The System Can Change

BIRTH PLANS
Vickie Hobbs says Your Birth Plan is More Powerful than you know.   You can also listen to Vickie on Episode 19 of her podcast (Thank you for Embracing Birth Mapping Vickie!).
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MIDWIFE BURNOUT
Midwives are burning out: midwifery continuity of care actually helps prevent this.  A win for mothers, a win for midwives.  why is this not standard?

GUT INSTINCTS
From national geographic: how trillions of microbes affect every stage of our life from birth to old age feature ​

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LACTATION
New podcast: Anthrolactology -  Episode One introduces lactation researcher Dr EA Quinn. 
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PND
This Midwifery Today article explores PND.  Could the key be in support - beginning well before birth?

SELF CARE
This news article tackled the Self Care industry, challenging society to step up and take a different approach.  Again, support seems to be the key.

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PERIODS: MENSTRUATION
This Ted Talk asks: Why Can't We Talk About Periods.  
If this topic interests you: see also bloody women (a previous newsletter)

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MAKING DECISIONS
Tracey Donagan looks at decision making in labour  

IDECIDE is a new decision aid is being tested in the UK.  Could this be the beginning of something awesome?  Could this pave the way for women-led care? or is it still falling short?  I am watching this with very keen interest.

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INDUCTION AND DECISION MAKING
Two recent articles on Induction look at the way we approach this (increasingly used) intervention.  The first is a review article  reflecting on evidence and clinical practice.  The second article* asked “What are the views, preferences and experiences of women and clinicians in relation to induction of labour more broadly, and practices of decision-making specifically?” .  I particularly like this article, which concludes:
There is a need to develop strategies such as decision aids, the redesign of antenatal classes, and clinician communication training to improve the quality of information available to women and their capacity for informed decision-making.
Both of these articles tell us that it is very important that women are supported in making decisions. Again, the evidence points to continuity of midwifery care for communication advantages (building relationships makes an enormous positive difference), both these articles show we also need decision strategies, and education which focuses on decision making.  Communication is an essential element in primary healthcare.  We can not be taken seriously as decision makers without the means to understand our pathways and express our choices. The role of the primary carer (be it a midwife, a GP or an OB) must include listening to the values and circumstances of the individual seeking care.  Shared Decision making actually means supported decision making.  In this model of care, the clinician provides recommendations, and opportunity to understand the options. The individual self-determines.  This means they need time, without pressure to process and consider the options.  In the induction scenario, this would include understanding why the induction is being offered, and the process.  Understanding the options (including waiting for spontaneous labour) are an important part of this decision.  Mapping out these pathways makes it easier to navigate.  
*I have added the PDF for this article into the resources

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CTG MONITORING
What is CTG Monitoring?  New blog by Dr Kirsten Small, a specialist obstetrician and gynaecologist, working as an educator, writer, researcher, and clinician. She is a lecturer for Griffith University, teaching in the Bachelor of Midwifery. 

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