Posted by & filed under birth rights, birth stories, birth story, birth trauma, midwifery, mother, mum, mummy, personal.

I have always had a passion for matters around pregnancy, birth and babies. For years I have enjoyed being a midwife, clinically in research and in teaching. My passion started at around 4 years old when my brother was born. Mesmerized by a growing belly and the fact that another human was coming in to the world, I read my mother’s antenatal books from cover to cover. Having just experienced the birth of my own baby, I felt compelled to write my own reflections and experiences down….

Please note: For personal reasons I would request that close family members do not read any further.

*Long post alert*

What happens when the midwife has a baby? We are people just like any other having a baby…right?…probably. Did I know too much?…Did that affect my choices? did I have a better choice and/or experience because I had ‘insider knowledge’?… One thing is certain. Having a baby as a midwife was unique for me.

The stick turned blue

Yes, our little Autumn baby was planned….and thankfully, we had no trouble conceiving our little darling, who was due to arrive conveniently after I had  been awarded my PhD. But my period being late and the pregnancy tests showing up negative confused me. This was my first experience of feeling as though ‘I should have known better’! … Of course, though I knew that all I was looking for was a little Human chorionic gonadotropin (hCG), the cheap sticks I had bought clearly were not sensitive enough to detect it…it took a friend to prompt me to spend a bit of extra cash on the test. Of course a fancy pants digital stick did the trick….Silly me. The midwife should have known better (was one of my first thoughts… and a recurrent theme throughout my pregnancy)! The pressure was on!

Of course when the stick did officially ‘turn blue’ my heart jumped into my mouth, knowing that this was an ‘oh sh*t’ moment. No take backsies. Yet, I have no idea why I panicked …it was planned after all! Perhaps it was because..

  1. My parents would know for sure that I was sexually active (ridiculous I know…especially as we have been together 18 years)!
  2. I really would need to finish my PhD in time
  3. Life was about to change for ever
  4. I think this pregnancy is a good thing (probably)

My unicorn was on her way..

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Choosing my care givers

Unlike many women who my just meet the nearest or most convenient midwife. I had the luxury of knowing a myriad of great midwives who could provide great care for me and my baby. I also had the luxury of knowing how and who to ask directly for what I wanted. I felt spoilt. This felt like a luxury that many women don’t have…but it was also a perfectly reasonable thing to be able to do. I was able to chose a midwife who I knew was ‘on the same page’… and who would care for me continuously throughout…Do all women get this opportunity?

Pregnancy symptoms

For years I have been caring for women with ligament pain, pelvic pain, odd sensations ad physical stresses and strains. Being pregnant myself meant that I could finally feel what I had been describing… ‘Ahh…that’s what hey mean by feeling a ‘twang”

One great benefit of being a pregnant midwife is also knowing what symptoms to worry about and what symptoms not to worry about. I imagine that this may have enabled me to experience somewhat less worry than others experiencing such things for the first time….In the beginning anyway!

To tell or not to tell…that is the question

Other than the midwives I knew, there were other care givers throughout my pregnancy who were meeting me for the first time. They all began with the usual spiel about risks/benefits/routine and procedure. The question is (or was).. do I let them go on talking like I know nothing.. or do I let them know that I am a midwife who is used to spouting this spiel myself.

In not telling them, I felt like a fraud.. Like I was making a fool of them… But in telling them of my profession, I felt as though I would be giving up my status as a ‘regular’ maternity service user. My cover would essentially be blown.

A desire for honesty got the better of me. I told all new care givers that I was a midwife. The following happened:

  1. Clinicians dropped any facade of being ‘ultra professional’ – They became more friendly… like we were ‘on the same team’.
  2. I was told frequently ‘Well you know all of this already so I won’t repeat it’

As they did this, I felt a mix of emotions. On the one hand…I felt truly part of the team…a sense of power and autonomy…On the other hand… I felt like I no longer had the safety net of being ‘nurtured’ through my pregnancy. Was I missing out?..I’m not sure. But I was no longer treated as a ‘regular pregnant woman’.

