The motivation behind my academic journey

It all started in Amsterdam in a student advisor’s office at the university. I didn’t get a place to study medicine after trying three years in a row. At the end of self and clueless what to study, she asked me if I ever thought about midwifery?

Up to today I am grateful for that suggestion. It led me to Belgium, Gent, where I did my basic degree in midwifery and back to the Netherlands to get my first work experience as a midwife. Born and raised in South Africa, the African in me never left. Curious to find out if there is something for me in my country of birth, the waves and people of Jeffrey’s bay lured me in and I re-located to South Africa.

It has been a humbling journey. Most people didn’t have a clue what a ‘midwife’ was and I had to explain myself. After registration with the Nursing Council I got green batches to put on my uniform. When I started to work in the local hospital the nursing sisters were kind of looking down on me, you are ‘just a midwife…?’ What do they mean ‘just a midwife’? I am a highly qualified and valued health care provider?’ Slowly but surely I started to understand what was going on in the ‘midwife world’ in South Africa.

I got involved in the community and was the co-founder of The Healthy Mom and Baby Clinic . On the side I started to work as a Private Midwife. Out of curiosity and because it is the degree to have as a midwife in South Africa, I enrolled for the post basic degree ‘Advanced Midwifery and Neonatal Nursing Science’ at the Nelson Mandela Metropolitan University. And my picture of the ‘midwife world’ became even clearer. In order to obtain my degree, I had to do a research. I was stunned by the high cesarean section rate in the private sector and decided to look at the factors influencing the mode of delivery in the private sector. My take home point was the absence of midwives in the low-risk population. It was shocking. My supervisor decided to publish my article and all of a sudden I saw the value of my research: now I have a voice. When she suggested doing my Masters Research, it didn’t take much convincing. This time I looked at collaboration between midwives and obstetricians. Because that’s the only way a midwife can work; if she collaborates with the doctors. An article was published again I took home, we need more and better midwives.

The midwives…!

Again, not much motivation needed to agree with my professor’s suggestion to do a PhD. I took a year ‘break’ of studies and carried on. This time I want to go big. I want to do something for the midwives in South Africa! The profession needs to be strengthened. The majority of midwives are working in public sector and I was done with private sector, so this time I was going to focus on public sector. What are the midwives saying? What is going on? I am still in the process of finding that out and I need your voice to be heard!

If you are a midwife working in the public sector of South Africa with more than three years experience in maternal health, please take some time to do my survey!

Start survey 

 

 

Book Launch from Shauna Blaak – Mom Awesomeness Series

I am excited to introduce you to a good friend of mine: Shauna Blaak.

Shauna is happily married to her college sweetheart, Erwin, and they have four teenage children. For the last decade, they have been living in South Africa and pastoring the worship ministry at Victory Church in Jeffreys Bay. She knows better than most the challenges that come with being the SuperMom of an International Family, and she has a wealth of wisdom to share with other moms who are perhaps asking themselves, “Who the heck am I now?”

Have a look at her blog and get your hands on her newly released book: ‘Identity: Finding the Proverbs 31 Woman in the middle of kids chaos’.

The Proverbs 31 Woman―you either love her, or you hate her. She will either inspire you to greatness, or she will remind you of your weakness.

Rising early, working late? No thanks. I can’t compete with that. I am definitely not a morning person. Does that really mean that I’m NOT a Proverbs 31 Woman too?

Great. More guilt!

Years ago, when the kids were little, I remember having a conversation with the Father in the middle of Walmart, of all places. (Yes, God shops at Walmart.)

I had been complaining to Him about how busy I was. I couldn’t compete with all of the other SuperMoms around me who ‘really had it together.’ I wasn’t rich enough. I wasn’t smart enough. I wasn’t skinny enough. I wasn’t popular enough.

I remember saying, “Sheesh, God. Proverbs 31 sucks. It’s not fair that I have to do ALL of this stuff and Erwin doesn’t. He just gets to be the husband and be served all the time. I’m so tired. I can’t keep doing this.” 

In hindsight, I realize now that Erwin had never demanded these things of me. It was I who put unrealistic expectations on myself, trying desperately to be the ‘good wife.’ I was trying to live up to the Proverbs 31 Woman and exhausting myself in the process. No wonder I didn’t like her.

