The Singing Doula

It's Been A Long Time.......

noreply@blogger.com (The Singing Doula) — Sun, 05 May 2013 17:05:00 +0000

.....but I think it's going to be OK now.

Where have I been?

Well, after Barry recovered from TB, it was my turn to be ill.

Turns out I have Fibromyalgia which is an auto-immune disease for which there is no cure at the current time. It's characterised by pain and chronic exhaustion plus a lot of other symptoms.

It's taken me a long time to come to terms with this, and learn how to manage what is essentially a new way of living my life, but I think I might just be getting there. So, I haven't given up, just taking time in finding new ways to get things done.

Had A Baby In The Last 6 Months?

noreply@blogger.com (The Singing Doula) — Mon, 12 Sep 2011 20:48:00 +0000

My friend, Dr Amy Brown is looking for participants in a research survey.

The point of the research is to look at women who did or did not use alternative therapies during their pregnancy and then look their birth outcomes.

We need your help.

So, here's the information you need:

Complementary and Alternative Therapies in Pregnancy and Birth outcomes
Swansea University Research Study: Complimentary and alternative therapies during pregnancy and birth and postnatal outcomes

We are looking for mums with a baby aged 0 – 6 months old to complete a questionnaire exploring their use of complementary and alternative therapies during pregnancy and possible associations with birth and postnatal outcomes. For example we would like to compare experiences for mothers who did or did not use treatments such as osteopathy, reflexology and homeopathy during pregnancy. Specifically we are interested in examining whether there is any difference in birth experience and postnatal health and well-being of you and your baby postnatally.

We have a particular interest in the use of osteopathy and physiotherapy during pregnancy but would like to explore any outcomes for chiropractic treatment, acupuncture, reflexology, homeopathy, massage and the Bowen Technique. We are also examining the impact of psychological support in working with a doula. This study is a small piece of pilot work. We hope to be able to explore any significant associations in more depth in the future.
The study is run by Dr. Amy Brown and Ross Johnston (MSc BSc (hons) OstMed ND DO) at Swansea University. It is completed using a questionnaire mainly of tick box answers with a few extra questions looking at your thoughts in more detail. It should only take around 10 - 15 minutes to complete at most. The study has full ethical permission from the research ethics committee.

We would be very grateful for responses from mothers who did or did not use any such therapies during pregnancy (or who indeed used a combination). If you are interested in taking part in the study or would like to take a look before deciding, the questionnaire can be found here. If you would prefer a paper copy please email Amy at a.e.brown@swansea.ac.uk

Thank you for your time

www.surveymonkey.com/s/childbirth

Many thanks,

Don't Ask Me To Save You

noreply@blogger.com (The Singing Doula) — Sat, 13 Aug 2011 20:41:00 +0000

Earlier today I was reading another doula's blog and a post entitled:

"What Not To Ask Your Doula"

Here's the link if you want a peek: http://yorubadoula.wordpress.com/2011/08/12/what-not-to-ask-your-doula/

But it was the title of this post that resonated most with me.

And I thought to myself:

"What is the one thing that I, as a doula, don't want you to ask me?"

It's easy.

Don't ask me to be your saviour.

You may not even realise that's what you're asking me. I understand that.

When a woman has suffered during birth, had a birth that didn't meet hopes and expectations, felt like birth was something done to her and not that she gave birth, then who wouldn't go looking for a saviour?

It's perfectly reasonable when you think about it. Having spoken with many women, I know that a lot of thoughts around deciding to have a doula go something like this:

Negative birth experience → Fear → Wanting to avoid a repeat experience → Who can make this go away? → Ask around now I'm pregnant again → I need a doula

And I totally understand why women might feel like this.

I get exactly why pregnant women might feel they need a protector, a body guard, a saviour.

It's just that I can't be any of those things because if I am, I put you straight back into the cage you're fighting so hard to escape from.

Let's face it, when most women talk about birth trauma and bad birth experiences, when you dig down to the root of the emotions, more often than not, it's about loss of power and control over your own physical body. It's about having your decisions and choices questioned, ignored and over-ruled. Sometimes it's about things, to which you never consented, being forcibly done to you against your will. It's about being made to feel stupid and insignificant for believing you had choices at all.

It's such a fundamental loss, such a blow to the person we recognise as our 'self' that makes the damage done so far-reaching, long term and completely unexpected.

It can manifest in PND, in PTSD, in panic attacks, fear of having another baby, in fear of birth. It can change who you are forever.

Even so, I cannot be your saviour.

Because I cannot, I will not, be the person to put you back into a cage.

Even if you ask me, I cannot, I will not, take over and disempower you just as you were disempowered before by others.

I will not disrespect you as a human being.

I do have something even better to offer, though.

What I will do is hold out my hand and help you step out of your cage.

What I will do is show you how to become your own advocate, so you can slam that cage door shut with you firmly on the outside.

What I will do is show you how to access the information you need to make your own informed choices.

What I will do is support you in whatever birth choices you make because I know, implicitly, that you want only the best and safest options for you and your child.

What I will do, when you make that leap of faith, is jump right alongside you.

But.......

What I will never do is be your saviour.

I'm In The Mood.....

noreply@blogger.com (The Singing Doula) — Sat, 13 Aug 2011 16:10:00 +0000

.... for writing.

I find stress kills my creativity.

I can't sing.

I can't write.

I can't think.

I can't breathe.

But, now, the dark time is almost over and I am stepping from the tunnel, back out into the light.

Back At Last

noreply@blogger.com (The Singing Doula) — Sun, 26 Jun 2011 17:55:00 +0000

Well, I've had a much longer break than I ever anticipated.

The bit I didn't tell you before was that at the same time as we were moving house, my husband, Barry, was becoming increasingly unwell. His left lung was crushed by fluid that had almost filled up the lung sac. His struggles for breath were debilitating and frightening to watch. The weight fell off him as you looked at him. He was so ill.

Things came to head with a bewildering round of visits to a general physician, a cardi-thoracic surgeon, blood tests, x-rays, ECGs, Echocardiograms, CT scans, pleural taps, surgery and eventually a diagnosis.

The journey to diagnosis was the worst bit. We knew it wasn't chronic lung disease or asthma or infection. TB had been excluded. That just left cancer.

We really thought it was cancer. The doctors thought it was cancer. Everybody thought it was cancer and of a type for which prognosis is very poor at best.

But it isn't. Thank God, it isn't cancer.

