing, preparing and nesting. But I'm about as prepared as I'm going to get now, and relaxing and nesting (a.k.a cleaning) are tricky as Duckling is on Easter holidays from nursery and around all day, every day, wanting near constant entertainment. "Come and play Mummy! Come on, pleeeeease!" is a perpetual request, with every game he comes up unfortunately necessitating bending down, crawling about, picking him up or making insane amounts of mess. I can keep him occupied with jigsaws, drawing or TV and a snack for short periods of time, but mostly he just wants to be outside, running about, making roads in his sandpit or digging in the mud and assorted discarded building materials that serve as our garden at the moment. For obvious reasons (sharp nails, rusty screws, broken glass) he can't really be left unsupervised to do this even if he'd let me.

Duckling has always been very Mummy-focussed, but with a new baby on the horizon (he totally gets what's going to happen), his clingyness and attention seeking have reached whole new levels. I understand why, and I try to strike a reasonable balance between reassurance, engagement and boundary setting, but it's bloody hard work, particularly as he now refuses to nap and is a total nightmare of over-tired selective deafness and "pick me uuuuup!" demands after around 3pm, when I'm at my most exhausted and in need of a little cooperation.

I know due dates are pretty arbitrary but I am fed up with being pregnant and heavy and slow and emotional and haemerrhoid afflicted. I am also naturally a little anxious about the birth and the baby too - I don't expect things to go wrong but I lost over a litre of blood last time so I know there's always a chance they might. I am sick of people asking me "any news?" and being vaguely disappointed / amused I haven't produced a baby to the expected timeline (as many people have pointed out "ha ha, you're late for everything!" Yes, I know, ha bloody ha). Or of being told "Ooh, you should aim for the 9th!" or, "well you can't have it today / tomorrow / next week Thursday as we'll be at the zoo / that's my Aunty Mabel's birthday!" I KNOW people are excited and worried in equal measure, and I know it's because they care about me, are keen to meet our new arrival and want everything to be OK. I remember feeling all the same things when my sister was two weeks overdue with her second. I don't blame them at all - but the fact remains I have NO control over this! And no, raspberry leaf tea, curries, pineapple, sex and jumping up and down do not work. I've tried. Not all at the same time though admittedly.

The baby will come. I really don't want to be induced as I'm planning a home birth, but if it becomes clear that it's genuinely medically advisable, I will be. All being well, in a week or two this strange frustrating limbo period will be over; a distant memory, obscured by the immediacy of a newborn. I know, ironically, I will miss the simplicity of just having one comparatively independent three year old. I will miss the relative quiet and freedom, because having two is inevitably going to be considerably harder - a screaming helpless baby AND a likely jealous and clingy pre-schooler? Why am I wishing this time away?! But it has to happen sometime; I can't escape the inevitable forever, and I really do want to meet my little bun. To give her a proper cuddle and relive that process of falling in love all over again. To see what she looks like, learn all about her little quirks and discover if she's going to be as chilled outside of the womb as she seems to be in it (she is so much less fidgety than her brother was). I just hope it happens soon, before my pelvis breaks, and that I can still do it without the need for kitchen tongs.

Tuesday, 21 March 2017

But you don't understand, I AM GOING TO HAVE A BABY!

The countdown has begun. Duckling #2 is due in 8 days. She is well engaged and ready to go, and my midwife estimates at least 8.5 lbs already (I sincerely hope I don't go too over my due date therefore, or she's going to be colossal).

It is hard to explain the feeling of being so close to a totally inevitable event but still so uncertain about when it's actually going to happen. I had forgotten the stress. Despite being gigantic, exhausted, uncomfortable and struck by regular electric cramps in my leg and back whenever I stand up, I am still nesting like crazy and want everything to be perfect and prepared, just in case. I plan to have a home birth, so it's not just a matter of having a bag packed, nursery ready and the car seat fixed - I need the pool inflated and a box full of towels and bin liners to hand, plus the hospital bag in case I do have to transfer in, and a rucksack for Duckling so he can go to Grandma's, and a torch, and a sieve (don't ask), and clean nighties, and food and coffee for the midwives, and, and.... Just in case. Just in case it's tomorrow. 

