Posts Tagged ‘labour’

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.


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.


Mia Scotland

Clinical Psychologist

Have you written a postnatal care plan yet?

October 10, 2016

You wrote a birth plan, because birth is a big deal. But did you write a postnatal care plan? After your baby is born, your whole body and mind are in transition. Transition can be so tough, it’s even got a psychiatric label attached to it (Adjustment Disorder). Your body is physically transitioning in crazy, magical ways, and you are mentally transforming to get used to being instantly interrupt-able, having strange sleep patterns, putting yourself second, and grieving your lost carefree past. You are learning to know and love your baby. (Honeymoons were designed to help you love your new partner. Babymoons should also be designed to help you love your baby). Your brain is processing the birth. The list goes on and on and on and on. So, don’t just go home and hope for the best. Here is an example of what your postnatal care plan might look like:

“My Postnatal Care Plan

I have written a postnatal care plan because I very much want to enjoy my first few weeks getting to know my baby. I am aware that I have a tendency to do too much, and to feel guilty when I’m not getting stuff done. I want to ensure that this doesn’t happen following the birth of my baby, and so I am planning how to take care of myself in the first two precious weeks with my baby.

Generally, I wish to spend time skin to skin with my baby, I wish to establish breastfeeding, and I would like my husband to be an integral part of this with us.

Immediately upon coming home:

My husband would like to carry me and our baby over the threshold.

I would like a warm bath with rejuvenating bath salts, and then I would like to get into fresh (new) pyjamas and into our king size bed with new fresh sheets, and my baby.

I would like the lights kept low, my phone and my remote control next to me.

I would like to eat a huge, warm, filling meal of cottage pie and peas, washed down with camomile tea and a glass of champagne.

I would like my husband to join us as much as possible in bed.

For the first two weeks after coming home:

I would like visitors to stay away for at least 12 hours, apart from the midwife and my lactation consultant, who I have pre-arranged support with.

In the first three days, I would like very close members of my family only, to visit.

I do not want my baby to be held by anybody else in the first three days, other than her father.

We have arranged for a food delivery of fresh fruit, salads, sandwiches, chocolates and champagne. There are plenty of ready cooked meals in the freezer too.

I have arranged for a cleaner to come in every other day to tidy and clean the house, as per my husband’s requests (she will not clean our bedroom).

I have specific herbal/homeopathic remedies that I will be taking each day.

After the first three days, I have arranged for a postnatal doula to come in and provide emotional and practical support every three days.

My husband will help to ensure that I get plenty of rest, by regularly encouraging me to go to bed, and ensuring that the household and visitors are taken care of.

My husband will take a few hours out of the house each day, to do something to help him to feel refreshed also.

According to how I feel, I plan to spend most of the first two weeks in and out of bed. I might take a walk or potter around the house if I feel restless, but if not, I will stay in bed to recover and adjust, both physically and mentally, and to help me to fall in love with my baby and establish breastfeeding.”

What do you think? If you are thinking “that’s a bit overindulgent” then you are totally not getting how important this time is. If you are thinking “it’s only relevant to rich people” then drop the champagne and the au-pair, but stick with bed and help from family. If you’re thinking “what if I’m a single mum” then think even harder about your postnatal care plan, because support matters, whether its from a husband, a mother, the NHS, a best friend or social services.

It’s my prediction that postnatal care plans will become more and more common. If you’ve ever used one, I’d love to hear from you.

Mia Scotland

Perinatal Clinical Psychologist

Five things you shouldn’t let the NHS do for your labour…

December 3, 2012

ImageI was at the wonderful Association of Radical Midwives conference last week, and the gorgeous Virginia Howes talked about the new fly on the wall documentary coming out in January called “Home Delivery”.  It’s a refreshing change from One Born Every Minute.  She showed us some excerpts from One Born. There were gasps of horror and tears in the room from the midwives (honestly!  They don’t usually watch it).  I felt sick, but I wasn’t shocked.  It’s what I see as a doula in some hospital births.  As I wondered why they were so shocked, it dawned on me that they don’t see it!  They are used to working in their own individual way, and don’t see other midwives in action like I do.  They don’t feel the enormous change in the ambience within the room at shift change – for the better or for the worse, depending on the midwives.  I wanted to say “but this is what happens. I see it all the time”.  And I realised that my horror and anger that I feel when I do see these things happen is justified.  I’m not being touchy feely or over sensitive or radical.  It’s not okay.  So, here are the five top things that happen in a lot in hospitals (the last one being on the phone) which conclusive research (and the law in the final one) suggests should not be happening.

Five  things you shouldn’t let the NHS do:

  1. Induce you before 42 weeks on the grounds of being over dates
  2. Tell you to put your chin on your chest and push hard
  3. Cut the cord soon after the baby is born
  4. Get you to lie on your back on a bed
  5. Tell you that you can’t have a home birth on the grounds of staffing shortages

Trust me, NONE of these are evidence based.  They all, in my opinion, contribute to more danger than less. Number one:  The national statistical outcome data suggest babies born after 42 weeks fare better than born between 41 and 42.  Number two: Valsalva pushing compromises the oxygen your baby is getting, exhausts mum, and has not been shown to speed up second stage. Number three: Cutting the cord immediately after birth is plain dangerous, but hospitals in my area are still doing it  (see TICCTOCC). Number four: Lying on your back for labour creates all kinds of problems for your pelvis and baby’s exit. Number five: Being made to have a hospital birth when you wanted a home birth could jeopardise your safety, as recent research suggests that mums are safer at home, and it potentially goes against EU legislation regarding dignity and human rights (see the work of Elizabeth Prochaska, who also gave an inspirational talk).

Okay, so here comes the apologetic sloppy bit.  I know our NHS is wonderful.  I know midwives work hard, tirelessly, compassionately and selflessly.  I know things in the UK are fabulous compared to so many other places in the world.  I love our midwifery in our country.  Maybe that’s why I care enough to get annoyed enough to write this article.  What do you think?