21 May 2015

Planning A Birth

When you are pregnant the first time, all the baby magazines, books and websites talk about your Birth Plan, as though it is something enshrined in law. While your midwife concentrates on various medical choices, which either horrify you or go straight over your head, the baby media remind you that you should pack incense and candles and soothing music. The reality of a first birth is usually some miles away from the happy ideal of the joyous birth plan. In fact, the birth plan is usually ignored. No pain relief sounds a noble thing indeed until the 36th hour of labour. No amount of Enya is going to stop you screaming like a banshee at some point. And that's fine.
I would argue that giving birth for the first time is inherently traumatic, regardless of how natural and beautiful it's supposed to be. It would certainly explain the vast numbers of women who speak of their first delivery in terms of awestruck horror. I certainly found my first birth traumatic, although most other women regard it with a mix of disdain and envy. Only four hours of labour? Lucky bitch. Yeah, four hours of labour is fine until you're going down the A47 at 80mph in the middle of the night, trying not to give birth in the front seat. That is less relaxing.
I was strongly advised to have a homebirth with my second baby. This was no problem for me: not only was my first birth traumatically fast, I also had an absolute shit time on the postnatal ward and was left in a very fragile mental state for six months. I blamed my postnatal depression mainly on my poor postnatal experience, and was scared it would happen again.
So, when the time came, I popped my middle boy out at home. I was considered low risk in comparison to the high risk of precipitate labour. As far as the labour and delivery went, it was beautiful and just like birth is SUPPOSED to be. Then it all went to shit.

I thought I was OK with my second birth. My baby was alive, somehow. I was alive and safe if a bit fucked up for a week, and I'd done it at home all by myself. It was a lot more controlled and easier to cope with than the first. I drew a line under it.

Or I thought I did, until I got pregnant again.
Initially, I thought I would have a homebirth. As pregnancy progressed, I realised that I was actually quite terrified of having another homebirth. They're great. They're lovely. They're amazing. Until they go wrong, and then they are SHIT. You have to hang around waiting for an ambulance, get dislodged from your comfy house to go and lie on a horrible hospital bed. And that's if you manage to get your baby out first - the idea of doing the same IN LABOUR fills me with horror.
My consultant got my notes from my old hospital, and said it would be a lot better if I had the baby on the consultant led unit so they can treat me immediately if I haemorrhage again.
And what upset me was not that the decision to have a homebirth was taken away, but that I no longer felt able to trust my body how to have a baby. I no longer WANTED to have a homebirth, and that felt very strange to me.

I've got 46 days to brew, give or take a fortnight. And I am dreading birth. I don't want to go into labour - not enough to be induced, which has been offered, but enough to already be second guessing my body's various twinges. I am scared of haemorrhaging again, scared of tearing, scared of everything. It sucks. I have never feared birth before, trusting wholly in my uterus to do what is expected of it, but now I am full of doubt. I sincerely hope that I am so sick of pregnancy that I welcome it by the end, because this anxiety is all new. It may be because I *know* this baby is my last, and I feel pressure to get it right, to minimise the curious feeling afterwards that I need to do it again to make it right.

There is no such thing as a perfect birth. There are only births that are good for the individual, and being realistic in your aims and expectations is the first step. I expect to give birth without pain relief - I have twice before. I expect to refuse induction unless the baby's distressed - I'm like that. I expect to be allowed to labour without monitoring or VEs - I've always laboured at home, so this might be a bit more of a stretch. I expect labour to be fast - if it's not, I shall be surprised! I am prepared to labour too fast to get assistance, which is part of the fear. I expect to haemorrhage, but I hope I won't. I expect to need surgical repair, but really hope I won't. I expect a big baby.
But that's all I expect. Everything else is too unpredictable to even think about trying to plan for.

20 May 2015

Culture and Bodies

Richard Dawkins posted a link to a story about a woman sent to jail for contravening a court order, insisting on her son's circumcision. Richard Dawkins, noted atheist, said this is wrong because it's based on respect for religion.

A very brief bit of research demonstrated that neither father nor mother are Jewish or Muslim (both of which require infant male circumcision), and the father is on record as saying he wants his son circumcised for personal reasons.
The USA has a strong culture of male infant circumcision, based on ideas of cleanliness and health, rather than religion. The USA's board of paediatricians say that it the benefits of male infant circumcision outweigh the risks of the procedure.

Some atheists shun religion on the base of no evidence. Empiricism is at the heart of atheism - "show me the proof and I'll believe". Well, in the USA, the evidence seems to point to male infant circumcision being beneficial. On this basis, surely all infant males should be circumcised?

Well, no, they argue, because there is choice. But where does the notion of bodily autonomy come into atheism, an ideology based on evidence and facts?

