Open Letter to the NMC

open letter to NMC freedom for independent midwives

I’ve mentioned this in passing in a few posts recently, finally I’m able to sit down and write a full post about the farcical treatment of independent midwives by their governing body, the Nursing and Midwifery Council (NMC). The backstory to this goes back years. In very brief summary, in 2014, it became mandatory for all health professionals to have indemnity insurance. Prior to this, independent midwives (IMs) were practicing without insurance. Clients would simply sign a declaration stating that they understood this, myself and the husbeast signed such a document when we hired our IM in 2011.

This worked absolutely fine in the overwhelming majority of cases. For two main reasons; first, the client entered into this arrangement with full knowledge and acceptance of it. If it had been a deal-breaker for a client/couple, then they simply wouldn’t have hired the IM and would have sought midwifery services elsewhere, either through the NHS, or a private provider (note: independent and private midwives are very different. Private midwives are employed by a corporate/private maternity care provider. IMs are self employed, totally independent and traditionally free from corporate/insurance interests).

Second, it is generally recognised that IMs provide the gold standard of midwifery care, therefore adverse outcomes are extremely rare. In the exceptional circumstances where something did go wrong, AND the IM was found to be negligent, it was up to the client whether to pursue a legal case or not. With the relationship typically built up between woman and IM, it seems inconceivable that the woman would decide to bankrupt the midwife. Of course, there are a couple of cases of this happening, but it is essential to look at the big picture and assess whether broad strokes that affect nearly 100 midwives and the many thousands of women that they care for are proportionate to the tiny number of cases where lack of insurance was a serious problem.

The reason that IMs were practicing without insurance was that there wasn’t an insurance product available to them. Insurers, with no knowledge of birth or midwifery, considered it too high a (financial) risk.

In 2014, however, when IMs were left with no choice in the matter, they found a provider who was able to create a custom policy tailored to their practice. Any IM registered with IMUK was covered by this insurance. Everything seemed to be going smoothly, until late last year, when the NMC suddenly decided that the insurance they had in place was not adequate. To date, they have refused to explain in what way it is inadequate, or what additional coverage would make it adequate. There have been muddled statements about there not being enough money in the pot to make a single large payout. However, it is my understanding that this isn’t true, and that if a claim were successfully made against an IM, there would, in fact be adequate funds available by the time the payout was expected to be made.

The NMC refuse to accept this and simply forced all IMs to sign a contract, under duress, stating that they would no longer attend births. The lack of warning left hundreds of women without their midwife for their births. Apparently, the NMC found this acceptable.

Birthrights and other organisations have been working tirelessly on this issue. Below is an open letter, written by Birthplace Matters founders, Paula, Jeannette, and Anna. The complete document and correspondence history can be found here. Please feel free to share widely. Tweet the NMC @nmcnews and #savethemidwife and make your voice heard. IMs and birthing women need our support.

Open reply to the NMC from Birthplace Matters – March 2017

Dear Catherine Evans and Emma Broadbent,

Thank you for your response to our letter. It is clear that your goal is to focus on compensating mothers after the event of their birth. We wish to explore this in broader terms and discuss what really matters to the many mothers we hear from at Birthplace Matters.

It strikes us that when a woman is hiring an independent midwife, it is often done as an act of insurance, to protect herself and her baby from damage which she does not want to repeat from an earlier birth. Sadly, the damage we hear about is occurring far too often as a result of ‘routine’ or commonplace procedures which are happening every single day up and down the country.

As such, far from being a luxury lifestyle choice for a wealthy and privileged elite, a woman’s decision to hire an independent midwife is much more often an act of desperation following anxiety attacks, symptoms of PTSD, and feelings of anger and sadness following an experience of giving birth under NHS care. Often, they just want to avoid the same ‘routine’ procedures and treatment again.

Your statement that women still have the option of choosing non-IMUK midwives, fine though they may be, is not actually viable for some – since some women live too far from one for that to be a safe option for birth – especially for 2nd, 3rd, or 4th babies etc, who may come too quickly for a midwife to drive 3 hours to her. In such cases women are left facing the option of going back under NHS care, choosing to birth alone with no midwives, or, as we have been hearing more and more recently, actually choosing not to have any more children. All three of these options are unacceptable when taken as acts of desperation. Do you see now what peril women are in because of this insurance fiasco?

