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housewifery
Dispatches from the domestic frontline
Friday 6 March 2009
Wednesday 4 March 2009
What housewifery means to me
I turned 35 on Sunday. I'm not sure I'm taking stock, or whatever one does as one year becomes another, but it has prompted a little evaluation of the way things are, particularly in the context of my housewifery and my blog.
In the course of explaining in my college class yesterday how a recent written assessment was enjoyable for me, in response to a colleague's assertion that assessments aren't fun,* I happened to mention that I blog. In the break, someone beside me, who I am rather drawn to, and who has shared the odd moan with me in the nicely conspiratorial way in which friendly alliances can be built, asked me what I blog about. I began: 'Oh, I started it while I was on maternity leave; it's about my life as a housewife.' This pricked up the ears of the two in front, and then another in front of them, and we had a little chat, in which I felt I wasn't properly representing myself. I mean, I was a housewife, I still do all the domestic work (or at least am responsible for it, delegating some bits). But even I don't really recognise that conceptualisation of myself.
On the way home, I met an old neighbour; in the course of our chat, I mentioned that I'm back at work and quite happy about it, and he said 'yes, gets you some of your identity back'. That's the econd time someone (another man in late 30s/early 40s, from London) has said that to me. This is what I struggle to explain: I don't feel I've lost any of my identity, or that my identity has changed. I am still the same. My priorities may have changed - I'm no longer out on the p*** every night, and nor do I want to be - but that part of me is not disappeared, or muted in me. Perhaps to the outside world - to people who don't know me.... So my external face might be different; new people I meet have different expectations or assumptions of me when I say I have a baby, or I'm on maternity leave. But what I don't say is 'I'm a mother'. That is still not how I conceive of myself; that's not how I identify myself. I'm Peggy. I'm a 17 year old in a 35 year old body. I'm a generation x-er, a slacker into music, I'm a drinker, a bad dancer, a smoker who hasn't had a cigarette for a long, long time. I like cooking, I like baking, I like personal finance and domestic efficiency. But the two lists aren't mutually exclusive.
So I looked last night at other people's blogs about housewifery, to see if I identify with those. Lots of American 'stay at home moms' (or SAHMs) seem to have God. And lots of these (possibly all) are rather sanctimonious about their vocation, and earnest about the blessedness of their lives. Several are retro, their authors into vintage, playing with a historical concept, role-playing, almost. Some posts, like 'School of Housewifery', are about being rubbish at keeping house. It's ok to be rubbish in the home as it is to be rubbish at maths; your skills lie elsewhere, somewhere better - the workplace, the arts. These posts are meant to be funny, full of pratfalls about juggling a hundred things. But I find them slightly undermining, somehow, of the value of domesticity (we don't need to be successful professionally, socially and domestically because domestically isn't important) in the same way I find the former overly earnest about the importance of their job. There's something interesing here, politically, that I'll try and retrun to another time.
But for now, Peggy at 35 received:
GoodFood 101 Cakes and Bakes
2 Cath Kidston (vintage domestic prints) tea towels and a carrier bag holder
Sunflower seeds ('For you and Babs to plant together!')
Some peacock orchid bulbs
Kimya Dawson's Alphabutt (album of children's songs)
An Alessi lily bird soy sauce bottle
I think this means my friends think I'm a housewife. And I'm pleased about that, because they recognise that that's partly about being brilliant and well-rounded, and it's partly a bit tongue in cheek. Because I'm a hundred other things as well.
* I think it's interesting that I found the assignment enjoyable because I was, for once, allowed to be a novice; my day job requires me to write as an expert. For this other woman, students she sees see writing as a chore, and essay writing a means to an end (passing the course), rather than an end in itself (consolidating and extending understanding/learning). She totally missed the point of the session - about using writing for active learning - about thinking differently about how and why we get our students to write, and using writing tasks differently, to inspire interest, motivate students and help them to learn. Not just as a hoop to jump through before you can progress.
In the course of explaining in my college class yesterday how a recent written assessment was enjoyable for me, in response to a colleague's assertion that assessments aren't fun,* I happened to mention that I blog. In the break, someone beside me, who I am rather drawn to, and who has shared the odd moan with me in the nicely conspiratorial way in which friendly alliances can be built, asked me what I blog about. I began: 'Oh, I started it while I was on maternity leave; it's about my life as a housewife.' This pricked up the ears of the two in front, and then another in front of them, and we had a little chat, in which I felt I wasn't properly representing myself. I mean, I was a housewife, I still do all the domestic work (or at least am responsible for it, delegating some bits). But even I don't really recognise that conceptualisation of myself.