Out-of-the-blue, I had one of those almost-audible moments of hearing God’s voice. This is what He said,

“Shauna, you are ALREADY a Proverbs 31 Woman. You see those boots in your cart?”

(I had about six pairs of winter boots in my shopping cart. Walmart was having an incredible end-of-the-season sale, so I was buying every size available because I knew that at least one of my four kids would need them next year.)

“Well, that’s just like verse 15, ‘She rises early and provides for the needs of her household.’  It’s not about being a morning person and working yourself to death—it’s about foreseeing the needs of your family BEFORE THEY ARE EVEN AWARE OF THEIR NEED.

“Your kids don’t even know they need boots next winter, but you do. You ARE a Proverbs 31 Woman!

“I’m proud of you!”

That moment RADICALLY changed my perspective on Proverbs 31 and my abilities as a wife and mother.

I realized that I had been looking at this all wrong. It’s not about working harder and performing better. Proverbs 31 isn’t a crazy ‘To Do List’ that I have to get done in one day. NO!

Proverbs 31 is a BLANK CHEQUE of purpose and destiny that I GET to accomplish in my lifetime!

What, seriously?

·    I GET to buy and sell land.

·    I GET to be creative and profitable.

·    I GET to be strong and beautiful.

That’s awesome! I’ll take it!

Breath in, breathe out…one wave at a time!

First pregnancy – Home birth

When one of my friends (in her mid twenties) mentioned that she was going to do a home birth, I must admit, I thought she was crazy or just naïve. It was her first baby, why take such a risk? This was two years ago, and oh, how my view has changed during this past year, as I journeyed through my own first pregnancy. I work with children and mothers with complications after birth and I always thought that the “safest” way for a baby to be born is in hospital. All the necessary equipment and trained personal are there; ready to help in the case of an emergency and the NICU and theater is just down the passage.

After working closely with premature babies over the past 3 years, I have come to realize that there are a lot of factors that can affect the baby during pregnancy, during labour and after the delivery, which has a direct or indirect impact on their development. I learnt what a massive roll oxytocin (the “love” hormone) and cortisol (the stress hormone) plays in our bodies. I learnt that if a woman is stressed during her pregnancy and delivery, this might have an effect on her labour and even affect how baby is born (this is just my opinion).

I realized that I knew very little about birthing a baby and what a mother needs during her labour process. My husband and I did an extensive 8-week ante-natal class (with extra sessions afterwards to desensitize my husband as he battled to deal with the thought of the whole birthing process). I did a lot of extra research, reading and speaking to professionals as well as mothers. What I found was that our modern day practices in hospital are still quite structured in such a way to make it comfortable for the healthcare practitioners and their preferences so that they can do their jobs well. When questioning certain protocols, I was told that unfortunately they couldn’t change the way they do certain things in hospital. This was odd to me, seeing that everyone seems to be pro-natural birth, but all I heard was the “what-if-something-goes-wrong” or “just-in-case-something-goes-wrong”.

This made me look into the possibility of a home birth. There were a few things that I wanted in place on my labour day and delivering at home would allow this to be a possibility.

One thing that was very important to me was that I did not want to be in a scenario where my baby or myself were at risk. We met with an advanced midwife, and asked her many, very direct questions to determine the “possible risks” of delivering at home. She answered all our questions and did not flower up the idea of a homebirth. After that, I knew that home births are safe for moms who are well informed with a low risk pregnancy and a strong support system. She made it very clear that it is no walk in the park, and that there is a 50% possibility that I would be transferred to hospital, seeing that she does not take any chances with mothers at home.

After my 37-week check-up, my Gynecologist reassured me that I was a good case for home delivery. My pregnancy was still low risk and she was happy to be the backup doctor on the day.

My water broke on the Friday evening around 7pm (at 38weeks and 2 days). I did not have any contractions at the time. After informing my midwife, she gave me 24h to go into labour, otherwise she advised that we go to hospital.   The next morning around 04h30, my contractions started! I waited till about 6am before I phoned my Doula (also a midwife) to inform her. She arrived about 20-30 min later and examined me. At that stage, I was 2cm dilated and in the early stages of labour.

I decided that I did not want to make use of any pain medication. I used various means of pain relief during the day. Initially, I was able to get through the contractions with focused breathing and movement, leaning on the kitchen counter and swaying side to side.

