Local Midwives collectively donate to fund a Student Midwife through “Hamlin Prevention Program”

As many of you are probably aware, the wonderful Catherine Hamlin and her husband Reg founded the Hamlin Foundation over 60 years ago…an organisation focused on eradicating Obstetric Fistula in Ethiopia.

Part of the Hamlin Foundation has set up the “Hamlin Prevention Program” training local Ethiopian women to complete a Bachelor of Midwifery Degree offered at Hamlin School of Midwifery. The Degree runs over four years, and on completion of the degree in Midwifery, graduates return to their communities to use their skills and knowledge to keep their birthing communities safe. Currently less than 15% of women in Ethiopia have a skilled birth attendant at their births leading to high rates of Maternal and Perinatal mortality and morbidity, including Obstetric Fistula.

To date, 170 Hamlin midwives have completed their Bachelor of Midwifery and these midwives assisted with over 30,000 births in the last year alone! And NOT ONE Obstetric Fistula occurred!

Juliana Brennan and Danielle Sorbello (Mamatoto Midwives), Robyn Partington and Lisa Wraith (Yarra Valley Midwives), Louise Noorbergen, Clare Lane, Amanda Schmidt (Embracing Birth), Elizabeth Murphy (The Midwife Collective), and Erin Coggins (Aveta Birthing Services) have jointly committed to fully fund one Ethiopian midwife to complete her full Bachelor of Midwifery over the four years through the Hamlin Prevention Program. Each years funding covers tuition fees, board and meals for the student midwife.

In areas of Ethiopia, where there is a Hamlin Midwife, Obstetric Fistula drops to ZERO!

Thank you so very much to the above named midwives for their wonderful contributions to such a good cause xxoo

Mamatoto’s Outcomes for 2019

It’s a bit late…but I had planned to publish Mamatoto’s Statistics for 2019 then Covid hit, and delayed everything! My priorities at this time was the safety of my Mothers and babies!
So…here goes!
Mamatoto had 48 births in total for 2019.
42% were first time Mothers
58% had had a baby before

54% of Mamatoto’s clients planned a homebirth
46% planned a hospital birth

Looking at all Mamatoto’s clients…
90% of first time Mothers had a vaginal birth
75% of first time Mothers had a spontaneous vaginal birth…
15% of first time Mothers had an assisted vaginal birth…
10% of first time Mothers had a Caesarean Section (last year was 0%)
0% of first time Mothers planning a homebirth had a LUSCS
100% of Mothers who have had a previous vaginal birth had a spontaneous vaginal birth
78% of all women planning a VBAC had successful VBAC’s
2% had a vaginal breech (undiagnosed hospital birth)

When comparing women planning a Homebirth compared to Women planning a hospital birth…
92% planned homebirth had spontaneous vaginal birth compared to
68% planned hospital births…this includes women planning a VBAC.
4% homebirth clients had an assisted vaginal birth compared to 8% planning a hospital birth…
4% women planning homebirth had a Caesarean Section (1 client previous LUSCS wanting VBAC) compared to 24% planning hospital births (A high % of these women had already had a previous LUSCS)

Post Partum Hemorrhoage: >500ml
Home 4%
Hospital clients 12%

Induction of labour:
Planned homebirth – 0%
Planned hospital birth – 9%

Perineal outcomes:
Planned homebirth clients:
39% intact perineum
39% 1st degree tear not sutured
22% had a sutured tear…8% 1st degree tears, 14% 2nd degree tears
0% Episiotomy

Planned Hospital Birth clients:
18% intact Perineum
55% sutured tear
27% Episiotomy

Special Care Nursery Admissions;
Planned Homebirth clients: 6% (1 baby Jaundice; 1 baby TTN)
Planned Hospital Births: 12% (4 babies, all low Apgars with good outcomes)

In summary, 90% of my first time Mothers had a vaginal birth, regardless of planned hospital or planned homebirth.

My clients who planned a homebirth had a 92% spontaneous vaginal birth rate, a 4% assisted vaginal birth rate, and a 4% LUSCS rate. 0% of first time Mothers planning a homebirth had a LUSCS.

