Series: What’s in Your Toolkit? 14 – Midwife Hannah Horne

Lovely Hannah, or @midwifehorne as she is to her many followers on Instagram, is a ray of sunshine on Instagram and writes a wonderful blog, Birthing Mamas Blog. She is a perinatal mental health specialist and has been through her own motherhood mental health journey. As Birth Trauma Awareness week draws to a close, and immersed in the #makebirthbetter campaign that has been gaining momentum on social media, I wanted to delve further into Hannah’s experience to find out her back story and why she came to be involved in mental health side of the pregnancy experience.

Tell me about yourself.  Tell me more about your day job, how long you’ve been doing it, how you came to be in the work you’re in.

I am a Mum of two and a Midwife. This year I have spent half my life working within Maternity Services. The babies born at the first births I witnessed and assisted at will be 18 within the next year. This fact makes me feel very old!

I have worked in the Midwifery-led Unit, Maternity Ward, Labour Ward, Maternity Day Unit and Antenatal Clinic. I have also attended homebirths. I was a Supervisor of Midwives for 9 years, providing professional leadership and ensuring high standards of safe care, until the role was withdrawn from statute earlier this year. I am passionate about birth and motherhood; striving to support women in positive birth choices, whatever they might be.

My latest role is Perinatal Mental Health Specialist Midwife; supporting women with pre-existing mental health disorders and those who experience new mental health concerns in the perinatal period.

How/why did you start your blog and Instagram account?

I started my blog and Instagram account about a year ago. My boys were 6 and 4, with my youngest about to start school. I started to reflect on how my life had changed through pregnancy and the early years of motherhood. I believe when a baby is born so is it’s Mother. This transition begins in pregnancy when the Mum to be alters her lifestyle for the new life growing inside of her, however when the baby is born that moment changes her life forever and is a defining moment for all Mothers.

How women are nurtured through pregnancy, birth and early motherhood can have great consequences both physically and emotionally for mother and baby and the relationship they share. By writing my blog I wanted to encourage positive birth and motherhood whilst raising awareness where birth and motherhood haven’t been positive in order that we learn and provide support for women who are struggling with certain aspects of pregnancy, birth and motherhood.

Recently there has been a lot more light shone on perinatal mental health, getting people really involved sharing their stories and chatting about these important issues. Do you find that mums to be are more aware of their mental health nowadays and understanding of pregnancy’s and early motherhood’s potential affects on it?

The recent support for raising awareness around perinatal mental health has been amazing. For a long time there has been a focus on ensuring maternity services have best clinical care from a physical perspective, which is undoubtedly important, however now that standards in physical care have been researched and developed the focus can shift from the purely physical to the emotional and mental wellbeing too.

We now know that 1 in 10 women suffer from a mental health disorder in the perinatal period (Maternal Mental Health Alliance, 2014). I think this is a reflection of how mental health is becoming a more acceptable ‘problem’ to talk about. I think that steps are being made in a positive direction, however there is still a stigma attached to disclosing mental health problems and there are still many women who won’t disclose that they are struggling, with 7 in 10 women hiding or underplaying their perinatal mental health disorder (Maternal Mental Health Alliance, 2014.)

There is also a lot of guilt attached to perinatal mental health problems, mums not being as happy as they ‘should’ feel or that they aren’t enjoying their pregnancy/motherhood and they ‘should’ be and this can really compound negative feelings.

I think this internal struggle alongside the stigma prevents mums from speaking out and seeking help. I am really proud that the trust I work in has Midwives and Doctors who regularly, directly ask women about their mental health which encourages women to talk about their problems. In the future I would like to see a more proactive approach to perinatal mental health, in terms of preserving mental and emotional wellness rather than reacting to mental illness. A change is happening in this direction, but there is still a long way to go.

What are your personal mental health tools in your own toolkit?

As a working Mum of 2 boys I try to maintain a balance with my emotional and physical wellbeing, although I haven’t always! When the boys were little I didn’t priortise myself much at all, I was always last of the list. Just over 2 years ago I had a lot of back pain as a result of many years of Midwifery and 2 children both born by Caesarean Section in less than 2 years. Lots of lifting and carrying at home, on top of 12 hour shifts on the wards contributed to imbalance in my strength and flexibility. I had a course of physio and started yoga classes. I started yoga for my physical recovery but it really helped my emotional wellbeing too. The yoga teacher entwined mindfulness within the classes and I soon found that not only was my body becoming more balanced but I was feeling less fraught and frazzled too, a welcome side effect!

Through this I became aware of how important it is to protect and promote all aspects of wellbeing in order to effectively cope with all that life throws at us. Moving in to the role I am now working in I have been increasingly aware of proactively promoting mental wellness. Achieving balance between good nutrition and hydration, good sleep habits, exercise and physical activity, doing things that are fun as well as enjoying rest and relaxation.

