Choice

On Thursday, obstetrician Maggie Blott, from the Royal College of Obstetricains and Gynecologists (RCOG) spoke on BBC Radio 4's Woman's Hour in a feature on pregnancy and birth, she stated that some women do not have a choice in where (and one must assume, how) they give birth.

The feature was generally very good and well balanced, I have no complaint with the BBC over this. The host, Jenni Murray was her usual calm and collected self, giving equal floor time to all of her guests. Sheila Kitzinger, founder of NCT and Birth Crisis, author and all around birth activist was interviewed and was asked about choice, birth plans and even orgasmic birth. A woman who had had a home birth recently was interviewed with her midwife and they both talked about how wonderful the experience was. The midwife was enthusiastic about home birth and talked about how rewarding her job was, which was refreshing coming from an NHS midwife, who are so often beaten down and jaded by the hideous system within which they have to work.

The issue of maternity services commissioning came up, following the Royal College of Midwives (RCM) recent conference, at which general secretary Cathy Warwick criticised the government for their U-turn on this topic. In the White Paper released in the summer, it was announced that while much commissioning would go to GPs to be determined on a local level (quite rightly so), maternity services would be commissioned by a national body. The reasoning for this is that maternity services is not generally dealing with people who are unwell, so is therefore outside of a GP's field of expertise. It is also something best looked at on a national level, because where complications do exist in small numbers not every local authority is going to have the resources to fund expensive facilities for very rare cases. It needs to be looked at on a larger scale so that the best provisions for those who need more care can be made in a sensible fashion. For example, not every local hospital needs a maternity unit and Special Care Baby Unit (SCBU), but at least one major hospital per region does need this. If commissioning is local then how will these facilities be funded?

However, some GPs inexplicably came out against this decision and have lobbied the government with such spurious arguments as "this is stupid". Hmm, helpful and how professional.

Cathy Warwick appeared on Woman's Hour and presented the case against GP commissioning. Health Minister, Anne Milton was also interviewed and she stated that no decision has yet been reached and that all sides were being considered. The general feeling among those in the know is that the government is going to come down in favour of the GPs. Why are the GPs even interested in this? What is in it for them? What does it mean for women and their families if their GP practice decides to reduce funding? The whole ethos of choice and quality care is under threat. It will become a postcode lottery as to whether a woman and her family can enjoy the essential quality of care that she needs. Women may end up having to travel large distances to receive their antenatal care if community midwives are made redundant by GP practices and the choice of where to give birth flies swiftly out of the window.

Which brings me back to the opening of this post. In the UK we are lucky to be able to exercise our fundamental human rights without fear from the government. Mostly. We are much better off than some countries. The Universal Declaration of Human Rights (UDHR) stipulates in Article 3 that "Everyone has the right to life, liberty and security of person." Security of person relates to the body and the mind, so basically every person has the right to bodily autonomy; they decide what happens to their physical body, and has the right to protect their emotional and mental wellbeing and no one has any right to override that autonomy. It would be under this fundamental human right that choice in birth comes. Every woman has the right to choose how and where they give birth. It may be that she has certain risk factors that may incline her care givers to recommend one place over another, but ultimately it is the woman's choice to take or leave that recommendation. For instance, an intense phobia of hospitals may mean that a woman chooses an elective caesarian in order to be able to plan the date and time of her birth and to control the amount of the time spent in that environment. Or it may mean that she chooses to give birth at home, perhaps even on her own with no midwife present if her phobia extends to hospital staff. That is her right.

During my first pregnancy I had no "risk factors". I was totally free from any medical-based prejudice towards one location or another for my birth. I was lucky enough too, to live in an area that nominally supports and encourages home birth. Unfortunately, there are so few women in this area choosing to birth at home that the midwives are not as skilled and experienced in normal, un-medical birth as they ought to be and as such, I was given a medical birth at home, which was never going to end well. Now I do have "risk factors". Next time I am pregnant, the NHS will "advise" me to have my baby at hospital. Not because it is what is statistically safest for me and my baby, but because their protocols are set out by a team of lawyers with the paralysing fear of being sued forever at the forefront of their minds. They want to control and manage all risk, rather than simply dealing with problems on the rare occasions that they do occur, so that they can say "we knew this was a risk and we tried to avoid it".

However, what many women genuinely do not realise is that they still have their fundamental human rights, as protected by the UDHR. They can decide for themselves whether to take the advice they are given or not. Because I am well-informed and have taken a great deal of time and effort to research the risks for myself and to analyse the reasons for protocols and guidelines to be in place, I know for myself that not only can I still have my next baby at home if I want to, but that there is even an official guideline that tells maternity personnel that I can make that choice. There is a NICE Guideline that states that women with one previous c-section should be treated no differently from any nulliparious woman (someone expecting their first child).