Choosing my own care pathways

In my experience as a midwife, I have seen how some professionals can dismiss the thoughts, feelings and desires of women wanting to make decisions in relation to their own care pathways. For more on this, please see Michelle Quashie @QuashieMichelle 

As such, I sometimes had to fight hard to make sure that the women in my care got what they wanted. I was expecting to have the same fight.

However, I found that once people realised that I was a midwife, they were more willing to trust that my own decisions were informed decisions. They seemed less intent on trying to persuade me one way or another. They seemed to respect and accept my choice more than I had seen some maternity staff respect the choices of other women.

For me this highlighted issues around respecting women’s choice. When do we feel that women can make their own choices without question?…and when do women’s choices cause clinicians concern?….

Whatever the opinion of others… I, as a midwife could seemingly make any choice I wanted with ease…. Is this the same for all? I think not.

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Birth choices

I have actually known what my own birth choice would be for a long time now. My main fear was that my choice would be made unavailable to me. Pre-conceptually I had consulted the obstetric team to discuss my birth choices…Would they be facilitated? because if not…did I really want to get pregnant in the first place?… the answer was ‘Let’s wait and see once you get pregnant’…Damn. I was really looking for a signed deal beforehand.

Once I became pregnant of course, they held all of the cards. I was pregnant…. trapped… The baby had to come out somehow, but I was beholden to them.. as they were the ones who would decide whether or not to facilitate my choice. This also altered the power balance and really made me feel vulnerable… at the mercy of those with the power to say yes or no. It was not a nice place to be.

My midwife, and my consultant midwife were 100% supportive of my decision, but they were not in a position to sign on the dotted line. I wanted a beautiful planned cesarean section. Something which goes against the grain for some.

When it came to meeting the consultant team, I was nervous about what they would ‘allow’. Now… I hate the word ‘allow‘ in maternity services, but this is how it felt. I was asking permission to have this… asking them to facilitate this. They had the power to say no. As a midwife, I believe I knew the right things to say to maximize my chances of them agreeing to my birth choice. I also had all of the up to date guidelines and research to back up my arguments should I need them. I was still nervously holding my breath.

There was some resistance, I had some extra appointments and some hoops to jump through, but with some firm words and some strong midwifery back up, I was able to get my birth choice ‘agreed’ or ‘allowed’.  Though the clinical reasons for my birth choice are too complex to explain here, it felt as though my decision making was not so trusted by other professionals in this case. I also had to repeatedly sit and listen to the list of risks involved, and be repeatedly asked if I had wanted to change my mind. Would this be the case if I had chosen a vaginal birth?

The sense of relief was immense…I could finally start to look forward to the birth and enjoy my pregnancy!

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Though this relief could have come much earlier for me… having the obstetric team on board pre-conceptually would have made my experience so much better!

What I really wanted to do was have my birth choice go unquestioned. I wanted to know all of the facts and then be trusted to make my own decision. Doesn’t every person want this?…

A “good birth” goes beyond having a healthy baby…

But I felt as though I may be denied my choice if it did not conform with what the health professional believed was the ‘right’ decision… This was utterly terrifying. The consequences of my choice being denied would literally mean that I would have less control over what would happen to my body. This was a horrifying thought. I would literally be forced to have a vaginal birth against my will. This is literally how the reality  felt.

For more information around birth rights see: @birthrightsorg

These experiences in relation to birth choices got me thinking about ‘informed’ choice in maternity care…

Everyone is ever so concerned about gaining ‘informed’ consent (and rightly so)… but is it disconcerting that we forever talk about the risks of Cesarean section and rarely the benefits? Equally…do we (as healthcare professionals) inform women of the risks of a vaginal birth? or a hospital birth? Wouldn’t that be ‘true’ informed consent?

As a midwife, I have to admit that my favorite type of birth to be in attendance of is an uninterrupted home birth….they are fab!… but that is my preference as a midwife. My preference as a mother was a cesarean section, and I have to ensure that I remain objective in respect to all women’s choices regardless of these facts.