We have a humanity-old tradition of our bodies being good only if intact and whole. This is a tradition that has endured, despite knowing our entire body regenerates every few years and is not, therefore, the same body as we started with. The DNA remains, but the cells regenerate constantly, otherwise we wouldn't get cancer. Amputees do not just suffer from the physical loss of their limb, but from the psychological effects. The tradition that we take our bodies with us to the afterlife goes back as long as we can find graves for ancient people. People were buried with things they used in life, things they might need in death, even slaves. This didn't stop with the birth of the big monotheistic faiths, or with the slow decline in religious belief. Even today, we sometimes tuck in mementos and possessions with our loved ones before their burial or cremation, whether we consider ourselves religious or not.

Various cultures all over the world deform their bodies with knives, with brands, with tattoos, with lip-plates, for reasons of religion, or traditional heritage, or to meet their particular standard of beauty. In the UK, this tends to be limited to tattoos, piercings and cosmetic plastic surgery. Harder body modifications like scarification are considered abnormal, whereas piercing a baby's ears is socially acceptable. Orlan, a French artist, has repeatedly undergone plastic surgery to challenge the norms of beauty, and been castigated for it. Too many modifications are seen by some as a sign of mental instability. It is entirely culturally dependent.

Circumcision was originally adopted by the Jews to differentiate themselves from the Gentiles. It was adopted by the Islamic faith for similar reasons, and broadly common in the Middle East at that time. It is the oldest surgical practice on record.
Unlike female genital mutilation, which is widely condemned for the barbaric practice that it is, male circumcision is considered generally harmless, with a very small risk of side effects. It is not specific to religion. In the UK, it is almost solely done either for religious reasons or because of phimosis (the foreskin 'balloons' when the child urinates). It has not been normalised through tradition. In the USA, things are very different. There is a growing anti-circumcision movement within the USA, but it is still a normal thing to do to your newborn son.

People do things because their culture informs their practice, and religion has often informed their culture. When people claim the UK is not a Christian country, perhaps they mean in terms of going to church and professed religion. In this, they are correct. But culturally, it is wholly Christian. We don't generally work Sundays, because of religion. Shops aren't open for as long for the same reason.The church practiced the earliest forms of taxation, and that noble tradition has continued in earnest. We get Easter and Christmas and the second bank holiday in May off because of Christianity. Going back further, we celebrate Bonfire night, Halloween, May Day, and touch wood for good luck, because of ancient religious practices we don't even have records for.

Unusually, the USA's preference for circumcision doesn't seem to be based on religion, but medical belief and recent tradition. It is, in fact, an exception to the religion=culture=practice rule.

So, it entertained me a little bit to see Atheism's Self-Appointed Spokesman attacking a court judgement based on evidence and personal autonomy, because of assumptions of religious connotations.

PS: I don't agree with the court ruling, at all. That poor child.

19 May 2015

Birth Story - Jack, 2011

I'm putting these up here for posterity's sake, rather than to horrify you all while you're eating your lunch, so please skip unless you love gory, onomatopoeic descriptions of birth. 

Gestation: 42w
Site: Home
First Stage: 90 minutes active labour
Transition: About two minutes
Second Stage: 20 minutes
Third Stage: Ages and horrific
Tearing: Deep, extensive, borderline 3rd degree
Weight: 7lb 12oz

The day before he was born was Easter Sunday. I felt odd all day. I had a few really vicious cervical pains, but nothing major or long. My sisters all came round so we danced. Really danced. I was buggered up afterwards, but evidently it worked. I kept feeling like my waters were going to break, but kept telling myself it was wishful thinking because I was getting closer to bedtime and my admission was looming. Everyone went home after dinner and I got Jimmy to bed, then went down to watch TV with Mum. This was around 9pm. I didn't feel right. I wasn't in pain, just felt restless and inverted. I had some ice cream and then felt like I was weeing. I said to Mum "Either my water just broke or I'm incontinent". I asked her to come to the loo with me to check and when I got to the bottom of the stairs, it just POURED out. I went to the loo and it was clear with some blood in, but definitely water rather than wee. A load more came out on the loo. Mum went a bit hysterical - I think coz she was pleased it was finally happening rather than panicked - and got a shower curtain on the sofa in case I kept leaking. I called the midwife and she phoned back a few minutes later, saying she'd pop out around half 11 (my waters broke approx 9:30) and I phoned the ILs to come and get Jimmy. The midwife phoned again while the in laws were round to say she was gonna come over sooner rather than later. Then I kissed my Jim goodbye and sat in curious limbo waiting for the midwife. I text his dad and told him my waters had gone and got back "OK. Good luck". lol.