My clients who planned a hospital birth had a much lower rate of spontaneous vaginal birth at 68%, but this is still much higher than the Victorian average. I did have quite a number of women with complicated pregnancies planning hospital births. Some of these women knew they would need an elective LUSCS and had a Private Midwife for support and continuity of care.

I had a very high number of women wanting VBAC in 2019 planning a hospital birth. Several of these women decided to have an Elective LUSCS at 42 weeks as they were únfavourable for induction, and they did not want to continue pregnancy to await spontaneous labour.
My other VBAC clients who had repeat unplanned LUSCS all had LUSCS for failure to progress in labour after very long labours, or very long pre labours that did not establish.

In every outcome, my homebirth clients had better outcomes. Lower rates of Caesarean, assisted vaginal birth, hemorrhage, IOL, SCN admissions, better perineal outcomes when compared to my clients planning a hospital birth. They were all at relatively low risk of complications too.

I have had a quick look at Mamatoto’s statistics for 2020 for the first half of the year and they are looking very good. Danielle has joined the team and we are on track for a much higher number of births than in previous years.
A much higher percentage of planned homebirths, about 25 births already, and two of those women have had successful VBA2C…(both in hospital). None of our homebirth clients to date have had LUSCS or transfers for an assisted vaginal birth.

Calmbirth Retreats are back!

Now that restrictions have been lifted, Juliana’s Calmbirth Retreats in the picturesque Yarra Valley are back!

The July course will remain online via zoom, but from here after, as long as further restrictions aren’t enforced, then Calmbirth retreats will be returning to the Yarra Valley, face to face!

To enrol please go to www.mamatotomidwives.com.au

Covid 19 and your plans for birth…

To Our Wonderful Clients and their Families .

Mamatoto Midwives and the Midwives of MMC have been in discussion regarding the corona virus (Covid 19) and how it will impact our model of care.

We would like to advise you of the following-:

We have made the decision to keep providing midwifery care:

  • attending antenatal visits– face-to-face visits will be limited to 10-15 minutes to take your blood pressure and to assess your baby’s growth with the remainder of the visit via phone or zoom.  Clifton Hill and Elwood clinics have closed down…Our Clifton Hill clients will be seen in Kew, and our Elwood clients seen in Hampton…specific details to follow…
  • Supporting women during their hospital birth where the woman’s partner has elected not to be present for the birth.  Hospitals are limiting support during labour to one person.
  • Providing homebirth.
  • Attending essential face-to-face postnatal visits and otherwise Tele-health visits during the postnatal period.

We will be making changes to the way we do things in line with the advice we are being given.  This may include wearing personnel protective equipment (PPE) – goggles, overshirts or gowns, masks and wipe-able shoes.  This is for our and your family’s protection and aimed at minimising the spread of corona virus.

We are strongly advising our clients to stay at home.  Wherever possible seek ways to limit your exposure. Our recommendation is to completely isolate from 37 weeks gestation in your home. This will greatly reduce your chance of contracting Corona virus before your birth https://www.dhhs.vic.gov.au/sites/default/files/documents/202003/Reduce%20your%20risk%20of%20coronavirus_Poster.pdf

Be informed

https://www.dhhs.vic.gov.au/victorian-public-coronavirus-disease-covid-19

If you are concerned that you have been exposed to corona virus or if you are feeling unwell please contact your midwife and call Corona virus hotline 1800 675 398 (24 hours).

If one of the midwives in the group becomes unwell they will be unavailable to provide care – we want to remain well to continue to provide care – however if our workforce is unable to provide two midwives for a homebirth we will have no alternative but to transfer a woman’s care to the nearest public maternity service. 

If you have a cough and a fever in pregnancy, you may be tested for Corona virus. If you test positive, when you are in labour the recommendation is to transfer your care to hospital care. This is more so to keep observation of your newborn.

We are living in very difficult times and as your are aware advisories are being updated daily.  Please contact your midwife if your have further questions or concerns.