Barry had surgery which included draining all the fluid from his lung and then sticking the layers of the lung sac together to prevent the fluid returning. Whilst the surgeon was at it he took biopsies which finally gave the answer we'd been waiting for.

It's a very unusual presentation of Tuberculosis. That's right, Tuberculosis, TB, consumption.

A disease you just don't expect to get in the UK these days.

The disease that had been previously excluded, but because of its rare type, was still sitting there, incidiously whittling Barry's life away, as we tried to find out what was wrong. Don't underestimate TB; untreated it would eventually have killed him.

Someone, somewhere, sometime, infected Barry but we will almost certainly never find out who that person was. There's no knowing which person's cough carried such a deadly infection.

Although the diagnosis came as a complete shock to all involved, it was also a last minute reprieve and it made us the luckiest people in the world. Infinitely luckier than winning the lottery.

I never thought that having TB could be lucky but, despite everything, we have so much to be thankful for.

Because Barry's TB is outside his lung, he was never a source of infection to anyone else. The only person ever at risk was him.

It's curable.

So, on the days when the treatment means that Barry is too weak to get out of bed, can't eat, can't sleep for the headaches, we still count ourselves very lucky.

In six months time he will be cured. If this had been the cancer we feared, in six months time he would probably be dead.

We're very lucky indeed.

Normal Service Will Be Resumed AS Soon As Possible

noreply@blogger.com (The Singing Doula) — Sun, 10 Apr 2011 09:58:00 +0000

We're in the middle of moving house.

I really wish it was as easy as this:

Instead I'm typing this surrounded by cardboard boxes and wondering how I will fit over 20 years of living here into them.

But the task must be accomplished so I'll be -

Happy Mother's Day!

noreply@blogger.com (The Singing Doula) — Sun, 03 Apr 2011 21:08:00 +0000

HAPPY MOTHER'S DAY

ALL MOTHERS EVERYWHERE

BECAUSE

WE'RE EARTH ANGELS

EVERY SINGLE ONE OF US

Unnecessary Deaths

noreply@blogger.com (The Singing Doula) — Sun, 27 Mar 2011 17:34:00 +0000

It's happened again.

This government, the previous one, and even the one before that, were warned countless times that their failure to ensure adequate numbers of midwives would result in deaths.

They wouldn't listen.

And now another mother and child are dead and a young husband's joy has turned to despair at their loss.

The saddest thing of all is that this entire situation was preventable.

It did not need to happen. It was easily avoidable.

For the story: CLICK HERE

As I understand it, Sareena Ali was admitted to hospital for an induction of labour because she was over 40 weeks pregnant.

Leaving aside the arguments for not inducing birth just because a woman is over 40 weeks, it's what happened next that is so horrifying.

It would seem that the method of induction caused Sareena Ali's womb to rupture. Whilst this side effect is rare, it can happen and is the main reason that women who are undergoing induction are advised to remain in hospital for monitoring so that any problems are detected early enough to avoid this sort of catastrophe.

In short, women undergoing induction are advised to remain in hospital for the safety of themselves and their unborn child.

We all assume hospitals are safe places to birth babies.

Yet, for Sareena, trusting her care providers killed her.

What is worse is that her care providers didn't only fail to monitor her as required by hospital protocols, they also ignored the requests and then the pleas of Sareena, and then her husband, for help as the pain became more unbearable.

They ignored her until she collapsed. They ignored her until it was too late.

There is no excuse. There is no apology that can be made to Mr Ali for the loss of his wife and child.

It was all preventable.

And now we have Averil Dongworth, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust, offering her apologies and trying to tell us what a rare event it is.

Rare event! I should absolutely hope that killing your patients IS a rare event!

Dying as a result of uterine rupture due to induction of labour is extremely rare, but dying in Barking, Havering and Redbridge University Hospitals NHS Trust due to lack of care by its employees is apparently not as unusual as once thought.

And, unfortunately, looking at the list of near misses within this Trust, this tragedy was just waiting to happen. There have been countless warnings about the poor standards of maternity care and yet nothing appears to have changed.

And, you know what, Averil, it's not just about employing more midwives. It's not just about numbers.

It's about employing midwives who actually LISTEN to women. It's about employing midwives who actually give a shit about the women admitted to their unit. I was going to write 'admitted to their care' but it seems some midwives employed in this Trust don't care at all.

I truly hope, as part of its investigation into this matter, that the senior midwifery managers for Barking, Havering and Redbridge University Hospitals NHS Trust take a very long hard look at the attitudes that prevail amongst their midwives towards pregnant and birthing women.

That's what needs to change.

If midwives fail to act as advocates, fail to listen, fail women, then mothers and their babies will continue to die.

For God's sake, let's make the deaths of Sareena and Zainab the wake-up call that maternity care needs.

Let’s Get Rid Of Maternity Beds!

noreply@blogger.com (The Singing Doula) — Sun, 20 Mar 2011 18:43:00 +0000

Our government, whilst busy renaging on its pre-election promises to train and employ more midwives, is also actively looking to reduce the current number of maternity beds in the UK.

You know what? I completely agree with this.

Only not in the way you might think.

I’m certainly not agreement with reducing the current resources in any way for maternity services when it’s obvious they are woefully inadequate any.

No, indeed. My issue is with these:

That’s right – the beds themselves.

It’s these monstrosities that I want to get rid of.

Why?

Because they are detrimental to positive birth outcomes.

Let’s face it, we’re conditioned on seeing a hospital bed to don a backless gown, get into the bed and lie there quietly, on our backs, awaiting whatever comes next.

That’s all precisely what a birthing woman doesn’t need. Research supports that immobility and restricted movement are associated with higher rates of instrumental deliveries and caesarean sections, and pain is often less manageable.

What a birthing woman does need is to be up on her feet, or on her hands and knees, swaying, rocking on a birthing ball, slow dancing with her partner, anything she wants to do, except be on her back in a bed.

So let’s stop pretending this is always necessary:

And encourage women to give birth:-

On hands and knees:

On a birthing stool:

Squatting:

Standing up:

In water:

Let’s make sure women never look like this when having their babies:

And let’s work together so birth looks like this!

A Rose Tinted View?

noreply@blogger.com (The Singing Doula) — Sun, 13 Mar 2011 19:49:00 +0000

Some one asked a question the other day: –

Do doulas have a rose-tinted view of birth?

I suppose the first thing to clarify is what is meant by ‘rose-tinted’.