On the way home, I met an old neighbour; in the course of our chat, I mentioned that I'm back at work and quite happy about it, and he said 'yes, gets you some of your identity back'. That's the econd time someone (another man in late 30s/early 40s, from London) has said that to me. This is what I struggle to explain: I don't feel I've lost any of my identity, or that my identity has changed. I am still the same. My priorities may have changed - I'm no longer out on the p*** every night, and nor do I want to be - but that part of me is not disappeared, or muted in me. Perhaps to the outside world - to people who don't know me.... So my external face might be different; new people I meet have different expectations or assumptions of me when I say I have a baby, or I'm on maternity leave. But what I don't say is 'I'm a mother'. That is still not how I conceive of myself; that's not how I identify myself. I'm Peggy. I'm a 17 year old in a 35 year old body. I'm a generation x-er, a slacker into music, I'm a drinker, a bad dancer, a smoker who hasn't had a cigarette for a long, long time. I like cooking, I like baking, I like personal finance and domestic efficiency. But the two lists aren't mutually exclusive.
So I looked last night at other people's blogs about housewifery, to see if I identify with those. Lots of American 'stay at home moms' (or SAHMs) seem to have God. And lots of these (possibly all) are rather sanctimonious about their vocation, and earnest about the blessedness of their lives. Several are retro, their authors into vintage, playing with a historical concept, role-playing, almost. Some posts, like 'School of Housewifery', are about being rubbish at keeping house. It's ok to be rubbish in the home as it is to be rubbish at maths; your skills lie elsewhere, somewhere better - the workplace, the arts. These posts are meant to be funny, full of pratfalls about juggling a hundred things. But I find them slightly undermining, somehow, of the value of domesticity (we don't need to be successful professionally, socially and domestically because domestically isn't important) in the same way I find the former overly earnest about the importance of their job. There's something interesing here, politically, that I'll try and retrun to another time.
But for now, Peggy at 35 received:
GoodFood 101 Cakes and Bakes
2 Cath Kidston (vintage domestic prints) tea towels and a carrier bag holder
Sunflower seeds ('For you and Babs to plant together!')
Some peacock orchid bulbs
Kimya Dawson's Alphabutt (album of children's songs)
An Alessi lily bird soy sauce bottle
I think this means my friends think I'm a housewife. And I'm pleased about that, because they recognise that that's partly about being brilliant and well-rounded, and it's partly a bit tongue in cheek. Because I'm a hundred other things as well.
* I think it's interesting that I found the assignment enjoyable because I was, for once, allowed to be a novice; my day job requires me to write as an expert. For this other woman, students she sees see writing as a chore, and essay writing a means to an end (passing the course), rather than an end in itself (consolidating and extending understanding/learning). She totally missed the point of the session - about using writing for active learning - about thinking differently about how and why we get our students to write, and using writing tasks differently, to inspire interest, motivate students and help them to learn. Not just as a hoop to jump through before you can progress.
Tuesday 3 March 2009
Baby catering
When we didn't know what to do with a squash a couple of months back, Terry consulted his oracle, the River Cafe cookbook green. He made the pumpkin and cinnamon risotto (risotto alla zucca e cannella), which was delish for us and Babs, and particularly good for getting some weight on the baby, because we could slather on the olive oil and parmesan at the end. It's been a complete failsafe for Babs, whose interest in individual foodstuffs is difficult to sustain.
Anyway, last week's grocery order included an organic butternut squash, which I made into squash and cinnamon risotto yesterday. We were missing oregano, but it doesn't seem to have harmed it much. And instead of chicken stock, our pescetarian and salt-fearing family demands Marigold vegan salt-free vegetable stock. Which again, doesn't seem to have harmed it any. My mum was visiting, and she really enjoyed it; Babs liked it, and scoffed everything on her plate; and Terry was very complimentary when he came home. Two adult portions and a tiddly baby size down, there was enough left for 4 ice cube trays and a two-person portion for the freezer. And it's vegan. If you don't serve with cheese.
So, by way of recommendation (modified a little bit for convenience/vegetarianism/babyfeeding):
Risotto alla zucca e cannella ('serves 6')
1kg butternut squash, pumpkin or onion squash
1 cinnamon stick, about 5cm (book says crushed, but I left it whole so I could fish it out)
1l stock
1 tbsp dried oregano (though it really was fine without)
4 sticks of celery, finely chopped
2 small onions, finely chopped
2 cloves of garlic
pinch of dried, crushed chilli
400g arborio rice (they say carnaroli, but the only organic risotto rice I could get was arborio. And truthfully, I don't know the difference.)
400g tin chopped tomatoes
extra virgin olive oil and parmesan (they say pecorino) to serve.
Pre-heat the oven to 220C/425F/gas 7, and heat stock.
