Karen Hall | Motherworldly

30 Mar

NCT courses: a clarification

This Guardian article today tells you that NCT courses “can set you back by £400.”

NCT is, by the way, a charity. Not a profit-making enterprise. Surplus from courses goes into charitable work such as campaigning for better services and support for new parents, and providing that support, usually completely free of charge to parents, whether they are NCT members or not.

This page shows very transparently the hourly rates for NCT courses.

This page shows that NCT discounts courses by up to 90%.

None of these pages explain the level of training (minimum two years, currently a foundation degree), assessment and CPD that NCT Practitioners undertake, nor the fact that NCT Practitioners are specifically trained in facilitating adult learning (unlike most midwives). NCT courses don’t just transfer information into passive vessels, and most people come out with tools and strategies as well as knowledge. Oh, and the “bought friends,” of course.

If you’re spending that much money (or not), you might want to look into the qualifications and ethos of the organisation you are spending it with.

27 Feb

Book Review: Why Homebirth Matters, by Natalie Meddings

Natalie Meddings is a doula and the founder of Tell Me A Good Birth Story, so sharing positive tales of birth is her way of life. She knows this subject extremely well, and has already covered it extensively in her previous book, How To Have A Baby. Her latest book fits nicely into the Why It Matters series, adding a good helping of How It Works so that this handy little text is both political and practical.

Meddings examines current attitudes to birth generally, and homebirth in particular, both from the medical perspective and that of the general public. However her own perspective, that “birth has never been safer” (p17) guides the reader as she explains the how and why of homebirth in a way that makes both logical and intuitive sense.

For expectant women and their partners, this book has a useful level of detail, making homebirth a realistic possibility, and without neglecting potential “forks in the road” (p109). This is a good resource for getting informed, and for navigating the various faces of the health service in a positive and productive way. This is the kind of little manual that you really could carry around with your pregnancy notes, dipping in as needed or wanted, to really immerse yourself in the way of birth.

[Disclosure: I was sent a free review copy of How To Have A Baby. I’d recommend it, and you can get a copy from the publisher, with a 10% discount if you use the code SPROGCAST at the checkout]

26 Feb

Book review: Why Mothering Matters, by Maddie McMahon

Why Mothering Matters is a book full of myth and metaphor, exploring the metamorphosis of woman into mother in a world of judgement and inequality. Maddie McMahon is well qualified to write this book, with her years as a doula, doula trainer, and breastfeeding counsellor granting her a profound understanding of the many different forms this transformation can take, and the almost endless pressures and influences that bear down on the work of mothering.

A contemporary companion to Naomi Stadlen’s What Mothers Do, this book starts its journey here in the 21st Century, listening to the voices of mothers who share their feelings and experiences. What this uncovers is a world of contradiction, where we can feel isolated and yet never disconnected from the world, and where advice comes so thick and fast that it is impossible to grasp hold of the threads that might be useful. We see the many different relationships that can smooth out a difficult day, or blow your confidence out of the water, just in a choice of words.

But this book is not all crowdsourced anecdata; and particularly in the chapter on ‘The Chemical Soup of Motherhood’ Maddie gives us the science behind attachment and baby brain development, relating this to the mother’s wellbeing as the foundation stone of healthy growth in both those areas.

We then swim deeper into the global and historical context of mothering, and page by page the book gets more deeply and gloriously feminist, capturing the essence of motherhood: it is hard, we even make it hard for ourselves, and then the world makes it harder; but it is amazing and under-appreciated. What would the world be like, Maddie asks; what would politics be like, if the country was run by a circle of mothers?

It’s a manifesto and a celebration, but also a very personal piece of writing. Maddie writes about how vulnerable mothers can be, and makes herself vulnerable with this subject which is clearly so precious to her. It’s a really beautiful piece of writing, in so many ways.

[Disclosure: I was sent a free copy of Why Mothering Matters by the publishers. You can get your copy here, with a 10% discount if you use the code SPROGCAST at the checkout]

Maddie talks about the process of writing the book in Episode 46 of Sprogcast.

02 Feb

Book review: Hard Pushed, by Leah Hazard

Hard Pushed is a memoir of midwifery, drawn from Leah Hazard’s years of experience in the NHS. Leah’s words bring the reader right into the maternity ward, sketching her colleagues and the women she cares for with mostly loving detail. This is a very different book from Ellie Durant’s New Walk, but similarly gives a real feel for the pressures and joys of modern midwifery.