So, when I hear an obstetrician from RCOG on national radio stating that women with a previous c-section, for this was one of several specific examples that she gave, "do not have a choice in where they give birth" I am furious. Not only is she stating that some women do not have their fundamental human rights for the sole reason that they are pregnant, she is also going against the guidelines she is otherwise so tied to!

Midwife Cathy Warwick was wonderful at this point in the interview and did intercede to state that women do still have a choice and should be supported in that choice even if she has risks that her obstetrician is unhappy with. However, my fear is that Maggie Blott has given a green light to her colleagues to lie to women in their care. I know that the practices of lying and coercion are already very common in maternity care, from my own experience and those of other women I know, but to hear it on national radio from a member of RCOG has had quite an impact on me.

I urge women and birth activists everywhere to not let this go by without comment. Tell your friends, relatives, strangers in the waiting room, that being pregnant does not strip a woman of her human rights! Write to RCOG and demand a formal public apology for Maggie Blott's comments. I will be doing just that.

And on the subject of maternity services commissioning, please write to your MP as a matter of urgency and demand that the government stand by its commitment in July. The final decision on this is due in just a few weeks so there is no time to lose. You can find contact details for your local representatives here: http://www.writetothem.com/

Guess the Weight

Guess how many sweets are in the jar, or better yet, guess how much the sweets inside the jar weigh. Not including the jar itself but including all the sweets you can't actually see in the photo....

I'll give you a little help, you see that green one near the top left? Well the distance from the highest tip of that sweet to the lowest tip of the red stripy one down the bottom is... let's say 25cm. NOW tell me how much the contents of the jar weigh.

What? You mean you can't work it out?

No, I couldn't either, neither can my mathematically gifted husband. Although he does argue that he is familiar with these kinds of sweet jars and would therefore be able to estimate that the sweets weigh 1kg. But he is missing my point a bit.

From looking at this picture alone, with one arbitrary measurement and without being able to see maybe 80% of the sweets in the jar, there is absolutely no way that with this information alone anyone would be able to estimate with any degree of accuracy how much the sweets weigh. My husband is right though, using his life experience, he can guess the weight fairly accurately. But we do know with some degree of certainty that these exact sweets were weighed before putting them in the jar prior to sale. The same cannot be said of a baby in the womb.

So why do so many people believe a sonographer when they say that their unborn baby weighs xlbs in utero? It's the same sort of equation. An ultrasound gives the sonographer a view of a small section of the uterus at any one time and gradually builds up a picture as the transducer is moved across the abdomen. Three measurements are taken during a growth scan, the biparietal diameter (distance between the 2 sides of the head), femur length and the abdominal circumference. These measurements are entered into a computer program which then calculates the estimated weight based on charts created by researchers. You would think it would be fairly accurate. All that science.

The problem is that for one, the scan is only as good as the sonographer. All humans are capable of error. What one sonographer measures one day may be totally different to what another sonographer measures the next (on the same woman and baby). I have even heard of one sonographer giving a woman and her obstetrician quite a fright by writing down measurements that implied that her baby had SHRUNK! That was human error, babies don't shrink, as the obstetrician quite rightly pointed out, and later apologised to her and admitted that a mistake had been made.

But also, who made these charts and from what research? My best guess is that researchers have measured aborted and miscarried fetuses in order to establish average lengths, diameters and circumferences at different gestational ages. I wonder how many samples they looked at before coming up with these charts? From how many different ethnicities? Did they account for growth abnormalities in unhealthy fetuses?

There is a wonderful bit of research that demonstrates the complete unreliability of growth scans in late pregnancy:

Pregnancy outcome following ultrasound diagnosis of macrosomia.
AUTHORS: Delpapa EH; Mueller-Heubach E
AUTHOR AFFILIATION: Department of Obstetrics and Gynecology, University of Pittsburgh, Magee-Women's Hospital, Pennsylvania.
SOURCE: Obstet Gynecol 1991 Sep;78(3 Pt 1):340-3
Extract: "In 66 of 86 women (77%) delivering within 3 days of ultrasound examination, estimated fetal weight (EFW) exceeded birth weight. In only 41 of these 86 women (48%) were the EFWs within the corresponding 500-g category of birth weight."

So basically, this study (admittedly only a small one), found that 77% of growth scans predicted a higher birth weight three days BEFORE birth, so if these scans really are as accurate as we are led to believe then 77% of babies shrink in the last days of pregnancy. See above. More alarming is that 48% of scans, i.e. less than half, were accurate to within 500g, which is more than 1lb. What a large margin for error! The difference between a 9lb baby and a 10lb baby can be a HUGE difference to the mother and her care providers both psychologically and in terms of her care during late pregnancy and birth. To look at it the other way, more than half of scans were LESS accurate than that. 52% of women scanned were expecting either much bigger or much smaller babies than they got.

Why does it matter?

