Episode 137 Infant feeding - A chat with Lyndsey Hookway

As we navigate the intricate journey of childbirth, there is a  balance between a mother's autonomy and stringent clinical guidelines.  Step into the world of Personalised Care in maternity services, where my discussion sheds light on the emotional complexities of honouring the unique birth plans of expectant mothers. This episode is a clarion call for healthcare providers to listen deeply, advocate for informed consent, and partner with pregnant women to create empowering birth experiences that resonate with their individual wishes.

Join us for an engaging exploration of the challenges and triumphs in the quest for Personalised Care. From the implementation of a cutting-edge maternity teaching module to the role of the Personalised Care Institute's e-learning, we uncover the ways in which professionals are striving to marry personalized care with the realities of clinical practice. As we close, I extend an invitation to contribute ideas for future discussions, and share the means to support the continuation of our enriching, conversation-led journey through the landscape of obstetrics.

Want to know more?
https://learn.personalisedcareinstitute.org.uk/
https://learn.personalisedcareinstitute.org.uk/course/view.php?id=35
https://www.england.nhs.uk/wp-content/uploads/2021/03/B0423-personalised-care-and-support-planning-guidance-for-lms.pdf

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Discover  the hormone oxytocin and its role in the birthing process  in the latest ObsPod episode. We unravel the dual nature of this potent hormone, once an unquestioned staple in Active Management of Labour.  Listen as we share an engaging conversation about its physiological impacts, the delicate balancing act required for its use in inducing labor, and the critical examination of its application in natural labor progression.

We discuss use of oxytocin over time,  We tackle the tough questions about its contribution to caesarean birth rates and dissect the role that confirmation bias has played in obstetric intervention. With a focus on the value of one-to-one midwifery care and the potential consequences of oxytocin use, such as hyperstimulation and fetal distress, our discussion paints a comprehensive picture of the complexities involved in labor management. We take a  look at the risks associated with administering oxytocin during labor. Highlighting scenarios where its use is beneficial against those where caution is paramount, we stress the importance of respecting natural labor progression, discussing alternatives. I extend an invitation to our listeners to contribute to the conversation and support the ObsPod, remember that this episode isn't just about the clinical—it's about informed consent and empowering women to make the right choices for their births.

Want to know more?
https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1996.tb09734.x
https://www.cochrane.org/CD007123/PREG_the-effectuse-of-the-drug-oxytocin-as-a-treatment-for-slow-progress-in-labour
https://www.nice.org.uk/guidance/ng235
https://www.nice.org.uk/guidance/ng235/evidence/f-use-of-oxytocin-in-the-first-or-second-stage-of-labour-pdf-13186672963

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Join me & my guest Dr. Kirsten Small as we build on our previous joint episode 157 Fetal heart monitoring in labour. This time we discuss the world of intermittent auscultation, you'll be enlightened by the evolution from the hands-on Pinard stethoscope to the advanced Doppler device. Dr. Small shares her expertise on the intimate connection care providers once had with this practice and how it's changing in today's clinical settings. We also examine the remarkable methods midwives employ in various care environments to monitor fetal well-being, revealing the depth and diversity of approaches.

Listen as we discuss cardiotocograph interpretation, the myths surrounding traditional CTG patterns and  upend long-held beliefs about fetal distress. We discuss the need to re-evaluate our understanding of decelerations. This episode promises to arm you with knowledge and provoke  reflection on the stories we've accepted without question.

We compare intermittent auscultation and continuous electronic fetal monitoring. We lay out the importance of considering the full spectrum of fetal heart rate information, dissecting the biases that can sway clinical judgment. Dr. Small's insights offer clarity on the practical application of guidelines  required to ensure informed clinical decisions. This episode not only educates but also invites you to contribute to our ongoing conversation about the complexities of maternity care.

Want to know more?
https://birthsmalltalk.com/
Kirsten has many fascinating blog posts to explore we touch on a couple of them here
https://birthsmalltalk.com/2023/05/24/keeping-up-with-physiology-research/ 
https://birthsmalltalk.com/2022/01/12/whats-the-deal-with-early-decelerations-and-head-compression/
She also runs online fetal monitoring courses for maternity professionals.
https://birthsmalltalk.com/courses/

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Embark on a poignant exploration of a topic that's often cloaked in stigma yet crucial to maternal health: obesity and BMI during pregnancy. Join me, Florence, on the ObsPod, as we unravel the intertwined issues of weight management and prenatal care, delving into the NHS classifications that inform how expectant mothers with a BMI over 30 navigate their unique journey. This episode promises insightful discussions and a deeper understanding of the practical applications and limitations of BMI as a standard of health, particularly during such a life-changing period for women.

This candid discussion also brings to light the specific hurdles and advancements that shape the experiences of overweight women in pregnancy, from ultrasound imaging difficulties to anesthesia considerations during childbirth. We'll reflect on the latest innovations, such as the TraxiDrape and Alexis retractors, which have significantly improved caesarean section outcomes for both mothers and healthcare professionals. Throughout our conversation, the emphasis remains on fostering empathetic communication, empowering women to feel informed and supported—a commitment that transcends the clinical environment and touches the heart of human connection.

