💚💜❤Preventing Birth Trauma at #artofbirth16💚💜❤

Recently, I was asked by Dr. Gloria Esegbona from the @art_of_birth to share some of my thoughts on birth trauma at the latest  summit at Kings College London. My first thought, as always was…. do you mean physical? or psychological?… I was assured that her latest event would be addressing both. Time to learn & grow 💚💜❤


And so how can we as midwives prevent physical birth trauma?

“we can reduce ventouse to and with left lateral & slow head delivery

“Preventable physical to & caused by poor positions and outdated pushing practices

Quiz – Which methods of pushing during vaginal delivery and pelvic floor relate to which perineal outcomes?

(No peeking at the link to get the answers first!)

#Discuss #GetYourGeekOn

-open-glottis technique?
-Valsalva pushing?
-incidence of instrumental and cesarean delivery?
-incidence of postpartum hemorrhage?
-urinary incontinence
-Episiotomy rates?
-maternal satisfaction?
-fetal heart rate (FHR) abnormalities?
-Apgar score?

No peeking at the answers link before you comment/answer below!

(We are still awaiting more evidence in any case)!

The Art of Birth is promoting art in the science of to prevent #birthtrauma 

And so what about the psychological trauma and the 2nd victim…the midwife?

Can we begin to understand women’s experiences in relation to psychological birth trauma? How do we revisit the language we use during birth? Can we all be more compassionate in our practice?

I was quoted on this day when talking about “superhero midwives” – healthy, well-supported lead to healthy, well-supported mums. …It is true…so many people wanting to do good….some burning out. Some traumatised.

I thank you all for hearing about my work on the wellbeing of midwives in the workplace.

I had some really great panel questions too…What I loved most about this conference was that I managed to receive lots of  and create  with so many inspiring midwives, doulas, students and others wanting to support each other, share and learn  💚💜❤.. I can’t wait to see some of you in the near future and learn more about how you have turned these lessons into practice. 💚💜❤

Until next time – look after yourselves and each other #GetYourGeekOn 💚💜❤


Maternity Transformation programme: Delivering the 2020 Vision at #Expo16NHS #MatImp #MatExp #BetterBirths #BUMP

Two experiences really stuck out for me at this years NHS Expo (2016) and one of these experiences, was a session looking at how we now move on to make the Maternity Transformation programme a reality. I was honored to be invited to join this session, and was keen to see how things were progressing. The session was hosted by Sarah-Jane Marsh (@BCHBoss), CEO of Birmingham Children’s Hospital and now Birmingham Women’s too, Sarah-Jane is now also leading the work on the NHS England Maternity Transformation programme delivery.

Throughout the session, Sarah-Jane spoke passionately about how we might now see real change….All of us in the room were no longer talking about change…we were signing up to make it happen.

See programme here: Maternity Transformation programme: Delivering the 2020 Vision

Following Sarah-Janes introductions and visions for the programme, we were invited to join a live panel debate. This was very much an interactive question and answer session with some very highly motivated maternity experts (as you can see below!)


This session was  filled with new ideas about how we can all come together using primary care and social services as key partners to implement #BetterBirths for all. Recommendations were that local maternity systems should support women’s participation in making new changes. Clinical networks and community hubs were also cited as ways to create and spread change. But at the heart of all this, it was clear that everyone can do their own little bit to implement the recommendations from the Better Births report. 


As you know…for me, I do not believe that excellence in maternity care is achievable without the provision of a thriving and healthy maternity workforce, who can enjoy a psychologically safe professional journey. Therefore, I shall keep working towards effective support for midwives in order to create better births for women and their babies.

As a lived example of how one maternity unit is implementing real change, we were also introduced to the B.U.M.P @Project_BUMP

First…we see where we are… what do we have and what do we want to change…what is working? What is failing us?…Lets make a realistic plan!

As women’s circumstances change throughout pregnancy (as may also their decisions and choices)…any new system must be flexible enough to respond quickly to the needs of both women and staff. This model ensures that the journey through maternity services can be enjoyed in partnership with the right staff, with access to the right support.

