Tuesday, 12 December 2017

Paying Women To Breastfeed: A few things to think about



Our old friend the NoSH study is back in the news today, I wrote about the feasibility study a while ago but they have now conducted and published a much larger trial looking at financial incentives to encourage women to breastfeed.

What is the Study?

 The study looked at electoral ward areas where breastfeeding rates are considered to be low and then randomly assigned them to either join a shopping voucher incentive scheme (the test group) or to continue with normal care (the control group). Those in the test group were asked if their baby was having any breast milk at 2 days, 10 days, 6-8 weeks, 3 months and 6 months. At each time point they got a £40 voucher is they said yes. 

What were the results?

This paper looks mainly at the 6-8 week time point. It found that 5.7% more babies were getting some breast milk in the test group than in the control group, although this dropped to 4.5% if the strictest statistical adjustments for differences between the groups were used. There was no significant difference in the number of babies who were exclusively breast fed or in the number of women who started breastfeeding.

What do we need to think about?

 With all scientific papers there are weaknesses that need to be considered, this one is no exception. The biggest one is pointed out in the paper:

How do we know the babies were breastfed?

For understandable ethical reasons the researchers couldn't ask all participants to pull up their top and prove they were breastfeeding. But this means we have to take their word for it that they were. The forms did have to be signed off by a midwife, health visitor or similar who could report back any suspicions to those running the study but they could also save themselves the paper work by giving their women the benefit of the doubt. 


Was it really the vouchers that made a difference?

The control group received "standard care" and, as many a new mum will tell you, standard care can be, frankly, shit. It can pile pressure on you to breastfeed but then leave you with no encouragement or help when you try. The difference between that and the test group may have amounted to more than the promise of a voucher. We know that women would have seen posters and leaflets and talked about the trial at their antenatal visits. The methods say that those who signed up were given a fridge magnet with information on where to get breastfeeding support and when they got their first vouchers they also received a letter congratulating them. 

We shouldn't underestimate the value of being able to seek help or the power of telling an exhausted new mum that that she is doing well and that other people, have noticed her efforts. There is also the possibility that women would feel more pressure to continue to breast feed or to report that they are, just because they know they are part of a study and they don't want to let down the researchers.

It's the textbook problem with trials of alternative medicine. Standard care gives minimal, rushed contact but those who see an alternative practitioner, someone who takes time to listen to them, feel much better. Regardless of the actual treatment. 

What we really need is a study where the support women receive is also controlled. Is it really the vouchers that make a difference or is it just having someone show they care?


Beyond the paper

No doubt a lot will get said about this in the news and the blogosphere. As I've said over and over a single paper shouldn't be considered all that important but of course it will be because it is about womens bodies and what we do with them. So it is worth thinking about the wider implications. 

Is it really ok to pay women to breastfeed?

I felt really uneasy with the pilot study's aim to financially incentivise women in deprived areas to breastfeed. It suggested those women needed to be bribed into looking after their babies in the way deemed best. This wider study focuses on areas of low breast feeding rather then specifically on deprived areas but I still find the payment aspect troubling.


The work of mothering is immense and unvalued. With a newborn baby feeding alone takes up as many hours in a week as a full time job. Except it's a full time job where you are on call 24/7 for months. But then there is everything else, the rocking to sleep, the nappies, the weaning the potty training, the school runs etc etc. Why should only one aspect of that, and one which not all mothers can do, be the only thing singled out for acknowledgement and reward? What does it say about our attitude to mothers if the basic biological act of lactating is more valued than all the other physical and mental work of parenting?

Does it even make a difference?

Would rolling this scheme out nationwide actually change anything? We have no idea at the moment. This paper only takes us to 6-8 weeks and says nothing about the health of the babies or their mothers. Importantly the only increase was seen not in exclusive breast feeding, but in mixed feeding and there is very little research into the benefits of that. It seems logical that any amount of breast milk will have some advantages but that's a guess. Mixed feeding could mean mostly boob, mostly bottle or anything in between, it's complicated, so most research just looks at babies who are all formula or all breast milk. 