The problem is, nobody else seems to be aware that she could come tomorrow and that EVERYTHING NEEDS TO BE READY. We have a half finished kitchen and extension downstairs, with no proper flooring, just concrete screed. I have to give birth in that room and there are still wires hanging out of the walls everywhere and a semi open soil stack causing an intermittent poo pong to fill the whole house. "The guys will come to finish off the electrics over the weekend," says my builder. "NO! EVERYTHING NEEDS TO BE READY NOW" I scream internally as I smile sweetly and actually say "Oh, right, are you sure they can't come any sooner?...".

With more work to be done, Drake is very reluctant to inflate my birth pool as it will be a fairly significant obstacle for the electricians. I just want it up, with all the associated paraphernalia stacked neatly next to it, clean and sterile and accesible. "Well, if you do go into labour, I'll have time to inflate it and fill it I'm sure," he says "I'll need something to do." "NO! THERE MIGHT NOT BE TIME! EVERYTHING NEEDS TO BE READY NOW!" I do actually shout at him. He doesn't get the polite treatment our builder does.

Even poor Duckling is getting the brunt of my irritation, as he is blissfully unaware of the urgency with which all needs to be prepared, and insists on unpacking every case I pack, unsorting every mess I tidy and interrupting every attempt to finish a task with a cry of "MUMMY, I need a snack / drink / poo / you to rescue this dinosaur from a tree with my fire engine because it's a MEMERGENCY!" Not as much of a Memergency as it will be if the brand new sofa isn't properly covered in plastic shower curtains Duckling. "PUT THE SHOWER CURTAIN BACK CHILD!".

Part of this panic is totally self-inflicted - my fault for insisting on a hippy dippy home birth in the midst of a major building project. But having fought so hard to actually have my midwife attend my birth at home (thank God she eventually managed to secure an honorary contract through the NHS), it seems a bit pathetic to now opt for a hospital delivery just because some of our skirting board is missing and there are no blinds on the bifolds yet. Actually that last one probably IS important if I ever want to be able to look our neighbours in the eye again. Nothing some brown paper and bluetack can't fix though I'm sure.

Deeply middle class circumstances aside, the desire to be as ready as possible to welcome your baby is surely universal. It's not just a crazy female hormonal drive. It's a recognition of the fundamental life change that is about to assault you, and the knowledge, perhaps even more stark for me this time having done this once before, of the pain and focus involved; and the total exhaustion and selfless abandonment of free time, autonomy and personal space that follows. Things need to be prepared - for the birth and beyond - while you still have higher brain function, two hands and half an ounce of sanity.

I should count myself lucky. Some women never get the opportunity to prepare. I often think the shock of suddenly having a baby days, weeks, or even months before you expected one must compound the trauma of prematurity more than many let on. Your baby isn't ready. But neither are you.

So yes, I am fortunate to have this time. It will be fine. We will be prepared. Maybe not ready for our second. I'm still not sure I'm ready for the first. But in a practical sense, we should be mostly there. And really, if I don't have time to corral all my random maternity pad purchases into one bathroom, or clear enough former garage junk from Ducklingette's "nursery" for a change mat to go on the floor, will it really matter? Probably not. I'll still try to tick those things off tomorrow though. You know, just in case...

Friday, 17 February 2017

The elastic band of Mum love

While I was walking home from the Childminder with Duckling yesterday, we passed a car stopped by the side of the road, outside the park. Just after we'd gone by, a Mum got out, removed a little boy of about four from his seat and set him on the pavement, then ordered his older brother out too. She was clearly furious, and the kids were visibly upset, though I couldn't tell what they'd done. She then got back in the car and shut the door. Duckling was fascinated and concerned in equal measure and tried to run back to see what all the fuss was about. I stopped him, not wanting to interfere in a family drama, but I too could not drag my eyes away. I felt for the Mum, clearly at the absolute end of her tether, but I was also worried about the kids. It was dark and cold and they were obviously distressed at the prospect of Mummy driving off. I couldnt be entirely sure she wouldn't either.

So we backed off, and watched from under the shadow of a tree for a bit. "Why they crying?" asked Duckling. I told him I didn't know but I suspected they were upset because their Mummy was very angry and she needed them to stand outside the car while she calmed down (and to teach them a lesson, I didn't add).