It’s generally accepted that to ‘see the world through rose-tinted glasses’ means you see only the good, best or most positive side of things. Alongside this runs the premise that by ignoring the bad and negative aspects, you are being unrealistic and fail to see the world as it really is. In short, you are setting yourself up for a fall.

Is that really true?

Does being optimistic, looking on the bright side and seeing the best in the world simply make one overly naïve and set to be rudely awakened by life’s realities?

And taking this back to doulas – do I, as a doula, have an overly optimistic and somewhat unrealistic view of birth?

I don’t think so at all.

I think, if anything, doulas have a very realistic view of birth because we’re right there as bystanders through the best and the worst of it.

But what does the best and worst of birth look like?

Some people might think that the perfect birth is one where an earth mama has her baby without any interventions, roaring in triumph as her child emerges.

The worst might be where something goes terribly wrong and mum and baby are saved within a hair’s breadth of their lives.

Perhaps I see things somewhat differently.

For me, the best births are the ones where regardless what happens or what interventions are needed, no matter if a baby is born vaginally or by section, that mum remained in control. Her dignity and right to be involved was respected. Her needs were given credence; her voice was heard. She gave birth; birth wasn’t something that happened to her.
These are the births that define what we continue to strive for until they become the norm, not the exception.

And the worst births are, of course, the reverse of this. I have listened to and read the stories of so many women who are traumatised by what happened to them. I’m talking here, not of the outcome of the birth of their child, but how they were made to feel by their care providers during that birth. These are women who were left terrified because no-one took the time to explain what was going on; the women who were talked down to and ridiculed; the women who were assaulted by people they thought they could trust; the women who many years later only remember the birth of their child as a time of pain and terror; the women who believed with absolute certainty that they were going to die and not one person gave them comfort; the women who, decades later, still cry and shake when they try to tell you what happened to them.

So, no, I don’t think I see birth through rose-tinted spectacles at all.

But I do see birth in colours.

Azure blue is the colour of my faith in women and the strength of femininity.

Gold is the colour of my absolute belief that every woman has the resources within herself to birth her baby in her own unique way.

I take those colours with me to every birth I attend and I wrap them around women like an aura. These colours burn within me like a flame so even when you lose faith and belief in yourself, I never do.

It’s that flame that drives me to show women how to advocate for themselves so they can ensure they are heard and respected in their choices.

It’s that flame that drives me to work alongside other dedicated professionals to change things for the better of all.

It’s a flame that will never go out; it burns clear and bright and there’s not even the smallest tint of rose about it.

Oh, For God's Sake!

noreply@blogger.com (The Singing Doula) — Sun, 06 Mar 2011 22:06:00 +0000

To the members of the Kings Fund health policy thinktank - how about you try unwedging your heads from your rectums?

The increased blood flow to your shared brain cell can only improve your thoughts. If not, perhaps you could just drown yourselves in your own tank so the rest of us don't have to read about your crass idiocy.

Your latest little gem - hospitals should use volunteers in busy maternity units to ease the pressure on overworked midwives.

Click here to read the article in The Observer

What fool thought that up?

You actually think that it's acceptable for just any volunteer to give breastfeeding support? I don't think so.

You actually believe that it's safe for an untrained volunteer to make clinical observations about a labouring woman instead of a properly trained health professional?

Who's going to train the volunteers?

Who's going to supervise the volunteers?

I bet the litigation lawyers are rubbing their hands with glee at this very moment.

Has the thinktank considered this very simple solution to the problem?

TRAIN AND EMPLOY MORE MIDWIVES!

You know, those 3,000 midwives that David Cameron promised to the Royal College of Midwives pre-election.

That promise that he has now renaged upon.

Personally, I think you'd be better employed thinking up ways to get us a decent govenrment that is genuinely commited to health care, but that's just me.

Inspirational Words From Will Smith

noreply@blogger.com (The Singing Doula) — Sun, 27 Feb 2011 17:30:00 +0000

I remember Will Smith when the Fresh Prince was first shown on TV. I've liked some of his music and enjoyed some of his films but never really thought about Will, the person, behind all of that.

And then I saw this clip the other day.

What an inspiration this man has become.

I really think this clip should be shown at every morning assembly in every school in the UK.

How great our children would become in the knowledge that everything is open to them if they just reach out and believe it can be so.

Amazing words.

Oh dear, Kirsty Allsop has a rant

noreply@blogger.com (The Singing Doula) — Sun, 20 Feb 2011 21:03:00 +0000

Of course, she's entitled to her opinions, but if you're going to rant it helps to get your facts straight if you want to be taken seriously.

Photo taken by Geoff Pugh

Here's what Kirsty had to say about having a Caesarean section:

Kirsty's point of view

So essentially Kirsty feels that:

Women who have Caesarean sections are stigmatised.
Let's be fair, I'm sure some women are treated differently and made to feel that somehow they have failed, and that certainly needs to change. However, it's certainly not something I've seen happening to the majority of women having sections, so I feel Kirsty is wrong to imply this happens to all women having this surgery.

The NCT are failing to ensure that parents attending their antenatal classes are being fully informed about Caesarean sections.
Again, I'm sure this may happen now and then. But again, to suggest that the NCT is failing all parents attending its classes by not discussing sections enough is untrue and unfair.

Also the NCT does NOT suggest to anyone that they ignore medical advice.

Kirsty argues that as 25% of women have sections, the NCT should be paying far more attention to this surgery and ensuring parents-to-be are 'properly' informed.

But there's a deeper issue to all this that Kirsty hasn't grasped.

Our section rate in the UK is actually 27% and has increased steadily over the last 20 years and continues to rise. This is becoming a source of immense concern to maternity health care providers.

Caesarean sections save lives - there is absolutely no dispute about that at all.

But sections also carry significant short and long-term risks for both mother and child, and there's no disputing that either. The research supports it categorically.

The issue is trying to find the balance between the number of sections that are genuinely needed to save lives, and the percentage that are not.

That's a shock isn't it? That there is a percentage of sections done in this country that might not have been neccessary?

The WHO states that any developed country should have a c-section rate of around 10% and preferably not more than 15%. Yet the UK rate is running close to double that. So, how can up to 17% of women possibly be having unneccessary Caesarean sections? Let me explain:

Research has established that some of the interventios that are becoming routine in childbirth are more likely to end in a Caesarean section.