Cut the squash in half lengthwise and widthwise, remove the seeds, and cut into wedges. Season with salt, pepper & half the oregano (or none of them - that was fine), place them on an oiled baking tray and cook for 30-40 minutes (until browned and cooked).
While the squash is roasting, heat a good glug of olive oil in a large, deep, heavy-based pan, and cook the onion and celery for 5-10 minutes, until softened. Add the chilli, remaining oregano and cinnamon. Fry these together briefly, and add the rice. Stir to coat each grain with oil, and cook til opaque - 2-3 minutes. Add the tomatoes and allow this to reduce - a couple more minutes, stirring. Then add the stock, a ladleful at a time - allowing all the stock to be absorbed before adding the next ladleful, stirring all the time. It really will catch if you don't keep stirring, risotto novices! Continue until the rice is al dente - about 15 minutes - then add the squash.
I add the squash peeled, in small-ish cubes; the book says to pass it, skin and all, through a mouli first (we just don't have one). Test for seasoning (add salt v cautiously if this is for a tiddler, and not at all for under-ones) & serve drizzled with extra virgin olive oil and freshly grated parmesan/pecorino.
Modified by me, but probably copyright Rose Gray & Ruth Rogers (2000) River Cafe Cook Book Green. London: Random House.
Really, really yummy. And half of it made 48 cubes, which at 6 per meal will do Babs about 8 meals.
Anyway, last week's grocery order included an organic butternut squash, which I made into squash and cinnamon risotto yesterday. We were missing oregano, but it doesn't seem to have harmed it much. And instead of chicken stock, our pescetarian and salt-fearing family demands Marigold vegan salt-free vegetable stock. Which again, doesn't seem to have harmed it any. My mum was visiting, and she really enjoyed it; Babs liked it, and scoffed everything on her plate; and Terry was very complimentary when he came home. Two adult portions and a tiddly baby size down, there was enough left for 4 ice cube trays and a two-person portion for the freezer. And it's vegan. If you don't serve with cheese.
So, by way of recommendation (modified a little bit for convenience/vegetarianism/babyfeeding):
Risotto alla zucca e cannella ('serves 6')
1kg butternut squash, pumpkin or onion squash
1 cinnamon stick, about 5cm (book says crushed, but I left it whole so I could fish it out)
1l stock
1 tbsp dried oregano (though it really was fine without)
4 sticks of celery, finely chopped
2 small onions, finely chopped
2 cloves of garlic
pinch of dried, crushed chilli
400g arborio rice (they say carnaroli, but the only organic risotto rice I could get was arborio. And truthfully, I don't know the difference.)
400g tin chopped tomatoes
extra virgin olive oil and parmesan (they say pecorino) to serve.
Pre-heat the oven to 220C/425F/gas 7, and heat stock.
Cut the squash in half lengthwise and widthwise, remove the seeds, and cut into wedges. Season with salt, pepper & half the oregano (or none of them - that was fine), place them on an oiled baking tray and cook for 30-40 minutes (until browned and cooked).
While the squash is roasting, heat a good glug of olive oil in a large, deep, heavy-based pan, and cook the onion and celery for 5-10 minutes, until softened. Add the chilli, remaining oregano and cinnamon. Fry these together briefly, and add the rice. Stir to coat each grain with oil, and cook til opaque - 2-3 minutes. Add the tomatoes and allow this to reduce - a couple more minutes, stirring. Then add the stock, a ladleful at a time - allowing all the stock to be absorbed before adding the next ladleful, stirring all the time. It really will catch if you don't keep stirring, risotto novices! Continue until the rice is al dente - about 15 minutes - then add the squash.
I add the squash peeled, in small-ish cubes; the book says to pass it, skin and all, through a mouli first (we just don't have one). Test for seasoning (add salt v cautiously if this is for a tiddler, and not at all for under-ones) & serve drizzled with extra virgin olive oil and freshly grated parmesan/pecorino.
Modified by me, but probably copyright Rose Gray & Ruth Rogers (2000) River Cafe Cook Book Green. London: Random House.
Really, really yummy. And half of it made 48 cubes, which at 6 per meal will do Babs about 8 meals.
Wednesday 25 February 2009
Chocolate Krackolates
What a name! That's the 60s for you. They're just cornflake cakes. By popular demand, from the Woman's Own Cookery Book, 1968: makes 12 small (kiddie size) or 6 adult size. (I tend to double the quantities).
7 tablespoons corn flakes (that's 34g if you have electronic scales)
1 tablespoon icing sugar or caster sugar
1oz vegetable fat or shortening (I use Pure or Sainsbury's 'Free From' marge to keep them vegan)
1 level tablespoon cocoa powder
1 tablespoon golden syrup (heat the spoon to keep it from sticking)
2 tablespoons dessicated coconut or 1 tablespoon grated orange peel
Melt the fat and syrup slowly in a saucepan; do not boil.