Because if a midwife sends a woman for a growth scan because of concerns late in pregnancy, and the obstetrician that the woman sees after her scan decides that, based on this one scan, her baby is too big or too small, then interventions may be advised that are simply not necessary. For example, if a baby is suspected to be too big, early induction or c-section will be advised. Except in the current NHS system the woman will come away thinking that it is not advice that she has been given, but an order to comply with.

Why does it matter?

Because interventions without clinical need are a waste of resources and may have long-lasting negative effects on the mother and baby. Caesarian sections are known to leave babies with more breathing problems, greater risk of diabetes and cause risk factors for the woman in future pregnancies, never mind the risk of post operative infection and post traumatic stress disorder.

Why put women through that? Why subject a woman at the end of her pregnancy to fears about the wellbeing of her baby? Even when the prediction of a too big or too small baby is accurate, how often does it actually mean ill health for the newborn? According to one study, "Our ability to predict macrosomia is poor. Our management policy of suspected macrosomic pregnancies raises induction of labor and cesarean delivery rates without improving maternal or fetal outcome." (My emphasis).

The Delpapa and Mueller-Heubach study above also concludes that "A trial of labor resulted in vaginal delivery in 76 of 106 women (72%). There were five cases of shoulder dystocia but no birth trauma. Estimated fetal weights and birth weights were not significantly different between the women who had a trial of labor and those who did not. Our results do not support cesarean delivery or early induction as a means of preventing infant morbidity when fetal macrosomia (weight of 4000 g or more or the 90th percentile for gestational age) is diagnosed by ultrasound."

So ultrasound is NOT an accurate estimate of fetal weight and even when a baby is genuinely large (4000g+), spontaneous labour and vaginal birth are still the safest option.

The C-Word

Cancer. What is it? Why are we so scared of it? And what can we do about it?

Cancer is basically the mutation of cells. Cells that divide beyond the normal growth rate for their type and that invade and kill neighbouring cells are loosely defined as cancerous, sometimes they also travel around the body via blood or lymph.

We hear alarming figures thrown around such as 1 in 3 women will contract a female cancer in their lifetime and that almost all of us can say that they have been in some way affected by cancer, either themselves directly or a loved one. It's no wonder that we are so scared of this disease. But is this accurate?

According to Cancer Research UK, there are now over 2 million cancer survivors in the UK, approximately 3.3% of the population and around 10% of those over 65 are cancer survivors. The number of diagnoses per year keeps increasing, but the so does the survival rate. The most common cancer is breast cancer, with about 550,000 current survivors in the UK today. In 2008 the mortality rate was 0.176% of the UK population. That doesn't sound so scary.

Why might cells mutate? 90-95% of cancers are caused by environmental or lifestyle factors, only 5-10% are genetic. Tobacco is the big one, we all know that, smoking is the cause of nearly 30% of all cancer deaths, 83-90% of lung cancer deaths and is also linked to cancers of the oesophagus, larynx, pharynx, oral cavity, pancreas, bladder, nasal cavity and sinuses, stomach, liver, kidney, cervix and myeloid leukaemia.

Other environmental factors that can increase the risk of cancer are UV exposure, weight, diet and infection.

But the one I really want to talk about is hormones, particularly female hormones and the "female" cancers; breast, cervical, uterine and ovarian.

Certain lifestyle choices are known to impact on our chances of contracting a female cancer. The combination oral contraceptive pill slightly increases the risk of breast and cervical cancer whilst taking the pill, but once no longer taking it the risk decreases again. However, there is a significant reduction in the risk of ovarian cancer for women who take the pill for five years, lasting for more than 20 years. And when I say significant, I really mean it: 50%. There is also a 40-60% reduction in instances of endometrial cancer (uterine cancer) for women who take the pill.

Having 7 or more children and having a first child before the age of 17 are known to double the risk of cervical cancer

The oestrogen only Hormone Replacement Therapy (HRT) has been shown to increase the risk of breast, uterine and ovarian cancers.

And last but by no means least, women are at 4% less risk of breast cancer for each year that they breastfeed and women who do not breastfeed at all are twice as likely to contract endometrial cancer and two thirds more likely to get ovarian cancer.

While all these figures are interesting, what I am most interested in is why. What no one seems to be saying is that cancer is thought to occur in cells that are over-stimulated, that's why the pill is so protective, it prevents ovulation and therefore gives the ovaries and uterus a rest from menstruation. Just like pregnancy and breastfeeding does. The pill basically replicates the consequences of reproduction, but in a more thorough and predictable way. It is my belief that the cells in any given part of the body are programmed to behave a certain way, according to their function and if they are not given the opportunity to perform their function as they expect then they are more likely to mutate and turn cancerous.