Yes breastfeeding is natural and it can be lovely but it also places huge demands on the mother and sometimes breast simply isn't best if her physical or mental health suffer as a result. So does the incentive - reward system leave babies healthier and mothers feeling proud and empowered?  Or does it just add even greater pressure to meet other peoples expectations? 


Embed from Getty Images


The word "holistic" makes me cringe. It usually sits alongside some kind of dubious claims about alternative medicine or fanciful nutritional advice but I'm going to use it here anyway:

 Shopping vouchers may or may not increase breastfeeding rates. That may or may not make a difference to the health of the mothers and babies involved but what we really need is a holistic approach to postnatal care and a total change in our attitude to the work done by mothers. 

A gift card and a pat on the head for having a go at one aspect of being a mum is nice, but it isn't enough. Even as a Mum who has breastfed three babies it feels a bit insulting. I am more than a pair of breasts, I give my children far more than just milk. 

and now I have to go breastfeed the baby...

SBX

PS Yes I know men are parents too and some Dads do an equal or more than equal share but in 2017 UK let's be honest, it's still more often the mother doing most of it.


Monday, 9 October 2017

Michael Odent Wants Me Dead


I've written about Michael Odent before here and here. For those not familiar with him, he is a retired French obstetrician, credited with, among other things, introducing water births.

This weekend he got himself a piece in the Guardian to promote his new book: The Birth Of Homo, The Marine Chimpanzee. I'll be honest, I've not read the book and I probably won't. Based on the Guardian piece I'm not sure that either my head or my desk could take it.

Embed from Getty Images

To be fair to the Guardian they do a very good job of politely questioning Odent's claims and bringing in experts in the field to counter them. But I'm not the Guardian, one of the great joys of having my own blog is that I don't have to be polite. So I'm not going to be:

Michael Odent is talking bollocks.

What's worse, he is spouting this guff from a position of assumed authority. A position that lets him spout it in the national press. Where people could be forgiven for believing it.

So, what has he actually said this time?

The book apparently relies heavily on the Aquatic Ape theory. The idea that, at some point in human evolution, we lived by and in the sea. It's a compelling idea and quite a popular one, although not with so much with evolutionary biologists. Thanks here to Professor Alice Roberts who I asked about this on twitter:




But it's not just the ancient history that is questionable in Odent's book. He manages to get in both Epigenetics and the Microbiome. Biology's current buzz words. Both are fascinating fields but scientifically they are barely past the newborn stage and there is no conclusive evidence for how or if they are altered by childbirth never mind if any differences actually matter.

Odent claims that Caesarean birth is somehow altering epigentics and causing Autism, a claim well countered in the Guardian piece so I won't go into it more here.

But it's not just Autism, Odent believes that the entire human race is doomed because we have side stepped evolution by using modern medicine to help infertile couples conceive and women who would have died in childbirth to survive.

Michael Odent thinks that humanity's end is neigh because women like me weren't taken out of the gene pool by dying agonizing deaths along with our babies.

Well yes, left to nature me and my three children would not be here. Modern medicine was life saving for both me and my first baby and without it the other two would never have been born.

But without modern medicine those particular babies would probably never have been conceived anyway. Their father wouldn't have made it through a childhood case pf pneumonia. Without vaccines, maybe one of us would have succumbed to smallpox or polio? I could have died years before getting pregnant if there were no antibiotics to treat the many ear infections I got from too much time in water.

Without modern agricultural techniques would we both have made it to adult hood? I certainly wouldn't be almost 6 feet tall.


Everything our species has done since we first sharpened a piece of flint into a tool or wrapped ourselves in an animal hide for warmth has altered our chance of survival and cheated natural selection of a few more victims. To single out childbirth, the only one of those things that exclusivly kills women and babies, is bizarre.

The modern world is a very long way from perfect. But Odent suggests he has new and terrifying evidence about the fate of mankind. That what is going to destroy us, in the not too distance future, isn't politicians who fail to tackle climate change, war lords who care only about their own power and righteousness or world leaders who ignore disasters and instead play golf and engage in international nuclear pissing contests. No, the thing that will bring about the end of humanity is all these modern women who refuse to lie there quietly and die like they should.

Really?