Add the cocoa, remove from heat and stir in the sugar.
With a metal spoon, quickly fold in the cornflakes and coconut/orange peel until well-coated.
Spoon onto a greased baking sheet (I use paper cake - not muffin - cases) and cool.
I seem to remember them coming out of the fridge hard, but recently they've been quite squidgey still. Possibly this is because I'm slap-happy with the syrup - they have been tooth-achingly sweet. To counter the sweetness, though, I'm tempted to halve the sugar; I think they need the stickiness of the syrup to bond.
Yummy.
7 tablespoons corn flakes (that's 34g if you have electronic scales)
1 tablespoon icing sugar or caster sugar
1oz vegetable fat or shortening (I use Pure or Sainsbury's 'Free From' marge to keep them vegan)
1 level tablespoon cocoa powder
1 tablespoon golden syrup (heat the spoon to keep it from sticking)
2 tablespoons dessicated coconut or 1 tablespoon grated orange peel
Melt the fat and syrup slowly in a saucepan; do not boil.
Add the cocoa, remove from heat and stir in the sugar.
With a metal spoon, quickly fold in the cornflakes and coconut/orange peel until well-coated.
Spoon onto a greased baking sheet (I use paper cake - not muffin - cases) and cool.
I seem to remember them coming out of the fridge hard, but recently they've been quite squidgey still. Possibly this is because I'm slap-happy with the syrup - they have been tooth-achingly sweet. To counter the sweetness, though, I'm tempted to halve the sugar; I think they need the stickiness of the syrup to bond.
Yummy.
Pesky squirrels
Garden update: the pesky rodents have been digging up the bulbs from our pots. I am not happy. A couple of casualties, then I put the pots in the shed. Hopefully they will shoot, unassailed.
The window box at the front has several shoots, but the back has none. The back gets all the morning sun. Possibly they're unrelated, and the front pot just had the bulbs that were further along. The rest of the garden looks lovely: yellow croci keep springing up, and we have a lovely couple of daffs in a crack between decking and fence. (Yes, cowboys).
The window box at the front has several shoots, but the back has none. The back gets all the morning sun. Possibly they're unrelated, and the front pot just had the bulbs that were further along. The rest of the garden looks lovely: yellow croci keep springing up, and we have a lovely couple of daffs in a crack between decking and fence. (Yes, cowboys).
Saturday 14 February 2009
Walthamstow lunch recommendation and gardening therapy
We had a fantastic valentine's day lunch at our favourite place in Walthie, the Portuguese tapas cafe the Windmill: Portuguese (salt) cod cream, baked goat's cheese, piri piri prawns - yummy. We forgot the patatas bravas, but with bread and really good olives that was plenty - so we didn't really need a pastel de nata and a slice of their supremely good apple and cinnamon cake (for which I daren't ask for the recipe have fruitlessly searched t'internet) that we had with coffee anyway. That lot came to £30 with a tip, which is a lot for lunch but reasonable (ooh, it included a beer, too) since we were there for almost two hours and they're so accommodating - nay, welcoming - of tiddlers. Also, I'm particularly happy to splash on their tapas of a weekend because I sometimes take other mothers there for their bargain weekday lunch - £3.50 for a dish and rice - when we take up time and large tables and often only drink tap water, so they're really only making any money out the repeat business.
Anyway, I truly recommend it, and it's a real asset to this part of town.
Afterwards, we came home via the park, and because it was such a lovely day, we went straight into our little urban garden to plant the bulbs we bought on the cheap before christmas - reduced because they were almost overdue planting back then. Terry dug around in the bed in the back looking for stones to use for drainage in the the two aluminium window boxes that came from dad's, which revealed, among the cat shit, an awful lot of pruning and tidying to do. So we pulled out all the dead stuff and got rid of the fallen leaves, and pulled up the hundreds of weeds (there's a particular plant that's everywhere, red stem and lots of shoots. Luckily the rootball is small and shallow, so it's easy to pull out, but it's all over the bed), and hacked back the pyrocanthas and the other tree-bush and the winter-flowering jasmine, and then I attacked next door's ivy, which has completely, unassailably, covered the fence we share, and finally got back to planting up the bulbs. We had heaps of tulips and daffodils and croci, so I have the two window boxes and 4 or 5 tubs. Most of the bulbs looked like they were still good, though half the daffs had rotted down to blackness in their papery casings, so hopefully we'll get a little spring colour, even if it is a bit late and half-hearted.