It took my husband quite a while to wrap his head around the fact that things are HAPPENING! We still laugh about the fact that he asked me if he could put up some shelving (whilst I am rocking through contractions). I had to very calmly tell him: “I don’t think we will get to put up shelving today”. I think it was his way to cope and keep busy

Back to the contractions…When movement was not that effective any more, I combined the breathing with TENS treatment to assist me during contractions. That helped quite a lot, until I went into active labour around 11am. After that, I wanted downward pressure on my lower back during every contraction, with every breath I breathed out. My midwife was notified when I transitioned into active labour and she arrived around midday. At that stage I was 6cm dilated. I also made use of a gym ball during active labour to help take the edge off from the contractions. Between the two midwives and my husband, they worked very hard to help and coach me through each contraction. We were such a great team and I am extremely grateful to them!

When my contractions got really strong, they suggested that I tried sitting in the birth pool. The warm water was really relaxing between contractions, but did not assist with any pain relief during contractions. The only thing that helped was rhythmical and focused breathing as well as the downward pressure with every breath I breathed out during contractions. I still recall my Doula saying to us at our anti-natal classes that labour contractions are like waves, and you need to try stay on top of the wave. Towards the end, music (I set up a playlist with music a week before I went into labour) was very helpful to break the silence and had a subconscious calming effect, which also assisted with dealing with the pain. I cannot recall actively listening to the music, but I do recall the relief before the pushing phase.

I reached the transition stage of labour in the birth pool. The pain is something that you do not want to re-imagine. Instead of being fearful of the next contraction, I focused on tackling each one as they got stronger, something that athletics (running hurdles) and surfing taught me. Not to fear the hurdle/wave, but to push forward instead of backing down. With that said, when it got quite bad, I recall thinking to myself: “This is our first and last baby. I am not doing this EVER again!” The pain was like nothing I have ever experienced in my life. I recall my Doula saying to me at some stage: “Not long to go”, and thinking to myself: “She better not be lying to me!” I had to constantly decide to fully trust the midwives and followed their instructions as best I could.

When they saw I was ready to push, they helped me out the pool and on to a birth stool. My husband sat behind me and assisted with the downward pressure on my back during contractions.

The pushing phase was once again a different type of pain, unlike anything I have ever experienced. During the pushing phase, my midwife asked me if I wanted to look “down there” using a mirror. When I looked, I saw nothing, even though it felt like her head should already be visible! Everything in me did not want to push, because it felt like I am going to fracture my pelvis by pushing, but I realized that there was no turning back at that point.   I closed my eyes and re-focused. With the coaching of the ladies, it took about three contractions (that I can recall) and our healthy baby girl was born.

My husband’s favourite moment was looking over my shoulder and seeing our little girl being born, spit out the amniotic fluid and taking her first breath. After crying for a bit, she started making sucking movements with her mouth. I completely missed this part as I still had my eyes tightly shut at that stage. She was handed to me straight away and as I sat back against my husband with our baby in my arms, he burst out crying and then I realized we did it, and I burst out into tears. At that moment my placenta spontaneously came out as well. I was so grateful, as I did not want any artificial hormones injected. Time of birth 13h50 (for baby and the placenta)! Weight 2.84kg, 49cm long.

I was assisted to my bed, where I lay skin-to-skin with my baby, while the midwives cleaned up. During that time, our baby started to bob her head and wiggle around. She found my breast within minutes and started suckling all by herself. That was such an amazing moment for me as this was one of my biggest desires, for my baby to be born un-medicated and given an opportunity to initiate breastfeeding within the first moments of her life, which she did! I am so proud of her!

Afterwards we all sat on the bed reflecting on the day and my midwife prayed, thanking Jesus for His tangible presence throughout the day and the birth of our precious little girl.

The Lord provided in every little detail. A few days later reading through my “birth plan” where I wrote down my desires for the birth, I felt like I received the biggest undeserved gift ever. I could tick off every box! Looking back at the day, I could not have asked for a more beautiful, ‘peaceful’, unmediated home birth to welcome our precious girl into this world.

Just dropping in…

My mom once told me that you give birth in a similar way your mom did, and since my mom had quite easy labour experiences, I was never concerned about the whole process. My midwife and friend, Margreet, said during an ante natal class that for a first pregnancy, it can take up to six hours for your baby to finally greet the world, from when you are about five centimeters dilated….so I was super relaxed.