At the end of the day.. a baby is coming out of you. There are a variety of ways in which this can happen. Should there be a default or ‘preferred’ way? or is this ‘preferred’ way subjective to each and every woman? If so then we must stop talking about the ways in which we might prefer women to give birth…and instead celebrate women’s choice in pursuit of their own subjective ‘positive birth’.

See here about the myths associated with positive birth

In my case, I felt a solidarity with Helen George from Call the Midwife, who was shamed for choosing to have a cesarean section. I also identified with some of the reasons she gave for her very personal choice. Of course there are many other reasons why women may choose a cesarean section. Some have been explored in the following paper:

Why do women request an elective cesarean delivery for non-medical reasons? A systematic review of the qualitative literature

From my perspective…the ‘rights’ and ‘wrongs’ of one’s birth choices are too subjective to ever cast judgment upon.

Challenging poor practice

The care I received from the English maternity services in my area was fantastic….For the most part. Unfortunately I did encounter one incidence of poor practice. Sadly this episode warranted escalation.

As a midwife, I know my duty is to take further action (escalate) mistakes in practice where appropriate. However, as a mother, I was nervous about escalating the poor practice of someone whom I relied on for my care (and to facilitate my birth choices). Would they take revenge? would I loose my place of birth? or would my birth choices be taken from me?…It was a very vulnerable position to be in.

“After all…If you complain to the chef..they may spit in your food.”

Thankfully, with the support of my midwife, I am now working with the General Medical Council (GMC) to ensure that other mothers and babies can be protected from the same actions being repeated.

Aside from this… as a midwife, I feel highly privileged that I was able to spot this poor practice and call it out. Another pregnant woman (non-midwife) may not have spotted this poor practice, and been put at risk unknowingly. This highlights how vulnerable women may be, as they trust us all with their (and their babies) lives. Here the role of the midwife as an advocate becomes even more important for those who cannot always safeguard their own care.

Patient & Public Involvement in research

INVOLVE briefings state that there is an important distinction to be made between the perspectives of the public and the perspectives of people who have a professional role in health and social care services. As midwives are not considered to be patients under this guidance, I have felt unable to participate in Patient and Public Involvement (PPI) activities during my pregnancy. This was difficult, as I would have loved to have participated in PPI whilst pregnant in order to contribute to the improvement of maternity services from a user perspective. This issue is worthy of further discussion… after all, health professionals can be ‘patients’ too right?

Antenatal education

My husband is surely sick of my chums and I always talking pregnancy and birth…and of course passion for the profession can get a little sickly for some. So, I wanted the father of my baby to hear what I already knew from someone other than me. I didn’t want him to rely on me for information…after all, I may come across as a know it all rather than an equal partner in his parenting journey. So we went to NCT classes.

The classes were great and the information was sound….Yet, as a midwife… I could feel myself wanting to ‘approve’ of the information given out to the group.

During the challenges set out for us as a group, I was anxious. What if I got a question wrong? or stuck an anatomy sticker in the wrong place?

oh the shame!

Thankfully, I made no mistakes and my midwifery knowledge held strong. Yet again, I felt compelled to disclose my profession to the group. Not to do so felt dishonest somehow, like I was tricking them into thinking I was new to pregnancy and birth from all perspectives…and not just from a parental one. As such, I was relied upon at times for the lived experience of maternity services. People were also generally glad to have me on their ‘team’ during group challenges.

At the end of the course, I think my husband was glad to learn from someone perhaps more objective than myself. I also think that hearing the facts from another birth educator strengthened my husbands faith in what I had been saying all along…For example.. he now trusts that it is indeed OK to have a glass of wine whilst breastfeeding (Very important)!

And just like any other mum of course… I needed to meet other people sharing the same journey as I was.

And so little ‘Loveday Alice Pezaro’ came into the world. I had the perfect ‘positive’ birth (for me).. The breastfeeding is going wonderfully…and we are now knee deep in baby sensory groups and Costa Coffee chats. This experience from the other side of the fence has provided me with more empathy for women and more passion for womens rights in childbirth. The journey was less scary than I thought it might be. But…………………

What if I can’t breastfeed?

