My Visit with a Birth Visionary, Jenny Smith, UK Midwife

On a recent trip to London, one opportunity that, I had hoped to have, was to meet well-known UK midwife, Jenny Smith. I became acquainted with the work Jenny has done in the field of maternity care, through a YouTube video about the natural caesarean (aka family-centered caesarean) protocol.

I have included this video in each of my labor doula and childbirth educator trainings for years, as part of the Caesarean module. It is such a beautiful example of a family-centered c-section, with the midwife, obstetrician and anesthetist are all working together to create a safe and meaningful cesarean childbirth experience for the birthing person, their partner, and the baby.

Jenny Smith, founder of the Jentle Birth Foundation, is the producer, narrator, and midwife, featured in the video: “The Natural Caesarean: a woman centered technique”.

I felt motivated to contact Jenny, to tap into her passion and success in making progressive change in UK maternity care. So, I corresponded with her, by email, telling her a bit about my background, as a long-time childbirth educator, seeking knowledge and inspiration from her.

In my initial email to Jenny, I expressed that in my Atlanta area, we have fairly high c-section rates, which can hover close to 40%, and that very few maternity care providers, even offered the family-centered caesarean protocol, to their patients. To my delight, she responded and was generously willing to share her time with me, in a face to face chat!  As birth educators, we often serve in the role of a change agent.

“Positive change agents can provide a forum for influencing and supporting others toward successful program implementation in healthcare organizations.”

(Source)

How was Jenny Smith able to pioneer the natural caesarean protocol to her London area maternity healthcare providers and gain its acceptance? How did Jenny become a change agent in her community?

So, I took a double-decker bus to the Belgravia area in London to meet Jenny for a chat. Over cheese scones and coffee, Jenny Smith answered my questions and indulged me in sharing her wisdom and experience over her 35-year career as a UK midwife. During the early 2000’s, there was a growing interest in natural birth and Jenny surmised that women undergoing caesarean sections were entitled to a birth experience that could reflect some of the elements of a participatory vaginal birth. Jenny Smith assured me that this progress, did not happen overnight. She emphasized, that the key to creating choice in the way cesareans were performed was through slow and simple means. It involved subtle changes.  Jenny explained that sometimes it meant doing some of the new protocol steps here and there until they became more accepted by doctors.

In 2008, Jenny Smith, midwife, an obstetrician and an anesthetist published an article in the BJOG is the academic research journal of RCOG (Royal College of Obstetricians and Gynaecologists) in London, entitled “The Natural Caesarean:  a woman centered technique”. These three pioneers brought this “radical” concept to the hospital administration/staff at Queen Charlotte’s & Chelsea Hospital in London.  For some, this new protocol, was a radical departure from old norms. After the article was published, she and her colleagues did experience some criticism from doctors, initially, while also gaining praise from women seeking, a more gratifying family-centered caesarean birth experience. Jenny Smith, is indeed, a fine example of a positive change agent in her field of maternity care.

In case you are not aware of options, available with a natural caesarean protocol, here are some of the options available:

• allowing a woman to bring something from home that is familiar and comforting to the operating theatre
• allowing for personal music selection to play during the caesarean
• allowing monitoring devices to be placed on the back and not the chest area
• allowing full range of motion of the woman’s arms without restraints
• lowering the drape to allow the parents to view the baby being “walked out” of the uterus, with a hands-off approach
• (this can take up on average 3 to 5 minutes, which allows the baby’s lungs to clear some of the inherent fluid)
• delayed cord clamping
• placing the baby on the mother for immediate skin to skin contact, to enhance initial bonding and breastfeeding, while the obstetrician, completes the surgical procedure

I have also, attached a family-centered caesarean preferences template here for reference.

The beauty of the natural caesarean protocol is that it allows for a less invasive and less impersonal birth experience. It can significantly lower the incidence, of a perceived traumatic birth. With the newborn being allowed to nurse within the first hour of life, it can boost breastfeeding success rates, simply because the baby has that immediate access to mother within the first hour of life. Other benefits include enhanced physical recovery and a positive memory of the birth.

Resources

• How to have a natural c-section | Mother&Baby
• Women who have ‘natural’ C-section bond more with their baby, say doctors | The Independent
• Natural Caesarean – a decade on | Positive Birth Movement

Gwynne Knap CCCE, CLE, CPD, CLD, CAPPA Faculty I became a labor doula back in 1999 after meeting Tracy Wilson Peters for coffee one day after picking up her business card in a baby gift shop. Having now taught over 500 couples in group and private settings, I am energized each time I meet a couple seeking a low intervention birthing experience. A year ago, I was approached by Tracy to take over for her in conducting Atlanta area Labor Doula & Childbirth Educator Trainings. I happily accepted the opportunity and have thoroughly enjoyed training enthusiastic new birth professionals. I am honored to act as mentor and teacher to women ready to embrace their calling as birth doulas and childbirth educators.