We live in Jeffreys Bay, about an hours drive to hospital, and my husband works up to three hours drive away from home, but with six hours to kill, that would give him enough time to get home, have a shower and get us to hospital in time to meet our new baby, or that’s what I thought.

Another friend of mine asked me after her son’s birth (about three years ago), what I thought contractions felt like, and we both agreed that it must be quite an intense tightening sensation around your abdomen, as the movies always portray. And she then said that she experienced it as rather gentle cramps (in the beginning though). We had this discussion again in my last week of pregnancy, and I remember feeling rather excited about the birthing process when I went to bed that night.

I woke up around 03:30 am, feeling gentle cramps, and started timing them while I messaged my sister in law in New Zealand (since she has three boys and would be awake this time of day), trying to find out whether this was Braxton hicks or the real deal. An hour later, we figured I am still okay and that I probably might be needing my rest. The contractions were about 4 – 6 minutes apart, lasting about 90 seconds. But I was rather chilled, because it wasn’t painful at all, so I went back to sleep again.

We were also advised in our antenatal class to find something to distract you from labour once it starts, like bake a cake, or go for a walk. Well, my husband read an article on superfoods eirlier the week, so my distraction was making superfood-cookies for him to take to work. (This ended up being my breastfeeding snacks a week later.) By 11:30 I finally finished the cookies, and was rather exhausted, with the odd gentle cramp as I discribed earlier. So I had a lie down on the couch, once again keeping tract of my contractions and its intensity.

An hour later, I asked Margreet whether she would be able to come see me around 13:00. I felt rather relaxed and wanted to have lunch first. In the meantime, my contractions were getting more intense, and getting to an uncomfortable state. By 12:45, just before Margreet arrived, I told my husband: ‘I think this is it, we should probably start heading to hospital sometime soon’. When Margreet arrived, she was more interested in our dog (her very cool surf buddy) and our new house (which we moved into only two weeks before), since I seemed way too chilled for someone in labour. On examination, I was already 5 centimeters dilated. In a very relaxed manner, Margreet tried to tell me to maybe start heading towards the hospital, and that she will notify the labour ward that we are on our way. To my husband she said quietly ‘Get to hospital NOW!’.

We arrived in the labour ward at around 14:00. Then it was documentation time, and checking my contractions and baby’s heartbeat, but both mommy and baby were super relaxed. By 15:00 I was 7cms dilated and the hospital nurse called for a delivery cart to be prepared. I found it quite comfortable bouncing on a big exercise ball, and ‘blewing my contractions away’ as Margreet told me to do. The contractions weren’t nearly as painful as I expected it to be. It was definitely uncomfortable though, to such an extent that I had to pause my sentences and blow the contraction away first. The hospital midwife showed me a position to try out, by standing with my elbows resting on the bed, and my back bent forward, knees slightly bent and hip width apart. So I tried it, and that’s when my water broke. Immediately I felt an intense pressure, and that was pretty much when I realized again what exactly was happening here. Why I was in hospital, because for a very short period of time, I sort of forgot exactly what I was in for.

I was asked to get onto the bed for the birthing process, but with the pressure I felt, i couldn’t imagine it being comfortable at all sitting down, and the bed was still very high. I managed to get onto the bed on my hands and knees. As I tried to find a way to lay down, I had two more contractions. I was still standing on my knees hugging my husband who was standing on the opposite side of the bed, when my baby ‘fell out’. The midwife barely had enough time to put her gloves on, that’s how quickly it happened. Our baby girl was born at 15:45. To me, giving birth was really easy, and a rather pleasant experience. I would definitely do it again, but next time, I might have to skip the baking…

 

My home-birth – the best experience ever

I wanted the most natural experience as birth is normal part of nature… Home-birth was the best experience ever.
I come from a family and society where most births were caesarean and it was unheard of in this time to give birth at any place other than a hospital. Birth was thought of to be something medical and that birth at home was for the olden days.

When I found out I was pregnant, it was a surprise and after a bit of a rocky start my pregnancy progressed well and Thanks to The Almighty I had no complications.

The first step was to decide which doctor I’m going to go to for my check ups and delivery. I have a passionate aversion to hospitals and always have preferred alternative natural treatments and health care professionals to medical doctors. Knowing a few ladies who have had successful homebirths for 3 and 5 kids each respectively, something was born into my heart and I told my family I was going to do home birth.