Hard Pushed is structured into pairs of chapters, briefly describing a theme, and then illustrating the theme with a story. We have Eleanor the lesbian mother, Star the hypnobirther, the 15 year old mum, the woman being pressured to breastfeed, the trafficked woman: composites and archetypes of the swirling complex mass of human need encountered in a midwife’s world. These women serve to illustrate what it’s like to be a midwife, and the real insight here is very much from a midwife’s perspective. So we see how incredibly hard midwives work, getting through the day on biscuits and coffee, with barely time to go to the loo; and this gives context to the irritation that comes across at the many tiny anxieties expressed by pregnant women, and the dialogue with women in labour that skates over informed consent (“‘We might have to make a wee cut,’ I call brightly.”) For any reader unaware of the overload on our maternity services, this is a very clear picture.

But Leah does write with love, and what comes across is the midwife every woman wants to meet in labour: intuitive, kind, skilled, and willing to bend the rules just enough to personalise care when it matters most. She writes with gentle humour, but doesn’t steer clear of the bleaker stories. And as in real life, leaves many of the vignettes with an unresolved ending, just as these women leave her maternity ward to get on with their own lives, unlikely to be seen again.

This is a book that can be read for easy entertainment, but the subtext is not hidden far below the surface: midwifery is a challenging vocation. It does me good to be reminded of the efforts going on behind the scenes, and to be thankful that there are women prepared to do this work in such trying circumstances.

[Disclaimer: I received a free review copy of Hard Pushed]

30 Jan

Book Review: The Breast Book, by Emma Pickett

Emma Pickett is just the person to write a book for confused or anxious or curious teenage girls. She has an abundant and fascinating knowledge of the subject, and a humorous, patient tone with which to impart it. What makes this book particularly special is the deep feminism that comes through on every page: your body is normal, your body is good, your body is your own for you to make decisions about.

The Breast Book covers how breasts grow, what they are for, and why society gives us such confusing messages about them. Illustrated with cartoons, photos, and anecdotes from women of all ages and one transman, it’s very accessible even for the younger reader. And while the younger reader may not take in all of this detail to start with, just owning this book means they have a reliable resource for when they are ready. It even includes sample notes to highlight in order to start a conversation with parents, should it feel too difficult to do this out loud. And parents, note: this book is not a substitute for talking to your daughter, but is an excellent companion.

29 Jan

Review: The Book You Wish Your Parents Had Read (and Your Children Will Be Glad That You Did), by Philippa Perry

Disclosure: I’m a fan of Philippa Perry. I’ve read her other books and I’ve seen her speak a few times. When I saw that she had written a parenting book, I shamelessly pestered for a review copy and an interview for Sprogcast.

The book arrived (and the interview was arranged; aim for the stars, people). It says it is a parenting book for people who don’t buy parenting books, which seems like an unusual marketing strategy. I think what she means by this is that hers is a non-mainstream position, she doesn’t lay down the usual guidelines about how much sleep the baby needs or pussyfoot around with the whole “just do what’s right for you” approach; nor at any point does she list the useful gadgets and best possible wardrobe for the accessory-baby of your dreams.

TBYWYPHR(&YCWBGTYD) starts by looking at how you, the reader, were parented, and by encouraging some reflection on the impact this has had (or could in future have) on your parenting. There are some short exercises to help with this, and a couple of illustrative anecdotes. It’s about noticing your trigger points, being aware of negative self-talk and where that comes from, and avoiding judgement. These sound like straightforward ideas with sound reasoning behind them, until you ask yourself how to put them into practice.

Happily the rest of the book goes on to explore this process, by looking into the world of the child and showing how empathy and compassion can be such powerful tools both on an everyday basis, and in difficult situations. The chapter on pregnancy was of particular interest, as this is the one place where Perry really gets into the socio-cultural context of parenting. There is a lot more to say about the challenges that modern parents face, in a world where expectations of parents are at odds with this approach. And crucially, most parenting books don’t touch on this at all.

Perry uses her own life experiences to demonstrate some of her points, giving examples where she got it right, as well as examples of when she got it wrong but it turned out okay anyway. What I took from this was not that she was a smug perfect mother who always knew the right thing to say, no, but that none of us is perfect and that just because we get it wrong sometimes that doesn’t mean we shouldn’t try. Parenting is, as Perry says, a long game with a high up-front investment in the relationship.