The ovaries expect to ovulate regularly until conception and then take a break of an average of 22 months (9 of pregnancy and 13 of breastfeeding, this is the average return of menstruation for women who breastfeed their children on demand). The breasts prepare themselves during pregnancy for lactation, regardless of the mother's intentions, the breast tissue fundamentally alters. What happens then if the mother does not breastfeed? Likewise, the cervix prepares itself for birthing a baby during late pregnancy and labour. So what are the implications for those who do not labour or who have a surgical delivery? I didn't find any statistics on that, but I'd love to know if caesarian sections carry an increased risk of cervical cancer. It certainly wasn't a risk listed on my consent form. Does some research need to be done on this?

Could we go back to a time before cancer became the single biggest health scare simply by living as our bodies expect us to?

Informed Consent

Every day for the last two years I have encountered either directly or recounted through someone else, at least one woman who genuinely believes that because she is pregnant she has sacrificed her most fundamental human rights. The vast majority of women become submissive to the will of their care providers and the NHS does nothing to correct this misconception, in fact, it perpetuates it. Women are regularly told by their midwives and doctors that they are "not allowed x", or they "must have y". I myself, while in labour, was told by a midwife that I had to have an internal examination every 4 hours. No consent was sought, it was presented to me as non-negotiable and this happens routinely, probably with the most regularity in relation to induction.

Women are told that their baby is due on a specific date, the Estimated Due Date (EDD), with the emphasis on "due" rather than "estimated". Women fall for this almost every time, if they go just one day past their EDD then their baby is "late". Midwives seem to not point out the fact that babies can and do arrive whenever they are ready and that the World Health Organisation (WHO) defines normal pregnancy as lasting anywhere from 37 to 42 weeks. Once a woman passes 40 weeks, which about 50% of women do, they are told that they are now on a clock and must go into labour quickly otherwise they will "have to be induced".

The exact date at which hospitals routinely induce women with no clinical need, varies from one area to another, but what doesn't seem to vary is the lack of informed consent. Women and their families are not given the facts that enable them to make a decision for themselves, they are routinely led to believe that they have no decision to make, they will be induced, this is non-negotiable. They are not told the risks of the induction process, they are however given exaggerated and out of date "advice" about the risks of remaining pregnant for longer than 41 weeks.

If a woman's waters break she is put on a clock and if labour does not start spontaneously within 24 hours she is told that she must be induced. I've known women be told this and given no reason, at best they are told that it is because of the risk of infection. What they are not told is that the risk of infection only increases significantly after 96 hours and that it is a significantly higher risk in hospital than at home. Premature rupture of membranes (PROM) occurs in about 6-19% of pregnancies, 86% of women will go into spontaneous labour within 24 hours and 94% within 95 hours. Statistically, a baby born in hospital is 4 times more likely to acquire an infection than a baby born at home and around 9% of women birthing in hospital will acquire an infection, the highest risks being those who have a catheter and especially those undergoing a caesarian section, both of which are higher risks for those undergoing an induction.

It saddens me to hear women talking about their births as though they have no choices, no input to how and where it happens and what makes it worse is when people like myself try to inform them we are accused of being bullies! It is my sincere hope that the tide begins to turn soon and that women are given full, accurate information and are empowered to make their own choices for their births. It is one of Airedale Mums' primary goals, though it is not clear yet how we go about achieving it.

Autumn

We are rapidly approaching my favourite time of year. I felt it today for the first time. All of my immediate family have summer birthdays, my mum is the last on 31st August (happy birthday Mum!) and once this date passes it's like autumn suddenly rushes up to meet me. The days are growing shorter, the evenings are still warm but there is a crispness to the air. It's about now that the memories of some of the best times of my life start to kick in and the anticipation of the forthcoming holidays and festivals starts to set my pulse racing. I always seem to reconnect with music at this time of year too. I listen to music all year around, but it seems to be a background thing most of the time these days, unlike pre-Jack when live music and clubbing were a big part of my life, but around this time of year I start really listening again and listening to different bands and artists, more rock and less of the pop and dance that I tend to go for in the summer months.

We're only 3 weeks from Mabon and I find myself feeling a little sad that we won't be at Avebury this year, which had become a little tradition when we lived in Bristol. I don't recall missing it last year, but we were busy with Jack hitting the six month mark and all of the challenges that came with that. Mabon is not my favourite Sabbat, but it is the one that I always get a little more excited about, perhaps because it marks entry into the festive season, where the next two Sabbats, Samhain and Yule, seem to come in such quick succession and everyone else gets excited about their secular or Christian counterparts.

I love the way we all get swept along with the season, like the golden leaves dusting the ground and the build up to its inevitable conclusion - winter. Don't get me wrong, the ridiculously long and drawn out build up to Christmas annoys the hell out of me. "Festive" goods and songs in shops from September is ludicrous, decorations and lights going up in October completely misses the point of the holiday to me. But what I do like are the simple things, the human aspect. I love the way people start grinning and wanting to talk about the holiday and I love the weather turning cool and crisp, the frost and even the first snow (when we get some before new year that is). But long before that, just the little buzz in the air, the sense that the seasons are changing, I love it and I felt it today.