Without exaggeration, some stories we have heard by women describe their birth in the language that rape victims use about the violation of their bodies by strangers. Some are triggered for weeks, months and even years afterwards, often suffering silently. Even if a birth appears on paper to have been a success, with no legal category for suing a hospital, it doesn’t always mean that a woman walked away from her birth experience unscarred. There are invisible wounds which cannot be accounted for in a tick-box on an insurance claim form. Some feel too beaten down to fight anyway.

We are hearing frequently from women who say they were ignored, laughed at and even abused by NHS staff – ironically, your actions in preventing IMs from practising is pushing some women to have to go back to the same place and potentially go through the same traumas all over again.

When we allow insurance companies, governments, and lawyers to determine the T&C’s of birth, it can be interpreted as a carte-blanche to behave appallingly, in the arrogant guise of rescuing women and protecting babies by a highly interventionist approach. The onus on deciding what is safe is therefore shifted away from the mother, where it rightfully belongs, and is assumed by her care team. When a woman is not trusted to make informed decisions, but is instead bullied, this undermines/violates her rights over her own body and her own baby.

This is why so many women seek out an independent midwife – because the word independent means just that – they know full well that whilst their midwife is insured for what is to most mothers, a reasonable and reassuring sum, these midwives are not entirely in the pocket of insurance companies so are not motivated primarily to satisfy insurance company tick boxes over and above the wishes of the mother. They often avoid the same knee-jerk interventionism that is offered within NHS settings, providing instead truly 1:1 watchful, continuous care with the time and space to be with-woman in the way that midwives in hospitals cannot due to restraints outside of their own control. Without wishing to offend individual midwives within the NHS who offer sterling care, we feel that this continuity actually makes independent midwifery a much safer model.

Even the very best NHS midwives will sometimes admit they are just too busy to truly give the full care and attention they would wish they could give to women, knowing that CTG monitors are a poor substitute for 1:1 care and have not been shown to have saved even one life. Even in those places where the NHS aspires to offer truly holistic care, it is not always consistently available for all women coming through the doors. When women are lucky enough to receive truly individualised and holistic care it is more often than not at a personal cost to a midwife’s career progression.

There are so many good NHS midwives working within the system who are being disciplined and over-ruled to satisfy bosses who are thinking of insurance and malpractice tick-boxes first and foremost. Many are leaving the system altogether due to stress and burnout in their attempt to balance gold standard care with restrictions from on high. As well as working within ever more restrictive insurance company T&C’s, it must also be said that the over-riding of mothers’ wishes within the NHS is done in a spirit of old-fashioned paternalism which is very tiring for women to have to put up with in 2017 after all the gains we have made to improve women’s rights elsewhere.

In the light of what we have discussed above, we at Birthplace Matters feel that the NMC’s definition of what it means to protect women and their babies needs to be re-evaluated. In 2017, it ought to mean so much more than a woman’s ability to claim financial reimbursement in the event of lifechanging birth complications – since no insurance company should have a monopoly on defining what those complications are. Clearly, many women are left scarred by their birth experiences in ways that are invisible, but are very real and life-changing for themselves and their babies in ways that affect whole families. Offering a wildly inflated sum like £10m is meaningless to a mother who has to drive a 10 mile detour so she doesn’t have to go past a hospital where she gave birth and who does not want to relive the trauma all over again by pursuing a legal case – especially if the hospital closes ranks and proposes what constitutes harm by their own definition only, ignoring or belittling her complaints.

The insurance cartel that is taking over birth practice is turning this very natural process into an increasingly clinical event with unhappy consequences for many mothers and babies. If such insurance-dominated practice was translating into safer and more satisfying birth it would make sense – yet the opposite seems to be true, judging by the soaring rate of inductions and other interventions which drive up the cesarean rate.