Clearing one corner of the bed, I pulled and pulled, then jumped back as something moved. What I could see looked gross, it could almost have been cat turd, but there was something sticking out, so it really looked like a slug with legs - and then I realised it was a little toad. Poor little thing stayed as still as still could be, so I asked Terry what to do and he suggested I just cover it with some of the leaves. I did, and we left it. It was still there half an hour later when we were back over that side with weightier implements to attack the tree with; hopefully not paralysed with fear....
A little robin was about too. Considering the amount of cat poo in the garden, we manage to attract quite a few birds. I've seen blue tits and robins and sparrows and a jay among the ubiquitous woodpidgeons and squirrels. The robin was really fearless. He sat on the back fence for a while, only a couple of feet from us, and we tried to show Babs, but I'm not sure she clocked him. A little while later, as soon as my back was turned, he was off the tree and onto the beds, where I'd clearly revealed some worms, and he looked happy. We moved the bird feeder and put up another, so hopefully we'll see a few more birds in the next few weeks.
It was so nice being in the garden; I haven't really been out there since the summer. The endorphins got me so fired up I swept up in the back and then swept out the front, and I'm still a bit buzzy two hours later. There may be hope for our allotment dreams yet.
Anyway, I truly recommend it, and it's a real asset to this part of town.
Afterwards, we came home via the park, and because it was such a lovely day, we went straight into our little urban garden to plant the bulbs we bought on the cheap before christmas - reduced because they were almost overdue planting back then. Terry dug around in the bed in the back looking for stones to use for drainage in the the two aluminium window boxes that came from dad's, which revealed, among the cat shit, an awful lot of pruning and tidying to do. So we pulled out all the dead stuff and got rid of the fallen leaves, and pulled up the hundreds of weeds (there's a particular plant that's everywhere, red stem and lots of shoots. Luckily the rootball is small and shallow, so it's easy to pull out, but it's all over the bed), and hacked back the pyrocanthas and the other tree-bush and the winter-flowering jasmine, and then I attacked next door's ivy, which has completely, unassailably, covered the fence we share, and finally got back to planting up the bulbs. We had heaps of tulips and daffodils and croci, so I have the two window boxes and 4 or 5 tubs. Most of the bulbs looked like they were still good, though half the daffs had rotted down to blackness in their papery casings, so hopefully we'll get a little spring colour, even if it is a bit late and half-hearted.
Clearing one corner of the bed, I pulled and pulled, then jumped back as something moved. What I could see looked gross, it could almost have been cat turd, but there was something sticking out, so it really looked like a slug with legs - and then I realised it was a little toad. Poor little thing stayed as still as still could be, so I asked Terry what to do and he suggested I just cover it with some of the leaves. I did, and we left it. It was still there half an hour later when we were back over that side with weightier implements to attack the tree with; hopefully not paralysed with fear....
A little robin was about too. Considering the amount of cat poo in the garden, we manage to attract quite a few birds. I've seen blue tits and robins and sparrows and a jay among the ubiquitous woodpidgeons and squirrels. The robin was really fearless. He sat on the back fence for a while, only a couple of feet from us, and we tried to show Babs, but I'm not sure she clocked him. A little while later, as soon as my back was turned, he was off the tree and onto the beds, where I'd clearly revealed some worms, and he looked happy. We moved the bird feeder and put up another, so hopefully we'll see a few more birds in the next few weeks.
It was so nice being in the garden; I haven't really been out there since the summer. The endorphins got me so fired up I swept up in the back and then swept out the front, and I'm still a bit buzzy two hours later. There may be hope for our allotment dreams yet.
Maternity matters
It's almost Babs' first birthday. It's played on my mind for months that I never got round to writing to the head of midwifery and the director of maternity services where I gave birth, to feed back on my experiences. I don't want to complain; really, I just want to let them know what happened, where there were failings, and where some of their development activity should focus. Everyone whose birth stories I have heard in the last year have included aspects which disappointed them - apart from the women who were able to give birth at home. Now, possibly this is because the home births, by definition, required the least intervention - were the most 'natural' - but it is not intervention per se that causes dissatisfaction (disappointment, maybe, but that's a very different thing). Dissatisfaction comes from the way we are spoken to, consulted (or not), treated, and the mis-match between expectation and experience. Sometimes this mis-match is due to the degree of intervention: I think it's reasonable for decisions to be taken without laborious explanation and formal consent when the degree of risk requires fast, decisive action. Hence I have little sympathy for the indignance of my contemporary who was not consented for an episiotomy when the baby clearly needed to be delivered as quickly as possible - but this post hoc indignance could have been mitigated by some sensitive and informative explanation following the events.