Want to know more?
https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/care-of-women-with-obesity-in-pregnancy-green-top-guideline-no-72/
https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/calculate-bmi-for-adults
 https://www.youtube.com/watch?v=3Xus_vsiZ5c
https://www.youtube.com/watch?v=dgN_0iffzzI

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Embark on a transformative journey through the complexities of alcohol use during pregnancy, as we unravel the myriad risks and the vital necessity of abstinence for expectant mothers. Grappling with the nebulousness of self-reported alcohol intake and the deceptive simplicity of a 'unit' of alcohol, we aim to demystify the misconceptions and bring to light the stark realities of alcohol-exposed pregnancies (AEP) and fetal alcohol syndrome disorder (FASD). With a staggering 400+ conditions linked to FASD, this episode is an essential listen for anyone invested in the future health of our children.

Navigating this sensitive topic with the utmost care, we engage with healthcare professionals on the front lines who embody the 'A-S-S-T' framework — a compassionate, judgment-free approach to supporting pregnant women. Through vivid stories, expert insights, and poignant reflections, we invite our listeners to contribute to a crucial conversation that impacts lives profoundly. 

Want to know more?
https://eschool.nationalfasd.org.uk/course/alcoholandpregnancy
https://www.rcog.org.uk/media/buohxsmm/pi-alcohol-and-pregnancy.pdf
https://alcoholchange.org.uk/help-and-support/managing-your-drinking/dry-january

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Are you already familiar with the life-saving role of blood transfusions in obstetrics? If not, get ready for an enlightening journey into this critical aspect of maternity care. This episode is packed with insights about the ins and outs of transfusions, from packed red cells to platelets, plus everything else a woman might need to replace following excessive bleeding during pregnancy or childbirth. We also introduce you to the role of a hematologist and a game-changing device called TEG. 

Pregnancy and childbirth can sometimes bring along unforeseen complications. Here, we delve into potential reactions during transfusions, the significance of monitoring and consent, and the intricacies of platelet transfusions. We also discuss the importance of knowing a woman's blood group and the use of O negative blood in emergencies. Wrapping up, we extend an invite to engage more with the topic and seek your support to keep the ObsPod alive and kicking. Tune in and immerse yourself in the world of obstetrics!

Want to know more?
https://www.rcog.org.uk/guidance/browse-all-guidance/green-top-guidelines/blood-transfusions-in-obstetrics-green-top-guideline-no-47/
https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/23998/inf1580-1-receiving-a-blood-transfusion-print-friendly.pdf
https://www.nhs.uk/conditions/blood-transfusion/
https://epostersonline.com/oaa2022/poster/p9?view=true
Willing to donate blood in the uk?
https://www.nhsbt.nhs.uk/

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Trigger warning this episode contains discussion of baby loss.

What if you found yourself entangled in a challenging and rare pregnancy condition, not once but twice, with a heartbreaking ending? Unravel the personal narrative of Jenny Chambers, the founder and CEO of ICP Support, as she shares her painful journey through Intra-Hepatic Cholestasis of Pregnancy (ICP). From the agony of stillbirth, the challenges of conceiving again, to her unwavering commitment in raising awareness about this complex condition, Jenny's story shines a light on the importance of support, understanding, and research for families affected by ICP.

We shift gears to shed light on the essential role of diagnosis and medical support, examining a mother's devastating account of losing two babies during pregnancy due to undiagnosed ICP. The narrative underscores the significance of self-advocacy during pregnancy and the critical need for increased awareness about potential complications. We then traverse the intricate journey of ICP research, treatment, and community support, bringing in insights from leading researchers and consultants who are pushing the boundaries in ICP treatment. We engage in a thought-provoking discussion on the impact of ICP on women's lives and the critical need for empathy and understanding from the medical community and society.

In the final part of our episode, Jenny reflects on her tireless work in raising awareness about ICP, her experiences within the NHS, and her instrumental role in connecting women with research teams. This conversation unveils advances in ICP research, the uses and limitations of sodium oxycholic acid, and the potential of new medication under trial.
Want to know more?
https://www.icpsupport.org/index.html#gsc.tab=0
Please contribute if you can to help this amazing charity keep going by  donating to their end of year fund raiser.
https://bit.ly/FundingTheFutureICPSupport2023


As we wrap up, we invite you, our listeners, to suggest future topics, extend your support, and join our endeavor to keep this podcast free and accessible to all. Your support makes a world of difference.

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Ever felt confused or guilty about your sleep position during pregnancy? Fear not, as I, Florence, an experienced NHS obstetrician, guide you through the maze of advice on this critical topic. Drawing from years of practice, continued learning and the latest research, I shed light on this topic, putting to rest unfounded fears and guilt. Together, we explore the NICE guidelines and dissect multiple research studies that have explored the impact of sleep position on stillbirth and fetal growth. My goal is to provide you with evidence-based knowledge, giving you the confidence and peace of mind you need during this special time.