Free stuff for Home Educators

One of my HE contacts has a fab blog here and is giving away free stuff in celebration of HE kids NOT going back to school! So just check out her blog and leave a comment about why you love HE and get yourself an entry into the prize draw :)

French Police Brutality

Captured on film in July, French police have shown themselves to be a disgrace to the law enforcement profession. African immigrants were forced to leave their council housing earlier in the month and had set up camp on the streets in the area. Women and children were the main occupants of the Parisian streets, with no where else to go, they stayed close to their friends and families. Many of the immigrants were there perfectly legally and had been living in France for more than a decade. Police arrived to move the campers along and the video, published on YouTube by French news site Mediapart, depicts the African families sitting peacefully on the pavement, arms linked together, being assaulted by the authorities.

Women were dragged away from their friends and families, babies ripped from their mothers' arms and wraps. One woman was pulled from the group by her legs, dragged over the ground on her back, where her baby was wrapped, she was pulled across her child, apparently squashing him into the ground. A pregnant woman is shown lying on the ground, her head perilously close to a concrete bollard. It is unclear whether she was injured or "playing dead" to make it more difficult to be moved, but the police were making a good go of shifting her.

I have never seen anything quite like this in my life. The brutality involved is shocking. To manhandle people in this fashion is bad enough but when you consider that it was women and children, who had done nothing more than attempt to sit it out when being forced to leave their homes, this is troubling indeed. I don't know if it is even worse to know that this did not take place in some obscure dictatorship, but right here in Europe, in Paris no less.

We live in troubling times indeed.

Here is the video, please be warned, this clip depicts police brutality upon women and children and viewers may find it distressing:

That Article

It has been covered extensively on the internet, so I won't write an essay, but I couldn't let it go by without some sort of comment....

The article in Mother & Baby Magazine that has caused such a riot among both formula feeders and breastfeeders. You can read the article here. Kathryn Blundell has caused much offence with her inappropriate remarks, calling breastfeeding "creepy" and referring to her breasts as "fun bags". Breastfeeders are incensed with her attitude and formula feeders frustrated that this article will now lead other women to assume they share Ms Blundell's views.

My favourite blog about it is this one which describes the financial incentives for such an article to appear in the magazine during National Breastfeeding Awareness Week.

My own opinion? Ms Blundell is a clever business woman when it comes to advertising for her magazine (she is the deputy editor), but with very little regard for the wellbeing of her readers or their babies. Mother & Baby Magazine have proven themselves to be 100% enthralled to their advertisers and not a respectable publication committed to printing facts and responsible journalistic opinion pieces.

Lactivism

I was recently having a conversation with a friend about breastfeeding and how to be a champion without alienating people by making them feel bad for their choices. It's a fine line. As a lactivist I want to tell people about the risks of formula feeding and I want to provide support for women who want to breastfeed, but I know that I have at times caused offence when discussing this topic.

I think that some women may be quite defensive about their decision to formula feed, despite vocalising their pride at this choice perhaps a part of them doesn't feel good about it and so they feel the need to justify it and defend it when they feel their choice is being criticised.

There are things I would like to say on the subject but don't feel that I can for fear of being judged to be judgemental - haha.

I am trying to change my approach into a positive one. There are people you will never reach, so it is best not to come at lactivism from that perspective, rather to simply be approachable to those seeking information and support. So I am undertaking leadership training with La Leche League so that I can be a peer supporter. I'm also going to plug other Lactivists blogs, websites and online stores ;)

First on the list is Lactivist itself. The website is a fantastic hub of information and support, not to mention their fantastic breastfeeding t-shirts! They are currently running a competition to win £40 of Butterfly Babies vouchers. See here for more.

A New Kind of Government

I'm not a natural optimist. I have to work quite hard to be one, but I believe that it is worth it and that it is a healthier attitude than pessimism. This week we have welcomed a new kind of government into power, a Conservative/Liberal Democrat coalition. As soon as the election results were looking like a hung parliament was going to be the outcome, this is precisely the solution I thought would come about. From some time over the weekend, when informal talks were happening and seemed to be going well, I had a good feeling about it. Lib Dems in Government.... how can that be a bad thing? Speaking as a Lib Dem party member and volunteer campaigner I saw this as a wonderful opportunity to do something different. The old system wasn't working, as a nation we were swinging between Labour and Tory and neither party were getting it right.

The election results showed that the nation was split. No party had an overall majority and so it became necessary for two or more parties to cooperate. This is precisely the kind of democracy that I have long wished to see in action. Why must we have an adversarial system? Why can't the politicians from different parties and different backgrounds at least try to work together? It works in other countries, it works in the European Parliament. Why shouldn't it work here?