We ask that you pay attention to the voices in the #savethemidwife campaign and recognise the ridiculousness of telling independent midwives they are not insured for enough without stating what ‘enough’ is, leaving them and their clients in a state of confusion and despair. Why not let mothers decide on what level of insurance they want to choose rather than letting the insurance companies dictate whether a woman can afford an independent midwife, or not? Independent should mean just that – forcing them to fall in line with the NHS suggests you do not appreciate the difference between the two uniquely different models. They should remain separate as they have been to date, and women should rightfully be at the helm in choosing what they need.

Yours in frustration,

Paula, Jeanette and Anna – The Birthplace Matters Team

3 Top Tips for a Chilled Out Winter with A New Baby!

90338.jpgThis time five years ago, I was heavily pregnant with the Bean – wait, what? Was that really five whole years ago? Where has the time gone?! Three years before that, hubby and I moved 220 miles when I was 26 weeks pregnant. I really don’t recommend doing that! It’s been a few years since I had a tiny baby, but I remember it pretty clearly and have definitely learned a lot since then. You find that parenting is rather like being on a swing. It takes a bit of effort to get going and coordinated, but once you’re in the swing of it, you forget the effort it took and it becomes second nature. I hope that some of these tips from a wise old bird will help a few new parents this winter.

1Layer up! Obvious really, but this is my number one top tip. I didn’t really get it the first time around. I kept wearing the types of clothes I had worn pre-baby and was forever the wrong temperature! Nursing burns serious calories (so go ahead and let yourself have a slice of that home made cake at baby group), and in your hormonal post-partum state, you may get hot flushes. You’ll want to wrap up against the cold, but then when you arrive at your destination, be prepared to shed layers to be comfortable.

Same goes for baby, by the way! Several layers is better than one thick snowsuit, especially if baby is going to be in a car seat or be worn in a carrier (more on that in a mo). It’s super important not to put baby in anything too thick when they are in their five-point harness car seat, as if the worst should happen and you are in a collision, that padding can prevent the straps being tight enough to keep baby safely in their car seat.

When the Bean was little, I spent the extra cash on some nursing tops, rather than making do with what I had. I highly recommend Boob for fantastic tops for this time in your life. I still wear my hooded jumper from time to time. You can add layers safe in the knowledge that you can easily get to your breast to feed baby, without the discomfort of bunching up excess fabric or getting a chill from having your side/belly/chest uncovered.

Invest2 in a good carrier…. or six! I know not all parents will agree on this one, and each to their own, but I find a pram or buggy totally impractical in winter. I’ve never figured out how the parent holds an umbrella while pushing a pram, and the thought of slipping on ice and a pram rolling away down the steep hill that we live on is unthinkable! The Munchkin was in a pram a fair bit when he was little, but it was spring-summer and I hadn’t yet really discovered babywearing properly. We did have a sling, but I didn’t get on with it. It took me a while to get to a sling library and find a better carrier. He was ten months before we ditched the pram and started wearing him exclusively.12043191_1060903917277302_6469733779818377733_n

The Bean has only ever been in a buggy when we were on holiday in Florida and it was too hot to wear him. At home, I’ve never felt the need to use one with him. I got seriously into babywearing after he was born, and invested in several fantastic wraps, a ring sling, and a gorgeous custom made, Dr Seuss-themed, half-buckle mei tai by Madame GooGoo! I was wearing this in London one day, when a woman approached me from behind and told me she had seen pictures of my carrier online (sling makers often share photos of their finished products before shipping them) and long been an admirer of it, she was so surprised to see it in person. The sling world is like that, very friendly and approachable. Carriers also retain their value quite well, so can be sold on when they are no longer in use. I had to sell this carrier on last year. I often wonder where it is now and if it is still getting lots of use.

Babywearing in winter is a great way to keep each other warm and safe. Light layers, as mentioned above, are best, to avoid over-heating. I absolutely loved putting my babies in leg warmers, as in the picture above, a great compliment to babywearing and cloth nappies.