The midwife (Suzy) turned up at half 10 and checked me over. My fundal height was 33cm by then - 9 weeks behind! She didn't want to do a VE until I was in labour coz of infection risk, so I took a low vag swab and she checked my wee and obs. Then we sort of sat around chatting. I'd had one, painless contraction before she arrived so she waited for me to have another. I told her when I had one, and the pain was in my kidneys. The pain went off long before the contraction did, coz she kept hold of me the whole time. She made me run up and down stairs a couple of times to try and get me going. I'd told her how Jim's labour had started almost identically, so she said she'd hang around rather than get home and have to come straight back out. I had my first "Oh shit, this is it" contraction around 11:30 and they started coming every 4 minutes after that. I didn't keep track at all, but Suzy did. My best friend Carly arrived around midnight - I told her she didn't have to come considering the hour, but I'm bloody glad she did after everything else that happened. By the time Carly got there, I was contracting regularly but not that painfully. I could still talk except at the very peak. Suzy did a VE around 12:15 and I was 2-3cm, not fully effaced, but very 'stretchy'. I felt a touch dishearted then, but then the contractions ramped up, probably from all the swishing of cervix. My labour 'start' time was 12:30am.

She phoned the second midwife out then. I was alright between contractions, but couldn't work out where I wanted to be when I was having them. I tried the toilet, which was OK. I tried crouching right down into my knees, which was really good for a while. Sue, the 2nd midwife, came out at about 1-ish. She came out in a rush because I was getting a bit pushy. They got nicely set up for the birth and then I tried kneeling on the sofa for the contractions, which was AMAZING. I recommend it. I knelt up the back and leaned on the back with a big sheet folded up under my face to whimper into. I have no idea what time anything much happened after I got on the sofa, mainly coz I had my back to the clock and everyone in the room. I kept trying to join in the conversation between contractions, but I was too buggered to turn round. I remember the midwives telling me I needed to take my trousers off and I thought "Not yet...not yet..." but then I started wanting to push at the top of the contraction, so they took my trousers off for me. It was very undignified for poor Suzy who was crouched between my legs ready to catch.
I had a couple of mega-contractions, and told Suzy I was definitely wanting to push. Then I had transition. I felt sick, but I wasn't sick, and started crying really quietly that I wanted to go to bed and I wanted my mum and suddenly thought "Bugger me, transition already". I don't think anyone heard me, I was mewing like a kitten with the pain, rather than howling. Then everything went really quiet and my next contraction had three pushes at the end of it. Mum and Carly thought I was lying when I said I wanted to push until I started bearing down.
I started pushing around 2:10am. I couldn't coordinate it very well to start with, Mum told me to pull my chin in and focus DOWN so I tried doing that instead and that worked far better. Once his head was up to my cervix, I started getting really emotional and crying that I couldn't do it and I wanted to go to bed and I didn't want to. I remember crying "I can't, I can't, I can't" and everyone else saying "YOU CAN". Then his head crowned and I managed to breathe his head through rather than just push him straight out. I was absolutely SCREAMING by that point. I didn't mean to, I couldn't seem to help it. Then he was out, all flobbetyschlobbety. It was about 2:24am.

I was still facing away from everyone and it took a few seconds to pass him up through my legs. I kept crying that I wanted my baby. He didn't cry immediately, and it seemed an age before he did. He pinked up so fast once I had him and I rolled onto my back so I could feed him. Then I fed him and cuddled him and was a bit WOW.

In the mean time, carnage was happening. He had two true knots in his cord, which I didn't really think about right then, but his cord was thick and jelly-like at the umbilicus from where it was all pushed up. He's been double clamped. I planned to have a physiological third stage, but once the baby was born my womb didn't want to push anymore. Then I started to haemorrhage, so they gave me syntocin quickly and started tugging me about. I just wanted them to piss off and leave me alone, I felt horribly ill from the haemorrhage (my official blood loss was 650ml, so over 3 times the amount I lost with Jim, and it was probably a lot more of that because it went under the shower curtain) and I wanted to faint even though I was sitting down. I managed to push the placenta out myself, then they started fiddling about to see to what extent I'd torn. The light isn't great in my house, but they deduced that I had torn all the way through and would probably need stitching in theatre. By then, I just wanted everyone to FUCK OFF and leave me alone. They called me an ambulance and helped me get dressed and get Jack dressed. My mum washed all the blood off me - I looked like I'd been in a horrible accident, lol.
He was wide awake and staring at me and I had my hand under his bum and he felt like he did in the womb, coz I was so thin I could feel his bum really well within.

A first responder turned up first, to 'stop the clock' as they call it, at which the midwives were most scathing. The full crew showed up not long afterwards. They got me in the ambulance and I sat on a stretcher holding Jack for his first car ride! Mum and Carly followed. All the neighbours must've thought something awful had happened coz I had two ambulances out. I got pulled through A+E on the stretcher and all the beaten up drunks had a look at Jack and said congratulations. I was bunged into CDS and transferred onto a bed.

A consultant came to poke me about some more. He said I'd torn all the way through, but not actually damaged anything in my arse, so I could be stitched as a second degree by a midwife. Neither Suzy nor Sue wanted to stitch me coz my sphincter was visible and they didn't want to fuck me up, so Stevie came to do it. She's the midwife who delivered Jimmy and did an excellent job of stitching that tear. While I was stitched up, they did Jack's weight and measurements.

