Mother Ship by Francesca Segal

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A mother’s experience of the Neonatal Unit

Mother Ship by Francesca Segal chronicles the first 56 days, from birth to discharge, that the author’s twin, 30 week, premature babies spent in the NICU. She describes a journey that is far from smooth sailing; rocky and filled with turbulence from the start. At the same time, it is one filled with hope, longing and joy, which ultimately steers this ship to its destination: home. 

Book cover for Mother Ship

Segal describes how she expected her pregnancy to progress, and how divergent from reality it became. At times, her words are soaked in guilt and come through to the reader in waves: “we are encouraged to believe that a mother’s body is mad and clever… though mine was not quite mad and clever enough to sustain a pregnancy.” It is soothed, in part, by her well-timed jabs of humour, expressed through the rose-tinted glasses of nostalgia. She celebrates bonds forged through shared experiences between the mothers of the ‘milking shed’, makes us appreciate the enduring presence of her husband and prioritises hygiene in a way that would make every Infection Control team proud. 

Importantly, Segal highlights many areas for improvement in the way care is provided. Her observations of the NICU bring attention to the lightning-fast and disorientating ward rounds, the constant use of medical jargon, frighteningly alien words second only to the name of that town in Wales (you all know where I am speaking about), and reluctance in having to involve yet another ‘Mum’ in decision making. Despite this, she showers gratitude upon the healthcare professionals with whom she shares a complicated but respectful relationship.

The book evokes a cocktail of emotions, prompts you to give your mother a call, and makes you ever so fond of little ‘A-lette’ and ‘B-lette’. Mother or not, clinician or not, a treat for all who read.

Why I am recommending this book

Tara George (GP)

Mother Ship provides a window into a world that may be familiar to many of us in a work context but seen here through the eyes of a mother. Disorientating, frightening, a liminal place where babies born too small, too soon may live or may die. What really struck me was the camaraderie of “the milking shed”, the irreverent humour, the ability ultimately to be human when that was all she had left. It left me expanding the horizons of what the word “mother” really is.  There are important lessons for those of us who look after whole families as well as for paediatricians – leaving your newborn (safely?) in the hospital and being at home, a mother with no mothering to do. As a GP with some interest in perinatal mental health, it is clear how much mothers in the scenario need support but it is also made strikingly obvious how little time she has for anything other than sleep, travel, endless expressing of milk and being in the hospital.  The moment of absolute compassion and wisdom when the nurses send her and her husband out for dinner one night reaffirms for me how truly amazing NHS staff are at both the high tech bits of medicine and at the human side.  

Mahima Chandrasekhar (FY2)

Medical school has always highlighted the merits of clear communication, empathy and a multidisciplinary approach to decision making. We practiced a lot of these skills in simulated environments and attempted to apply our learning into the clinical environment, to varying degrees of success. Reading Mothership has provided me with the perspective of the mother. Apart from being an enjoyable and moving story, it has provided some constructive feedback on our communication as a health profession. This book has given me several points to reflect on:

‘Mum’ has a name!

It is often hard to remember all the names of all the children and parents. However, making that effort to ask for her name in the ward round will improve the quality of your rapport. It will also make the mother of your patient feel more like she is part of the team making decisions about the child: which she is.

The mother of your patient might be a patient too

Sometimes, the child is born via emergency C-Section, and the mother standing opposite you, less than a day after the operation, is on a cocktail of drugs to allow her to achieve basic functionality through the haze of pain. The information you are giving may not be absorbed in the way you intend, and something as small as offering her a chair to sit on, can make the world of a difference.

Avoid jargon

I often have to Google certain terms and abbreviations, especially when moving on to a new job. If it is confusing for a medical junior, I can imagine it being downright disorientating for a non-medical parent. Explaining the plan and developments in detail without jargon can help avoid unnecessary anxiety and misunderstandings.  

Involve parents in the decision making

Inevitably, parents will need to care for their children when discharged from hospital. Ensuring they are aware of the ongoing medical issues, red flags, NG tube training, basic life support, emergency numbers to call, is paramount for a safe discharge. Involve parents early, to avoid information dump at the end.

Being at the start of my medical career, everything is a learning point, and I could go on. You will make your own reflections, both personal and professional, when you pick up this book.

Mother Ship is an enjoyable learning experience on communication. A case-based discussion that is riveting and heart-warming, right in the comfort of your own home, with a warm cup of tea in hand and a rich environment for reflection. 

If you want to go deeper then please watch this heartfelt talk from neonatologist, Jasmine Antoine, about being the parent, not the practitioner in NICU.

About the authors

  • Mahima Chandrasekhar is a foundation doctor currently based in Oxford and budding Paediatrician. Tara George is a salaried GP, GP Trainer and GP Training Programme Director in Derbyshire. Pronouns she/her. When she's not doing doctory things Tara loves to bake, to read novels, run and take out some of that pent up angst in Rockbox classes.

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