BRA Birth Experts TALK! #8 Zoe Turoff, Midwife

braexpertzoeName: Zoe Turoff

Role: Midwife

Location: Essex

 

Why do you love things all pregnancy, birth and baby?

 

I feel privileged to be ‘allowed’ to be present at a woman’s’ and her families most intimate time of their life.  The thing that I love most of all is building up trust between the woman and myself. That she trusts me to act in her and her baby’s best interest. What is there not to love at being in that position?

What brought you to this line of work?

I only became interested in Midwifery after my own pregnancy and birth experiences.  Both were different circumstances but also both, that I felt could have been more positive experiences and so much more supportive.

After the birth of my first child I had suffered PTSD, not due to pregnancy, but was probably more impacted because of pregnancy.

During my second pregnancy I asked for help, advice and reassurance, as I was petrified that it would happen again. The response I that I got was a referral to social services and the stress/anxiety that went with that. This was not a malicious action from the midwife but I felt that she had no awareness of peoples’ life experiences.

I’ve always enjoyed helping and caring for people but knew nursing was not something that I wanted to do. Nursing was caring for sick people and I knew being around sick/ill people all of the time could be detrimental for my own health. Pregnancy is about ‘well, healthy women’ some who may have medical conditions but generally are mainly well.

After my last pregnancy experience, I began to look at midwifery as a career and felt that I could make a difference to women’s experiences and that I could be a better midwife than my own midwife was to me.

What does your work involve and why do you feel it is so important?

My work is extremely varied as I also volunteer and teach outside of my paid employment. All of which is extremely important.

Midwives will find their own niche within their career some may prefer community, postnatal, antenatal, clinic, or labour experiences.  I myself enjoy ‘high risk’ midwifery. High risk means anything that could complicate pregnancy, labour and birth that requires more intense monitoring of a woman and her baby.

A midwife is a woman’s advocate. I want to be able to enable her to have a safe but as ‘normal’ a birth experience that I can provide within that high-risk setting. Enabling her to be able to make evidence informed decisions regarding her care but also catering for her wishes as much as am able too.

What is the most important piece of advice that you would give a pregnant woman?

Enjoy your pregnancy foremost, but to also listen to your body. Women know when there is something not quite right. Do not feel that asking a midwife or a health professional a question is silly or feel that you are bothering them. Trust your instincts.

What is the most important piece of advice that you would give to a new mum?

Enjoy your baby!

Forget about the housework or entertaining visitors. When baby sleeps take a nap yourself.

For the first week, turn your house phone off and leave an answer machine message saying that you will contact them when able too, put a note on the door stating ‘do not disturb, new baby’.

If people insist on visiting ask them to bring dinner over, let them make you tea.

Most importantly don’t let too many people handle baby especially if sleeping. Leave baby to sleep.

Do you have any great tips for childbirth or a ‘must have’?

I am a lead midwife for a perineal trauma clinic and I also teach perineal suturing. I am a really big advocate for perineal massage. It may not prevent trauma but evidence suggests that it lessons vaginal trauma caused by the birthing process. Most of us will moisturise our skin to leave it supple and to try and prevent stretch marks in pregnancy. But none of us really consider about moisturising/massaging our perineum. This process enables the perineal skin to stretch rather than just tear during the second stage.

What is your personal birth philosophy?

I believe that our bodies were created to grow, birth, and feed our babies and we should trust that. That a woman in labour is both powerful and yet also vulnerable, a combination of which that is breathtaking. I believe that a woman should labour and deliver where she is most comfortable, and I support that choice whether it is at home, in a birthing centre, or in a hospital.

I believe that pregnancy and birth are normal processes of life and that women should work with labour and not against it. That pregnancy is not an illness and should not be treated as such.

I believe that a woman should be informed about all of her options and be encouraged to carry out her own choices. That she should be satisfied and delighted with her birth experiences.

I believe that prenatal preparations, labour, delivery and the postpartum period are all as equally important. That women in either of these stages should have ample support so that no one, no procedure and no habit impedes on her experience and satisfaction.

What are your thoughts on preparing for childbirth?

I only tend to meet women just before or during the labouring process, but I would advise a number of things that may prepare them.

My biggest piece of advice is not to have your birthing plan set in stone. This can lead to a dissatisfied experience if the birth does not go according to what you have set in your mind for a perfect labouring experience. My biggest obstacles in providing the best possible care for labouring women are their birth partners. For example a woman may be absolutely against an epidural and may have stated to her birthing partners that ‘whatever happens I do not want an epidural’. Things may then become complicated, long, or she may not be coping, so as her advocate I may offer her additional pain relief such as an epidural. This is where it becomes complicated she may agree to it, but her partners are adamant that she really doesn’t want one.  Sometimes leading to conflicted interests.

I would also suggest that she eats regularly leading up to the birth. Many women do not feel like eating or they start becoming nauseous pre delivery. I have found from experience, that lack of nutrition pre labour can really impede on delivery.  If women don’t eat they begin to burn their fat stores instead of food stores, this leads onto a woman’s body giving off a by product called ketones. Now there is research for and against ketones during labour (see ketones as a physiological process or pathological process) but I find that the more ketotic a lady is the more dysfunctional her labour becomes. She still experiences painful contractions but they don’t always dilate the cervix and then can possibly lead on to a cascade of intervention for example: intravenous fluids.

Ensure she empties her bladder regularly and fully.

We are a nation of car users nowadays and we tend to have many women present in labour where babies are in the ‘back to back’ position. This can lead to a longer labour due to sub optimal positioning of baby. Use a birthing ball, this helps to widen the pelvic outlet and helps optimal positioning of the baby, or when lying down do so in the ‘kneel prayer’ position when relaxing. When women scrubbed their doorsteps they rarely had ‘back to back’ positions of their baby, this was because they were always bending over.

So the key aspects to preparing for childbirth are:

  • Nutrition
  • Hydration
  • Bladder care
  • Optimal positioning

 Your top tips for getting back to work after birth and working around your family?

I think this is very personal to each woman and their family. Don’t set yourself unrealistic targets. Utilise offers of help and don’t feel the need to be a martyr.

Perineal Suturing Instructor, The London Perineal Surgical Skills Course for Midwives http://www.londonperinealsurgicalskills.com

 

Parent Educator, The Baby Planners http://thebabyplanners.co.uk

 

Parent Educator, Women’s aid

 

Midwife, Basildon and Thurrock NHS hospital Trust http://www.basildonandthurrock.nhs.uk

 

Twitter @zturoff

 

Full profile can be found on Linked In

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