This was another real fear for me…having supported so many other women to breastfeed… what if I couldn’t do it myself? I mean… if the midwife can’t do it…What hope is there? 😮😨😩

These types of fears and anxieties resonate with other midwives who find themselves becoming mothers…In fact, the very pertinent research of my friend and mentor Dr. Sarah Church demonstrates how;

“a reliance on professional knowledge may create opportunities for choice and increased autonomy in some situations, although the need for intervention during childbirth, for example, may challenge the degree of autonomy exercised by midwives and the choices available to them. As knowledgeable experts, midwives demonstrate a very different understanding of risk and safety in relation to their own experiences of childbirth. Professional knowledge may increase their anxieties which may not be addressed appropriately by caregivers due to their professional status. The use of knowledge in this way highlights potential conflict between their position as midwives and their experience as mothers, illustrating that midwives’ ability to exercise agency and autonomy in relation to their pregnancy and childbirth experiences is potentially problematic.”

Final thoughts and reflections

  • Being pregnant as a midwife increased both my anxieties and my autonomy.
  • My professional knowledge impacted significantly upon my own perceptions around risk and safety in maternity
  • As a midwife I knew how to best ‘get’ my birth choices.
  • I felt vulnerable at times, especially in calling out poor practice.
  • I felt as though I was treated differently because of my professional background
  • The pressure to ‘get it right’ was always on.

In conclusion, the whole experience of childbearing was much better than I thought it would ever be. I feared much more than I needed to, and in retrospect, I had a wonderful experience. If only I could have anticipated such good outcomes in advance…the fear of the ‘worst’ happening may have never been an issue. One thing is for sure. My experience of being on the other side of the fence will enrich my midwifery practice forever.

On another note..There are so many wonderful midwives and initiatives out there making births better for women and their babies…There are not enough words to mention all of their wonderful work in this single blog. But I would urge further reading around the following groups:

@birthrightsorg

@MatExpBazaar

@NatMatVoicesorg

@BirthChoiceUK 

@birthpositive 

…and Many more (happy to add to this list if suggestions are given)!

My baby ❤ ‘Loveday Alice’

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If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

Posted by & filed under Uncategorized.

 

Sublime Turbulence

‘Sublime Turbulence’ Robert Rice Flickr Attribution-NoDerivs 2.0 Generic (CC BY-ND 2.0)

I was fortunate enough to hear David Eagleman talk at Auckland’s recent Writer’s Festival.

Eagleman is a neuroscientist and writer (https://www.eagleman.com/) and was sharing his thoughts on creativity.

This was of great interest to me as my own students in the Media and Communications in Health Promotion course are reaching the end of the semester and after rounds of presentations and cycles of formative feedback, this week they presented their creative projects. They had minimal instructions but lots of encouragement to try out new things and spend time reflecting on the learning process. Eagleman talked of ‘being fearless in the face of error’. That too often we stop at the first hurdle or see these hurdles as evidence we have failed, forgetting that with each round of trial and error essential refinements can be made. This really stayed with me, as I reflected further on our students and the invitation we gave them to try, and possibly to fail, and to reflect, and to tweak, and to try again. This seemed to be a new concept to them with many reporting that usually they hand in work and it is marked and there is not the same opportunities for these cycles of growth.

So- maybe we need to ensure that making and learning from errors is a more prominent part of the learning experience, to support students to stay with a problem, to develop grit and perseverance.

More focus on process than product.

Fully embracing the turbulence of learning.

 

 

Posted by & filed under Uncategorized.

Written by Jim Lusted, Learning Designer/Senior Lecturer in Sport Studies

Since the University moved to online assignment submission some years ago it has been much easier to judge the originality of student work. If an assignment is set up using a Turnitin submission point, a similarity report is automatically generated for each assignment. This provides the marker with a % score of how much of the student work matches material contained in Turnitin’s vast database – some 62 billion webpages, 734 million student papers and 165 million academic sources.

While this automated process has really helped staff judge the credibility of student assignments, your own judgement is still needed to interpret the similarity report. This blog offers some tips about how to ‘read’ Turnitin reports – and to consider a range of factors beyond just the overall similarity % score to help you make a judgement about whether you should refer an assignment to the academic integrity and misconduct process.