I was stitched, then had a diclofenac suppository, then started wishing everyone would DIE and leave me alone, because there's only so much vag pulling about I can stand and the doctor was ROUGH. Suzy and Sue went home to sleep - poor Sue had a clinic yesterday and we had a cup of tea and some biscuits. Then Carly took Mum home. It was gone 6am by the time everyone went.
Jack settled nicely and I had a doze for a bit. His dad rang me, having been informed of his son's birth by a barrage of texts and voicemails *eyeroll*. A woman came and did his hearing test, then a midwife came and did his paediatric check. Then I was discharged.

Birth Story - Jimmy, 2009

I'm putting these up here for posterity's sake, rather than to horrify you all while you're eating your lunch, so please skip unless you love gory, onomatopoeic descriptions of birth. 

Gestation: 40w 4d
Site: Hospital
First Stage: 4 days of on and off annoyance, then 2.5ish hours active labour
Transition: ONE. HOUR. NEVER. AGAIN.
Second Stage: 55 minutes
Third Stage: Interminable, probably around 30 minutes
Tearing: Long, internal, second degree
Weight: 9lb 1oz

On his due date, I had a haemorragic show. I trotted obediently up to the hospital, who found me to be 2cm dilated and likely to start soon. I went home, feeling quite proud of myself for managing to have a well behaved body.
The next morning, I went to see my midwife, who did a VE and sweep and found me in much the same position as before. I bled all damn day and after worrying about the amount of mucusy clots, went to CDS and they said I was fine and to go home and wait for stuff to start.
The next day, we went to my mums because I was in a furiously bad mood and sick of clock watching and being stuck in the house. We went to the pub for lunch and I was getting the odd twinge. Nothing major, enough to make me wince. Around 3pm, I started to get fairly regular, weak contractions. They got slowly stronger until they were coming every ten minutes. Around midnight, they suddenly got very painful and I started getting a lot of HIDEOUS back ache. I couldn't cope with the backache so we went to CDS. Again. Yes, again! A very nice midwife examined me and said I was 2-3cm and not ready yet. I cried. A lot. I really thought that was it. Anyway, we didn't get home til 4am and I still had quite bad backache. I went to sleep but could still feel the pain in my sleep.

The next day, a Thursday, I got up around 10am and had no pain. No pain at all. I was HEARTILY PISSED OFF. I made a decision to stop worrying about every pain and washed my filthy hair, had a nice bath and read a book. I kept falling asleep. We had a curry and watched TV and then decided to watch Bill Bailey as my mum kept telling me laughter would do me good.
Lo! Bill Bailey had been on but ten minutes and I felt a little gush - this was around 9:30pm. Then a bigger gush. I instantly got VERY EXCITED and went to the loo and it was not wee, and I was MOST PLEASED. I phoned CDS, they said to come in. All the way there, I kept losing a little fluid at a time.

The midwife examined me (yet again) and said I was 2cm dilated and my cervix was still in the wrong place. By this time, I was slightly irritated because my cervix appeared to be un-dilating itself. This was before I knew about the variation in finger size that is crucial in gauging dilation. She said my waters were leaking around the baby's head but still intact at the front. She said I could come back in the morning for an induction, or wait for it to happen on it's own. She said they would induce me on Sunday morning if I still hadn't started because of infection risk etc. I opted for Sunday and made an appointment for monitoring on Friday afternoon. The whole time I was in hospital, I was losing fluid. On leaving hospital, my backache started and I started getting small pains.

We got home at midnight and I knew that I'd started properly and it was just a matter of waiting til I couldn't take it anymore. I was still on a bit of a high because I KNEW it was finally happening. The pains suddenly got a lot worse around 1am and I went for a bath. The bath did JACK ALL for my contractions but helped with the shitting backache. I took one paracetamol around then. His dad decided to go to bed for a bit as we'd had so little sleep the night before and we figured we had a few hours before anything dramatic happened. I kept needing to sit on the toilet as I found it easiest to cope with the contractions on there, so he went to bed and I sat on the loo, trying to read a book...
I went and got in bed with him after a bit, somehow thinking that I could get some sleep myself. With hindsight, that was a laughable... I was having MAJOR contractions and trying so hard not to scream and to breathe through them instead and in between, I wasn't really there - I was very much in my head. I managed to let him sleep til around 2:15am and then woke him up screaming WE HAVE TO GO TO HOSPITAL NOW...FUCKING NOW.