Miss A, bringing down the human race, one dribble at a time

Tuesday, 18 July 2017

Healthy Eating - We Need Honest Information Not Expensive Ingredients


I am currently breast feeding a small baby. Which means two things: 

1: I spend a lot of time idly scrolling through Facebook. 
2: I am constantly hungry. 

So I was very happy for the random algorithms at face face to offer me a recipe for a “Healthy” chocolate dessert.

I am not one of those women for whom the baby weight simply falls off because they breast feed. Nope, it makes me crave cake and biscuits and all the things that add up to far more calories than I’m expending. So healthy chocolate pud? Yes please.

But a quick glance at the ingredients left me disillusioned.

Annoyingly (those bloody algorithms again) I now can’t find the recipe but I do remember some of the key ingredients:

150ml coconut oil
120ml honey
100g dates

All wholesome natural stuff right? This must be a healthy, natural food, to nurture this empowered Mama through her breast feeding journey? (Sorry I think the snark snuck out again, it’s not a ****ing journey, I’ve been stuck in the same chair for so long I’m loosing feeling in my bum).

Anyway…

I thought I’d check out the healthiness of those ingredients by plugging them into the MyFitnessPal recipe function. Assuming I could restrain myself to only a ⅙ portion then each slice, based on only these ingredients, provides 347 calories, 23.7g of fat and 34.1g of sugar.

I guess we could argue about the definitinon of healthy but I, and I suspect most people, would assume a healthy food was low in fat, sugar and calories. 

This dessert has almost as much fat as a Big Mac (which has 25g). Both make up around a third of an adult daily allowance. The recommended amount of sugar for an adult is 90g so the “healthy” dessert gives more than a third of that, almost as much as a Mars bar (35g of sugar) and that’s without the other ingredients. They are mostly almonds and cashews. I’ve not included them as I don’t have the quantity but while both are great for their protein content they are also high in fat and therefore calories.

Ah but it’s natural sugar and natural fat!

Your body doesn’t care. Honey may seem more wholesome, but our our bodies are only interested in the molecules of glucose and fructose, they don’t really care if they come highly refined from a big company or straight from your local organic bee herder.

I’d agree that coconut oil is great. It did a wonderful job of sorting out my dry scalp last autumn (though it’s a pain in the ass to wash out) and the health visitor advised using it as a moisturiser on the baby (it’s slippery but as MissM puts it “mmmm she smells like sweeties”). But as a health food? There are all kinds of claims about coconut oil but the evidence for most of them is weak, relying on extrapolation or studies done only on animals. Stripped back to the molecules again, coconut oil contains more saturated fat than lard. Yes, lard. The American Heart Association has issued a warning about it’s use. (There is more info on all this in this Guardian article)

Don’t get me wrong the recipe sounds absolutely delicious. I love all the ingredients, I’m a big fan of honey in particular, it has way more flavour than caster sugar. but the idea that recipes like this are healthier than the traditional alternatives is misleading.

Why am I bothered?

Because I have three daughters. I want them to grow up to be healthy but also to have a healthy attitude to food. To be able to enjoy the pleasure of a cool bowl of Gazpacho on a hot summers day or a rich meaty stew in the depths of winter. I want them to have a piece of cake, but not too much and without any guilt. I don't want them to worry unnecessarily about every single thing they consume. Food should be a fun, social part of life not a burden.

I’m also uncomfortable about the elitism in a lot of these “healthy” foods. While far too many people are struggling to to buy enough to feed their family, these recipes demand exotic and expensive ingredients. You can get Sunflower oil for around 11p per 100ml The leading brand of coconut oil costs £2 for the same amount (I’ll admit to looking this up on Ocado so cheaper options may well be available!). These recipes offer an exclusivity, follow them and aspire to be part of the elite, the instagram ready wellness warriors, the good and the clean. But what do "good" and "clean" imply about everyone else? Should I be feeling dirty because I had butter on my baked potato tonight?