 

Get the set up right to get the most accurate report

Start by making sure the similarity report generated is as accurate and useful as possible. When you first set up a Turnitin submission point in NILE, you are offered a daunting list of options to select from. Follow this help guide from the Learn Tech team (Learntech@northampton.ac.uk) to ensure your similarity reports check exactly what you want them to.

Before you begin marking, a useful tip is to overlay the similarity view with the marking view of the Turnitin site (see right).  This allows you to continually keep a check on originality as you go through the process of marking the work – and helps you contextualise the areas of similarity. You’ll be able to easily spot where exactly the larger pockets of similarity are being used across the assignment.

 

Look beyond the percentage score..

The overall % score gives us a quick, rough indicator of how original a student submission might be. It’s certainly a good starting point, but it shouldn’t solely determine your verdict of the assignment and it’s really best not to set a benchmark score to guide your overall judgement – the process ultimately requires a qualitative judgement to be made. Let’s look at a couple of scenarios where the percentage originality score (high or low) might not necessarily tell the full story of who has written the assignment.

a) A small score but a big problem?

Anything below 20% is fine, right? A score like this does indicate that the vast majority of the assignment is original. But…

  • A small percentage score could ‘hide’ one or two (or more) long paragraphs of ‘copied’ text that is acknowledged as such. While only taking up a small proportion of the assignment, such large chunks of unsourced text may lead you to concerns about possible plagiarism.
  • A similarity score of zero may also raise some concerns. If an assignment contains absolutely no material derived from other sources, particularly if you are sure that the work contains the use of quotes and paraphrasing, you may want to question why the report is so ‘squeaky-clean’. There are all kinds of tips on the internet for students to try to ‘trick’ Turnitin that might possibly be at play. You might also be entering the world of contract cheating, which is much harder to identify (and prove).

 

b) A big score but with good reason?

Anything over 30% must be a problem, right? Not necessarily – ask whether there might be any plausible reasons for the large score, particularly if it is repeated across several students in your cohort. Potentially valid reasons for high similarity scores might include:

  • The use of a generic template or pro-forma that students have used to structure their assignment – is this the primary cause of the high score?
  • The inclusion of appendices in a student’s work are these being highlighted?
  • Several students referring directly to the same source or quote or content (e.g. a prescription protocol) that has been used regularly in the module
  • Several small passages of quotes being used appropriately and suitably referenced

 

Look beyond the similarity score – there may be a perfectly good reason for the relatively high % score.

 

The grey areas where your judgement is needed

This may all sound straightforward, but there are always going to be difficult judgements to be made when cases are not as clear cut as those above. The ‘grey areas’ tend to relate to two main areas:

1. Paraphrasing another source – is the student trying to re-phrase another person’s work? Some students are better at this than others, and there are online tools like Grammarly that students may be tempted to use to help paraphrase (often with poor results). You need to decide whether this paraphrasing is a deliberate attempt by the student to claim the work as their own, or more a case of poor academic practice.

2. Referencing – are the sections under scrutiny indicative of a student presenting the work of others as their original efforts, or perhaps the result of poor referencing practice? Consider the quality and style of referencing through the work (good or bad) to help decide how ‘deliberate’ the student is being in failing to acknowledge other sources of work. Again, the judgement here is between willful academic misconduct or poor academic practice.

In these types of ‘grey’ cases, its best to seek a second opinion – from a trusted colleague, an experienced member of your team or even a quick chat with an Academic Integrity Officer (AIO) before you decide whether to formally refer the student to the academic integrity and misconduct process. Getting a second opinion usually helps you come to the right verdict in the end.

 

Posted by & filed under Conferences and publications, learning design, Training.

Written by Jim Lusted, Learning Designer

I recently attended a workshop hosted by Northampton Students’ Union (SU) and facilitated by the National Union of Students (NUS) where SU staff, academics and student representatives were introduced to a project called the ‘Greener Curriculum’. This is certainly a more catchy title than the more commonly used term Education for Sustainable Development – shortened to ESD – which represents an area of activity gaining increasing prominence across the HE sector.