After a minute or so, the Mum made to drive off. The little one wailed, running after the car. I didn't know what to do. My motherly instincts made me want to run over, give them a hug and tell them it would be OK. Had she actually gone, there is no question I would have done - that prospect was why I was watching, just in case. But she stopped, clearly just wanting to scare them a bit. Then she drove another metre up the road. The kids looked terrified, and the little one sobbed some more, but they continued to stand where they had been put. "What's going on? Surely Mummy wouldn't leave us?", their body language said. "Is their Mummy going to go away?" Duckling asked. "I really hope not," I replied, "but we're waiting here just in case she does."

Thankfully she didn't. Eventually, after a good four or five minutes, she got out, put the kids back in the car with some stern words of remonstration (I couldn't hear what) and drove off. I breathed a sigh of relief and carried on home.

I don't know what the kids had done and I don't know how many times she'd asked them to stop doing it. I don't know what else was going on in their lives, if this was a one off incident, or a demonstration of a frequently used disciplinary technique. I do know there have been times when Duckling has driven me to that point of irrational rage where you just want to Teach Them a Lesson. Would I have done the same? Possibly. I am not a big fan of fear as a disciplinary technique, so I'd have to have been pushed pretty damn far, but I can't say it would never happen. I understood.

Yet I also felt their terror acutely. I would have been distraught if my Mum had ever done that to me as a kid. Duckling often gets upset if I go upstairs without him - he would be totally beside himself if I dumped him on the pavement and threatened to drive off.

Perhaps I should have judged her more harshly or intervened directly therefore, but the fact was, she didn't leave.  She stayed because she was their Mum. Parenting is incredibly hard sometimes, but one thing I've come to realise in my first three years of motherhood is, come what may, my elastic band of love always pulls me back from the brink. That's why I didnt intervene. I couldn't truly believe, even though I didn't know her, that a Mum could snap that band and leave her kids behind. Thankfully my faith was right on this occasion. I hope it always will be.

Sunday, 29 January 2017

The NMC and their ban on Independent Midwives

I am due to give birth to Baby #2 in just over eight weeks' time. Until early January, I knew that birth would most likely - and hopefully - take place at home, in a pool, with an Independent Midwife (a self-employed midwife who works outside the NHS) I knew well and trusted.  My midwife has looked after me throughout this pregnancy, and cared for me during my previous pregnancy and birth too. In an ideal world, every pregnant woman should have the opportunity to receive such comprehensive and consistent care. I can highly recommend it - it's brilliant.

However, on a practical level, the NHS cannot offer this: shift work patterns, organisational complexity, lack of funding and lack of midwives mean that continuity of care for most is just a pipe dream. The vast majority of women muddle through the system just fine. Some have a great experience. For others it's just OK, but they get a healthy baby at the end of it, so they count themselves lucky. For others still, pregnancy and birth can be a waking nightmare that leaves them with PTSD or worse. It is a bit of a lottery.

The female body is designed to gestate and birth a baby. However, that doesn't mean that things can't go wrong - we're designed to defecate too, but that doesn't mean nobody ever gets constipated. That is why we have trained midwives, obstetricians, and paramedics to help us through (with birth, not constipation, obviously. Although my midwife did have some handy hints about piles).

The issue comes when your care provider doesn't do the right thing for you and / or your baby. At the minor end of the scale, they may fail to consult you, mistrust your instinct or belittle your intelligence. This is pretty common, and as women many of us will be depressingly familiar with this kind of treatment so we may not even notice. At the more serious end, they may intervene when no intervention is necessary, or fail to intervene when they really should have done. This can lead to terrible outcomes.

People make mistakes. I've made plenty in my line of work and my Independent Midwife has probably made a few too. She is human and I am not naive. It is therefore reassuring to me to know that, should she get it majorly wrong, she has indemnity insurance that will pay out in the event her mistake leads to a life-changing injury to my baby, or worse my own or my baby's death. However, did I choose to go with her because she has that insurance? No. I chose her because I felt it was less likely there would be a terrible outcome with her caring for me: continuity of care has been shown repeatedly to improve safety and reduce risk. My choice. When I had Duckling, Independent Midwives couldn't even get insurance. I still booked in full knowledge of this, because a good, calm birth with a skilled, informed practitioner who followed evidence and trusted me to understand my options and the risks involved felt like a pretty good deal. It was a choice I paid for yes, so a choice I could only make because I am privileged enough to be able to afford it. I recognise that. But still, my choice, and indeed my right.