In addition, we dive into a fascinating MRI study that demonstrates how different sleep positions affect fetal oxygen saturation and placental blood flow. The importance of the position you aim to sleep in, not the one you wake up in, is highlighted.

Want to know more:
https://www.nice.org.uk/guidance/ng201/evidence/w-maternal-sleep-position-during-pregnancy-pdf-331305934396
https://www.tommys.org/pregnancy-information/im-pregnant/sleep-side/sleep-side-research-behind-campaign
https://www.tommys.org/pregnancy-information/im-pregnant/sleep-side/sleep-position-pregnancy-qa
https://physoc.onlinelibrary.wiley.com/doi/10.1113/JP284269

As I continue my quest to make obstetric care more accessible, we discuss ways you can support TheObsPod and help keep this platform free for all. Hear about how you can contribute and get involved, suggesting topics for future episodes. So, join me on this journey, as we bridge the gap between medical professionals and expectant mothers, one podcast episode at a time.

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

Today is a much awaited episode having been brewing for over three years since I started the podcast which seems apt given the subject. How does it feel to be pregnant after fertility treatment, what might be the issues maternity staff need to be aware of ? What maternity care do we need to provide to the increasing number of families in our care after assisted conception and a fertility journey. Join me in an episode ready for fertility week (30th Oct -4th Nov) hear my thoughts about pregnancy after fertility. This episode with special  thanks to Katie Eaves an inspirational midwife
https://www.all4maternity.com/support-for-midwives-with-infertility-and-having-fertility-treatments/
https://www.thefertilitypodcast.com/midwifeandinfertility/

Want to explore more?
https://www.hfea.gov.uk/about-us/publications/research-and-data/fertility-treatment-2021-preliminary-trends-and-figures/#footnotes-i
https://www.rcn.org.uk/Professional-Development/publications/transition-fertility-maternity-care-uk-pub-010-338
https://www.hfea.gov.uk/about-us/our-blog/new-guidance-published-to-support-women-transitioning-from-fertility-to-maternity-care/
https://www.thefertilitypodcast.com/
Finally pregnant podcast https://open.spotify.com/show/148o2wODSIMyMFtsbZdods

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...

How much trust are you placing on the CTG monitor as you welcome a new life into the world? Get ready to have your beliefs challenged as Dr. Kirsten Small and I dissect the language and implications surrounding fetal monitoring during labor. We dive beneath the surface to expose how CTG monitoring can become a source of moral panic, shifting the focus from the true essence of childbirth. 

Dr. Small, a critical voice in the field, and I navigate the complex world of CTG monitoring. We reveal how misleading language and beliefs can cloud our judgement about its effectiveness. Our conversation brings to light the dire need for a randomized controlled trial to evaluate physiology-based CTG interpretation conclusively. Together, we grapple with the challenge midwives and healthcare professionals face in reconciling evidence-based understanding with the stringent guidelines they are bound by. 

As our enlightening chat progresses, we unmask the complex nature of fetal monitoring during labor. From discussing Dr. Small's informative online courses to debating the implications of directly measuring oxygen levels in labor, we leave no stone unturned. We challenge the concept of central monitoring in labor, discussing its effectiveness and potential challenges. Whether you're a maternity professional, birth worker, or someone intrigued by fetal heart rate monitoring, this conversation offers insights and debates that will make you reconsider what you thought you knew. Tune in for a perspective-altering discussion that is sure to stimulate your thinking around fetal monitoring.

You can find Kirsten & her courses here on her website https://birthsmalltalk.com/
as well as on Instagram & Twitter @birthsmalltalk

Thank you all for listening, My name is Florence Wilcock I am an NHS doctor working as an obstetrician, specialising in the care of both mother and baby during pregnancy and birth. If you have enjoyed my podcast please do continue to subscribe, rate, review and recommend my podcast on your podcast provider.
If you have found my ideas helpful whilst expecting your baby or working in maternity care please spread the word & help theobspod reach other parents or staff who may be interested in exploring all things pregnancy and birth.
Keeping my podcast running without ads or sponsorship is important to me. I want to keep it free and accessible to all but it costs me a small amount each month to maintain and keep the episodes live, if you wish to contribute anything to support theobspod please head over to my buy me a coffee page https://bmc.link/theobspodV any donation very gratefully received however small.
Its easy to explore my back catalogue of episodes here https://padlet.com/WhoseShoes/TheObsPod I have a wide range of topics that may help you make decisions for yourself and your baby during pregnancy as well as some more reflective episodes on life as a doctor.
If you want to get in touch to suggest topics, I love to hear your thoughts and ideas. You can find out more about me on Twitter @FWmaternity & @TheObsPod as well as Instagram @TheObsPod and e...