I ran downstairs in my knickers, bra and shirt and tried to phone CDS to warn them I was coming. But instead I had a massive contraction and threw up everywhere and had a big loss of water. His dad came down, still half asleep and I was trying to phone CDS again but couldn't stop screaming with the pain so gave him the phone. They said they would get some pain relief ready. You must remember that at this point, I'd only been in labour for two hours and figured I had HOURS to go yet.
His dad had to get me dressed and put a towel down on the car seat so I didn't mess it up and found me a sick bucket. Somehow I was still functioning reasonably well between contractions and managed to wash the bowl I'd been sick in up and get my notes together.

He drove to hospital at 80mph while I was screaming all the bloody way and trying to remember to breathe and I remember thinking that I must be a proper fucking wimp to make such a fuss when I had so long to go. Apparently I told his dad off for driving too fast and what if the police stopped him. I was clearly not entirely with it. At this point, contractions were around 4 mins apart and lasting 40 seconds, with definite peaks and troughs of pain. Nothing like what I thought it would feel like anyway. By the time we got to hospital, it was 2 minutes apart and at the end of every one, I was losing loads of water.

I don't know how the fuck I got up to CDS. His dad had to carry me up the stairs. When we got to the stairs, I declared that I couldn't possibly get up them and I wanted to go home and not have the baby anymore. He just lugged me up the stairs anyway, lol.

CDS were VERY busy and they took ten minutes to find me a room. I don't know how I managed to stand up for that long. It was the birthing pool room, which is kept at a nice 28 bloody degrees. Because it was so hot, they left the door open and put a screen across it. I then deafened the entire hospital
I spent the next twenty minutes in the toilet screaming and asking why I needed to push and I couldn't push because I'd break my cervix and why the fuck did I need to push and where the FUCK were the DRUGS?? Annoyingly, there were two canisters of entonox in the room with no way of using it. I felt they were taunting me. In between contractions, I was just talking complete gibberish about wanting to get in the giant bath. His dad kept trying to touch my back or bump to calm me down and I was yelling at him to get off me. It was the most frenetic moment of my life those last few minutes before the midwife came in.
The midwife (Stevie) came in, took some history and my obs and then asked me to lie on my back for an examination (I was all over the place until then, mainly on my side). I told her I wanted to push. I laid back and she did it and just as she finished, I had another contraction. She told me to be quiet and listen (in a nice way) and told me I was fully dilated and if I wanted to push, that was fine. Oh and did I want any pain relief? I asked how long it would be, she said an hour max and I said no, I would be fine! She said she was going to get another midwife to assist and wouldn't be very long. She came back with a student to help.

I remember saying over and over that I'd done it by myself and I couldn't believe it. His dad was absolutely shell shocked. I didn't have time to change position or my t shirt or anything. I hadn't even brought the labour bag, with the camera in, up.

In between pushes, Stevie was asking me about my birth preferences, which is hilarious looking back. I remember being amazed that it didn't hurt once I knew the baby was coming. It was a huge HIGH just to know that I'd done it without any help. God did I make some noise though, I was like something out of the Exorcist. The midwives were absolutely brilliant and kept telling me how well I was doing and to breathe slowly in between and try and relax when I could and how to position myself to take better advantage of the pushing. His dad just held my hands really tight, and kept stroking my head with some wet tissue paper (no time for flannels) and it kept falling in my eyes and making me laugh. Everytime I opened my eyes, I remember being amazed that I was in hospital having a baby.
The baby's head crowned and I remember yelling "Shit that stings", even though it actually didn't, and they told me that they would ask me to push, then pant, then push again. His head came out and then his body and that felt WEIRD and then they plonked him straight on me, this giant red and blue and purple baby that somehow used to fit inside me. With a giant blue umbilical cord that weighed a ton.

I was sort of in shock for a second at this little person. The student cut the cord because his dad didn't fancy it. They gave me the syntometrine which I consented to in labour because I was absolutely PETRIFIED of haemorrhaging. And then he was all ours and on top of me and I was still wearing my bra and t shirt, lol. His dad said something about him being a boy and then we all sort of calmed down a bit. The placenta came out around 20 minutes later, although it felt like five minutes and felt very odd when it came out, like having another baby. They said it was a very large placenta and would barely fit in the bowl! I didn't look.

Stevie cleaned me up and I asked her if I'd torn and she said yes and she was going to have a look if I needed stitches. They put a towel over the baby and I was in a strange half-sitting position and couldn't get my bloody bra off. I managed to eventually, and then fed him. He seemed to know exactly what to do although he didn't suck for long. Stevie said I needed some stitches and went off to prep. They put me in stirrups, but it wasn't uncomfortable at all. I wasn't really aware of anything except having this baby all of a sudden.

His dad held the baby for ages while I was being put back together and was very nervous of him. I have to admit, I was a bit scared. He was really wriggly and slippery. He pinked up nice and quickly though. I know I fed him again, but I don't remember when. His dad went and phoned parents to inform them that I'd finally dropped and it'd all been rather quick. I went and had a bath, which was a shock. No bump and outrageous bleeding. I knew the bleeding would be bad, but it's still a shock when you've been period free for so long! I went back, had some food which made me feel horrible and then walked over to the postnatal ward.

