Simple pleasure

My life as a midwife brings the personal and the professional into an unpredictable, ever-changing mix. As long as I have mothers and babies on my books, I am conscious of the possibility that I may be called out at any time. This is particularly important to me at Christmas time.

Today is Boxing Day, and I am reflecting on our family's Christmas celebration. I want to record here a few of the simple pleasures that I experienced this Christmas. I call them simple, because they happen without any fanfare or note, but actually these pleasures are part of a wonderfully complex natural order that is ours to enjoy.

• I treasure the births of two babies in recent days, with all the struggles and challenges birth brings. The knowledge that a young mother can confidently nourish and nurture her child, with loving support from the baby's father, gives me great pleasure. 
• I treasure the singing of carols, reading of the scriptures, and reflecting on the reason for the celebrations.
• I treasure the feasting: meals with family and close friends, sharing good food and fellowship. 
• I treasure being able to take food from our garden and include it in the festive meals: eggs, herbs, peas, spinach, broccoli, leek, spring onion. 
• I treasure the special festive foods that we make and eat: the stuffed turkey, the pudding in a cloth, the big fruit cake, the decorated gingerbread house 
• I treasure the special family gatherings: this year we had a memorable performance of the Owl and the Pussycat from our seven-year old Poppy, who has realised that she can read even nonsense words like 'runcible'.

There are many more simple pleasures that come to mind.  Yet I know, dear reader, that this time of year also brings its share of pain and sorrow for many people.  Families with fractured relationships, and people suffering illness.  The experience of loneliness and loss will often destroy pleasure and suck hope out of life.  There is no simple answer, no easy fix, when sadness and fear threaten to overwhelm us. 

With this in mind, whether times are easy or difficult, I am reminded that the principles for a life of integrity are, "to act with justice, to love kindness (mercy), and to walk humbly with our God." (Micah6:8)

Thankyou for your comments

Hospital back-up for planned homebirth

This post is a continuation from the MIPP midwivesVictoria blog

Midwives in this part of the world use the public maternity hospitals to make backup arrangements when we are planning homebirth. As a general rule, we plan to use the hospital nearest to the woman's home, that has the capacity to provide emergency obstetric services at any time of the day or night.

My home is situated about 20K East of the Melbourne CBD - about 30 minutes' drive from the Women's Hospital in Parkville. It takes approximately the same amount of time for me to get to either of the other two major 'tertiary' referral centres: the Mercy in Heidelberg, and Monash in Clayton. Box Hill hospital's Birralee Maternity Unit is about 15 minutes' drive from my home; the Angliss in Ferntree Gully is about 30 minutes.

I am happy to attend any hospital, either when my client requires transfer from planned homebirth to obstetric/hospital care, or when a woman in my care chooses to give birth at that hospital. The focus of a midwife's care is the *woman* - not the planned place of birth. I have often said to other midwives, and to women in my care, that *homebirth* is not an outcome. It's a location - a setting for birth.

The importance of having a plan for transfer to hospital from planned homebirth has been highlighted since the new regulatory authority AHPRA has been set up, with a long list of codes, guidelines, and statements that define a midwife's practice.  The NMBA Safety and Quality Framework for Privately Practising Midwives attending homebirths  has a requirement for  "Clearly articulated referral pathways for referral and /or consultation in accordance with ACM Consultation and Referral Guidelines."

Homebirth is the unique domain of women who intend to give birth without medical intervention, establishing labour spontaneously at Term, and progressing to birth without the need for medical or surgical assistance.  Babies born under such conditions are usually well, and require little or no assistance to make the transition from the womb to the outside world.

The midwife's role in planned homebirth is to determine when, and if, complications arise.  At that point the decision may need to be made to transfer to hospital.  Such a decision cannot be made at the time of booking, or even at Term prior to the onset of labour.  The decision-making process is an ongoing, dynamic one, which must take into account all the related factors at that point in time.


Your comments are welcome.

a womb-baby's heart

 A couple of weeks ago I reflected briefly upon some of the uncertainties that parents face, especially when an abnormality is detected in their womb-baby.  I linked to the evolving story, as told by Petrina and Dave on their blog, whose womb-baby's heart was in distress; whose little body was distended with fluid that the wee heart was failing to direct through the tiny body.

We are a family who believe in the power of prayer, and we are asking GOD to protect this unborn child and mother; to guide the minds and hands of the professional care providers, and to bring blessing through this difficult time.


Some years ago a young couple spoke to me about their womb-baby, who had been diagnosed with a serious heart defect at the 19 week anomaly scan.  They had been anticipating the wonder and joy of the birth of their first child.  Instead they experienced unutterable shock.  They had been advised to abort the baby.  They quickly and confidently declined the offer.

Our faith community at that time united in prayer for the young couple, and for their womb-baby.  We prayed for him each time he had surgery, and we have watched him grow. 

This week his story has been told in a Herald Sun newspaper article.

IN Melbourne's eastern suburbs on Friday, a boy called Kush will join classmates at a graduation dinner celebrating the end of his primary school years. Last year, he qualified for his school's cross-country competition and he plays cricket every weekend.
He's a kid who was never expected to live long enough to even start primary school, let alone finish it. This little chap functions on only three heart chambers. He's cheeky and smart and he has a mile-wide smile.
He has endured four open-heart surgeries - the first was when he was just five weeks old.
At 19 weeks gestation, medics discovered he had a serious congenital heart defect. They recommended termination because of the likelihood he would die early and painfully.
But his parents would not consider abortion.

In reflecting about our young friend Kush, and about Petrina and Dave and their womb-baby, I want to encourage midwives to remember that the life of a baby in the womb, even a womb-baby who has an imperfect heart, is a gift from God to that family.  As they learn to do whatever is possible to promote health and wellness, they also learn to accept the possibility of loss of a child - a journey that one would never choose.  These are life lessons, and are the lessons our parents and grandparents had to learn, in a different time, when the possibilities of restorative medical and surgical interventions were vastly less than they are today.

I am sure it has been difficult for Petrina and Dave to share their journey, often not knowing what the next day will bring, with an open audience.  Yet I sense that they and others will be helped, as a little network forms around a tiny and less than perfectly functioning womb-baby's heart, knowing that they are not alone. 

In a society which pretty well assumes that it's *best* that a baby who may not survive birth should be aborted - terminated - I honor parents who stand against the prevailing trend, and treasure the life of that womb-child.


Thankyou for your comments