Farewell Catherine Hamlin

As some of you may have heard Catherine Hamlin died last week at age 96. Catherine who was an Obstetrician and Gynaecologist dedicated 60 years of her life to the care of vulnerable and marginalised Ethiopian women suffering horrific birth injuries. Catherine performed thousands upon thousands of fistula repairs herself, and taught local women operative procedures and trained locals to be surgeons and carers for these vulnerable women. She also set up a midwifery training school, which Mamatoto Midwives has been financially supporting.

Due to the legacy of her work, hope and dignity remain options for pregnant girls and women in Ethiopia.

Catherine together with her late husband Dr Reginald Hamlin set about eradicating obstetric fistula, a condition caused by obstructed labour which is an entirely preventable condition. Obstetric fistula is a condition whereby there is a hole between the bladder and vagina or rectum. Women with this condition face incontinence, shame, social isolation and chronic health problems.

Obstetric fistula can be prevented by timely access to obstetric care, and delaying the age of the first pregnancy.

Mamatoto Midwives has supported the work of the Hamlin Foundation by donating to the foundation over the years. This support will remain, bringing hope and dignity to Ethiopian women.

Danielle joins the Mamatoto team…

Danielle joins the Mamatoto team. She has been a midwife for 11 years, working in a number of continuity of care models through her career including the COSMOS program at the RWH in Melbourne and Midwifery Group Practice “Birthing in our Community”program in Brisbane working with Aboriginal and Torres Strait Islander families.

Danielle has also travelled internationally and has a beautiful 2yo daughter Daisy…

We warmly welcome Danielle into our team…I am sure you all look forward to meeting her xxoo

Mamatoto extends its clinic to Chirnside Park…

Mamatoto now have clinic rooms in Chirnside Park (Located Outer East Melbourne). We are joining a team of Osteopaths at Koru Natural Therapies. We are consulting all day at Chirnside Park on a Monday. Evening appointments are also available xx

Koru Natural Therapists Osteopaths are specialists in Pregnancy care. They also offer Pregnancy massage.

We are still at Clifton Hill all day on Wednesdays. Call Juliana on 0419253778 for more information…

Mamatoto’s Statistics for 2018

This photo just melts my heart...the true meaning of Mamatoto...it means Mother Baby in Swahili...what effects one also effects the other...

Even though I am on holidays, I have been keen to collate my statistics/client outcomes for 2018. I think it’s important for women to have up to date statistics from their health care provider about their client’s outcomes so they can make an informed choice about the right care provider for them if they want certain outcomes for their pregnancy, labour and birth.

General Outcomes:

To summarize my year, I had a really busy one! I attended 52 births, which is my busiest year on record by far! 25 of my clients planned hospital births and 27 planned homebirths which is a fairly even distribution (some homebirths I attended were my colleagues clients). I included these numbers as some women ask me how many of my clients choose hospital births and how many choose homebirths…

Out of all my clients 31 women had a baby before (Multigravida) and 21 women were having their first baby (Primigravida).

My most interesting statistic for this year is that 100% of my first time Mothers had vaginal births this year (21 women) 81% had Spontaneous Vaginal Births (SVB’s) and 19% had assisted Vaginal births with forceps or Ventouse (Vacuum). 0% required Caesarean Section.

Baby Outcomes:

My clients live baby rate is also 100%, 6% of my client’s babies required Special Care Nursery (SCN) admission, all of these babies were planned hospital births. 0% of my clients planning a home birth required SCN admission.


Birth Outcomes

When looking at all my clients outcomes together; 81% had SVB’s, 10% had assisted vaginal births, so 91% of women had Vaginal births. 9% of all women had a Caesarean Section (5 women). Of these women, 3 had already had a caesarean section before and were planning a Vaginal Birth After Caesarean (VBAC) and two clients were having their second baby…both caesareans were for fetal distress, one at term and one at 33 weeks gestation.

VBAC

19% of all my clients were attempting a VBAC. 70% succeeded (which was lower than last year) and 30% required a repeat Caesarean Section. One of the Caesareans was for a Placental Abruption at term in early labour, One was pre-labour for a 4.8kg baby in a transverse position at term, and the other was for a client with a delay in second stage after a failed trial of ventouse in theatre. My clients attempting VBA2C (all planned hospital births) had 100% success rate.