I admire the skill and ingenuity of these kinds of recipes. What I don't like is the marketing. Make them because they are delicious, because they are gluten and dairy free if that appeals. Make them to experiment, because the ingredients offer subtle differences in taste and texture and you can afford that luxury. Make them because food is a vital part of life but one that can also be a pleasure, something to share with loved ones or take a moment to yourself to enjoy. But don’t think there are magical ingredients, and that a cake made of coconut oil and honey is any healthier than a good ‘ole Victoria sponge and please, don’t make your money or earn your clicks by telling people something is healthy when it isn't.

Most of us, and I definitely include myself in this, need to eat a little better. It’s hard when you are busy and tired and reaching for something quick and sweet seems irresistible. But we can only make good choices if we have good information, not garbage wellness fads that will only shed the pounds from our bank accounts.

SBx

Wednesday, 28 June 2017

Breastfeeding; Science, Advice And Survival


I’m on baby number three now, so I guess that makes me an experienced mum (at least of this age group). But from this exalted status I have only one* good bit of advice:


Don’t judge other parent’s choices by what works for you. Or your own by what works for them.


The main thing I’ve gleaned from eight years of all this is that every family and every child is different, even when those children are siblings.


Breastfeeding is a perfect example of this. Depending on which of my babies we’re talking about it has brought me joy and despair, pride and exhaustion, love and boredom in varying ratios. I could tell you that it is easy and natural, hellish and a serious risk to maternal health or just a bit tricky and tiring. Each description is accurate, but only for one child.




Before my eldest, MissE, was born I was confident that I would breastfeed her. Afterwards I was hell bent on it, hoping that it could go some way towards making amends for my failure at giving birth. Ultimately she was exclusively breastfed for 14 months and at some point it became easy and convenient. But in the first few weeks I was sucked, shell shocked and exhausted into a never ending ritual of feeding, sterilising, pumping and topping up. It left me feeling less than human, worthless other than for my potential to lactate. An inconvenient dairy cow in grubby PJs.


In some ways believing I had to breastfeed was the only thing that kept me going through those interminable nights and days. But with hindsight, especially after the far easier experience I had with my second child, I wonder if it was really worth it.


MissM wiggled straight up for a feed as soon as she was placed on my chest in the operating theatre. She’s rarely stopped eating since. When breast feeding is that straightforward then yes breast is probably best. But I’m fairly sure there is a line somewhere, where the benefits to the baby are outweighed by the harm, physical, mental or both to the mother. In our current society that is almost a taboo, we revere the martyrdom of motherhood and to suggest stopping  something that is good for babies for the sake of the mother seems unconscionably selfish. But babies need mothers who are able to care for them (and, shhhhh, mothers are still people too).




But to get back to the much veered from theme of this blog - what does the science say about all this? In all the variations, what can we take as fact?


The short answer is, it's complicated. I doubt there is any other area of parenting where we have so much data and so few answers.


Spend a few minutes on Google and you can conclusively prove whatever it is you happen to believe. Certainly there is good evidence that breastfeeding reduces respiratory infections in young babies but beyond that it gets more confusing. You can easily find studies that prove breastfeeding increases intelligence, reduces obesity and wards off a plethora of other health issues. But come at it with a more sceptical view and there are plenty of other studies to prove the first batch wrong.


It is, of course, impossible to do a gold standard randomised controlled trial on breast feeding. That would require a large number of mums to agree to someone else dictating how they feed their baby, then having that baby followed up for years. Practicalities aside it would never pass an ethics committee. So instead we have to rely on studies which either question people about what they did or which look over existing data and try to make links. This brings us back to our old friend correlation v causation:


In developed countries,  those with a higher socioeconomic status are more likely to breastfeed their babies. They are also more likely to be healthier and better educated. So is it breastfeeding that is benefiting those babies? Or is that just one, coincidental, part of a whole package of privileges?


Good studies will try to control for this, those that critique them will say the controls aren’t good enough. It will need someone far smarter and with far more time and data than me to say conclusively what and how significant the true benefits of breastfeeding are. One interesting study from last year looked at the difference between siblings where one was breastfed and another wasn’t. These children had, presumably, very similar upbringings and there was little if any difference between those breast and bottle fed. But this is a single study and no doubt has its own flaws.