Most high street carriers are unsuitable for babywearing safely. They don’t allow for parents to follow the “TICKS” guidelines, and forward facing positions place stress on the wrong parts of a baby; chiefly their spine and crotch (these are jokingly referred to as “crotch-danglers” in the babywearing community). So, if you are going to wear your baby, make sure that your carrier enables you to wear baby in the correct position (Tight against your body, In sight at all times, Close enough to kiss, Keep the chin off the chest, and Supported back – upright, facing you,. These are the T.I.C.K.S.). Back carries are great when babies get a bit older, but newborns are best worn on the front so that the TICKS can be observed.

There is a wealth of detailed information out there for those wanting to wear their babies, so I urge you to take a good look around the net, find a local sling library, and get support. There are loads of groups on Facebook dedicated to this!

3Don’t over-do things! If you are just about to have a baby, or have recently given birth, for goodness sake, don’t try to take on too much this festive season! It’s not worth it. Take it easy. Nest, or snuggle into your “babymoon” and enjoy your new baby. Get help in for Christmas, from family or friends. Don’t feel you have to cook a huge feast for all of your extended family. Traditions are great, but they can wait until next year if they involve a lot of effort. Let yourself have this pause from the hectic hustle and bustle of the season, your body will thank you. Stock up the freezer with easy-to-heat meals; get shopping delivered instead of traipsing around a supermarket with a baby; say no to the invitations that you know you need to skip this year; keep it simple. I had the Bean at the end of January, so Christmas 5 years ago was a fairly low-key affair. I was waddling everywhere and unable to sleep comfortably due to my huge bump.

Nursing a newborn means resting and nourishing your body, rushing about trying to fit in too much won’t do either of you any good. If you have commitments that can’t be skipped or delegated, then find ways to manage them. You might have a school run to do with an older child, or a relative to care for. Of course you need to do these things, but try to have realistic expectations of yourself.

I hope some of this is helpful. If you have any more tips for the season, do please share them in the comments below. I love to hear from readers!

 

The All Powerful Birth Contract

My lotus caesarean was possible because I gave the possibility serious thought and planned for it, just in case. I discussed each aspect in depth with my independent midwife and prior to my labour she even floated the vague idea past the Consultant Midwife at the hospital, as a hypothetical situation, for her to discuss with her colleagues. When we arrived at the hospital we produced the following document, which details all of the conditions on which I would accept obstetric help. It is firmly worded, leaving no room for anyone to override my consent. I am so glad I had it and I am reproducing it here in the hope that others will be able to use elements of it, or the document in its entirety, to enable them to get the care and the birth that they are entitled to. It is written with the fact that I had independent midwives and a doula and was planning a home birth, however, it can be edited for those with NHS care providers and those planning a hospital birth. Please feel free to take what you can from it and share it with anyone you may feel would benefit from it.

Birth Contract

Baby expected: Early 2012

Planned place of birth: Home

Independent Midwives (IMs): ****

Birth Partners: ****

Onset of labour

If delivery prior to spontaneous onset of labour is medically indicated, I will only consider induction of any kind or caesarean section after very careful discussion with my independent midwife (IM) and husband.

Labour/Admission to Ward pre-section

I wish for my husband, IM and doula to have access to me to continue providing support, though I understand if this is only possible by rotating persons present in the delivery room.

My birth supporters have been given direct permission to advocate for me if I am unable to do so for myself.

I do not consent to vaginal examinations.

I do not consent to CFM without careful consultation with my IM about the possible risks vs benefits.

The birth space will be respected; anyone wishing to enter the room must knock and await invitation to enter, quiet voices will be used, lights will be dimmed.

I do not consent to the use of prostaglandins.

I do not consent to augmentation of labour with ARM or syntocinon. If there is a genuine reason to accelerate the birth of my child I will agree to caesarean section after discussion and agreement with my IM and husband.

I do not consent to administration of pethidine or any other opiate pain relief.

I will only consider epidural anaesthesia after careful consultation with my IM.

Birth & immediate post-natal period

I do not wish to be coached to push.

I will be using whatever position is most comfortable for me.

I do not consent to episiotomy unless an emergency situation develops.

I do not consent to ventouse or forceps delivery without consultation with my IM.

My baby will be handed directly to me for immediate skin to skin.

