Knowledge is power

Jenny Hicken, a Network Delivery Team Facilitator with the Northern Clinical Networks and Senate in Newcastle, reflects on the powerful messages coming out a successful maternity network event:

Last week saw the culmination of months of planning as my team hosted its first maternity event since the establishment of the Maternity and Child Health Strategic Clinical Network.

My colleagues and I organised an educational networking day for nearly 100 midwives from the Northern Clinical Networks region (the North East of England and North Cumbria) on the theme of the latent phase of labour and achieving normality in childbirth – topics about which the midwives in attendance had plenty of opinions.

As a lover of social media in healthcare I was thrilled to link up for the day with @WeMidwives, the national Tweeting midwives community. I virtually hosted an all-day ‘chat’, Tweeting from the event using the hashtag #WeMidwives to gain the opinions of midwives around the country – another string to our networking bow. Catch up on the Tweets from the day here.

We were also glad to showcase the work of the 6Cs team, with a presentation from Birte Harlev-Lam (NHS England’s Head of Maternity & Children’s Services) being a highlight. Perhaps it was quite telling that when asked, barely half the room of midwives put up their hand to show they had heard of Compassion in Practice or the 6Cs initiative, so there is clearly a need to involve midwifery more, as a lot of the focus has been on nursing up until now.

One of the presentations made on the day which I was personally interested to hear was on the role of antenatal education for women experiencing the latent phase of labour. How does the information women receive in the antenatal period contribute to their ability to cope when they go into labour?

Good antenatal education can empower pregnant women to be confident, calmer and clear about what is happening to them when the time comes. However, there are still many women who can’t help but panic when their labour doesn’t follow their textbook expectations, or is much more painful than they had imagined it would be.

Is there something we can do to enhance current antenatal provision to manage women’s expectations better, to keep them calm, and to help their birth partner support them (another topic we discussed at length on the day)? If the number of women in very early labour arriving in desperation at our hospital maternity units is anything to go by, perhaps the answer should be “yes”.

Of course, the information given to any patient before receiving treatment is vital to enable them to fully understand what it entails, address any potential complications, and allow them to be engaged and active in the decision making process.

The difference with antenatal information is that the majority of pregnant women should not be considered ‘patients’. In a low risk, uncomplicated pregnancy the emphasis should always be on normality – a natural, unmedicalised process – something many midwives I have been in contact with are at great pains to stress.

However, one aspect of antenatal education I think merits some thought is how women can be prepared for possible complications in their pregnancy. How much information about pregnancy specific conditions or adverse outcomes should women in early pregnancy be given? If they have no reason to assume anything will go wrong, should we give them cause to worry by talking about such unpalatable topics as placental abruption, prematurity, or stillbirth?

I think there is a fine but very important line between letting women bury their head in the sand, pretending these types of tragic outcomes don’t happen, and giving them so many horrendous scare stories about everything that could go wrong, they make themselves frantic with anxiety for their baby’s health.

It is vitally important for the health of both mum and baby for women to be in tune with their pregnancy and to recognise when something is ‘not right’ – but they can’t necessarily do this on their own.

Encouraging pregnant women to be aware of their baby’s movements, or to recognise the symptoms of developing pre-eclampsia, or to consider the seriousness of any pain or bleeding, are important interventions that should not be shied away from.

Charitable organisations such as Count the Kicks and Action on Pre-eclampsia aim to raise awareness of the signs and symptoms of pregnancy complications among both the public and health professionals. These campaigns help both mums and midwives understand the importance of being mindful of the unwelcome possibilities.

Ultimately, women rely on their midwives to recognise when they might need obstetric intervention, but they can do a lot to help themselves – if only they are given the right information.

Jenny Hicken

Jenny Hicken is a Network Delivery Facilitator in the Northern England Clinical Networks, and is part of the Mental Health and Dementia Network team.

She is currently working on projects addressing the wellbeing of vulnerable groups, and represents the Network team on the North East and North Cumbria ICS Zero Suicide Ambition Steering Group. She also keeps a hand in with the Maternity Network team, with whom she has worked closely on a number of pieces of work.

Jenny lives in Newcastle upon Tyne with her husband and two young sons, and has worked in the NHS since 2009.