But I’m going to stray into personal opinion for a moment here. I suspect that, if you ignore the wellbeing of the mother for a moment (hmm, just a moment? That would be nice) then the average breastfed child will probably have some, perhaps fairly small, advantages from the list of those currently contested. But there is no such thing as an average child so it will always be impossible to know how much influence breast or bottle has on any individual.




So what am I doing this time?


Neither of the above. Technically I’m mixed feeding. Something which is rarely included in studies as proportions of breast v bottle vary too much between individuals.


I had hoped to exclusively breastfeed again.  There is something special about that fleeting period where the only thing in the world that your baby needs is you. In looking at a plump, giggling, six month old and thinking I made her, all of her. But I found myself with a baby who was losing weight and screaming all night. All very similar to when MissE was born, except this time I know the problems aren’t because I'm a hopeless mother, or just not trying hard enough. It just happens, it’s just really hard sometimes.


When I pitched back into the grueling cycle of feeding, topping up and expressing, this time eight years older and with two other children to look after as well,  I decided to let one or two of the night top ups be formula, so I could skip the pumping bit and get at least a little sleep. This has lingered on as a bottle of formula in the evening so that my husband can do that while I grab a few hours sleep between the evening and early hours cluster feeds.


For now it is getting us through these exhausting first weeks and three or four hours of uninterrupted sleep at the start of the night feels like a revelation with a newborn. I am not someone who copes well without sleep.


Would I recommend it to everyone? Hell no. I’m pretty experienced at this having a baby thing now and all I know is that I know very little about any baby other than mine, and often not much about them. What we are doing is working for us at the moment and and that’s good enough.


SBx

*Actually I have two pieces of advice - buy four times as many muslins as you think you will need and never throw them away, they have so many uses!

Wednesday, 7 June 2017

London Bridge Won't Fall Down


I have a new baby. MissA is just three weeks old and so I live in a world where normal time is suspended. Day and night are a continuous blur where sometimes it just happens to be light or dark. Where I long to sleep all the time but could be summoned from that slumber at any moment. Thrown back into the cycle of feeding and burping and changing, that can stretch and shrink at random whenever I think a routine may be emerging.

So when the terror attacks in Manchester, and then London happened I was drip fed the news every few hours through the night as I lay in darkness, feeding my baby and scrolling through the crowd of information and misinformation on twitter. 

Perhaps it is the sleep deprivation and the surging hormones, but these attacks felt far too close. My Mum is from Manchester and I spent a lot of time there as a kid, visiting my Gran. The youngest victim in that attack was barely older than MissE. She wore the same supermarket school pinafore in the pictures on TV.

London Bridge and Borough market are my manor. A few minutes walk up the road from our old flat, the flat we brought our first baby, MissE, home to after she was born, the flat we returned to after many nights out in the local bars and restaurants before she arrived. The flat where I decided to rename my blog after a silly in-joke from school and the borough where I live, Southwark.

But what I felt most, in the glow of my little phone screen, was sadness and frustration at the utterly pointless loss of life.

I  am exhausted from looking after my tiny new baby, I am hurting and bleeding from her birth and I know it will be months if not years before I get a decent nights sleep. But oh how much I love her.

Most, hopefully all, of those who died, even the killers themselves, have been the subjects of that love. They have been the most precious thing in the world. Held and fed and cared for through long, exhausting nights, by mothers who sought no reward other than to keep them safe and see them grow. What right has anyone to take those much loved people away? Ordinary, joyful, young people who should have given their mothers so many more years of comfort and worry and love.

What is the point in it? London has been attacked forever. Alfred The Great saw off Viking invaders more than a thousand years ago. Guy Fawkes tried to blow up parliament in 1605 and we've turned it into an excuse for a party. The IRA, although their tactics were different, did far more damage than this during the bombing campaign of my childhood. Non of these attackers won, none of them changed our way of life and they never will. So why are people still trying?

I don't believe this is truly about religion. I'm no expert but it seems to me to be more about angry, entitled young men who just happen to have latched on to this particular cause to make themselves feel more important then their lives suggest they are. If they couldn't claim to be acting for their god they would just be picking fights in nightclubs or abusing their girlfriends like so many others who feel the world owes them whatever they want. 