And I sat upon the fucking PN ward until 9:30pm. I'd requested a 6hr discharge and they said they would aim for lunchtime as I was fine. The physio came round and I had a blood test to check my iron stores. My womb went down brilliantly. A midwife came round and taught us how to give him a bath. He failed his hearing test, twice, because he had such a wet delivery .There was a midwife handover at 3pm and that was the last time I saw anyone until 8pm, which is pretty shitty by any standards.

The paediatrician came round and frightened us by telling us he should be feeding every 3 hours when he hadn't been fed since I'd gone on the ward at 9am. He's also got an undescended testicle, which is very common. His dad got in a panic about the feeding and we tried to feed him but he wasn't interested. I wasn't worried, as he'd fed three times since delivery and had latched on etc very well. A fucking horrible old cow of an auxillary came and said they wouldn't discharge me unless he fed. 8pm is kick out time for dads, and she tried to make him leave so I burst into tears and he went and complained to the nearest midwife. Who happened to be the head of CDS. She came round to talk to me and I said that if he hadn't fed again by 4am, I would come back and admit myself and I really didn't want to stay in hospital and would self discharge otherwise. She said she would get my midwife to come round and have a chat.
My midwife, Hayley, came and apologised profusely for not seeing me before as they were mighty short staffed and had two emergencies. She had a look at me and him and said she was happy for me to go home and it was entirely usual for newborns not to feed for a long time after birth and as he'd had three shitty nappies and sicked up a lot of crap, he was probably fine. She was nice, I wish she'd been around earlier than I might have got home earlier.
We got packed up and off we went, me hiding the fact I was feeling incredibly faint and dizzy. I hadn't managed to sleep at all all day, constantly expecting to be discharged home. We got back to ours and the grandparents all popped in for a look, which I didn't mind. Sure enough, he wanted feeding as soon as we got in the door and then every 2 hours after that. My mum cooked me some food as I hadn't eaten for over 24 hours, and then we were left alone with our tiny boy.

17 May 2015

Always Autistic

Jimmy is still autistic. Obviously.

We’re still waiting for his autism assessment. The older he gets, the more classically Aspergers’y he becomes. Things that were within normal behavioural limits a year or so ago are now evidently not.
He’s struggling with the concept of the baby. I don’t think he will give a shit about the practicality of having a new baby - he doesn’t see such things as affecting him, they are beyond his emotional compass - but he is worried about the change. Combined with fears about moving into year 2 and having to do more work, and he’s not a happy little boy at the moment.
His behaviour at school has become very violent, and he’s now almost unteachable. He just doesn’t stay in the classroom long enough to take anything in. They let him wander, because when he is ready to pay attention, he comes back and is much easier to teach and less disruptive. He ran away recently and he’s started physically stimming, where it’s all been mainly verbalised before. He bites nonstop - he has a biting chew thing on a necklace because otherwise he bites children or himself. He’s been known to try and break his own bones. His sensory overdevelopment is not getting any easier to deal with. The school can't do much until he gets his autism assessment, so we remain in limbo. Sixteen months of waiting and it doesn't get any less frustrating.

At home, he’s not so bad. He has the odd meltdown, but we mostly keep him in an environment he can cope with and give him plenty of warning if we’re going anywhere. For the first time ever, we managed to have a good family holiday, because we've learned to manage our expectations of him and protect him from unpredictability. He doesn’t sleep through, but he rarely screams all night long. It is a blessed relief.

It’s hard work. It will always be hard work. I don’t really mind. I get very angry when people (most usually school staff) suggest I’m not doing everything I can to put boundaries in place and support him. You cannot SURVIVE parenting an autistic child without a strong framework of rules and boundaries; to suggest I don’t have enough undermines the enormous improvement he’s made over the last two years as well as me as a mother.

It’s hard to explain that autism doesn’t get better. It doesn’t go away. You cannot rewire a child’s brain to make them work the same as everyone else (and would you want to?), but you can help them learn coping strategies and understand other people’s behaviour in a way that makes sense to them. The greatest gift you can give to your autistic child is empathy - to see the world from their eyes, instead of expecting them to see it through yours. In fact, fuck autism, that’s true of ALL parenting.

8 May 2015

The NHS Is Doomed

No election should be fought on a single issue. No party should stand on a single issue - one of my main problems with UKIP outside the rampant fascism is their focus on immigration at the cost of everything else. However, the NHS is a massive issue that should have totally dominated this election, far more than taxes, immigrants or the EU.