The Tories and Lib Dems demonstrated in their talks that they were able to sit down and compromise, that they were able to put the interests of the nation above the interests of their parties. The leaders passionately want this to work and even though they will undoubtedly face some opposition from within their own parties, I believe that they can set the example and make it work.

I have encountered a lot of negativity towards this coalition already. I believe this comes down to two fundamental causes: Firstly that this is a new way of running the country and people are wary of change. This way of working has not been proven to work in Britain before. Secondly, bigotry. I'm sorry to say this, especially of friends, but so many people have blinkered views of politicians, or of one party in particular. I've heard people saying "Look what happened last time the Tories were in power!" But I say to them - that was a long time ago. Thatcher came to power over 30 years ago. The political landscape has changed since then, the population has changed since then and the politicians have changed since then! I have found myself reminding people that this Tory party is NOT the same as the one under Thatcher. It is not the same as the one under Major. This is Cameron's Conservative party.

We all saw what happened to Labour under the "New" banner of Tony Blair, the party did change. No longer is Labour the left wing, unionist party of old. For a long time now the Liberal Democrats have represented the most left wing of the three main parties and under Cameron we can already see the Conservatives edging towards the middle from their old position on the right.

Don't get me wrong, I'm not jumping for joy at a predominantly Conservative government and I do have an edge of scepticism to my view. We have a proven Eurosceptic in the Foreign Office and an early pledge to hack public spending. But what I am saying is let's not judge this coalition before it has even got going. They have settled upon a 5 year fixed term parliament. Let's at least give them that long to show us what they can do, how well they can work together.

If it doesn't work, if the economy doesn't recover as well as the experts suggest it should be able to in that time, if Lib Dem policies are continually blocked then fine, vote differently in 2015. We can always go back to the old system (but I doubt that will happen if we get the reform we want!) but don't condemn this one just because it is different or not what was hoped for.

Catching Up

OK, so here is the first instalment of the catch up that I talked about. These posts are from when Jack was 3 months old.

June 26^th 2009

So anyway... Jack's bedtime routine seemed to have gone back to normal last night, but about 20 minutes after putting him in his crib asleep he woke up crying. I tried to soothe him and he was fine the moment I lifted him out. Then cried as soon as put back in. I thought he might be hot so put him on the bed to take his sleepsuit off and he went straight to sleep right there!! So I think that makes it official.... he has outgrown his crib and feels constrained in it.

Time to get his cot! We put it off as non-essential but can't delay any longer. Fitting it in our room requires a little rearrangement of furniture, but we want him rooming in until he's six months so we will work it out.

I'm trying to encourage Jack to think about rolling over, he's shown no inclination so far and went through a long phase of hating tummy time. I tried him on his tummy for the first time in a few weeks the other day and he was fine with it, so now I'm trying him on his front every day. He shuffles about loads on his mat, which is very smooth. He wouldn't get anywhere on the carpet lol!

June 28^th

He's three months old today. I suppose I should log what he can do:

grab and hold objects placed in front of him
draw things into his mouth
swap things from one hand to the other
shuffle about on his back
just starting to show an interest in crawling but lacks the strength!
"talk" - he can take his turn in conversation and makes some wonderful noises
smile
giggle
follow an object or person around the room with his eyes
watch the cricket and tennis lol!!
refuse to smile for the camera

He's still exclusively BF

A few other thoughts for today... expressing. I've so far not been able to get into a good routine. Mornings are typically best for me and there was a period when I was waking up quite engorged and getting a good 4oz in one go. But then my supply adjusted to just let down on demand, rather than fill and empty and it got loads harder to express, I went back to only getting about 1oz but I had a good week of pumping every day and it went up to about what I was getting before. But it's now been a good couple of weeks since I expressed.

I want to get back into it. I've got about 20oz frozen but I'd like to increase that as I'm going to see Leonard Cohen in a few weeks so Andy will probably get through all the frozen supply while looking after Jack. Can't imagine what my boobs might feel like by the time I get home that night as the gig is in Birmingham, so I won't be feeding Jack for about 6-7 hours including travel time. Maybe I should take the pump and express both on the way there and back?

Something to add to the things Jack can do at the three month mark.... deliberately take mummy's glasses off her face.

I was leaning over him, letting him explore my face with his hand and he started to reach for my glasses. He pulled them down my nose and grabbed at the lenses. It was very deliberate, like he was working out why there was a part of mummy's face that came away!

It's a big day today, not only is Jack three months old but we are going up to the local snooker club this afternoon to present a prize. My grandad, who Jack is named after, played there for thirty years, right up until he became house bound at 98 years old. He passed away at 99 in February 2008 and we now live in his old house. After he passed away my mum donated a trophy in his name to the club and the tournament was last weekend, the prize presentation today. I'm looking forward to introducing little Jack to some of the people who knew his great grandad.