The world doesn't owe us anything, we don't deserve flashy cars or designer clothes, we aren't entitled to anyone's love and other's aren't compelled to share our religion or the opinions we spout on the internet. But we do all owe it to each other to remember the tears and pain and exhaustion of those who raise us. That has nothing to do with religion or nationality. Whoever we turn out to be we were all once tiny, new and precious. 

London bridge isn't falling down. Young girls aren't going to stop screaming with excitement at pop concerts. Young people aren't going to stop moving to London and drinking and chatting in the bars and restaurants. Perhaps there will always be someone with some cause who wants to change that but it's been a thousand years or more and no one has managed it yet. The never will.

Thursday, 25 May 2017

Better Postnatal Care


Our new baby, MissA is here. When I'm a bit less sleep deprived I'll write more about her but for the moment I want to share an old post. 

The Mumsnet Better Postnatal Care Campaign began not long before MissA was born, when the subject was very much on my mind. Even when facing a potentially complicated Cesarean I was often more scared of the ward afterwards than the surgery itself. That's because of what happened when my eldest child, MissE was born. That birth was long and terrifying but what followed only added to the trauma and has stayed with me ever since. It took me almost six years to be able to write about it but I'm sharing that post again now in support of the Mumsnet campaign:

#BetterPostnatalCare

Tuesday
I arrived on the postnatal ward of a busy London hospital at some point on a Tuesday morning. I was oblivious to the time by then, days and nights had blurred together as the straight forward, natural birth I had planned (and foolish assumed was pretty much guaranteed), had taken me from wallowing in the birthing pool of the midwife unit to, eventually, lying shaking and terrified on the operating table. 

I do know that my daughter was born by emergency caesarean at 2.33am. Afterwards I was taken back to the delivery room for a few hours. I hadn't slept since the previous Saturday night, my husband had done a little better but was still extremely tired. He dragged out a sort of school gym mat that was propped in the corner and fell asleep on the floor. My beautiful new daughter dozed peaceful in her little plastic crib next to me. I was utterly exhausted, I should have slept but I couldn't. I'd been convinced of the very worst when my baby was whisked away, silent and unseen behind the blue surgical screen. But even once she was sleeping safely beside me I couldn't relax, I couldn't let go of the fear that something might happen, that someone needed to stay awake and watch her. At some point one of the midwives who had looked after me earlier in my labour popped in to say hello as she started her next shift. She'd been home, probably seen her family, slept, eaten. This was a whole new day for her but for me it was just a continuation of a timeless blur, I barely recognised her and couldn't speak to thank her for her help, whenever it was that she had helped.



I don't remember much about that day after I got to the postnatal ward. I was wheeled down on my bed, unable to move. The staff on the delivery ward all cooed over how beautiful miss E was with her full head of dark hair. I kept wondering if this was really my baby, I already loved her fiercely but how could something this beautiful have come from my ugly body? Had some switch been made behind that blue screen? I told myself that that made no sense, but still the doubts crept back.

I do remember that night though.

For a while it seemed that everything would be fine, I was the only person in a four bed room and at some point the lights were dimmed and I lay down, with one hand resting protectively on the tiny crib, and started to drift into sleep. I looked at the time on my phone, amazed I'd been awake for so long. An hour later I was woken up by voices and the clanking of equipment as another mother was brought into the room. I never learnt this lady's story. My best guess is that she was readmitted as her baby was jaundiced and had to be put under a lamp. Whatever had happened, the mother was clearly in desperate need of help herself. She spent the rest of the night pacing up and down the room, rambling and shouting, I couldn't make out what she was saying or in what language, I had no idea if it was directed at her baby, herself or maybe at me. With hindsight I know she was harmless, that I should have tried to help her but that's not what I thought at the time. At the time I felt extremely vulnerable, I still couldn't move and I was terrified of this "crazy lady"* and what she might do to me or my baby, the baby I needed to protect. So I did what I could and lay awake and vigilant all night. Once, a midwife came in and asked her to be quiet, but then they left us alone for the rest of the night. I should have called them, asked them to do more for my sake and hers but I was too scared that she would over hear me complaining and then take her revenge once the midwife's back was turned. Our room was at the end of the ward, out of the way and I had already learnt that the call button could wait twenty minutes for a response, if anyone came at all.