I knew nothing about the procedure at this time but it’s the decision that my heart felt at rest with. I was hoping for everything normal. My hubby was very supportive and in fact very glad that I chose this option. My mother, who has had 4 ceasars out of 5 children also supported my decision, but being a mother she did have concerns.

The next step was to find a midwife, the lady who had delivered the ladies I know was no longer practicing but after a few enquiries and referrals, we were directed to a midwife, but unfortunately after the first appointment it turned out that she and I were scheduled to be giving birth around the same time. Thankfully she referred and set up my next appointment with my current midwife a brilliant lady from J-Bay, Margreet. Happy at having found someone at last and that my dream seemed to be unfolding finally, we drove to the peaceful coastal town, a mere 30 min from PE, for the first check-up with her. All went well and thankfully continued well as baby grew and pregnancy progressed. We were happy with what she had to say and I was very soon very happy and comfy with her as my midwife.

At 36 weeks on a Sunday night reaching home late after a braai, I just got into bed and I experienced a sharp cramping in my stomach, which continued. When I checked it appeared the show had begun. This was the first sign of labour. It was a shock to see red too, having not seen anything for about 9 months! Going back to bed I told my hubby and we both started getting excited. The pain came aprx every 10min going down to every 7 min. Somewhere in the early morning I sent a message to Margreet, telling her what I had experienced. She was super fast and a light sleeper too apparently, as she called back within a few min and after asking questions and establishing my progress!

It turned out I was still in very beginning stage. Our doula would come at 7am to do a check up. As the morning grew I became increasing uncomfortable and pain got worse. But what was a better place for me to be feeling like this other than my home?? I was super comfy in my on home and in my own personal space. I could rest as I wished, which was on the bouncing ball mostly, as it helped ease the pain. Around 5am some water burst! My mom, my brick, came around 6 am and our doula, Michelle, was there soon after. After doing an internal around 7am, which by the way is more horridly painful than the contractions and the birth itself 😉 I was only 3cm dilated. It was very disheartening all night aprx 6 hours and only 3cm!!!

But then she helped me do what I believe as a miracle…. breath.

I was supposed to have a training session with her that week but labour came before the appointment!
So, for the next few hours it was 1, 2, 3, 4 in….. and 1, 2, 3, 4, 5 out. Or along those numbers, memory failing right now. But what this teaches you, it to relax. It makes your body relax. It lets your body give into the contraction. You can actually feel your body opening. Whereas when I had remained tensed all morning with the contractions, my body could not do what it needed. I tell you, it was like a miracle. Within the next 5 hours I was 9cm!

When Michelle left for a few hours, my hubby and mom took turns to support me, rubbing my back which was aching by now, helping me by counting for my breathing. I could not focus on breathing correctly without assistance. The pain started getting much worse. I could barely walk and sat on the bouncing ball mostly before going to the bed.
Around 12pm Margreet came. By then I wasn’t too aware of my outside surroundings, more so of the consuming pain and a downwards pressure. Another internal showed I was about 9cm dilated. Yay! Now there was something happening.
I cannot be sure what happened around me in the next 3 hours, memory very hazy. .. I didn’t want hubby to stop rubbing my back, it was damn sore. I was on the birthing stool next. And Michelle had returned. Somewhere after 2pm Margreet did another internal and broke some more water.

I was fully dilated. My body was ready to push. By 3:20pm we had a beautiful healthy baby boy, 2.46kg. A sweet bundle of true joy. A few stitches and warm shower later I was trying to feed my baby and although slightly shaky, very much better already!

I cant say I was afraid, not before and not during birth. It was what I wanted and Thanks to my Almighty He gave me the wisdom to decide something against the norm which by the way is thee ultimate natural and normal humane way and the strength & health to have a normal home birth. Almost 4 years later, with a very much bouncing bundle of limitless energy, I write this story of my birth. All details as best I could remember. Whenever the time may be, I’ll go the same route again without thinking twice. If you have a healthy pregnancy, go for it! Its an experience you wont regret ever!