Partly, the problem could be attributed to the 'empowerment' of women by encouraging them to write a birth plan, without fully preparing them for the deviations from normality that could indicate wide deviation from this list of hopes for their care. Our antenatal community midwife ran through the ways some of my points might not work out, and encouraged us to think flexibly; she tried to impress on us that things might not go smoothly, and so, for example my desire for no epidural might not be realistic. I could accept this; but I (unlike so many others) was able to think flexibly because I was well prepared for many of the possible deviations from normality because of the work I do. For several years, I have worked with midwives and doctors and have become well acquainted with the work of the delivery suite, the language of maternity, the roles and responsibilities of the different professions and the ways that even initially straightforward labours and deliveries can be complicated. But for this experience, my understanding would have been patchy. Were it left entirely to the PCT (the primary care trust, which organises and delivers primary care in an area approximate to the borough) and the antenatal classes they provided, it would have been woefully limited.
The PCT provided a 4 week programme of antenatal classes. The first, 'normal labour' was reasonably useful and complete. The second 'deviation from normality', given by a different midwife, was appallingly inadequate. The scheduled 2 hour session lasted barely an hour. Deviation from normality covered precisely one possibility - the need for induction of labour. And even this did little to explain what might occur, and over what timescale. (Only when my induction was booked when I was >40 weeks was I told I would need to attend the night before.)
Anyway, this lengthy preamble is to introduce the letter I have finally, belatedly, hopefully sent to the hospital I gave birth in. I have so far only sent it to the PALS (patient advice and liaison service) team, because there was no address for the head of midwifery or the director of maternity. Because of the way maternity care is structured and funded, I should also send it to the PCT maternity lead. I would seriously urge others to feed back their experiences - importantly, good and bad - to the people who organised and delivered their care. In the climate of chronic underfunding, poor staffing and competing priorities, it's important to lobby - hard - for attention here.
Dear ...
I gave birth at [hospital] in March 2008 after a transfer from home, and though my experience was reasonable, there are several points on which I think Maternity Services requires feedback.
I had two brilliant community midwives overnight, and they persuaded me by the early morning that due to my slow progress, it would probably be best to transfer to hospital for syntocinon to speed things up and an epidural for a bit of a rest. My labour had been long and slow and I totally saw the logic in reserving energy for pushing (ie, intervention now might save intervention later).
I transferred in by ambulance at about 6am, and my care (after a while, possibly via the labour ward co-ordinator) was handed over to Midwife1. Midwife1barely acknowledged us when she took the handover, and this lack of eye contact and engagement with myself and my partner set the tone of the care she offered and the experience we had with her.
A cannula was put into the back of my left hand reasonably quickly and I was kept supine with the CTG - something the community midwives had tried to avoid when we arrived: they had put me on the CTG but standing up, to try and keep things moving. Mariam barely talked to me about what she was doing, never told me why things were necessary. I was not treated as a partner in my care. I was the object of a course of treatment/action.
Given that we arrived at around 6.30 or 7am, I was surprised when, at about 11am, Mariam started doing something with the drip. I asked her what she was doing and was told she was putting the syntocinon in. I couldn't believe this was only happening now, hours after we arrived. No explanation was given, so I don't know whether this represented a delay or whether this time lag was normal. It would have helped considerably if she had talked to us when we arrived about what needed doing in what order and how long the process might take. Given that I was transferred to speed things up, this felt like an incredibly long time for things to be taking.
At one point, without warning, while I was talkling to my partner on my right, Midwife1 picked up my left hand, and did something which sent a fierce, shooting pain into my hand and up my arm. I was alarmed, and asked what on earth she was doing. She told me she had had to flush the line; end of story. No further explanation was given of what this meant or why it was indicated. But more shocking than the pain was that she did it without gaining my attention first, let alone my permission.
Later, when I started to shake, I worked out that I hadn't eaten since 8pm the previous evening, and thought it could be low blood sugar. I knew (through common sense, not from Midwife1) that because of the chance of going to theatre, I could not eat, and framing it thus, I explained I was hungry and asked if there was any glucose in the drip. She told me I couldn't eat, so I explained that I understood this, but that I was concerned about my energy etc, and again asked if there was glucose in the drip. She told me she didn't know. This in itself is slightly concerning - the qualified midwife doesn't know what's in her client's drip - and she read the bag to see. It was Hartmann's solution, and I now know what that means. My concern is that, again, no explanation was given when the drip went up of what it was or what it was for. Midwife1 couldn't engage with me further about my hunger; I tried to tell her I was shaking and I hadn't eaten; she told me it was labour. I sent my partner out to ask for the co-ordinator, and she came and also told me it was labour. Nothing was done to address the issue that it was now more than 12 hours since I had eaten. (I have since found out that shaking in labour is not unusual, but neither the midwife of the co-ordinator explained this to me satisfactorily).