Induction of labour is the prime culprit here. If we want to reduce Caesarean section rates in this country all that has to be done is to stop routine inductions without a valid medical reason. Inducing a woman just because she's over 40 weeks is the classic example here.

Whilst any woman who needs an epidural during birth should have one, we also have to accept that epidurals contribute to increased section rates.

Continuous feotal monitoring is still routine in many maternity units despite the fact that research shows that its only consistent outcome is increased section rates, not saving the lives of babies as supposed.

It seems the more we interfere with childbirth, the higher the section rate soars.

One only has to look to the USA to see what will happen - the USA has an escalating section rate, yet its maternal death rate is also increasing. This suggests that sections are not always saving lives, but are contributing to deaths.

Over here, most NHS Trusts and Local Health Boards are actively putting plans in place to reduce their C-section rates. How do they do this?

By looking at ways to normalise childbirth.
By looking at ways to reduce unneccessary interference during a natural process.
By looking at ways to encourage women to trust their own bodies and their ability to birth their babies themselves.
By finding ways to minimise the risk of having to do surgery in the first place.

Pretty much the same philosophy as the NCT when you think it through.

Birth is not a medical intervention. Our section rate is as high as it is because we, the UK nation, don't believe birth is natural, normal physiological event anymore.

Having a section is not to be taken lightly. It's major abdominal surgery yet, to many women, it's portrayed as some sort of easy option. Any woman who's had a Caesarean will tell you it's anything but easy.

Therefore, it makes sense to avoid it at all costs, to educate yourself in all you can do to birth vaginally.

And sometimes that does mean questioning your care providers. Like the doctors who told you, Kirsty, that you would suffer a "definite rupture".

Did you actually ask them exactly what was meant by that? Because a blanket statement like that is simply not true. It may have been perfectly possible for you to have birthed your second child vaginally, depending on your individual circumstances, of course.

So, as a nation we need to start working together; childbirth is everybody's business.

All of us have a responsibility to help reduce the section rate in our country.

That means parents-to-be have a responsibility to ask their care providers for ALL the information needed to make informed choices, not just swallow everything they're told without question.

It means women have a responsibility to educate themselves in ways and means to manage their own births to ensure their needs are met, and the risk of a section reduced.

It means that the rest of us have a responsibility to encourage all pregnant and birthing women to believe in themselves and their ability to birth.

And when a section is the right outcome, we all have a responsibility to ensure that women undergoing surgery are just as supported as anyone else.

Happy Valentine's Day

noreply@blogger.com (The Singing Doula) — Mon, 14 Feb 2011 19:20:00 +0000

Sending love and positive vibes to the world.....

....in chocolate, of course.....

Great Things About Welsh Maternity Services!

noreply@blogger.com (The Singing Doula) — Sun, 13 Feb 2011 19:14:00 +0000

At a time when there are so many complaints and concerns about maternity services in the UK, let's have a look at some of the positive things going on in Wales.

First of all, Wales leads the way with the highest home birth rates in the UK.

Wales Delivers On Home Birth Rates

This isn't about the pros and cons of home birth. It's about the fact that women must have choice in choosing where to give birth.

There's no right place for all women to have their babies. It's a lot more complex than that. Hospital isn't always safer, or cheaper. Homebirthing women don't take midwives away from women birthing in hospital - if anything it's the way around. It's a matter of what is right for each woman according to her individual needs and situation.

That's why it's important that home birth remains an option in maternity care.

Well done to Welsh Maternity Services for ensuring that women's choices are upheld.

And now to Abertawe Bro Morgannwg University Health Board where midwives have won an award for their support of breastfeeding women in their care.

Welsh Midwives Win Mothercare Award For Supporting Breastfeeding

"The midwives and a group of dedicated mothers have over the last four years transformed themselves from a mothers supporting team midwives to a charitable trust supporting breastfeeding mothers. These area covers South Wales’ valleys and coast. Currently, there are eight peer support groups led by peer leaders; and 75 peer trained peer supporters."

What a great achievement considering the appalling breastfeeding rates in the UK. It's estimated that only 24% of women are still breastfeeding at 6 months and only 1% are breastfeeding exclusively despite WHO recommendations. A much cited reason for this is that breastfeeding women feel unsupported both practically and emotionally. We have to accept that breastfeeding as a mothering skill has been lost to two generations of women. Consequently, in order to learn how to breastfeed their own babies, women need knowledgeable, skilled help and support. Abertawe Bro Morgannwg's project has ensured that this has happened.

And a word of praise for Peer Supporters - all are women with personal experience of breastfeeding, and all give freely of their time and energy in order to support new generations of breastfeeding mums. Thank you Ladies, you're stars, every one of you!

And just to make your heart melt here's a lovely picture of a future breastfeeding mum:

Please Complete This Survey Looking At The Promotion Of Breastfeeding In The UK

noreply@blogger.com (The Singing Doula) — Sun, 06 Feb 2011 17:30:00 +0000

Pretty much was it says in the title, people!

Here's the link:

http://www.surveymonkey.com/s/breastfeedingpromotion

The only criteria to be eligible is:

You must be pregnant or the parent, (mum or dad), of a child between 0-36 months old.

The point of the survey is to garner information from parents themselves to look at how breastfeeding is introduced, supported and promoted to parents living in the UK straight from the horse's mouth, as it were.

There's a huge amount of breastfeeding information that comes to parents from health professionals, the NHS, other organisations and the government.

But how useful is it? How supportive is it? How has it influenced your decisions and choices around breastfeeding your child? Has it made your breastfeeding journey better or worse?

This is what the survey hopes to establish - what parents think.

To date, Dr. Amy Brown has had 700 replies but more are needed.

Especially from DADS!

So, come on menfolk, we need the male perspective on breastfeeding.

Nothing from this survey will be wasted. Amy's intention is to utilise all the information to help both health professionals and parents find their way through the myriad of truths, myths and choices around breastfeeding your children.

So, please don't think you have nothing to say, your opinion is highly valued because parents, collectively, have more experience in the nurturing of children than anybody else in the UK.

Come and tell us your point of view - it does matter!

The Changing Face Of Welsh Maternity Care - But Will Anything Actually Change?

noreply@blogger.com (The Singing Doula) — Sun, 30 Jan 2011 19:50:00 +0000

The Welsh Assembly has just announced the publication of a draft document - Strategic Vision for Maternity Services in Wales:

http://wales.gov.uk/newsroom/healthandsocialcare/2011/110126maternity/?lang=en

You can view the entire document here:

http://wales.gov.uk/docs/dhss/consultation/110124summaryen.pdf

Of course this is a hugely positive step forwards for maternity care in Wales.