First time ZAMBIA

Just back from a week of Zambia with my dear friend, housie and fellow mission hearted medical person: Mari.  If I don’t use this moment to write some impressions down, life is going to carry on quickly and the writing will not happen.  There is something about going somewhere for the very first time, you can only experience the first time once… I love it so much.  This trip was a bid of a surprise that has come my way and I did not have any chance to ponder too much upon it and do some research about the country. So it was a true empty canvas for me.  The first impression was from the air, the beautiful Zambezi finding it’s way through the african planes.  Then Livingstone, a clean beautiful settlement where the people have the biggest smiles.  Even though I came with little expectations, I was quite surprised to see the beautiful houses, the tarred roads and way too many South African franchises, they seem to import everything…!  Yet the shocking realization that the Kwacha is stronger than our Rand…! And so does my first impressions carry on.  The purpose of the visit determines what kind of impressions one gets and I could not have asked for better exposure to this beautiful place.
We were blessed to be hosted by a beautiful Zambian family.  I met this couple when they were expecting their third child in our clinic in J-Bay, about two years ago.  That pregnancy and birth birthed a vision in their heart to see a Healthy Mom and Baby Clinic become a reality in Zambia.  After a couple of emails and meetings in J-bay, I seemed it fit to go visit.  This couple are leaders of an organization called Elijah Mission International.  Their Mission is ‘to confront injustice and empower individuals to be agent of change in their communities’ and their vision ‘see communities where God’s dream is realized for every individual’. They are involved in different projects to empower youth through arts and music and run different programs, to be honest I am not too sure what they all do as I was connected to Anne, who heads up the clinic’s work.
Anna, a beautiful woman that has learned to allow God to be the centre of her life and tapped into His big heart for the world.  A nurse by trade, a wife of a Zambian doctor, a daughter of an American family. She caught on to Elijah’s Ministries vision and stepped in to make it a reality.  We met the team, did some home visits, school visits and prayed.  But more than everything, we could be there to walk alongside another woman for a week, to cheer her on, to look with her and see where it is going.  What a privilege.
Saturday tourist day, yes I can do the tourist thing too.  We couldn’t have asked for a better touring guide than Bruce himself, an intelligent, well travelled Zambian that could tell us so many ins and outs we would never get from the Lonely Planet guides.  Victoria Falls were magnificent and seeing the sun go down over the mighty Zambezi just made the day complete.
Mighty waters.... Majestic
Mighty waters…. Majestic
The Sunday we visited Overland Missions, a dream come true for me.  I have been following this organization for a while.  Walking on their base, seeing some salty sold out people that live out the great commission, travel the roads no one else would and reaching people groups of which governments say they don’t exist… I was moved to the core.
A F R I C A  my heart beats for you.

Kelly’s Water Birth Story

From the beginning of my pregnancy I knew I didn’t want to be lying on my back on a hospital bed when it came time to deliver. I was already very interested in water birth from my previous pregnancy and had my heart set on it this time round. Due to hospitals in PE not accommodating actual water birth and me being pregnant for the first time, the birth didn’t go as planned. The whole experience was not what I had expected and I wanted a more personal experience this time around. I had to go with the traditional way of giving birth. St Georges Hospital do have baths but you are only allowed to be in it while your dilating which to me defeats the whole point of water birth.

more “Kelly’s Water Birth Story”

My Beautiful Home Birth: From heaven straight to home

My husband and I are blessed with 3 beautiful children. We adopted our first child, our second was born in the hospital, and our third child, Lisa, was born at home and I will cherish this beautiful memory forever! I wanted to have a home birth, but I thought it wasn’t possible in South Africa and my husband was not keen on the idea at first. “ What if something goes wrong?” was his main concern. So I prayed, and researched home birth even more thoroughly, to have plenty of arguments to convince my husband that this was the safest, most sensible thing to do. And it is true, for woman with a low risk pregnancy, a planned home birth with a skilled midwife is just as safe as a hospital birth (if not safer!) for mom and baby.

more “My Beautiful Home Birth: From heaven straight to home”

Laughing All the Way to the Labour Ward

A woman walks down a harshly lit corridor of a small provincial hospital in a smaller Eastern Cape agricultural town. She’s heavily pregnant, four days overdue if her scans are to be believed. Not that she’s taken much stock of ‘due dates’, knowing that the baby will come when he’s good and ready. She stops beside her husband to let another contraction pass, barrelling through with the force of a freight train.

more “Laughing All the Way to the Labour Ward”