June 29^th

Jack had his meningitis c vaccination this morning. Andy went into work late to come with us. Last time we saw the nurse was when we went in to an appointment that had been automatically booked for Jack's first round of jabs and we had to argue with her about what we do and do not consent to and she seemed most put out that we didn't let her stick him with anything on that occasion!

It was a different nurse today. At first she was sure that it must be a mistake that it said men c only in the notes but we explained what we wanted and she was fine about it! She put it all in his notes so if it's a different nurse next time we don't have to go through it all again.

Jack cried for a few minutes, but Andy walked him around the nurse's office while she filled out the paperwork and updated his file on the computer. He was a bit grumpy afterwards but not too bad. I put his continued grumpiness today down to the heat. Though he has been very clammy so I keep checking his temperature for signs of a fever from the jab.

That was the one thing I was a bit unhappy about with the nurse... she didn't mention any side effects of the jab. Now, I know what to watch for anyway as I have researched the subject so thoroughly, but if she never tells parents what to look for I worry about that for other parents who don't realise how potentially dangerous these vaccinations can be. It may be that she didn't say anything to us because it was obvious to her that we are well informed, having chosen not to follow the NHS schedule, and that normally she does give parents all the information. But I doubt that's the case. The NHS seems woefully unwilling to say anything negative about immunisations.

You'd like to think that if vaccines weren't dangerous they wouldn't be offered. But the truth is that the men c vaccine was rushed to the market without undergoing one single safety test. The government vaccinated 11 million children in one year as a grand "catch up scheme" without waiting for the pharmaceutical companies to do their tests but in the 10 years since its introduction there have thankfully, been very few negative outcomes [30 deaths as of 2007]. But its effectiveness has been shown to be about 60% [83% for the first year then falling off], which is not considered high enough by normal vaccine standards. If it was shown to be dangerous you would hope the government would withdraw it, but they waited 5 years to comply after an international review dictated that all mercury-containing vaccines should be withdrawn! So not a good track record.

Reclaiming Birth

Sunday 7th March 2010 - Reclaiming Birth

What a day! Jack and I somehow managed to get up and ready in time to leave after a truly appalling nights "sleep". Andy drove us to the station while I continued to umm and ahh about whether to take a borrowed buggy or keep Jack in the mei tai. When Ruth and her mum arrived with no push chair for Eva my mind was made up, so when we kissed Andy goodbye he took the buggy away with him!

We boarded the train and had a pretty good journey to London. Both babies were very good. As we arrived a couple of hours before the march was due to start we decided to swing past Hamley's toy store for gifts for our little ones. Unfortunately they were having a big birthday celebration and only allowing people in who had baked a cake!! So we stood outside with others who were queueing for admittance for a few minutes before deciding to make a move.

We got to the park and took a quick trip into the Imperial War Museum to use the facilities and then sat out and had some lunch. We met up with Family Parkin, Jo and Oliver, and Debs and Hannah from Airedale Mums. We got ourselves organised, bought t-shirts and got ready to march.

The crowd steadily grew, bright pink balloons bobbed overhead and signs and banners were being hoisted all over the park. The word went out for us to move to the road behind the big Reclaiming Birth bus so myself and the other Airedale Mums took to the street with our pink t-shirts and signs.

The procession moved slowly through the streets, escorted by marshals and the police, though their presence was hardly felt (unlike at my previous demos!) we chanted and sang and answered questions from journalists moving through the crowd. One child started up the chant "Keep birth normal!" which rang out for quite a long stretch of the march. To hear a young girl shouting this phrase with so much verve really moved me. The next generation need to feel as passionately about this as we do if things are going to change for the better long term.

It was a glorious day with clear skies and plenty of tourists eagerly snapping pictures of us. We arrived at Whitehall and came to a halt, speeches were made from the top of the bus, guests included Beverley Beech from AIMS and one of the Albany midwives.

It was at this point that a couple of the babies in our party started to struggle, there was a lot of noise and no movement to keep them content in their slings and we were stood in the shade where it was remarkably cold. We moved over to the Department of Health building and sat down in the sunshine, most of us took the opportunity to breastfeed out little ones and were joined by a couple of Albany Mums! I thought it a very fitting scene! (Keep breastfeeding normal too!)

The speeches ended and the crowd began to disperse. We made our way back to Kings Cross for the return journey, tired but exhilarated from our exertions.

Next time...

I have been feeling very down recently. For months now Jack's sleep has been terrible. We have had better periods but they never last long. He is tired and grumpy in the day, sometimes only satisfied when he is breast feeding and I am perpetually exhausted too. He fights sleep most nights and for most naps. I feel like I spend over half my life trying to get him to go to sleep. I am miserable and not really enjoying being a parent at all. Neither of us have the energy to play or go out or do anything much during the day and I spend the time I'm not dealing with him counting down the hours until Andy comes home from work and I can get a little help.