But, I do wonder, HOW these changes are going to be implemented in terms of interacting and communicating with pregnant and birthing mums and their families in order to change behaviours.

The draft picks out that being over-weight, smoking and excessive alcohol comsumption during pregnancy are all key issues in poor outcomes for both mothers and babies.

I don't disagree with that for a moment.

The statistics show that rates for all these issues are higher amongst Welsh mums when compared with mums in other parts of the UK. I don't dispute that either, and fully recognise the need to address this.

It's just that these issues have been highlighted for some time now; there are any number of strategies, protocols, groups, clubs and self-help organisations in place to encourage women to loose weight, stop smoking and drinking alcohol during pregnancy and before conception. Yet, rates remain high.

Unfortunately, whilst the intention is to help, most people feel like this when the NHS tries to aid in making life style changes:

My concern is that if more money is thrown into addressing these issues in the same way, without changng the plan of attack as it were, then that money will be wasted.

I will be adding sending my comment on this draft to the Welsh Assembly and I will asking these questions:

How are you going to change your approach to addressing these issues because it's obvious that current strategies don't work?

Have you considered that new approaches might require more staff, most of whom would be midwives, BEFORE you decide current staffing levels are adequate?

Have you thought of actually asking pregnant women what they feel might be the most effective way to help them loose weight and so on, instead of assuming you already know?

But really my key point will be this:

If your plan isn't working then get a new plan. Simples!

And Following Up From My Post Of January 14th 2011.....

noreply@blogger.com (The Singing Doula) — Thu, 20 Jan 2011 00:46:00 +0000

Have a look at this:

http://www.bmj.com/content/342/bmj.c5955.full/reply#bmj_el_248152

I read an interesting comment that was an adjunct to one of the newspaper 'articles' on this subject. It was written by a retired, (I think), GP who was under the impression that the BMJ could only possibly publish robust clinical evidence and, therefore, the Frewtrell et al paper must be sustantive and meaningful.

Oh dear, his face must be as red as the reddest of blushing tomatoes.

Obviously other BMJ readers don't agree with him. And looking at their qualifications and the standard of their critique, I'd say they know what they're talking about.

At the end of last year the BMJ was suggesting that the Wax study was a valid reason for advising pregnant women against homebirth.

Now this.

Perhaps, if the BMJ wishes to continue to be seen as a publication to be taken seriously, its editors might want to consider the calibre of the articles it publishes, and the recommendations it makes on the back of those articles.

I hope the BMJ is going to apologise to UK parents for its contribution to the confusion and chaos this article has generated. The BMJ editors chose to publish it. Did they not review it first? How could they not notice its flaws and poor quality? Or consider the fall-out it might cause?

Or was this a case of even bad publicity is still publicity?

The people of Britain are waiting for an explanation.....

Are You A Cat Or A Dog Person?

noreply@blogger.com (The Singing Doula) — Sat, 15 Jan 2011 22:54:00 +0000

I'm most definitely a cat person, despite the fact we have an elderly dog called Bob.

And, I'm forced to admit, though never in Bob's hearing of course, that when he shuffles off this mortal coil, having another kitten or two about the house will be on my to-do list rather more quickly than true mourning should allow.

It's not that I don't like dogs, I do. It's just that I prefer cats. I feel I have more affinity with cats.

Despite their aloofness, their picky eating habits, the destruction of prized possessions and their habit of leaving of bits of dead things around to be trodden on by bare feet, I like having cats around the house.

Cats live in your house in an ethereal kind of way. You know they're there but you don't always see them. It's a bit like having a house elf but without any housework or ironing getting done unless you do it yourself. You know this is wrong but you're so overjoyed at having a house elf, you don't care. And so it is with cats.

On the other hand, you most definitely know you live with a dog, usually because he is resting heavily on your feet no matter what you're trying to do. Of course dogs have their uses - Bob always lets us know if some one's at the door. He also lets us know when some one isn't at the door often around 2am. And, if we don't like someone, Bob will adore them which means we can smile smugly at each other when said person leaves our home covered in dog hairs and Bob drool. There's no better payback than knowing someone you loathe will spend the next week trying to get white dog hair off their best black trousers.

But while dogs are vastly entertaining, I miss not having a cat around.

There is no-one to cut me down with a withering glare of contempt when the food bowl is empty.

There is no puzzled face asking me to explain how it can possibly be raining outside both the front AND back door at the same time, after having insisted I open both for the purposes of checking. After all, one cannot trust a human's judgement in such matters of importance. Wet paws are not to be borne!

There is no waking in the night to find a warm, purring little body keeping my feet warm. Or waking me up at 5am by licking my face because said body now needs a wee or possibly just an early morning stroll.

There is no-one to humour me by dashing after rolled up paper balls and madly twitching bits of string. My husband refuses to play which I think is rather mean of him.

And, of course, of greatest import is that cats really, really don't like chocolate which means I don't have to share at all.

Yes, I really miss not having a cat about the house.

Why Don’t We Let Our Kids Choose?

noreply@blogger.com (The Singing Doula) — Fri, 14 Jan 2011 21:23:00 +0000

Well, well, yet again the media is awash with claims of another swipe at breastfeeding.

Today’s controversy was sparked off by this little gem around the issue of exclusively breastfeeding up to the age of 6 months before introducing complementary foods , and the possible harm this might cause:

http://www.bmj.com/content/342/bmj.c5955.full

Essentially, these four authors have produced, not a valid research trial, but simply a small, selective review of current evidence and came to the following conclusions:

Areas of clinical concern over recommendation to breast feed exclusively for six months

Evidence challenging the adequacy of breast milk as a reliable sole source of nutrition to six months

• Higher risk of iron deficiency anaemia (identified in data from the developing and developed worlds) known to be linked to irreversible adverse mental, motor, and psychosocial outcomes. The lack of a screening programme in the United Kingdom to detect such adverse population effects is a further concern

• Concerns over a higher incidence of food allergies

• Higher risk of coeliac disease, with concomitant long term complications

But what the authors then go on to say is that although these areas are raised as concerns from the review of current literature, there simply isn’t enough valid clinical research to be absolutely definite in saying these are reasons to change current WHO and UK guidelines.