In revising the pathways of maternity care, we are ensuring that we can provide services that meet the needs of every woman and staff member. Yet women must be able to move freely between these pathways as required. We must also move towards and help women to engage with the most appropriate pathways for them and their families. Often we know that the most appropriate pathway for women is midwifery led care….and so here we must increase capacity. We must also engage, educate and empower women to embrace this midwifery led model of care (where appropriate) as we work in partnership with them to achieve the very best in maternity care outcomes.



We also heard wonderful success stories from the University Hospitals of Morecambe Bay who were really using the ‘Plan, Do, check, Act’ tool to snowball their improvement activities…

And of course the  team were also rocking out the session in their usual style. However, I was personally most touched by the women who came along to this session in order to share their stories.

A powerful poem by ….

A poem inspired by @HeartMummy….

These experiences are always so powerful to hear, and really reinforce how the ripples of everything we do can resonate in both the smallest and largest ways. We must keep sharing…Thank you.

File 06-09-2016, 22 56 47


Great quotes from the session…

‘Pizzas are Delivered, Babies are Birthed’

‘We all have a part in bringing to life’

‘There are 28 recommendations. All important. Don’t cherry pick!’

‘Failure to dilate ? Incompetent cervix ? What do such words do to women ?’

‘The energy in Birmingham for & is infectious! programme’


The Maternity Transformation team are are now calling for expressions of interest from local maternity systems to test models of care to improve maternity services. Local maternity systems will need to align with Sustainability and Transformation Plan (STP) footprints, and so applications will need to be supported and approved by the identified leads for the STP footprint areas. Completed applications should be submitted to the Maternity Transformation Programme team by email to england.maternitytransformation@nhs.net by Monday 19 September 2016.

Have you signed up?

There is a real enthusiasm here for real change in the maternity services. It is where life begins, and it is here that we have the largest opportunity to get things right for our future. Let’s make sure we take every opportunity to get things right.

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


Midwives in distress: Working towards a consensus in the solution

Firstly, the reason that it has taken me a while to write here is that I have been buried in the most fascinating data from round one of my Delphi study to achieve consensus in the development of an online intervention designed to support midwives in work-related psychological distress. I won’t spoil the results for you, as I hope to be publishing the results in the new year, but suffice to say, there were many conflicted opinions, new ideas and strong voices within this expert panel.

I am very excited to move forward with this project in light of these responses!

This project now feels as if it is starting to belong to the people who have been a part of this so far. They are shaping the vision for this, and growing it with their support…. Its awesome!

Last month I was also finalising the revisions for my latest paper , ‘Midwives Overboard!’ Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. This latest output was kindly co-authored by Wendy Clyne, Andrew Turner, Emily A. Fulton, and Clare Gerada. I for one am very proud of this piece of work, as it shines a light upon the current situation, in which midwives all around the world are indeed suffering in psychological distress. Writing this piece not only became cathartic in resolving my own professional experiences, but it has also reinforced to me that there is a real need and desire to design an intervention to support midwives….and now I am a little closer to turning this vision into practice.

You can reach the 2nd round of the Delphi study here (This study is now invite only, but watch out for new opportunities to become involved in more research soon)!

I have been submitting papers to conference so that I may begin to share these results in person…but I will not have this opportunity until the ‘Great Minds Don’t Think Alike’ – Nursing and Midwifery Conference, in January 2016.

I hope to meet some of you there!


Designing a platform to support midwives…The Research Protocol is out!…are you in?

As I was preparing for my yearly performance review this week, I had a new maternity unit want to learn more about my research. More and more people are wanting to join the swell of participants, willingly giving their time to help shape the design of a platform designed to support midwives in psychological distress. This is becoming a powerful collective movement just in time for the launch of the first round of Delphi questioning. By the end of this month I will be sending out the questions whose answers will shape the design of an online intervention. These are indeed exciting times.

Midwives online support

I wanted to thank those who have shown a last minute interest in taking part in this study. Your opinions will be valued ones and I cannot wait to see the ideas and opinions that will shape this project. There is still time to get involved if you, or someone else you know would like to enhance the evidence base for this project. You can read more about becoming involved with the project here.

For those already invested, I wanted to share the full protocol with you in the interests of transparency. This has now been published within the Journal of Medical Internet Research protocols, and you can read it in full here or below.