 

What is sustainability?

At the start of the workshop we were asked to define ‘sustainability’. Most of us immediately came up with environmental issues such as recycling, creating less waste, energy efficiency and so on, but we were also encouraged to consider the social and economic aspects of sustainability that we might not immediately recognise. This makes up what has been termed the ‘3 pillars’ of sustainability, or the ‘triple bottom line’ of people, planet and profit.

This holistic approach is reflected in the United Nations’ 17 Sustainable Development Goals that were adopted in 2015 to commit nation states to take action not only on high profile ‘green’ issues like climate change, but also concerns such as social equality, poverty, protecting life (human and non-human), and ensuring a quality education for all.

Education and sustainability

These are all unarguably worthy causes, but what role might universities play in promoting sustainability? The workshop asked us to consider this in relation to our own circumstances at Northampton. The NUS defines ESD as ‘education that aims to give students the knowledge and skills to live and work sustainably’, and their vision behind ESD is to ensure students leave higher education being part of the solution rather than the problem when it comes to tackling some of the big issues mentioned above.

The NUS have commissioned research that shows that two thirds of students want to have sustainability issues embedded into their programmes:

 

“Sustainable development is something universities should actively incorporate and promote.”
(NUS 2018)

Students want to engage with the big challenges of our times through their studies – be it environmental, social or economic – and they want to explore ways they positively influence the world around them.

Education for sustainable development @ University of Northampton

As the workshop progressed, many of the participants noted the apparent similarities between the guiding principles of ESD and the ideals that underpin Northampton’s status as an AshokaU ‘Changemaker’ campus. Indeed, one of the manifesto commitments of a Changemaker campus refers explicitly to sustainability:

“Operating in socially and environmentally conscious ways to model changemaking for students and other institutions and contribute to the vitality of people and the planet”

(AshokaU 2018)

We felt that Northampton might be particularly well suited to embedding ESD into the curriculum when channelled explicitly through the Changemaker agenda. This academic year, as part of the UMF assessment review, all modules have been required to articulate revised learning outcomes, including some directly attributed to Changemaker values. This gives teaching staff a real chance to reflect on how they are embedding such values into their curriculum and where they are providing students with opportunities to explore some core principles of sustainability in their studies.

Embedding ESD in the curriculum – some ideas

We were given a number of useful resources and tips during the workshop to help consider how and where ESD could be embedded into teaching practice and curricula. Firstly, although some courses may be more aligned to ESD principles than others, like the social sciences (indeed, courses like Geography are likely to have sustainability as a core topic), we were encouraged to consider how every subject has the potential to include ESD perspectives. A really useful A-Z guide, called #sustainabilityAtoZ has been produced by the NUS to showcase examples across the breadth of academic disciplines where ESD has been embedded into programmes. Similarly, a website called www.dissertationsforgood.org.uk has recently been set up by the NUS as an attempt to try to bring together dissertation students with local and national organisations – with a view to creating dissertation topics and projects that can have a direct impact on the ‘real world’.

The future for ESD

It seems like many of the big issues facing the HE sector at the moment – debates about ‘value for money’, student satisfaction, graduate employment and so on – lend themselves to ESD being given ever higher profile in future higher education policy and curriculum design. Our workshop discussed several examples of universities across England who had undertaken big reviews of their own university wide curricula (much like our UMF review) to better align graduate attributes and skills more closely to ESD principles such as social responsibility and impact. With all this in mind, I expect we will be hearing much more about the idea of a ‘greener curriculum’. I personally really welcome the renewed interest developing a social conscience among students through their studies, and at Northampton in particular I see a real opportunity for us to creatively explore the ways in which ESD values can help bring the ‘Changemaker’ agenda into our teaching at the University.

Posted by & filed under 1819, LearnTech News, modules, NILE, NILE standards, programme sites.

We are pleased to announce that your 1819 module and programme sites have been created and are now ready to receive your content, so you can self-enrol now.

This year (as last) we have again chosen to differentiate between courses taught at the University and those delivered by our academic partners, to reflect the different needs of all concerned and so LearnTech has developed and updated separate templates, making for a more tailored student (and staff) experience.