In short, there is no substantial clinical evidence to support that introducing any baby to solid food before the age of 6 months will reduce these risks or make a difference to a child’s long term well-being.

I would also take specific issue with the argument that breast-fed babies, particularly exclusively breast-fed babies, are at a higher risk of developing iron-deficiency anaemia.

Why?

Well, first, let me say that I don’t dispute that iron-deficiency anaemia can be linked to poor developmental outcomes. That bit’s fair enough.

My issue is that to extrapolate this statement to imply that any baby with low Haemoglobin (Hb) and Ferritin levels must be at risk of poor development is wrong because this simply is not known and cannot be bandied around as a fact.

To my mind, the reason we don’t know is because no-one, to my knowledge, has bothered to:

A) Investigate whether or not these apparently low levels in breastfed babies are actually a perfectly normal physiological phenomenon.

B) Investigate breastfed babies with apparently low Hb/ Ferritin levels to see if they are unwell or if their development is affected and to what degree. Let’s face it, poor development caused by nutritional deficiency is very complex and unlikely to be caused only by not enough iron in breastmilk..

C) Compare the development between babies whose Hb/Ferritin levels are supplemented in addition to their usual milk intake and those who are not.

D) Look at breastfeeding mums. It’s established that a woman’s body will leech whatever is needed to ensure her breastmilk contains adequate nutrition for her child. Therefore, if a breastfed baby needed more iron, then the mother who have that iron taken from her body would, to my mind, eventually become ill. Yet I’ve never seen one recorded case of such an event.

E) Compare early cord cutting, (which can deplete a newborn of up to 40% of its blood volume including Hb and Ferritin), delayed cord cutting and the relationship to Hb and Ferritin levels in babies.

Is it to be accepted that millions of women for thousands of years, allowing for natural selection and survival of the fittest, have failed to produce breastmilk with enough iron for the well-being of their children and the long-term survival of the species? I think not.

It makes the premise that because babies in poorly developed countries may present with anaemia that this is a valid reason for giving all babies in the UK iron supplements somewhat ludicrous. Don’t you think?

Breastmilk gives long term protection against infection – that’s a given. I’ve never heard of a child dying from breastfeeding related anaemia. What would YOU choose? What do YOU think is more likely? That your child might die due to infection? Or that your child might die due to iron deficiency anaemia related to breastfeeding? Isn’t that a good enough reason to carry on exclusively breastfeeding if your child is indicating that he or she is not ready for solid food?

And, oh yeah, article authors – if you really want me to take you seriously, don’t try to tell me that not weaning an exclusively breastfeed baby by the age of 6 months means that child won’t eat leafy green veg later in life. Puh-leese!

Anyhoo, back to the issue in hand – these authors aren’t telling us anything new at all. They’re just saying they’ve looked at selected research and it might suggest that an earlier introduction to solid food could be benefical, but no-one knows for certain until more research is done.

Yeah, thanks for that.

So why did they write this article? As a colleague said – maybe they wrote it just to get published in the BJM.

It’s a good point, but actually I’m starting to wonder if there’s a much darker side to this.

Three of the four authors of this article have declared their interests with formula milk manufacturers.

And what better way to promote your own interests than by publishing an article full of innuendo, half-truths and unknowns and then calmly sitting back and watch the media do all your dirty work for you?

Ah yes, the media. Let’s give them a hearty congratulation for failing to see they’ve been suckered over royally, and have upset and confused the majority of parents across Britain into the bargain.

A lot of people only read headlines but don’t read the story. So picking out words and phrases from today’s headlines on this issue and we see: “breastfeeding”, “harmful” , “not best”, “cause allergy”, “exclusively breast-feeding for six months 'causes allergies’ ”, “breast is not best”.

Media people, what exactly do you think you just told the UK about breastfeeding? You just fired off all the formula manufacturers' bullets for them.

Restrictions on formula advertising? Pah!

Formula manufacturers will be chortling all the way to the bank after the superb job you just did on ‘dissing’ breastfeeding.

http://www.medicalnewstoday.com/articles/213696.php

http://www.dailymail.co.uk/health/article-1347006/Breast-feeding-6-months-causes-allergies-warn-British-researchers.html

http://www.thesun.co.uk/sol/homepage/woman/health/health/3351004/Breast-milk-can-put-babies-off-food-cause-allergy-says-study.html

http://www.guardian.co.uk/lifeandstyle/2011/jan/14/six-months-breastfeeding-babies-scientists?

And what about the kids, our babies?

Because at the end of the day this is actually about our children.

I’m getting rather tired of various ‘experts’ in childrearing and parenting telling us that ‘every child is an individual’ and then proceeding to inform us that ‘your child should be doing X,Y or Z by this date or age.

When it comes to weaning why don’t we just let the kids choose?

Babies are actually very smart little people. This is almost certainly because they can’t read newspapers or clinical research. Or perhaps because they only read on the toilet.....

They will show you very clearly when they’re ready to start solid food. They don’t need to begin eating solids just because they reached a specific date. Breast milk doesn’t expire just because your child is 4 months old today.

Children need to begin solid food when they are ready. Let me repeat that:

WHEN THEY ARE READY.

Why don’t we try listening to our children instead of the media who haven’t a clue. Why don’t we ignore so-called experts who don’t give a damn about our kids and just want to promote themselves and their own interests.

Come on, nation, get a grip and listen to the children.

Need To Get My Mojo Working

noreply@blogger.com (The Singing Doula) — Sun, 09 Jan 2011 23:16:00 +0000

Etta James once sang:

"Got my mojo workin', but it just won't work on you"

My problem is my mojo ain't even working for me, never mind, you!

I'm not sure if this is the post-Christmas blues or that, really, I need to hibernate until March.

Either way, my zest for the written word is nowhere to be found.

Which, when you write a blog is a bit of a bummer to say the least.

So, I'm going to set myself some writing goals:

1. Update my doula hand-outs and contracts by Wednesday next week.
2. Three proper blog posts, not whinging posts, by next Sunday.
3. Finish the two missing articles for my website by the end of January.

I shall do this!

I shall conquer!

'Veni! Vidi! Victi!' and so forth.

I am motivated!

I think.......

First Post Of 2011

noreply@blogger.com (The Singing Doula) — Sun, 02 Jan 2011 22:15:00 +0000

Well, here we are - my first post in 2011.

I feel this should be a moment of revelation accompanied by fireworks and tinkling cymbals.

But it isn't.