I felt that the book became increasingly practical, and I was particularly grateful for the ten or so pages on parenting teens (perhaps the next book could expand on this). Parents of toddlers would find it useful, especially on days when parenting feels like wading through mud, and not in a good way. Most people reading it will wish that they had read it sooner, so I am strongly recommending it for the expectant parents in your life, alongside a huge helping of support. While it’s never too late to do better, it’s definitely never too early to be more compassionate and understanding.

20 Dec

Book Review: Why the Politics of Breastfeeding Matter, by Gabrielle Palmer

This small book in the Why It Matter series from Pinter & Martin is a distillation of Palmer’s earlier, bigger book with a similar title: a good starting point from which to explore this huge and frankly upsetting subject.

Palmer begins with the well-established health case for supporting and protecting breastfeeding: more than 2,000 baby deaths per day worldwide, as a broad headline; and many far-reaching consequences that affect families every day, in the developed world and beyond. The history of commercial baby milk substitutes going back over 100 years is clearly explained, showing how the creation of a market, rather than the health and wellbeing of infants, has always been the industry’s main motivator. The book explores the ethics of testing the product on the market – also known as giving untested formula milk to babies; as well as the growth of the close relationship between health professionals and manufacturers. This relationship has led to the complete undermining and misunderstanding of normal breastfeeding, to the point at which breastfeeding failure is now framed as a “flaw of women’s bodies” (p45); meanwhile historical practices at the time of birth, and social pressures to parent in certain ways, sabotage the breastfeeding relationship and contribute to this vicious circle of ignorance.

Palmer explains why the ongoing Nestle boycott matters, why the WHO developed the International Code for the Marketing of Breastmilk Substitutes in 1981, and how the milk manufacturers created unnecessary products like follow-on milk in order to exploit its loopholes. One unanticipated side effect of this was to present breastmilk purely as a food product, erasing the importance of the breastmilk relationship, and making it harder for society to value this fundamental aspect of motherhood.

The huge implications of all of this for global issues like poverty and climate change are introduced towards the end, leaving the reader potentially feeling angry and cheated by big business; and hopefully ready to fight for change.

Disclosure: I was sent a free review copy of Why The Politics of Breastfeeding Matter by the publisher; you can order it here, with a 10% discount at the checkout, using the code SPROGCAST.

21 Oct

Book review: Milk, by Emma Rosen

Emma Rosen knew she had a book in her, and motherhood gave her the material. Milk is, as subtitled, a story of breastfeeding in a society that’s forgotten how. The thing that will stay with me long after reading this, is how strongly I identified with her experience of feeding her first baby; and (although I never experienced this, having stopped at one), how healing I found it to read about her second birth, along with the feeding and mothering experience that I will always wonder if I could have had. I hope this book gets out to pregnant women, in that place where it is hard to grasp the reality of life with a baby, and prepares them just a little bit more to navigate those early months.

Emma’s book alternates between telling her own story, and telling the story of breastfeeding; and in doing so, places her own experience within the wider context of breastfeeding in 21st Century Britain, and in the world, and all of history. There is so much useful information here, and it is thoroughly referenced, too.

For anyone looking for insights into pregnancy, birth, and the world of a new mother, this is a really lovely read, and one that doesn’t shy away form the gritty reality of the physical and emotional changes of this momentous time. This might be the first time I’ve read a book that really succeeds in conveying that reality without either hyperbole or sugar coating. A properly good book.

[Disclaimer: I was sent a preview copy by the author. You can buy it from all the usual places.]

29 Aug

Feeding with a Supplementary Nursing System

Thanks to Jaclyn Currie for this guest post. Jaclyn is a stay at home mum to a busy two year old, British expat in Nova Scotia and La Leche League leader.

We’d been trying unsuccessfully to conceive for almost two years when I was diagnosed with Hashimoto’s. I fell pregnant almost as soon as I started on thyroxine and had a very healthy pregnancy. We moved to Canada when I was around 10 weeks pregnant and there are few midwives in this province but I had excellent care from my doctors, who were very responsive to my birth wishlist! It was only towards the end of the pregnancy I found out there might be a risk of low milk supply but given that I’d planned a natural labour and delivery with a doula in the local maternity hospital, I thought I was doing everything possible to ensure baby would breastfeed well. As I was new to the country I also started attending La Leche League meetings to meet new, likeminded people.