By now time had definitely returned and I was acutely aware of it. I watched the minutes and hours tick past, snatching glimpses of it on my phone screen, hidden under the bed sheet. Until it was just about morning and I thought it would be ok to call my husband. To shake him out of his much needed sleep and ask him to come back in the moment visiting hours began.

Wednesday
I remember a little more of my second day on the ward, there were family visitors, all delighted to meet the first member of a new generation, I felt the need to tell them all about her birth but I slowly realised, everyone was there for the baby. Not me. At some point we discovered that I still had a catheter in and the bag was full so it was removed, along with the cannula that had been tugging at my veins for days. I desperately wanted a shower but wasn't sure if I could, was it ok to get the scar wet? Would I even manage to stand in the room alone? Was I allowed? I managed it in the end, trying hard to get clean without actually looking at my body, trying to leave no trace of my blood in the shared bathroom.

By this point I'd been moved to a busier room, I couldn't help overhearing the conversations with the lady in the bed opposite. She had a new baby, just like me, but she had no where to take him home to and was waiting for a bed in some kind of hostel. How dare I complain in the face of that? What right had I with my lovely husband and nice flat to demand more time of the staff?

I remember the next night vividly too, far too vividly. Once again the lights were turned off and partners ushered out. But this time the ward stayed noisy. In the bed next to me another mum talked loudly on her phone, her TV blaring. She was told to keep it down but paid no attention. The bed opposite was briefly free until a new occupant arrived, her baby had just been born by emergency C section and her shocked and exhausted expression mirrored my own. As she was brought in I was sitting sideways on my bed, half naked, trying desperately to get a decent feed into my uninterested baby. I remember the look of horror on the face of the new woman's partner when he saw me. One of the midwives noisily changed the bed sheets, clanking the sinks and bins right next to me. I could feel again by now and the pain was growing. I pressed the call button to ask for some pain relief but no one came. Later I tried again, to get someone to help me lift my baby so I could feed her but again no one came.

Eventually the adults on the ward grew quieter just as the babies grew louder. I managed to flag down some pain relief but it wasn't enough and eventually, reluctantly, I was given a morphine tablet. I don't know if it was that or just the shear exhaustion but suddenly I began to hallucinate. At first it was just a little movement in the corner of my eye, down on the floor near the door - a mouse? Surely there wouldn't be mice running around the ward? If nothing else it was spotlessly clean. Then slowly the creature took the form not of a mouse but a moose, a cartoon moose that I used to draw at school. I knew it wasn't real but that only made it all the more terrifying, was I loosing my mind now? Would I soon be the "crazy lady" pacing the ward?

Still my baby wouldn't feed. For two days I been told this was terrible, or absolutely fine.  That there was something wrong with her mouth or she just needed a rest. But I needed to feed her, I had to make her ok and do something right for her, but she just wouldn't, what was I doing wrong? I wanted help but couldn't ask for it, no one seemed interested, every bit of advice I'd had contradicted the last and besides, I really shouldn't make a nuisance of myself.

Eventually it all became too much and I allowed the tears come. But it wasn't the quiet restrained little weep I had expected. It was the gulping, sobbing, unstoppable cry of a small child, I knew everyone could hear me but once I had started I couldn't haul back any control. After a while one of the midwives came over and asked what was wrong. For a moment I thought she would help me, that she would do something, so my baby would feed and I could sleep. Or she would just just tell me that yes, what I'd been through was horrible and I had every right to feel shocked and upset by it. But no. She told me sharply that I must stop crying and making a fuss or I would spoil my milk and not be able to feed my baby at all.

Then she left.

I should have called her supervisor, I should have complained and asked for help. But I didn't. Instead I listened as the supervisor (who I think was informed of the incident by another of the mums) and the midwife argued about her behavior in the corridor outside. The midwife then stomped off leaving the rest of the staff chatting about last night's TV. The supervisor did briefly come over to check I was ok but didn't mention the incident. Neither did I, I knew better than to ask for help now.