It's a very peaceful moment but also one of quiet determination to continue to do I can to improve the lot of pregnant and birthing women.

Only yesterday, Cathy Warwick commented that by reneging on his promises, David Cameron may well place birthing women and their babies at risk.

http://www.guardian.co.uk/commentisfree/2011/jan/01/midwives-safety-compromised-david-cameron

Not really a good start to the year for the government, is it? To be actively failing our country's future.

Because these babies are our future. They are the hopes and dreams of us all.

Wouldn't you think that as the most precious commodity we have that we want to take much better care of them?

Don't you think they deserve the best and safest start to life that we can give them?

Obviously our government does not.

But I do, and so do many other people like me. And we're all going to carry on chip, chip, chipping away at the situation until it resolves into what it should be - one to one midwifery care for every pregnant and birthing woman in the UK; the normalising of birth for every pregnant and birthing woman in the UK; the protection of maternity services for every pregnant and birthing woman in the UK.

Merry Christmas!

noreply@blogger.com (The Singing Doula) — Sun, 26 Dec 2010 17:39:00 +0000

Merry Christmas

And

Happy New Year!

As an aside I've just watched all the episodes of 'One Born At Christmas' on Sky Plus. What I still find annoying and, well actually, totally aggravating is the lack of skin to skin between mums and their newborn babies.

Why does the western world have this obsession about separating mum and babies with towels, clothes, distance, protocols and the compulsive need to weigh and measure? I'm not talking here about poorly babies but your average, perfectly healthy baby who just needs some peace and quiet to adjust to his new world from the safety of his mum's arms.

Here's what skin to skin looks like - exactly as it says - nekkid baby on nekkid mum, then cover them up and leave them alone!

Even Dad's can do it!

A newborn baby's primary senses is that of smell and hearing. They learn their parents by smelling their skin, by listening to their voices, by being close. Newborn's regulate their own temperature and heartbeat by tuning into mum by being skin to skin with her.

How do we expect them to do that wrapped up in layer upon layer of clothes, wraps, shawls and blankets?

Let's have a New Year Resolution!

Let's make sure all our newborns get their first view of world from the comfort of their mother's embrace wherever and whenever possible.

Let's decree that the need to find out how long this baby is, or how heavy, can wait while mum and child get to know each other in those magical first minutes that only happen once every new lifetime.

Let's just breathe along with each new arrival and enable the beginning of a new life to be a time of serenity and peace - and nekkidness!

A Few Of Our Family Festive Food Favourites

noreply@blogger.com (The Singing Doula) — Sun, 19 Dec 2010 21:19:00 +0000

Like the title says these recipes are old favourites that come out time and time again for celebrations, holidays and just when we fancy a treat.

Alas, no pictures of my own yet, but I will take some and add them later. The current pictures are just to give you an idea of how the dishes should look.

I'm posting this first recipe especially for my friend Amy.

American Apple Cake

My mother first made this when I was a child. I think the original recipe was in a Marguerite Pattern or Mary Berry baking book, but I'm not sure. Essentially this is sheet cake with a scone base. The scone has a hint of cheese then it's overlaid with slices of apple and topped with dark brown sugar and cinnamon.

First of all:

You need a standard sized swiss roll tray around 12" x 9" - lightly greased

Heat your oven to 200°C (Gas mark 6)

Ingredients:

10oz (285g) self raising flour                   At least 4 eating apples
1 level tsp baking powder                       (I usually use 6)
1oz (30g) castor sugar                            2oz (60g) dark brown sugar
Large pinch of salt                                   (It does need to be dark sugar)
4oz (115g) butter/ cooking margarine       Ground Cinnamon to taste
2oz (60g) grated hard cheese                   Ground Ginger, Cardamom and
( I use mature cheddar)                           Nutmeg can add variety
¼ (140mls) pint of milk

Method

Sift together the flour, baking powder, sugar & salt
Rub in the butter/ margarine until the mix resembles breadcrumbs.
Mix in grated cheese
Add enough milk to mix up to a soft dough. So, don't throw in the whole quarter pint. Add about half of it and then bit by bit until the mix is right.
Knead on a floured board until it's not sticky any more. Be gentle as you want to keep some air in it.
No need to roll this out. Plonk it into the swiss roll tray and pat and push it to line the whole tray evenly.
Peel and core the apples and slice them thickly.
Now line the dough with overlapping slices until all of the base is covered.
Mix the dark brown sugar with the cinnamon. I add pinches of nutmeg, ginger and cardamom for extra spiceyness. Go gently with these extras as you want to keep the spiceyness rich and smooth to compliment the apple.
Sprinkle the sugar and spice mixture evenly over the apples.
Bake for 20-25mins.

(I always bake this with another bigger tray or piece of foil underneath to catch the sugar as it melts and drips - saves having to clean the oven later.)

This tray bake freezes beautifully. When I defrost my current batch I'll post my own pic for you.

This is gorgeous warmed through and served with whipped cream or vanilla ice-cream.

Here's a pic showing how this Apple cake should look. Mine always looks a lot darker because of the brown sugar and spices.

The next dish is one I have made every Christmas Eve since we got married. It's OUR Christmas ritual and this is probably the only thing I only make at Christmas and never at any other time of year.

Prawn Chowder

Again, it was my mother who made this chowder first. I have no memory of where the original recipe came from, other than it is also probably American and a variant of a traditional clam chowder.

This does take a bit more preparation and I often make this over two days. This chowder tastes much better if made the day before and kept refrigerated.

Ingredients

For the stock:
At least 2lbs (900g) of prawns WITH THE SHELL ON - this is very important
1 onion, 1 carrot, Bay leaves, Black pepper

For the chowder:

At least 1lb (450g) of good quality potatoes ( I use Maris Piper)
1 large fresh leek
Extra prawns - as many as you like - well drained
Double cream - between ¼ - ½ pint (140 - 280mls)
Salt & pepper
Around 2oz (60g) butter

Check you have a large, fine-mesh sieve and big enough pans before you start. I use a huge stock pot to make this. Don't forget you need a big enough bowl to hold all the stock when you drain from the pan through the sieve.

Method:

The method may be a bit vague particularly with regard to quantities. I've cooked this for so many years I make it almost by instinct so I don't measure out anything. The traditional chowder recipes often include sweetcorn. I don't, simply because I prefer it without, but you could always add sweetcorn if you wanted.