The template and NILE Standards have been updated for 2018-19 following recommendations approved at the University’s Student Experience Committee and Faculty SECs. Please refer to these for up-to-date guidance on what to include in which section of your NILE sites when preparing them for the coming academic year.

You will note that in-site guidance has again been streamlined to allow for any necessary dynamic updates throughout the academic year, incorporating links to existing support, thus avoiding duplication and avoiding potentially conflicting advice. We have again included the ‘Support for Tutors’ and ‘Support for Students’ resources lists, so please also refer to these for your own assistance and for that of your students.

The template is designed to build on last year’s updating of content: you should therefore all find yourselves in a strong position for this year’s plan to copy over only what is required for the coming years teaching.  N.B. If you are using Pearsons content, please do not copy over any site content without first contacting Learning Technology.

For those of you unfamiliar with the process of preparing your sites for the coming year, we have provided updated guidance on how to do this, as well as having Learning Technology team members on standby should you require extra support and assistance. Please email LearnTech Support in the first instance or contact your designated LearnTech.

Posted by & filed under #internationaldayofthemidwife, academia, EDS, Ehlers-danlos syndrome, hEDS, midwifery, My Projects, My Research, Publications, Research.

 or ‘International Day of the Midwife’ falls on May the 5th of every year. The theme for 2018 in three languages is…

  • Midwives leading the way with quality care
  • Sages-femmes, ouvrons la voie avec la qualité des soins
  • Matronas liderando el camino con un cuidado de calidad 

Also… Every May is Ehlers-Danlos Syndrome (EDS) awareness month around the world.

As such….for , and EDS awareness month… I shared 10 top tips for caring for women with hypermobile Ehlers Danlos Syndrome (hEDS) during pregnancy birth and beyond. These tips come from my latest paper, authored in partnership with Dr. Gemma Pearce (@GemmaSPearce) and Dr. Emma Reinhold (@DrEReinhold ), entitled …

Hypermobile Ehlers-Danlos Syndrome during pregnancy, birth and beyond

Here, we present care considerations for midwives and the multidisciplinary team caring for this unique subgroup of childbearing women. However, we hope that women with hEDS will also benefit from this paper, as they make decisions in partnership with their professional health care teams. You can read the press release from this paper here.

I would personally like to thank the board members of the British Journal of Midwifery for making this article FREE for all to read. I would also like to thank the Royal college of Midwives for sharing news of the article here…and the Nursing Times for sharing further news here.

So what can midwives do to maximize the quality of care given to women with hEDS throughout pregnancy birth and beyond?…First of all….Know the facts…

  • There have been no prevalence studies since EDS received a major reclassification in 2017
  • Earlier estimates from 2006 suggest a prevalence rate of 0.75-2% for hyper mobile EDS
  • hEDS is the most common form of EDS
  • Up to 78% of women with hEDS could also have a diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS)
  • POTS predominantly occurs in women of childbearing age
  • EDS is considered to remain largely under diagnosed.

Tips for midwives

  1. Discuss individual needs with women, as no two cases will be the same. Do this early, and always in partnership with the woman and the wider multidisciplinary healthcare team.
  2. Consider early referral to obstetric, physiotherapy and anaesthetic teams in partnership with the woman.
  3. Consider the need for alternate maternal positioning during pregnancy, birth and beyond. To minimise the risk of injury, positioning should be led by the mother.
  4. As wound healing can be problematic, the use of non-tension, non-dissolvable, deep double sutures, left in for at least 14 days is advisable.
  5. Wait longer for local anaesthetics to take effect and consider giving maximum dosage. Always be led by the mother on whether pain relief is sufficient
  6. Always consider the significance of a routine observation in light of existing POTS and/or EDS symptoms
  7. Promote spontaneous pushing rather than directed pushing during birth
  8. Promote effective pain management and the use of therapeutic birthing environments to promote reductions in stress
  9. Consider additional joint support for newborns suspected of having hEDS
  10. Document all joint dislocations and bruising marks on the newborn from birth to avoid misdiagnosis and/or wrongful accusations of mistreatment.