After this series of events, I was so fed up I asked my partner to ask the co-ordinator for a new midwife. Midwife1 was sent for lunch and reassigned on her return. As she left she engaged with us for the first time in the way I would have expected a midwife to behave all along, telling us she hoped to be back to see the birth. Fortunately the next midwife was brilliant; engaged, supportive, discursive, informative and friendly. Everything the previous midwife wasn't.
I realise it's almost a year, and Midwife1 may not even be working at the hospital any longer, but my complaint is not about her per se; I really just want to highlight, with concrete examples, how the service can be disappointing. Clearly this midwife needs some direct performance management; her communication skills and professionalism were lacking. I was lucky - empowered because I am articulate, knowledgeable, and undaunted about challenging poor practice. Not all the women in the catchment area would be able to challenge this, and without complaints poor practice is able to continue.
My experiences with the post-natal midwives and the limitations of their breastfeeding support (my baby could not latch on) were also disappointing. I requested the support of the breastfeeding leader, which was documented in my notes, but I never saw her; I was discharged with no further mention of it, and unclear about what or how much to feed my baby. I think it was just assumed that she would eventually latch on or that in my sleep-deprived and hormone-addled state i would be able to figure out formula feeding - even though I had made it clear I wanted to breastfeed and the PCT breastfeeding talk had discussed nipple confusion, so I was (and told them I was) adamantly against bottles. I was desperately confused on discharge, and though I made extensive use of the breastfeeding network in the few days postnatally, I had no formal support, my baby absolutely could not latch on, and she undoubtedly suffered because we were discharged home at 4pm with no idea how we were going to feed her, or how much and how often she needed to be fed.
I hope that these comments will be of use to the service. This is absolutely not about pointing the finger at particular members of staff, just about highlighting areas for development. I understand that there are competing priorities for training, x days mandatory training have to be undertaken, the service is short-staffed, making backfill difficult, etc; but there is clearly a need for training on breastfeeding support, and making sure that no woman leaves the service as I did, with no way of breastfeeding and no resources for expressing (no one showed me how or even mentioned it) or feeding by other means (eg syringe).
Yours faithfully,
Partly, the problem could be attributed to the 'empowerment' of women by encouraging them to write a birth plan, without fully preparing them for the deviations from normality that could indicate wide deviation from this list of hopes for their care. Our antenatal community midwife ran through the ways some of my points might not work out, and encouraged us to think flexibly; she tried to impress on us that things might not go smoothly, and so, for example my desire for no epidural might not be realistic. I could accept this; but I (unlike so many others) was able to think flexibly because I was well prepared for many of the possible deviations from normality because of the work I do. For several years, I have worked with midwives and doctors and have become well acquainted with the work of the delivery suite, the language of maternity, the roles and responsibilities of the different professions and the ways that even initially straightforward labours and deliveries can be complicated. But for this experience, my understanding would have been patchy. Were it left entirely to the PCT (the primary care trust, which organises and delivers primary care in an area approximate to the borough) and the antenatal classes they provided, it would have been woefully limited.
The PCT provided a 4 week programme of antenatal classes. The first, 'normal labour' was reasonably useful and complete. The second 'deviation from normality', given by a different midwife, was appallingly inadequate. The scheduled 2 hour session lasted barely an hour. Deviation from normality covered precisely one possibility - the need for induction of labour. And even this did little to explain what might occur, and over what timescale. (Only when my induction was booked when I was >40 weeks was I told I would need to attend the night before.)
Anyway, this lengthy preamble is to introduce the letter I have finally, belatedly, hopefully sent to the hospital I gave birth in. I have so far only sent it to the PALS (patient advice and liaison service) team, because there was no address for the head of midwifery or the director of maternity. Because of the way maternity care is structured and funded, I should also send it to the PCT maternity lead. I would seriously urge others to feed back their experiences - importantly, good and bad - to the people who organised and delivered their care. In the climate of chronic underfunding, poor staffing and competing priorities, it's important to lobby - hard - for attention here.
Dear ...
I gave birth at [hospital] in March 2008 after a transfer from home, and though my experience was reasonable, there are several points on which I think Maternity Services requires feedback.
I had two brilliant community midwives overnight, and they persuaded me by the early morning that due to my slow progress, it would probably be best to transfer to hospital for syntocinon to speed things up and an epidural for a bit of a rest. My labour had been long and slow and I totally saw the logic in reserving energy for pushing (ie, intervention now might save intervention later).