I practise mindfulness to some degree every day and I try to walk or do some yoga each day, even if it’s only for 20 minutes. I also try to attend a yoga class once a week and swim too. It doesn’t always happen, but that’s life isn’t it. What I will say that I feel very much more self-aware now and am more in tune with my feelings and better able to notice when I need to rest or when I need to be more physically active, which helps me feel more balanced.

How do you balance kids and work? 

It’s a work in progress and the scales are very often up and down. I am very lucky to be well supported by my husband and our parents. When the boys were small I worked 2 long shifts, alternating days and nights each month, and grandparents looked after the kids for a day each week. I did miss the boys going to work and coming home when they were asleep, but then I never had to cope with the bedtime routine after a day in work which was no bad thing!

This shift pattern allowed me to keep working but still be with my boys 5 days a week, it was tough at times and I spent most of the early years feeling tired never quite recovering from work or ‘mum-ing’ but then I think most Mums of young children are shattered for one reason or another. As the boys settled in to preschool and school I missed them a lot when I worked weekends, so finding a role I loved that allowed me to work more regular hours within the week has been brilliant.

However, everything is always a trade-off and now that I work in a specialist role there is no-one to handover to at the end of the day, so leaving work on time can be a struggle and knowing that you need to be at home with the kids when an urgent work issue comes up can be difficult. My husband has always taken an active role with the childcare, from when I returned to shift work when the boys were 9 months old he has been there when I haven’t. As a teacher his school holidays are a godsend and I look forward to the end of term when I can just focus on getting myself ready in the morning, rather than shouting ‘put your shoes on’ at least 10 times whilst trying to use my mindfulness not to get stressed about getting to work on time!

It has also provided a good balance for our relationship with each other and with the boys. Whilst I have been able to work part-time and have been at home more regularly throughout the year, the school holidays when I am in work allow them all time together. The support we have had from our parents has been wonderful, given the boys the opportunity to have a close relationship with all their grandparents and saved us a fortune, however it’s important to be mindful not to take advantage of goodwill when family are helping you out.

Having worked in different roles, varying levels of part time hours and different shifts I have come to the conclusion that however you manage the whole work/mum/life balance it will never be perfect but there will be positives and negatives. I just try to focus on the positives as much as possible and ignore the dreaded mum guilt which inevitable whatever we do.

What would be your top tip for keeping your mental health on track throughout pregnancy and early motherhood?

Taking care of yourself has to be a priority. Ensuring you are fed and watered, that you get a break, do gentle exercise like walking and pregnancy/postnatal yoga and mindfulness have to be my ‘go to’ top tips.

Trying to find the motivation for these things in pregnancy when you are tired can be difficult but setting up positive habits and coping mechanisms before the baby arrives makes it much easier to maintain these once the baby has arrived and takes over your life. Ring fencing time to do what you need to take care of yourself is important, discussing this with your partner and family will help them support you in this as you become a mum.

Mums to be spend a lot of time preparing for labour, which is a good thing, but not many women plan how they are going to adjust to the biggest change of their lives. Planning that a relative could cuddle the baby while you take a nap or have a bath uninterrupted will allow you to rest and recharge. It’s often the small things that boost your mood and can be the difference between sink or swim when your every moment is given over to your baby.

When I had my first I had a difficult birth which required a lot of recovering from and my son had a dairy allergy which was undiagnosed for 6 months so he didn’t sleep. Whilst I was happy to hand over the reins with the household chores I wanted to be able to do everything I thought a mum should and cope on my own when my husband went back to work, with an endless stream of visitors. I have always been independent and this was going to be no different. Except it was. A few weeks later it all unravelled and I was an overtired mess.

My Mum came to the rescue and sat downstairs with my son for a few hours each day whilst I slept. This was the best thing that could have happened, a couple of weeks later I was much better able to cope with everything. Never under estimate the power of sleep! After that, sleep became a priority over everything. With my second son I learnt from my mistakes, accepted all the help going and didn’t get out of bed unless I had to. There are two things I like to tell new mums; everyone will have advice for you, it is not because you are not doing a good job it’s because they want to help, so smile and listen, if you hear something you like then try it, if not disregard it all and carry on doing your thing, you know you and your baby best so don’t worry about what anyone else is doing; and being a new mum is wonderful and tiring in equal measure, it is impossible to ‘enjoy every moment;’ enjoy the moments you can and survive the rest, it’s what all mums do! As an outsider looking in it may appear all the other mums have it all under control, but they are probably thinking the same about you.

#caesarean #mentalhealth #workingmotherhood #birth #midwife #caesareanbirth #Fertility #mentalhealthawareness #perinatalmentalhealth

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