Talking to people, exchanging ideas, hearing stories is important to us at WOMBLY. In the first interview we speak to midwife LuiseKaschel:
Luise, you work as a freelance midwife. What is your day-to-day work like?
I support families in the countryside during the sensitive phases of life during pregnancy, around the birth, in childbirth and until the end of the breastfeeding period. The accompaniment takes place in the home environment of the families in order to keep the long journeys with a newborn as short as possible. I offer medical check-ups during pregnancy, with the exception of ultrasound appointments, and advise families on all topics relating to pregnancy, birth and the time afterwards. A good network enables me, if necessary, to get other professional groups on board to support me. Informed preparation is an important cornerstone in the personal decision-making process of expectant parents. In the time after the birth, whether at home, in the birth center, after an outpatient hospital birth, after an operative birth, after a premature birth with subsequent stay in the children's hospital or after a "silent birth", I visit the families daily at first, several times a week and then at longer intervals, depending on the support needs and wishes of the parents.
How important is the profession of midwife and how many births have you already accompanied? How many women cared for?
I think it is extremely important for women's health throughout life to have an independent professional by their side during this particular phase of life. The profession of midwife includes a great deal of medical knowledge of the physiological processes during pregnancy, during childbirth and in the puerperium. In order to recognize abnormalities in good time and to react conscientiously, the knowledge and skills of the midwives are required to guide mothers and their newborns through this phase of life in a healthy way. So far I have probably looked after 1000 families with the most diverse needs and support needs.
6 out of 100 children are born prematurely. What are your experiences with preterm babies? How are the parents and the children doing and what difficulties often arise here?
Most premature births are unplanned. The parents and the children often find themselves suddenly in a situation that was far away for them in their physical and mental situation. In addition, there are often exceptional medical situations that are associated with worries and difficult decisions. Due to premature birth, the start of optimal nutrition with breast milk does not go smoothly. Children are often unable to maintain their own temperature, need breathing assistance, and sometimes have congenital conditions and may need surgery within the first few days and weeks of life. I accompany these children and families at home after they have been discharged from the children's hospital. The mothers are often released from the gynecological clinic after a few hours or days and are then accompanied to the children's ward. Here it is important to me to establish contact with the wives, fathers and siblings. During this phase, you have many questions and urgently need support, which the hospital staff often cannot provide.
Once discharged and at home, it is important to consolidate what you have learned, to gain trust and to dare new paths outside of the clinic. Sometimes children are discharged home with a feeding tube or a monitor to monitor heart and lung function. It is important to these parents to receive support with their challenges but also to regain a certain everyday life. They also wish to be part of the structures in everyday life in this extraordinary situation that arises over weeks, months, years or a lifetime.
Midwives are among the first points of contact in families. The time in childbirth is nice at the same time, but also full of questions and sometimes worries. How to strengthen families who have a less easy start after birth?
Parents are grateful for every good conversation. They do not want to be alone, they are grateful for sympathy. First attempts at breastfeeding, including with cables and hoses, and expressing breast milk are things that you can actively contribute to. There is often great uncertainty among outsiders. The heavy burdens are often seen first, for the parents it is Finn, Eddy, Greta or Fritzi who were born. They don't want to be sorted out like crooked vegetables from the supermarket, they want to be part of the big community that has just become parents of their first, second, sixth or ninth child, which is as different as the eggs are big, small, thick, thin , long, short, spotted, spotted, raised, yellow, white, green, dark green, beige, cream white and brown from my chicken coop - no two are alike.
You have three children yourself. Have your birth experiences changed your perspective on your work as a midwife?
Birth is the beginning, as a mother I know that parenting begins at this point. The birth of my first daughter was accompanied by a wonderful, older colleague. She herself has no birth experience of her own and I admire her appreciative, appreciative manner towards all mothers and fathers. At that time I decided not to be guided by my personal experiences, because every path is very individual, we are all shaped differently and go through different experiences. In my work as a midwife, I have learned that nature does not conform to norms and expectations. That we should have the courage to engage in life that doesn't fit the norm. Many parents prepare themselves intensively for this exciting time with the newborn, some things succeed, but we must always be aware that we cannot influence many things, it comes as it comes and we can learn to live this life that comes .
Wombly creates adaptive clothing for children with disabilities. Be it a gastric tube, an artificial anus or a ventilator, orthoses or prostheses. The garments have snap fasteners on the sides for quick access to the "problem" areas. How important do you find such adaptable clothing and what problems have you encountered in your professional career, especially in relation to impractical clothing?
There is hardly any practical clothing for children with disabilities. Parents often worry about accidentally pulling important cables or hoses. The whole situation is new to them. Many know how exciting it is to handle a newborn. Practical clothing is helpful for full-term babies, premature babies and children with disabilities in everyday life and all the more helpful if they are adapted to their special needs. If the clothing is too big and does not fit the skin, children cool down quickly. You often only find out what is practical when you are stuck in the individual dressing situation. It is all the more helpful to benefit from the experience of others and to be able to purchase clothing that has already been optimized. The easier it is to deal with, the quicker parents have the courage to take care of the often very tender children themselves.
What would you like in terms of the initial equipment for babies with physical disabilities?
It would be nice if the clothes were affordable and/or the parents received unbureaucratic financial support from the health and nursing care insurance companies for the equipment of babies, children and adults with disabilities without any delay. Just recently I heard that every family in Sweden receives a package with basic equipment for their baby. If you do not want this, you will receive financial support worth the initial equipment package. It would be helpful if parents of babies with physical disabilities sent a package with addresses for support, such as the association rehaKind - which has set itself the task of enabling children and young people with disabilities to receive high-quality and individual aids and thus secure the right to active participation . A piece of adaptive clothing could also be included in this pack to show practical possibilities.
Which clothing sizes should definitely be focused on more?
The sizes for small and very small babies with a body weight of 1000g - 3000g. But there is also no age-appropriate selection for young people with physical disabilities.
What materials should garments be made of from a midwife's point of view? Should children's things be rented to become more sustainable?
Rented things are wonderful. They conserve resources, and thus the environment, and are appreciative of those who produce them. Used, more frequently washed clothes contain fewer harmful substances. This is then healthier for our skin. When manufacturing, care must be taken to ensure that the clothes can be washed at high temperatures, since children with disabilities and frequent surgeries have a weaker immune system. Despite all of this, parents find it nice to keep a favorite piece of clothing or two as their own. They secure memories of a special time and tell stories that children in particular love to hear over and over again.
If you could change something about the job description, what would it be?
I wish for less power in our job profile. Knowledge makes you powerful and I experience again and again how colleagues exploit this power and severely hurt women with it. Families find themselves in helpless, vulnerable situations in which they need a shelter. I can't stand midwives who don't recognize this situation and use it to exercise their power.
And I would like a job profile that can develop even more in a healthcare system with less cost efficiency and performance, in its humanity, love and authenticity. Politicians have been called upon for many years to change the financial conditions for self-employed midwives in such a way that their work can be carried out without financial losses due to the constantly increasing costs of professional liability and special legal protection insurance.
Thank you Louise for the interview
Luise has been a midwife since 2011, first in the birth center, then freelance without midwifery in rural areas east of Berlin, married, mother of three children, currently training to become a lactation consultant at the European Institute for Breastfeeding and Lactation / IBCLC.