I transferred in by ambulance at about 6am, and my care (after a while, possibly via the labour ward co-ordinator) was handed over to Midwife1. Midwife1barely acknowledged us when she took the handover, and this lack of eye contact and engagement with myself and my partner set the tone of the care she offered and the experience we had with her.
A cannula was put into the back of my left hand reasonably quickly and I was kept supine with the CTG - something the community midwives had tried to avoid when we arrived: they had put me on the CTG but standing up, to try and keep things moving. Mariam barely talked to me about what she was doing, never told me why things were necessary. I was not treated as a partner in my care. I was the object of a course of treatment/action.
Given that we arrived at around 6.30 or 7am, I was surprised when, at about 11am, Mariam started doing something with the drip. I asked her what she was doing and was told she was putting the syntocinon in. I couldn't believe this was only happening now, hours after we arrived. No explanation was given, so I don't know whether this represented a delay or whether this time lag was normal. It would have helped considerably if she had talked to us when we arrived about what needed doing in what order and how long the process might take. Given that I was transferred to speed things up, this felt like an incredibly long time for things to be taking.
At one point, without warning, while I was talkling to my partner on my right, Midwife1 picked up my left hand, and did something which sent a fierce, shooting pain into my hand and up my arm. I was alarmed, and asked what on earth she was doing. She told me she had had to flush the line; end of story. No further explanation was given of what this meant or why it was indicated. But more shocking than the pain was that she did it without gaining my attention first, let alone my permission.
Later, when I started to shake, I worked out that I hadn't eaten since 8pm the previous evening, and thought it could be low blood sugar. I knew (through common sense, not from Midwife1) that because of the chance of going to theatre, I could not eat, and framing it thus, I explained I was hungry and asked if there was any glucose in the drip. She told me I couldn't eat, so I explained that I understood this, but that I was concerned about my energy etc, and again asked if there was glucose in the drip. She told me she didn't know. This in itself is slightly concerning - the qualified midwife doesn't know what's in her client's drip - and she read the bag to see. It was Hartmann's solution, and I now know what that means. My concern is that, again, no explanation was given when the drip went up of what it was or what it was for. Midwife1 couldn't engage with me further about my hunger; I tried to tell her I was shaking and I hadn't eaten; she told me it was labour. I sent my partner out to ask for the co-ordinator, and she came and also told me it was labour. Nothing was done to address the issue that it was now more than 12 hours since I had eaten. (I have since found out that shaking in labour is not unusual, but neither the midwife of the co-ordinator explained this to me satisfactorily).
After this series of events, I was so fed up I asked my partner to ask the co-ordinator for a new midwife. Midwife1 was sent for lunch and reassigned on her return. As she left she engaged with us for the first time in the way I would have expected a midwife to behave all along, telling us she hoped to be back to see the birth. Fortunately the next midwife was brilliant; engaged, supportive, discursive, informative and friendly. Everything the previous midwife wasn't.
I realise it's almost a year, and Midwife1 may not even be working at the hospital any longer, but my complaint is not about her per se; I really just want to highlight, with concrete examples, how the service can be disappointing. Clearly this midwife needs some direct performance management; her communication skills and professionalism were lacking. I was lucky - empowered because I am articulate, knowledgeable, and undaunted about challenging poor practice. Not all the women in the catchment area would be able to challenge this, and without complaints poor practice is able to continue.
My experiences with the post-natal midwives and the limitations of their breastfeeding support (my baby could not latch on) were also disappointing. I requested the support of the breastfeeding leader, which was documented in my notes, but I never saw her; I was discharged with no further mention of it, and unclear about what or how much to feed my baby. I think it was just assumed that she would eventually latch on or that in my sleep-deprived and hormone-addled state i would be able to figure out formula feeding - even though I had made it clear I wanted to breastfeed and the PCT breastfeeding talk had discussed nipple confusion, so I was (and told them I was) adamantly against bottles. I was desperately confused on discharge, and though I made extensive use of the breastfeeding network in the few days postnatally, I had no formal support, my baby absolutely could not latch on, and she undoubtedly suffered because we were discharged home at 4pm with no idea how we were going to feed her, or how much and how often she needed to be fed.
I hope that these comments will be of use to the service. This is absolutely not about pointing the finger at particular members of staff, just about highlighting areas for development. I understand that there are competing priorities for training, x days mandatory training have to be undertaken, the service is short-staffed, making backfill difficult, etc; but there is clearly a need for training on breastfeeding support, and making sure that no woman leaves the service as I did, with no way of breastfeeding and no resources for expressing (no one showed me how or even mentioned it) or feeding by other means (eg syringe).
Yours faithfully,
Labels:
birth,
breastfeeding,
delivery,
labour,
maternity,
midwifery,
patient satisfaction
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