Research into EDS and childbearing is in it’s very early stages. We hope to build on this work to make a difference for all women with hEDS during pregnancy, birth and beyond.

pregnant belly

If you would like to follow the progress of this work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

 

Posted by & filed under #CMALTcMOOC, CMALT, FuturePlans, SOTEL.

This week we cover an overview of digital publishing formats and CMALT portfolio submission requirements. We hope you have enjoyed your participation in #CMALTcMOOC 2018, and although the 7 weeks finishes at the end of this week, this is just the beginning for the community that has been established! We hope that you now have an understanding of what is required for producing a CMALT portfolio, and encourage you to continue working on developing and sharing your portfolios. You are invited to further PD cMOOCs such as

You are also invited to take part in a final participant survey to give us feedback. This week we will also host our final Participant Hangout reflecting upon their CMALT cMOOC experience.

cMOOC Feedback Invitation:

We want to get your feedback on how we can improve #CMALTcMOOC. We have an information sheet, consent form, and online survey for your feedback. Also, if you are willing to let us use your CMALT portfolio as an example there is also a portfolio showcase opt-in. The links are:

Info Sheet: http://bit.ly/1XywKQ5

Consent Form: http://bit.ly/26bPN4B

Survey: https://goo.gl/forms/cDhKGbGbudf221312

Portfolio showcase option: http://goo.gl/forms/J629u943tGsM4OGy2

Future Plans

Remember to check out the growing list of examples for the CMALT Portfolio sections in the Project Bank at https://cmaltcmooc.mosomelt.org/project-bank/

While the “Future Plans” section is not assessed you must complete it. This can be as detailed as you like. The purpose of this is to help you plan for your professional development; it will also be useful when preparing to meet your continuing professional development requirement to remain in good standing.

This week we will also look at an overview of digital publishing formats suitable for an ePortfolio to be submitted for CMALT accreditation. Portfolios can be submitted for review by three different dates throughout the year: 31 January, 31 May, and 30 September https://www.alt.ac.uk/certified-membership/submitting-portfolio

 

CMALT ePortfolio Examples

A list of Australasian CMALT holders can be found at: http://ascilite.org/get-involved/cmalt/

Example AUT CMALT portfolios

Posted by & filed under CMALT, SOTEL.

This week we explore participants’ individual areas of specialisation in learning technologies. Use the Project Bank https://cmaltcmooc.mosomelt.org/project-bank/ to share a Blog post or VODCast describing an area of specialisation relevant to your context.

We will also schedule a Hangout later in the week where participants can discuss and share their specialisations.

Reflect upon why you have chosen this specialisation?

Comment on one another’s PODCasts or VODCasts giving feedback.

As well as the core areas, CMALT candidates are required to demonstrate evidence of independent practice in one or more specialist options. This reflects the fact that, although there are common areas of work for learning technologists, practice is extremely diverse and everyone specialises in something different.

Your specialist topic should reflect an area where you have particular expertise. This may be unique to you or common across your team, but goes beyond what would be expected of any learning technologist.

In describing your specialist option you should refer to the CMALT principles and values:

  1. A commitment to exploring and understanding the interplay between technology and learning.
  2. A commitment to keep up to date with new technologies.
  3. An empathy with and willingness to learn from colleagues from different backgrounds and specialist options.
  4. A commitment to communicate and disseminate effective practice.
Because these are specialist options you should be clear what makes your work distinct from common practice; many people teach on online courses, but designing and delivering fully online courses requires specific skills and would be considered specialist. . Similarly, many teachers provide blended learning, but developing and sharing guidelines for such practice or working with a distinctive blend of contexts might distinguish your work as specialist. It may be that your specialist option is common amongst the group that you work in as you all work in a similar area; that is perfectly acceptable.Evidence for your specialist activity is likely to be very specific but could include: reports, papers or presentations you have written; this could be backed up by a job description plus written statements supporting your specialist knowledge from colleagues, clients or managers; active membership of professional or other bodies; certificates of completion of specialist training programmes or courses.