I do not consent to prophylactic administration of syntometrine.

I do not consent to premature cord clamping.

If my baby is in need of medical attention, it will be provided with baby in my arms or on a firm surface right beside me. There is NO NEED TO CUT THE CORD FOR THIS. I am planning a lotus birth, the placenta will remain attached to my baby, even in the event of a caesarean section.

My baby will be treated gently and respectfully; no vigorous cleaning, no routine suctioning of the airways.

I do not consent to routine administration of vitamin k. If the birth has been traumatic then I will consider oral vitamin k only and only after discussion with my IM and husband.

My family and I will not be separated. Provision will be made for my husband to remain with me and our baby at all times.

Caesarean Section

I will only consent to a caesarean section upon careful discussion with my IM and husband.

My IM is to accompany myself and my husband to theatre.

I do not consent to routine prophylactic antibiotics during surgery.

Anaesthesia should be in the form of spinal block, rather than epidural. General anaesthetic should only be administered with the direct consent of myself or my husband, upon the advice of our IM.

Voices will be kept low, as will lighting for the birth.

Forceps are only to be used to extract my baby after thorough efforts by hand have been exhausted. My IM will be watching.

My husband and I wish to discover the sex of our baby ourselves, no one else is to announce it.

The baby will be handed directly to me, uncleaned and with the cord intact and un-clamped.

Administration of syntometrine will be delayed until the cord has stopped pulsating. If this takes an unusually long time we can negotiate.

My placenta is to be kept attached to the baby and removed from me only after the umbilical cord has stopped pulsating. I understand the risks of my abdomen remaining open for this period.

If my baby requires immediate medical attention, it will be provided with baby in my arms or on a firm surface right beside me/between my legs. There is NO NEED TO CUT THE CORD FOR THIS. I am planning a lotus birth, the placenta will remain attached to my baby unless there is a clear medical need to separate them, not including resuscitation, as this can be done on a firm surface beside me. I do not consent to my baby’s primary source of oxygen (through blood flow from the placenta) to be cut off.

If I am unable to hold my baby immediately following birth then my husband is to be the primary contact.

If my baby does need to be taken from myself and my husband then my IM will remain with him/her at all times.

My baby will be treated gently and respectfully; no vigorous cleaning, no routine suctioning of the airways.

In the event of caesarean section, I will only consent to oral vitamin k if for some reason the cord has been clamped prematurely.

If the surgery takes place at night, provision will be made for my husband to remain with me and our baby.

Provision will be made for my baby to remain close to me at all times, including use of a co-sleeper bed/crib.

In the Event of Transfer for Retained/Adherent Placenta

My baby is to accompany me into theatre, as are my IM and husband.

My husband is to remain with me and our baby at all times, if admission is at night then provision will be made for him to remain with us.

Provision will be made for my baby to remain close to me at all times, including use of a co-sleeper bed/crib.

Feeding

I am planning to breastfeed and do not consent to my baby being given formula under any circumstances. If I am under GA then my husband and IM have permission to put the baby to the breast for me and express my milk to be given by cup or syringe. My milk or donor milk is to be given if I am incapacitated or unable to feed my baby myself for any reason.

I do not consent to the use of bottles under any circumstances.

Admission to Special Care

If my baby needs admission to the special care unit, my husband and I will be given unlimited access to our baby and we will be using Kangaroo Mother Care.

Please see feeding instructions above. If tube feeding is required for any reason, the milk MUST be breastmilk.

Entering the Birth Head Space

Before Christmas I decided that I needed to start winding down towards my forthcoming birth. I started cutting back on my volunteer and support work and tried to focus on me and my family. Christmas made it easy, plenty of family distractions. Entering January brought some challenges, it has been hard to stay away from the forums and groups that I typically frequent and to keep “work” at bay. If my professional life were completely disconnected from birth and parenting then I would just keep going, keep life normal for as long as possible in order to prevent days or weeks of waiting for birth. But my “work”, such as it is, is to support other pregnant women and new mums through problems they are having with their maternity care providers. I’m a sensitive person, I am easily emotionally stirred by the experiences of others and I find it extremely difficult to turn a blind eye to the problems of others. While this is a massive bonus normally, allowing me to fight passionately on behalf of others, at this point in my pregnancy I really need to focus my emotional energy inward, on myself.