I was referred to the post-dates clinic at 41+5 and hoped to be told all was well and to come back in a couple of days. Baby had been head down for many weeks and was moving well, but unfortunately his heart-rate was dipping dramatically and the decision was made for an emergency caeserean… then thankfully downgraded to monitoring, then induction overnight with Foley catheter, then pitocin to start in the morning.

I had a fast induced labour but managed with gas and air, lots of movement and bouncing! But he wasn’t responding well to the contractions and the decision was made to use the vacuum to help him out (avoided forceps thankfully), but I had lots of tearing and lost around 800ml of blood.

My son was born 9lb with an apgar of 9! Turns out the cord was around his neck but he found his way to my breast easily and I was relieved all was well.

Over the next couple of days I was able to express a little colostrum and the nurse said he seemed to be latching well. He was sleepy though and then had jaundice so he was put under the lights for a couple of days (this can be done in room thankfully). No real concerns around feeding though it was starting to be a little sore on one side.

Finally we got home and he fed ALL the time! I knew this was normal and made myself comfy on the sofa. My son was a happy and sweet soul. He rarely cried and the public health nurse who visited was happy to help with some positioning and tips. I mentioned it was very sore but she couldn’t see a tongue tie. She was a little concerned he didn’t seem to be having enough dirty nappies but was overall content. However between week 2-3 he didn’t gain any weight at all. Looking back at picture, he was a spindly little thing! I was reading everything I could, and had met with my LLL leader who’d suggested some bodywork to help his latch. However, nothing was helping him gain weight so with so much guilt and sadness I realised I was going to have to supplement. I wasn’t well versed in milk-sharing so formula it was (of course, I had some, thanks Nestle *eyeroll*) but I was very wary of bottle feeding him given my desire to breastfeed, and still suspected he had a tongue tie. I had a friend who’d started using an SNS system a few weeks previously (also hypothyroid!) and I asked my LLL leader if she could help me out.

It was such a learning curve, but I suppose equally so would bottle feeding. I hated giving him formula but he drank so much and immediately started gaining weight. He was thriving on every drop of milk I made, plus 8-12oz of formula a day. It was still agony, and we had him assessed at 7 weeks, with a posterior tongue tie diagnosed and revised. Thankfully around 9 weeks breastfeeding finally felt comfortable and easy, even with the tube. I very quickly gave up supplementing overnight so we could get more sleep, which he seemed fine with.

We started BLW at 6 months, which he loved but ate very little. He always preferred to breastfeed. Around 8 months it started being a battle to get the tube into his mouth, and at 9 months he would yank it out of his mouth. I decided at this point it wasn’t worth the battle for the 1-2 oz he was having so we stopped supplementing at this point. I was so worried, and his weight did fluctuate until he started properly eating good portions at mealtimes, around 15 months.

It was such a battle, and so many people didn’t “get” it; I had people laugh out loud at the tube, and wondering why I didn’t just give him a bottle… but I am sure given his tongue tie he would definitely have preferred it to my low supply boobies! He was 2 in May and still loves to breastfeed often. It brings us both a lot of peace and calm. I felt so much guilt for the longest time, but I am so glad we persevered.

27 Aug

Book review: New Walk, by Ellie Durant

New Walk is the first novel of midwife Ellie Durant, and a fitting companion-piece to Alice Allan’s Open My Eyes from the same publisher. It tells the story of Chloe, a Leicester teenager who has been the responsible member of her family in the years since her mother died, and has finally decided to do something for herself, and applies to study midwifery.

The main philosophical theme of the book is that dilemma between selfishness and responsibility: do women have the right to decline medical advice? Or to choose what happens to their own bodies? And who has the power?

Chloe is a likeable character going through some tough times, supported (or not) by a diverse cast. The plot may not twist much, but it is soundly structured, satisfyingly ended, and well decorated with the details of Chloe’s learning about pregnancy and birth. Ellie Durant writes confidently about what she knows, giving this novel a sincere and grounded feel. It’s light reading with some darker tones: great summer lit.

[Disclaimer: I was sent a free copy of New Walk by the publishers Pinter & Martin. Get yours here with a 10% discount at the checkout, using the code SPROGCAST]