Archive for the ‘compassionate midwifery’ Category

Meerkats and Perinatal Mental Health: What is the one thing I do when meeting some-one who is depressed or anxious?

November 9, 2016

It’s help them to calm their brain.

meerkat-alert

Picture a meerkat, up on the tips of his feet, eyes and ears peeled for danger. Red Alert. The meerkat is on patrol for the night. His brain and nervous system are hypervigilant, sensitive to all dangers, out to protect his clan.

Now picture the other miakats (that’s how I like to spell it!). They are asleep. They are warm and curled up, maybe cuddling up to a fellow miakat. They feel safe. They feel relaxed. They are resting and reenergising for the next round of activity.

They swap. Once the patrol miakat has done his patrol, he can rest, while some-one else takes over patrol duty.

The problem with anxiety and depression, is that the brain’s alert/danger system is stuck to “on”, leading to exhaustion. This alert/danger system shows itself in the inability to sleep well, the constant worrying about whether you are good enough, or whether your baby is healthy enough, or whether other people are talking about you, constant restlessness mixed with tiredness, irritability, and so on.

So, the first thing I do when I meet some-one who is depressed or anxious, is help their brain to switch from the alert/danger system, into the calm/relaxed system. I relax them in session, and then I give them a relaxation MP3 to listen to every evening as they go to bed. It’s like a sleeping tablet that has no side effects. It’s like a respite for the brain, from that constant struggle. It’s the start of things getting better for them.

meerkat-sleeping

Mia Scotland

Clinical Psychologist

http://www.yourbirthright.co.uk.

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Fear of Birth, fear of the system.

July 10, 2015

I I’ve just spent a day with midwives at the Fear in Birth conference at Huddersfield.  I love going on midwifery conferences, because the energy in the room is always one of care, compassion, power and hope.

The many speakers were thought provoking, interesting, and inspiring.  The thread throughout the day was of the important of continuity of care – that if we can provide women with the same midwife throughout her perinatal journey, we can do so much to dispel her fear, and that will have a positive consequence for her  and her baby.    I don’t know why, after so many years of it being so obvious that continuity of care is a “no brainer”, we are still failing to provide this basic need in our NHS system.  It almost feels like every effort is being made to AVOID continuity of care, and the part of me that is prone to “conspiracy theories” begins to wonder if it is a subconscious but deliberate attempt to stop women connecting and uniting.

There were two areas that were not raised, which I have been mulling over.  One is the fact that midwives are the only NHS profession who understand what birth actually is.  I will repeat that.  Midwives are the only profession in the NHS who understand normal birth.  Every-other profession  shares the cultural view of society – that birth is dramatic, dangerous, fast, excruciatingly painful, and usually goes wrong.  Midwives, as a whole, do not share this view.  They know that birth can be joyful, empowering,  ecstatic, easy, and safe.  They know the joy of birth, the miracle of the birthing body. No one else in the NHS does. In my opinion, midwives are the only profession in the NHS who can really address birth fear, because they are the only ones who really get that it doesn’t have to be feared.

The second issue is about what causes birth fear and why it is growing so dramatically. I’m sorry to say, that one of the main reasons, is because women have had poor experiences of the system.  They don’t trust the system, and they are scared of it, because it has let them down so many times.  Only two hours ago, I have had a woman on the phone, looking for support.  She told me eloquently and clearly, why she wants a doula.  Her words saddened me deeply, and I can’t give the full depth of raw emotion and beautiful wording that she used, but here is a snap-shot.  She told me that at the last birth, “they left me on my back, in stirrups, with my leg up, I felt like I was being raped, there was so much wrong, I can’t even begin, in the end they wanted to do a c-section, and they told me that they were doing the c-section because they needed the bed”.  Whilst in tears, this strong, able women, tells me that while she is trying to negotiate a VBAC, “they make me feel like my choices are ridiculous, I feel so vulnerable, manipulated, their words are so heavy, they’re pushing on a bruise, I want to trust my instincts but they’ve taken that away from me”.  These stories are what scare women.  We can’t just blame media portrayals of birth, we can’t just blame individuals with a history of child abuse.  We also have to look to a system which denigrates women, belittles them, tells them what they are and aren’t allowed to do, puts them on their backs for “internal examinations” that do nothing to progress labour, leaves them on their backs against all the evidence, straps them to the bed with wires that they are told are necessary to keep their baby alive, even though the evidence tells us otherwise, tells them they are too old, too fat, too overdue, too thin, to have the baby, play the dead baby card (as if mum is putting her needs above her baby’s) and so on and so on.

So, midwives, you are so important in reducing birth fear.  You can spread the word, that birth is a positive incredible natural process.  And you can continue to fight to keep the midwifery-led units alive, along with their ability to respect birth and respect the woman.  The more of those we have, the better things will get.  You know that, I know that, but I just wanted to say it again.  Midwives, you rock!

Compassionate care and marketing: things I love and hate

March 2, 2015

mia brochure photoArrgghhh!  I’m having a bit of a crisis with telling others what I do.  It’s called marketing and I absolutely hate marketing.  I’m stuck on the part about  “how do I actually get people to GET what my workshops are about, before they’ve come along to EXPERIENCE what they are about?”

People come back a lot to my workshops. But why do they come back? I don’t actually know, and any good marketing consultant will tell me I need to know that.  Okay, how do I go about that? I do feedback forms.  They tell me that people “loved it”, found it “inspiring” and “really useful”.  But I’m still left not really knowing.  It’s sometimes the same in therapy. People change and turn their lives around, but I’m left thinking “which bit actually made the difference?”

And the answer is in the question. It’s not one bit that does it.  It’s the package.  I use hypnosis in my work, and that means that I focus on how people feel more than what they know.  So, my workshops aren’t so much about what facts you learn.  You can learn facts by getting on your computer.  (And then, when you’ve got off your computer, if you’re anything like me, you can promptly forget them again).  I’ll give you an example of what I mean.  I heard a talk by the wonderful Sheila Kitzinger a few years ago.  She had me completely entranced.  She moved me.  But when it came to tweeting some parts of what she had said, I couldn’t remember a thing that she actually said!  She had immediately put me in a state of hypnosis with her storytelling (she didn’t know she was doing this to her whole audience, or rather, she may not have labelled it as “hypnosis”).  I came away feeling powerful, excited, enthused and motivated to change maternity for the better. Hypnosis works at a deeper level than your cognitive, rational mind. It transforms how you feel.

So, in my workshops, we integrate the facts bit. If it’s about compassion, I give you the science and physiology behind compassionate caring. I give you a working definition of compassion.  I tell you that there is a very important difference between compassion and empathy, and that you need to know the difference to protect yourself from burnout. But I also work at the emotional level.  The workshop is designed to enhance your motivation and excitement.   You leave feeling that you are an amazing midwife already, and the course helps unlock that potential even more.  I leave you wanting to get back to work, and be excited about your next appointment.  It also translates to home life, not just work.  I leave you wanting to go home and cuddle your children or your dog.  I leave you feeling encouraged.  Not just because it feels nice to feel great, but because research shows us that it makes you a more compassionate midwife.  Win-win.