There are others like me, with passion, enthusiasm and time to provide advice and support to those who need it. Acknowledging this and trusting them to continue to do so in my absence has been challenging, it is something I absolutely must do now.

A couple of weeks ago, my tribe of wonderful women friends and my amazing mum, came together with me to celebrate my pregnancy and the new life about to be born, in the form of a blessingway. It was a truly wonderful occasion, with friends coming considerable distances to join me for this, so much thought and attention had been applied by all, especially the lovely Jo who organised it. It was a deeply spiritual ritual, tailored to me and my beliefs, but hopefully open enough for those present to share in the thought behind it even if they came from different spiritual or religious backgrounds. Together we shared our fears and hopes, channelled energy and most importantly…. ate cake!

In the moments since in which I have struggled to keep worries at bay, I have looked down at my henna belly, touched the beads strung upon the necklace made for me and imagined the women of my tribe encircling me. Feeling their energy and support around me and within me is a true blessing.

As I approach this birth, which could happen any time in the next few weeks, I will continue to remember that and draw on it for the strength I need to overcome the challenges of the end of pregnancy and to enter the head space I will need for birthing my baby.

I feel emotionally ready to enter birth, I’m prepared on a practical level too with everything we need gathered together and ready to use. We have had a trial run with the birth pool, inflating and filling it, which, of course, had to be followed by an evening spent relaxing in it by candlelight. So now it is simply a case of allowing baby to be physically ready to choose the day. This is the hard part for me, being gracious and patient, though I know and believe it to be necessary and worthwhile. I’m still a normal human woman, I am uncomfortable with my size now and not sleeping as well as I wish I could, I’m bursting out of all of my maternity clothes and constantly fending off the “When are you due?” question with my suitably accurate “Some time soon” response.

I was given some affirmations at my blessingway and have written more for myself since. I share some of them with you now.

I am a link in an endless chain of birthing women.

300,000 women will be birthing with me. Relax, breathe and do nothing else. Labour is hard work, it hurts and you can do it.

We have a secret in our culture, and it is not that birth is painful, it is that women are strong. – Laura Stavoe Harm

I am surrounded by love and support.

My baby will be born at exactly the right time.

Live every day, enjoy each moment of pregnancy, for it won’t last long.

Every day my baby grows more ready to be born.

My body knows how to grow and birth the perfect baby.

Every day my body is preparing for birth.

Use this time wisely.

“When are you due?”

It’s pretty much the first question from everyone who finds out that you’re pregnant. I think on a rational level, the vast majority of people know that you can’t really predict when babies will be born, but I suspect the majority still believe that the Estimated Due Date (EDD) is scientific and accurate at least some of the time. The truth is though, it’s an arbitrary date determined by outdated pseudo science, a best guess, based on the probable misunderstandings of ancient theories.

The theory goes that pregnancy lasts for 40 weeks (9 months + 1 week) from the first day of a woman’s last menstrual period (LMP). Where did this idea come from? It’s called Naagele’s Rule, named after German obstetrician Franz Karl Naegele (1778–1851), who devised the formula. I don’t believe that Naegele plucked this idea out of thin air, it is likely that he read Aristotle’s theory that pregnancy lasts for about 10 lunar months, and Naegele assumed that a lunar month was 28 days.

Aristotle, however, was what I call a “well rounded wise man”. He was a philosopher, mathematician, scientist and sociologist. With his education in physics, it is extremely likely that he knew that a lunar month is not in fact 28 days, but nearly 29.5 days, making 10 lunar months 295 days, NOT 280, over 42 weeks, NOT 40. What a difference to pregnancy length that makes. What Aristotle actually wrote was:

pregnancy may be of 7 months’ duration or of 8 months or of 9 and still
more commonly of 10 (lunar) months, whilst some women go even into the
eleventh month. 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1341914/pdf/bmjcred00258-0017.pdf

Naegele’s Rule also assumes that all women have exactly 28 day cycles and that they ovulate on cycle day 14. Obviously, this is not true. There is great variation in both cycle length and ovulation timing. There is a suggested alternative formula, Parikh’s Formula, which is a date calculated by adding 9 months to a woman’s LMP, then adding the length of her average cycle, then subtracting 21 days. For example, a woman with 35 day cycles whose last period began on 1st January would do the following calculation:

1st January + 9 months = 1st October

1st October + 35 days = 4th November

4th November – 21 days = 14th October

This EDD is approximately one week later than EDD calculated by Naegele’s Rule.