For a while I have been telling myself that things will be different next time. Next time I won't get into the habit of breastfeeding the baby to sleep, which would hopefully prevent any of these sleep issues from taking root in the first place. But today I have been contemplating the whole Attachment Parenting issue and whether it has really worked for us as a family or not and I have to conclude not. I have the utmost respect for the people for whom it works and who are satisfied as parents by using these methods and in theory it sounds like a wonderful way to parent. But I just don't feel like it has been right for me personally. I look at the other children that I know and the mums I know online and find myself constantly envious of the way their children sleep, the activities they do together and so on.

I found myself thinking "Next time I don't think we'll follow this path again. I want to enjoy being a parent and I can't do that while this tired." Which led me to the next obvious thought... how can I even contemplate "next time" right now? I am way too busy with Jack to have a newborn to worry about, never mind the stresses on the body of being pregnant. I really have to be practical about this. There is no way I can go through pregnancy and have a new baby while Jack is this demanding. No way.

And from there to... if I hate being a parent so much, am I sure I even want another one? Ever?

Much as I want to go through pregnancy again, desperate as I am to give birth, I have to admit that I actually don't want another child.

I can't have a baby just for the birth. It has to be because Andy and I both want another child and right now I really, really don't. I don't want to go through any of this again and it is by no means guaranteed that different parenting methods would prevent these issues.

Don't get me wrong, I love Jack. I love him so much it actually aches! I love watching him grow and learn and I love the way he looks at me and I love that he needs me so much. But I do not love the way I feel the rest of the time. I do not even remotely like not having the energy to even play with him for five minutes. I just can't see myself being able to cope with two children when I am not coping with just one. I have been having a little cry at the thought that if this feeling persists then I may never, ever give birth. But I feel like I might be ready to let go of that dream because giving birth is not the only thing that matters in life and if I grow old and grey never having done it I will not be less of a woman.

Clever boy!

Jack now knows how to turn the xbox on via the Guitar Hero guitar. He takes great delight in pulling the guitar out from under the TV cabinet and going straight for the on button, once it lights up he will then be entertained by flicking the toggle to navigate around the menu on the TV screen. He can definitely tell that what he does on the controller has an effect on the TV as he looks up to see what his actions have done!

In other (but related?) news I have recently joined my local home education yahoo group and am very excited to see that it is fairly active. There are language classes, a climbing group, story circle, trips to Doncaster Dome and I expect many more activities I have not yet seen advertised. I just hope it stays as active over the next few years until Jack is old enough to join some of the groups! But for now it looks promising and is giving me ideas about how I can direct his early years learning.

I'm going to be putting together a development review of his first ten months over the next few days, following a dispute on the parenting forum where I have been keeping a journal. I will try not to bombard this blog with too much at once and keep my backlog to the point lol!

Maternity Matters

I've been involved in the NCT 'Location, Location, Location' campaign to hold NHS Trusts accountable for meeting the deadlines for birth choice in the government Maternity Matters document. My MP has actually been very helpful and I have had replies from the Undersecretary for the Department of Health as well as the Chief Executive of my local Trust. The former was not very promising, she basically fobbed me off saying that they had recruited more staff and therefore met the deadline (end of 2009), despite the fact that only 4% of women actually have a free choice of where to give birth - the target was 100%. My local CE however, was very positive, there are two new midwife-led units in development in the area and the Maternity Services Liaison Committee has been relaunched. I promptly replied saying I would like to join the MSLC! I am very driven to see changes in the maternity services offered and this is a great way for me to help do that.

All of this has fuelled my desire to help inform and empower women. Unfortunately, I am always finding people who do not welcome information. They would rather be afraid, surrender to the doctors in white coats because I suppose that is easier than finding strength from within.

I recently had a conflict with someone on an internet forum who said that she was "not allowed" to go past her estimated due date due to history of placental abruption. She lost her baby at 20 weeks because of this, so I understand why she is afraid. However, when I pointed out that no doctor can "allow" or "disallow" anything she became very upset and hostile towards me. She turned her story around, saying that she had asked for intervention if she did not go into spontaneous labour before 40 weeks as she felt that the stress and worry of another problem would cause her to have a traumatic birth. I tired to point out that there is nothing magical about her estimated due date and that her using the word "overdue" to any day beyond that is factually inaccurate and not helpful to her own state of mind. She really didn't like that!

I have been stewing over this for a few days and need to get this off my chest. Whenever women talk about doctors "not allowing" them to do something they are perpetuating the myth that doctors have power over our bodies during labour. It is this myth that keeps victims of birth trauma from realising that something wrong was done to them. Birth trauma is physical or psychological abuse, it includes intimidation ("Your baby will die if you don't let us do this") and sometimes even rape (vaginal examinations without consent). So when I encounter someone who is saying that she is "not allowed" to go past her EDD and that this isn't even the truth as she perceives it it actually makes me quite angry.