My right has now been taken away. The Nursing and Midwifery Council (NMC) has decreed that the level of indemnity cover offered by a plan specially set up by IMUK, the official membership association for Independent Midwives, is "not appropriate". Specifically, should a catastrophic claim arise tomorrow, they believe the insurance fund would not contain enough to pay out a full settlement immediately. Despite the fact claims usually take several years to process, by which point much more will have been paid in and the funds would be adequate. And it has been accredited as financially sound and Solvency II compliant, which is more than the NHS' own compensation scheme has been. And that the NMC's actions have been deemed unlawful as they themselves state that it is not their role to speculate what an appropriate level of insurance cover might be for non-NHS practitioners.

All 80+ Independent Midwives (IMs) around the country are covered by this insurance and they simply can't get any alternative cover - it took years of hard graft to get the current scheme working. Yet in full knowledge of this, with just three days' notice before Christmas, the NMC stepped in to ban IMs from offering care to their clients (or even being present) during labour and birth, unless they found cover elsewhere, apparently "in the public interest". I understand the basis of their concerns, but as I stated in my letter of complaint to them, I do not feel this is in my interests. My choice and my right have been taken away, and I now have no idea where my birth will be or who will attend it, which is more than a little stressful.

I have faith in the NHS. I think it's an incredible institution full of incredibly caring people. I genuinely believe they will do their best for me and I don't want to appear an elitist snob about having to have a baby the same way most other women in this country do. If I didn't have an informed IM as a sister, I'd no doubt have been NHS all the way with my first. Indeed, I am very glad and very lucky the NHS will be there (I hope) to support me now it looks like my chosen midwife can't. It will be OK in the end I'm sure.

But I'm certainly not as sure about that as I was before Christmas, when I could be reasonably confident that the woman who brought my son into the world (and stemmed my blood loss from a freak laceration, called an ambulance and nearly got arrested speeding after that ambulance on our way to the hospital) would be there to welcome my daughter. Plus I don't know how I am going to navigate my way back into a system I have been out of since my 8 week booking appointment. Nothing causes more of a spanner in the intricate workings of NHS bureaucracy than a set of patient notes in a non-standard format with uncharacteristically legible handwriting. I strongly suspect I'll spend far more time repeatedly explaining my entire back story to my assorted NHS friends than I will telling them about my contractions and how I REALLY can't take them anymore. And don't get me started on the battle I'm likely to have over internal examinations. I had no idea at any point in my last labour how dilated my cervix was because my midwife was experienced enough to know what stage I was at without poking about. I was just left to get on with it. Excruciating pain aside, it was great and I gave birth feeling entirely unstressed and unmeddled with.

The really worrying thing about this decision though is the impact it will have on women who didn't, like me, have a good birth experience the first time around (and it was good, even with the pain and the drama at the end.  I will get round to writing about it one day). Women who have been traumatised by the treatment they endured at their local hospital, who scraped together enough cash to pay for an IM, and now they have no alternative route for receiving care, would rather give birth at home alone than risk returning to a place full of awful memories and mistrust. Leaving these women stranded is not in their interests. Concern about possible long-term financial difficulties that would only arise were something very unlikely to happen does not excuse an action which puts women and their babies at very real and immediate short-term risk. The NMC's decision is not about women's safety or the competence of their midwives - their real remit as a regulator. It's about money. And it's sad that they have chosen to put the latter before the first two in the assumption that this is what matters the most. This could have been handled SO much more compassionately and sensibly.

So sort it out NMC.  By the time you do, it'll probably too late for me, but you owe it to the thousands of women who will need a choice in the future, and the dozens of caring, dedicated midwives out there who have bravely stepped outside the system to offer the level of support they feel women truly deserve.

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To find out more about this issue, you can read the official IMUK and NMC press releases, plus a great post from Philosophy, etc.

You can also sign a petition to get the NMC to allow women their rights in labour.