Pezaro, S, Clyne, W (2015) Achieving Consensus in the Development of an Online Intervention Designed to Effectively Support Midwives in Work-Related Psychological Distress: Protocol for a Delphi Study. JMIR Res Protoc 2015 (Sep 04); 4(3):e107

This paper details how this study will generate a consensus around the development of an online intervention designed to support midwives in psychological distress. With your involvement and support, the ideas you contribute will inform the design and build of a new platform, which I hope will go on to make a difference.

Thank you to all of you for showing your support and giving your time to this research. I am so looking forward to launching this study with you in a couple of weeks! – Until then my friends…be excellent to each other.


#Expo15NHS #MatExp & #HealthyStaff4HealthyPatients: Sharing passion for #NHS staff well being at @NHSExpo

As I come to the end of my 1st year as a doctoral researcher, I have also become very busy in preparation for my yearly performance review. I am definitely keen to share all of the exciting work I have been doing, and I hope the performance review panel will share my enthusiasm for this research journey. It has certainly kept me busy, hence the lapse in blog posts!

This week I had an inspiring experience at the #Expo15NHS conference with colleagues from @NHSEngland, @NHSEnglandPX , @MKHospital, @CovUni_CTEHR and @SheffieldHosp. The agenda was jam packed with the showcasing of innovative ideas, new models of care and collective movements for positive change. I was definitely among my ‘Tribe’.

As I moved from presentation to presentation, chuckling at the amusing quips from @RoyLilley I quickly saw the widespread passion for creating a healthy future within the NHS. The exhibitors were also really inspiring, and it was amazing to see new technologies emerging within health and social care. Secretary of State for Health Jeremy Hunt MP challenged the NHS to ensure all patient were able to access their full medical records online by 2016, accompanied by a commitment to a review of data security. I know that there are many change agents ready for this challenge (myself included). I am indeed excited for the future.

Day one of #Expo15NHS saw NHS England Chief Executive Simon Stevens announce major new work to support NHS staff to improve their own health and wellbeing, with specialist packages for GPs suffering signs of burnout. This of course was music to my ears. I am now even more certain that the research I am doing to support healthcare professionals (starting with midwives) in psychological distress is relevant, powerful and firmly on the national agenda.

This theme of NHS staff well being dominated NHS Expo. As such, I was keen to follow this with the honor of presenting a scoping view of the literature in relation to #NHS staff health and well being, and exploring the impact that staff health may have upon work performance and staff engagement. Delegates, commissioners, clinicians, academics and policy makers came to this seminar in search of supporting healthy staff for healthy NHS organisations. It was encouraging to see that this seminar had been over subscribed to in advance of NHS Expo. Indeed, some people were turned away from the session!

NHS Expo

Myself and Rhian Bishop (Staff Engagement Lead at Sheffield Teaching Hospitals Foundation Trust) presented workshop 20 of the pop-up university sessions at @NHSExpo : Improving staff experience to improve performance….

The session focused on the impact staff engagement and experience has upon organisational performance, specifically patient experience. The session was aimed at commissioners and policy makers, and outlined why staff experience is so important. It also offered examples from an organisation has has improved staff experience to great effect.

This session was very well received. I saw smiling faces, engaged thinking and delegates taking notes. So I wanted to take this opportunity to thank those who shared our passion for the health and well being of #NHS staff at NHS expo. The future definitely looks brighter in this respect now that we have you on board.


#MatExp @ #Expo15NHS

Aside from my own session, I also wanted to raise the profile of an amazing midwifery movement known as #MatExp. #MatExp is a powerful grassroots campaign using the Whose Shoes?® approach to identify and share best practice across the nation’s maternity services. I had the privilege of becoming a part of their seminar at NHS Expo. Their enthusiasm is contagious! They engaged all of us to reflect upon the importance of kindness, empathy, and compassion in midwifery care. As I reflected upon my own practice and personal experiences, I also reflected upon the need to show ourselves compassion, look after colleagues and create #healthystaff4healthypatients. I am definitely proud to be part of #MatExp ..they are raising the profile of the midwifery profession and flying the flag for better maternity services. I hope the #MatExp crew can become a part of this research journey and share their rich wealth of knowledge and experiences.

But for now…In the words of Bill and Ted “Be excellent to each other”….