Making the stock:

You're going to use the shells from the prawns as a base for the chowder stock. So, the first long and boring task is to meticulously peel all the prawns. Save the prawns themselves for later and put all the shells, heads, odd legs and so on in a large pot.

If you don't know how to peel prawns, then this lovely Australian gentleman explains all:

Peel and quarter the onion and carrot and throw them in with the shells and add 4 or 5 Bay leaves.

DON'T add salt yet.

Slowly bring the whole pan to the boil and then simmer for around an hour. If you're a purist, you can skim the stock to get a clearer liquid. If you're like me, then you don't bother and just stir the stock now and then.

Check your stock for flavour. If it seems a bit watery tasting then turn up the heat and reduce it until you have the flavour you like. You want at least 2L of stock. You can always freeze what you don't use.

Leave the stock to cool slightly, then drain it through a fine sieve and put safely to one side. Note: If you don't use a fine sieve you'll end up with bits of prawn shell in the finished chowder which gives a somewhat unpleasant, crunchy consistency, similar to eating egg shells. Best avoided I think!

Making the chowder:

Wash and finely chop the leek. (You can use onions but I feel leek gives a more delicate flavour).

Melt butter in a large, heavy base pan and gently sauté the leek.

Peel and cut the potatoes into small cubes around an inch square. Now, I've said at least 1lb of potatoes, but it all depends on the size of the pan and how much stock you have. I aim to have enough potatoes so that when I add the stock, the potaotes fill the pan to about an inch below the surface of the stock. So, you may need to add extra once the stock is in the pan.

Add the potatoes to the leek and butter mixture and sauté for a while but don't let the potaotes brown.

Add the stock so the poatoes are covered by about one inch of stock. Add more Bay leaves and black pepper. Add more potatoes if needed.

Bring to the boil then turn down the heat and simmer gently until the potatoes and leek are soft but not mushy. Keep an eye on things as you don't want your stock to over-reduce so you have to add water.

At this point, you can stop, cool the chowder and freeze it if you're being super-efficient and cooking ahead.

Otherwise, add the double cream. Again, you need to judge according to how much of the base soup you have, and according to taste. You want to add enough cream for a rich, smooth chowder but not so much that it becomes a somewhat sickly cream soup. If in doubt, add little by little, stir and keep tasting.

Don't let the soup boil once the cream has been added.

Add the prawns - the ones you peeled plus as many extra as you like; just make sure they're well drained.

Stir, leave it to rest with the heat off. NOW check the seasoning - this is the time to add salt to taste.

I always serve this chowder the garlic bread.

Onion Dip

This is an original Philadelphia cream cheese recipe and can be found in a very tattered little company booklet that must date back to the seventies at least, and belongs to my mother. I've adapted this slightly to suit my taste but everyone in our entire family loves this dip; our friends and neighbours love this dip; people we only just met at parties love this dip.

It's very easy to make and is a staple for every get together, party and celebration in our family.

Ingredients:

4 x 250g packets plain cream cheese - MUST BE FULL FAT AND NOT FLAVOURED
1- 2 large heaped tablespoons of good quality greek yoghurt - NOT that yukky thin, sour 'natural' yoghurt
(You can use Cremé Fraiche as well)
1 dessertspoon lemon juice
1 small onion
Salt to taste

Check you have a grater with a very fine mesh

Method:

Mash the cream cheese in a bowl until smooth.
Add the yoghurt and lemon juice and mix until completely smooth
Peel the onion and grate on the fine-mesh grater. What you want is the onion juice and the onion pulp. This will not work with bits of onion, no matter how finely chopped. The point of the juice and pulp is to add flavour while keeping the mixture as smooth as possible. If your dip has little lumpy bits of onion in it, then your grater is not fine enough.

Add at least a dessertspoon of juice and pulp. Add more if you want a stronger onion flavour.

Salt to taste.

The dip should be pristine, creamy and as smooth as you can make it. A reasonably firm texture - not runny but easy to scoop onto things - similar to peaked, whipped double cream is about right.. If the texture is too firm, just add a little more yoghurt or cremé fraiche.

This is another dish that tastes so much better if made the day before.

I sprinkle on a bit of paprika to make it look pretty and serve with crisps, nachos, crudités, or little cheesy biscuits.

Place on the table and then retreat hastily to avoid being mown down by the ravening hordes.

Enjoy!

Not That I'm Obsessed.....

noreply@blogger.com (The Singing Doula) — Sun, 12 Dec 2010 21:48:00 +0000

I'm convinced that I starved to death in a former life.

Seriously.

At least, that's my excuse for my obsession with food and I'm sticking with it - like icing to a cake.

I am at my happiest when my food cupboards and freezer are full to bursting - stock staples, treats, baking ingredients, huge joints of meat, old favourites and new things to try.

I don't want to eat all this largesse. I want to gloat over it, savour it, prize it and know that, no matter what, I will not go hungry.

Christmas magnifies this need to complete obsession every year.

Easter, birthdays, anniversaries - none of these celebrations bring out my need to hoard food as much as Christmas does.

Every year, round about now, I take an afternoon out with my recipe books, menus and lists, mug of tea at one elbow and bar of chocolate at the other.

I make new lists, new menus, read much loved cookery books and plan my Christmas feast.

Then I sort out my food cupboards, de-clutter my fridge, defrost my freezer and go shopping.

Oh, the joy and total bliss of carefully arranging my purchases; each in its proper place. I get very upset if anyone moves anything or, horror of horrors, tries to EAT a morsel.

Hands off, this is for looking at only!

Eventually I set to and begin the great cooking spree. Christmas week is my favourite time of year as that's when I do most of my baking. The house is warm and redolent with cinnamon, ginger and nutmeg. It's like hibernating wrapped in a blanket of spices.

I never manage to cook everything on my lists. It doesn't bother me. It was never about that.

It was all about the ritual of planning, and in knowing that if I did want to cook everything on my lists then I can. Everything I need is in my kitchen - just in case I feel hungry.

My favourite Christmas memory is just after midnight when Christmas Day is brand new. Everyone is asleep, the house is warm and quiet and still smells delicious. I am standing at the kitchen door having just put the turkey in the oven. It will cook slowly and succulently until I come back down to make Christmas lunch.

With a great sigh of satisfaction, I look around at the prepared vegetables, the biscuit tins and Tupperware boxes full of goodies and treats, my full to bursting fridge and the bottles of wine lined up like soldiers ready for battle.

Then I turn off the lights.

I won't be starving this year and for that I'm very grateful.