The NHS is a socialist ideal - free healthcare for all. It's a very simple, very expensive ideal. It was introduced as a post-war reform, to centralise, regulate and democratise healthcare. Prior to this, healthcare was paid for either as it was necessary, or by insurance. My granny and her sister were in hospital for weeks with diphtheria in the 1930s, and that was paid for by their father's work 'stamp'. There was a lot of self-medication then as well - this being in the days before antibiotics - mostly with unregulated supplies of opiate based medicine. Colicky baby? Opiates! It was to be paid for through work-related National Insurance, which was not dissimilar to what most people were used to paying anyway. It was an ideal system.
The NHS, since those days, has mutated into an enormous, bureaucratic beast. In attempts to save money, managers were brought in to regulate practice. They have ended up sucking more money out of the NHS in wages than they save in administration. I was an NHS administrator, I know we are very necessary people, but I was on minimum wage to begin with and some are on hundreds of thousands of pounds a year.
Labour had some interesting ideas on how to make the NHS more profitable - mainly by getting private firms to build hospitals on a sort of hire-purchase agreement. Then they started selling off the buildings and responsibility for hospitals and GP surgeries to private companies. That worked fine, until the private companies decided they couldn't afford to run them anymore, and withdrew. You see, that's the real problem with privatising aspects of healthcare, as it has been with privatising other public services. When it ceases to be profitable, the private sector simply run away. Free healthcare is not a very lucrative business, so this is likely to happen a lot more in future.

The coalition government also made a lot of cuts to the services offered on the NHS, as well as raising prescription costs enormously (£7.20 per item in 2010 to £8.20 in 2015). In a startling deviation from my usual lefty saucepan-banging, I believe prescription costs should be around £0.50 per item, but applicable to all but the critically ill and the extremely poor. I know how much medication costs wholesale: it shouldn't be free to as many people as it is, but neither should it be prohibitively expensive. The coalition government also cut staffing, particularly in nursing where I suppose they think people won't notice, and in A+E departments, where people certainly do

The problem with the new Conservative government and the NHS is that the Conservatives are ideologically opposed to the NHS. This isn't me being a bleeding-heart liberal: they believe in telling us what to do to keep healthy, and that is as far as it goes. The Conservative viewpoint on health is that it is your responsibility, your fault and your problem if you're ill.
Thatcherism took this even further into the realms of market liberalism. Don't be fooled by the name, the liberalism refers to the freedom of the markets, not you. Market liberalism holds that the market should be free to set costs without government interference. So not only are you ill (which is your fault), your treatment price is inflated. Hurrah for Thatcher (said nobody, ever).

And the thing is, that would be FINE if health was merely down to a matter of personal responsibility. But we all know it's not, even if we try and convince ourselves ideologically that people give themselves cancer, or depression, or chronic disease. We all know someone healthy cut down in their prime by some apparent fluke illness or accident. We all know someone who's done every single recklessly unhealthy thing you can imagine and lived to a ripe old age.

One of the biggest factors in your lifespan and your years of freedom from disability is your wealth. The more money you have, the healthier you are likelier to be, and the longer your life. There is a nine year gap in average lifespan between the richest and poorest areas of the UK. NINE YEARS. Not only is there that lifespan gap, there's also a huge gap in experience of disability.

Now, there are loads of reasons poor people experience poor health, and very few of them are down to personal factors. One of the main reasons is infrastructure. When you live in a poor area, your access to doctors, hospitals, transport, nutrition, good housing, employment, and exercise is limited. Your exposure to pollution, cigarette smoke, accidents, antisocial behaviour, stress and housing-related issues like mould is increased. Education also has an important, if unexplained, effect on health - more educated people tend to be healthier, and schools in poor areas tend to have lower qualification rates.
All of this is exacerbated by work. If you are fairly well off and work in the private sector, it's likely that you have a sick pay scheme. You may even have health insurance. Even so, suddenly being unable to work for a long period of time can be a disconcerting, depressing and stressful experience. However, when you work in lower class employment, or in the lower sectors of the public sector, you are dependent on statutory sick pay. SSP is currently £88.45 a week. You cannot claim SSP if you are on a zero-hours contract, or a very low wage. It's eligible for six months, after which you either continue on nothing, be sacked for continual absence and thus ineligible for jobseekers allowance, or leave work and switch to a disability benefit. I know a lady who was sacked because she'd had too many periods of sickness in the last few years, and then had a bad chest infection. Her previous absences were due to having chemotherapy. This was perfectly legal. Naturally, switching to a disability benefit is universally considered a bad thing by the Conservatives. Far better to keep the working masses in work, surely?

Yet it is the working mass, the seething, swarming low-paid mass, that needs the NHS most, potentially costs the benefit system most, and is capable of paying back into the economy. These are the people the Conservative government would prefer did not exist. The people they wish would be as wealthy as they are, so they didn't have to worry about society. The people they continually push down the ladder through social and economic inequality, and then seem surprised when it costs the state money to do so.  I'm sure there are plenty of individual Conservative MPs and voters that staunchly believe in the NHS, but that's not the party line, so they may as well piss in the wind.
Thatcher said there is no such thing as society. Unfortunately for her acolytes, there is, but don't expect the gentle dismantling of the NHS infrastructure to stop now the coalition has ended.