Not long after that the baby screaming really kicked off, my own alternating with one of the others in the room so that it was a constant din. I had to get out of there, I staggered to the desk and asked if there was anywhere I could go to be alone with my baby and away from the noise. Someone waved in the direction of the ward lounge, but it had dazzling automatic lights that left me feeling exposed so I asked if there was anywhere else and was pointed down the corridor to to a little room used for expressing milk.

I spent the rest of the night in that small, beige, rectangular room. There were two big machines and a plastic chair. MissE slept on and off in her crib or in my arms, though I was scared I might finally fall asleep and then drop her. Mostly I sat on the plastic chair, alone in the dark, checking off the minutes and hours on my phone until morning. When I thought it would be getting light outside I went back to my bed. No one checked on me, no one noticed I'd been gone for hours.

All I knew now was that I needed to leave. Yes I had had major surgery and my baby wasn't feeding well, but there was no way either of us could recover there and I doubted my body or mind would hold out for another night. I lay on display in my bed as the doctors and midwives did their morning ward round, discussing me as if I wasn't there, ignoring my attempts to join in the conversation about my body and it's failings.

It took hours and a lot of nagging but eventually, against the advice of the medical staff, I left. Shuffling painfully down the corridor, not fast enough to get to the room where my baby was having her first checks, but I made it out, using our new pram as a walking aid.

It was Thursday afternoon, I'd slept for a total of one hour since the previous Saturday night. I had been through an exhausting labour and emergency surgery, followed by two nights awake and afraid. I felt broken in every way and now, I had to go out and become a mother.




SBx

* I don't use the phrase "crazy lady" lightly, and I certainly hope it doesn't cause anyone any offense, it is just the best way I can think of to describe my perception of her at the time.

Tuesday, 2 May 2017

37 Weeks Pregnant And A Little In Denial

I've been pretty absent from the blog for a while for a combination of reasons. Some of these were simply practical. We've just finished a building project in our house, it's great but has meant every single room was in chaos. Combine sorting that out with two kids, a job and needing to go to bed at 8pm every night as I'm so tired and nothing much else has got a look in.

I think there may be another reason though, if I'm honest I've been a little in denial about this whole baby thing. Now I've passed the 37 week mark I should probably try to get over that.

When we started trying for number three, I'd expected to get pregnant very quickly as I had done with both MissE and MissM. But the months dragged on and I was beginning to resign myself to it not happening. Then, almost a year ago I found out I was finally pregnant only to have that excitement crushed by a miscarriage that dragged on for weeks.

When I got those two little lines again, only six weeks after the previous pregnancy was finally, surgically, ended. I didn't dare celebrate. This time an early scan shouted out good news. The little flicker of a forming heart appearing on the screen as soon as the ultrasound wand was placed on my belly. No searching around in a black void, no uncomfortable internal ultrasound. The twelve week scan showed everything to be just as it should be too but, unlike my first two pregnancies, I didn't feel like putting up a facebook post or writing about it all on here. It still felt too fragile, too risky.

We told close family and, because I work in a biohazard lab, my manager and health and safety team. But I held off spreading the news more widely until after the 20 week scan, by which point people would probably have guessed from looking at me anyway. As far as my poor abdominals are concerned, resistance is now futile.

Even now, I'm finding it hard to believe that I am full term pregnant, everything is going well and the C section is booked in less than two weeks from today. I've been pregnant for most of the last year, with two almost back to back first trimesters. Being pregnant is now my normal state, So it's strange that it will be ending so definitely and so soon.




But of course it will and today is the first time I have sat down with a cup of tea, no kids, no work and no massive to do list. I'm finding it hard to take on all the advice to relax but I probably should. It just took me almost forty minutes to walk a little over a mile and I'm waking up several times each night with the all too familiar hip pain I remember from before MissE and MissM were born. I should probably be making a concerted effort to get over that denial.

But then, although it has taken a long time to get this far, It's been even longer since I had an actual newborn to care for. MissM is almost four and half. Somewhere in the depths of my patchy memory I seem to think it's quite hard work, but maybe I'm just misremembering that.

I've done it all twice before. This baby is going to sleep and feed perfectly.

So it'll be easy this time right?

Right?

(No, it's not just a river in Egypt)

SBx