A small study in 1990 by Mittendorf et al. found that the parity of the woman was a factor in the length of her pregnancy. First time mums had an average pregnancy of 41 weeks and 1 day (41+1), second and subsequent babies arrived at an average of 40+3. Some studies have also found racial variations in pregnancy length.

Normal human gestation is usually defined as 37-42 weeks, by the WHO, maternity professionals and academics, and yet the myth of the EDD persists. Midwives and obstetricians do nothing to correct this misconception, they often seem to fixate on the EDD, first calculated by LMP and then by ultrasound, the infamous “dating scan” that most pregnant women have at about 12 weeks in the UK. (My views on the reliability of ultrasound are explored in my previous post “Guess the Weight”). The dating scan has a 6 day margin for error, officially, and yet it is relied upon so strongly that a woman’s knowledge about her own body is usually dismissed in favour of what the machine says. For instance, were we using NHS maternity services for this pregnancy, the sonographer that did our early pregnancy scan (for reassurance) would have us believe that this baby was conceived 8 days prior to ovulation and 3 weeks after the last time we made an attempt to conceive, a passing familiarity with human conception will tell you that this is impossible. No, in fact, this baby was conceived when I actually ovulated and not by some freaky and convoluted miracle process of my dear husband’s swimmers breaking all records and my body releasing an egg more than a week before all the physical signs indicated the possibility.

Even so, knowing when you conceived doesn’t actually give you any particular insight into how long your pregnancy will turn out to be. Gestation is a natural process and as such, it can’t be timetabled. There is great variation and most of it is completely incomprehensible, there is no known explanation for the wide variety in gestation lengths, it’s just an organic part of life and one that I think we would all do well to accept.
People pin all of this importance on the EDD and their care providers make it worse by rushing to intervene as soon as pregnancy continues beyond 40 weeks, which it does in more than 50% of all pregnancies! In my own small way, I try to challenge this by reminding people of the “Estimated” in EDD and emphasising that normal pregnancy is 37-42 weeks. I have also refused to tell anyone the precise date that I will be 40 weeks pregnant. I know when that date is, as I know when we conceived, but it is not my EDD, to me there simply is no such thing as an EDD. Our midwife knows the 40 week date, but together we have no expectation that there is anything special about that one day. It’s a vaguely useful day to note down so that we have an idea of what 5-6 week period the baby might put in an appearance, that’s all. To all of our friends, family, neighbours and random acquaintances, we expect this baby to arrive some time in February, probably.

Guess The Weight

Guess how many sweets are in the jar, or better yet, guess how much the sweets inside the jar weigh. Not including the jar itself but including all the sweets you can’t actually see in the photo….

I’ll give you a little help, you see that green one near the top left? Well the distance from the highest tip of that sweet to the lowest tip of the red stripy one down the bottom is… let’s say 25cm. NOW tell me how much the contents of the jar weigh.

What? You mean you can’t work it out?

No, I couldn’t either, neither can my mathematically gifted husband. Although he does argue that he is familiar with these kinds of sweet jars and would therefore be able to estimate that the sweets weigh 1kg. But he is missing my point a bit.

From looking at this picture alone, with one arbitrary measurement and without being able to see maybe 80% of the sweets in the jar, there is absolutely no way that with this information alone anyone would be able to estimate with any degree of accuracy how much the sweets weigh. My husband is right though, using his life experience, he can guess the weight fairly accurately. But we do know with some degree of certainty that these exact sweets were weighed before putting them in the jar prior to sale. The same cannot be said of a baby in the womb. More

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