Expect it to get worse. Expect it to become more overt. Expect to become anaesthetised to the idea that the NHS is a salvageable , workable entity. Expect to be unsurprised when it's rebranded, or you are asked to put down a deposit when making a GP appointment 'to ensure your attendance'. Expect GPs to be blamed. Expect A+Es to be blamed. Expect managers to be blamed. Expect ill people to be blamed. Expect immigrants to be blamed. In fact, expect everyone else to be blamed for the sad, but necessary dissolution of the NHS except the government.

I love the NHS - I love it as staff, I love it as a patient, I even love it as a parent of a disabled child, where it's failed us most.
I hope I'm wrong about this. Ask me in five years. 

7 May 2015


I vote. I've always voted, ever since I was old enough. My first election was 2005, when I was 20 (so long ago!). I was so excited - I don't know why, it just felt momentous! I voted Labour, because my mum told me to. I know, that's not how politics is supposed to work, but I knew fuck all about politics. My school - a very highly rated grammar school - didn't bother to teach us about the electoral system. It was vaguely alluded to in history, mainly in terms of National Socialism and the birth of Parliament back in the middle ages (the Glorious Revolution was also left out). We had one lesson, in general studies aged 17, where they told us about political parties in the UK, and a Conservative MEP came in to tell us about being an MEP once. I tried to boycott this on account of burgeoning Communist sympathy, but to no avail. DISSENT IS NOT TOLERATED IN HIGHLY RATED GRAMMAR SCHOOLS. There were no politics-linked courses available to us either at GCSE or A level. So, it's not really surprising that I was clueless.
And it's not surprising my mum told me to vote Labour either. I grew up poor. Not so poor that I was starved to death and freezing, but poor enough to rarely have new clothes, that food was spread thin, that my mum would get in a terrible state every August at the idea of fitting us all out for school again. Too poor for university. Too poor to learn to drive. That sort of poor. My parents squarely blamed our poverty on the financial crash of 1988, and Thatcher, but were culturally Labour voters anyway. My grandparents were agricultural workers on one side, and industrial workers on the other. There was, and is, no money in my family.

In the 2010 election, things had changed. I was now married, with a little boy, not poor and more independent of mind. The area I lived in was staunchly Conservative - landowners and landlords usually are - and I knew I definitely wasn't one of them. I believed in fairness, and equality. I believed that people who needed help should get help. I believed in a better future for my children, however they ended up. I voted for the Lib Dems, based on disillusionment with the lies of Tony Blair and Labour, and the faint promise of Nick Clegg to actually change things. Alas, I was wrong.

This time, everything's changed again. I'm back to being poor. The coalition has made life many times harder for anyone without privilege. I'd rather gnaw off my arm than vote for the unholy alliance of Cameron and Osborne. UKIP offer a right-wing alternative, with no immigrants and loads of money...from somewhere. The Lib Dems have some good politicians, but are no longer credible.  The Greens can wave and shriek "we're here" as much as they like, but they're not credible either. I don't know if Ed Miliband can change anything, but I like the cut of his jib. I don't care if he can't eat a bacon sandwich in a refined manner. He could stick a spoon in his ear and sing the Hokey Cokey before every meal for all I care. It's not about him, it's about the ideology. It's about fairness, equity and justice. And unseating the Nemesis.

Elections are not about certainties. They are not about fear, no matter how many times David Cameron points at the SNP, shaking and gibbering. They are full of lies and deceit and broken promises. But they are also our only hope at having a say. They are our only hope of changing anything. It is a leap of faith to make an X next to someone you've never met, and say "I hope you can represent us and that you change things for the better."

But it's all we have.

The newspapers tell us it's a waste of time to vote, that we cannot make a difference, that a landslide is impossible and a coalition is almost certain (NB: they also said this in 1997, days before a major Labour landslide), that we will all DIE if legitimately elected ministers are allowed to legally rule the country, that the NHS is definitely safe, that it's not safe, that it is safe HONEST GUV, that we cannot trust a man with a face full of sandwich to run the country, or a man who was once in the Bullingdon club, or a man who drinks more than he speaks sense, or ANY WOMEN AT ALL. The newspapers lie. The newspapers are full of more shit than the politicians. Shun the media at this difficult time.

I don't care personally who you vote for, but I hope that you vote, if you can. There is a huge swathe of people, mostly younger people, who have no idea about politics and think their lack of knowledge deprives them of the moral right to vote. There is a most excellent quiz here that tells you who you should vote for based on policies rather than a bunch of faces. You don't have to be Jeremy Paxman to have a say in how our country is run. Politics is for everyone. And the idea of everyone voting scares the living daylights out of the government, and the media. So do it.