Medical Intervention:

13% of my clients had an epidural in labour (in hospital of course). Only 6% of my clients had an Induction of labour, and 6% required their labour to be augmented (sped up with syntocinon).

Homebirth Transfers:

Out of all my planned Homebirth clients, 11% of clients were transferred to hospital before birth (either before labour or during labour). 8% were Multigravidas and only 3% were Primigravidas. None of the transfers were for emergency reasons (Fetal distress, bleeding etc).

Perineal Outcomes:

Out of all clients 33% of clients had an intact Perineum (lower than last year), 21% had a 1st degree tear, 15% had an episiotomy in hospital, 0% had an episiotomy at home, 23% had a second degree tear, 2% had a 3rd degree tear (with the use of forceps in a hospital), and 0% had a 4th degree tear.

Birth of the Placenta:

Physiological S3 – Home 70% and Hospital 34% Active S3 – Home 30% and Hospital 66%

Postpartum Haemorrhoages (PPH):

4% of my clients planning a homebirth had a PPH >1000ml. Both women were not symptomatic of PPH. 0% of my hospital clients had a PPH >1000ml.

Waterbirths:

2% of my hospital clients had waterbirths (this is because many hospitals don’t offer waterbirth as an option…only Box Hill Hospital and the Royal Women’s Hospital. 60% of my homebirth clients had a waterbirth.

Shoulder Dystocia:

0% homebirths, 2% hospital births (forceps birth)

In summary, I have a very motivated group of clients, all of them are planning a natural birth. This year I have attended hospital births mainly at Box Hill, RWH, Angliss and Mercy. I have also collaborated more closely with two obstetricians in different hospitals with great outcomes. I have also collaborated very closely during women’s pregnancy with Dr Chris Davenport who I hold in very high regard, and he has offered my clients wonderful support and the utmost respect for their wishes. I also work with an amazing team of midwives who are ‘completely on the same page’ as me and who I trust and love dearly. I really can’t thank you enough Clare and Louise for all your support this year…

My homebirth client numbers have also increased this year, especially the number of first time Mothers planning a homebirth. This I believe is because of the increased interventions in some hospitals, but also because we now have reliable statistics on the outcomes of Mothers and babies in Private, Public and homebirth options in the state of Victoria. Homebirth has been shown to be a very safe option of care for women who are well and healthy with better Maternal outcomes and very similar Perinatal (baby) outcomes.

Homebirth isn’t for everyone though, and some women don’t feel comfortable at home. They are much safer in a hospital if this is where they want to be…but what works very well for my first time Mothers is that I care for them at home until labour is well established, then go into hospital. I do believe that this model of care that I offer at Mamatoto Midwives has improved the birth outcomes of my first time Mothers enormously.

I can also attribute many positive outcomes to my clients who attend my Calmbirth classes. They are completely different to hospital classes and if we are able to help women believe in their bodies ability to give birth, and trust the process of birth, and have a detailed understanding of how stress and a negative mindset can negatively impact on their birth, outcomes and experiences can be different.

My intact and 1 and 2 degree tear outcomes aren’t as good as last year, however I attribute this to a 100% Primigravida vaginal birth rate. My clients rate of severe perineal tears is thankfully very low.

In conclusion, I really want to thank my amazing families, my birth Mama’s, your courage, strength and determination is something to be admired…thank you for trusting me to be your midwife and to HOLD your birth space, Much Love, J xxooxxoo




The real meaning of birth…

What a great start to life this little man has had…and his Mother.  An empowering birth journey, surrounded by people who love them both and genuinely care about them…

Photo taken by Bree Downes Photography…and published with parents permission.

We need to be reminded about the potential dangers associated with directed pushing

The very talented Dr Rachel Reed has recently written a brilliant blog about directed pushing and it’s harmful effects on both Mother and baby. She has also included evidence to support that women need to be supported and

‘allowed’ to follow their own bodies when it is time to birth their babies. Happy reading…

Supporting women’s instinctive pushing behaviour during birth