If the baby can turn, it will turn.... Claire Dabreo

Breech presentation is a baby who is feet or bottom first rather than in the usual head down position for birth. If you are told your baby is breech at 32 weeks it's perhaps better to think of it as your baby just hasn't had the chance to turn yet. Staying relaxed is both physically and mentally beneficial for you and your baby, so avoid unnecessary stress early on!

If your baby is breech at 36 weeks you may be offered a External Cephalic Version (ECV). EVC is when your obstetrician will attempt to manually turn your baby from the outside, success rate is 50% , and it can be uncomfortable. 

Many women also look into gentler methods to encourage a baby to turn - acupuncture and moxibustion are often on the list. If this sounds a bit 'out there' to you, it is worth knowing that even 'The Royal College of Obstetricians and Gynaecologists' stated the following in March 2017 :

"Women may wish to consider the use of moxibustion for breech presentation at 33–35 weeks of gestation, under the guidance of a trained practitioner".

[New 2017] External Cephalic Version and Reducing the Incidence of Term Breech Presentation Published: 16/03/2017 The Royal College of Obstetricians and Gynaecologists

I have spoken to Claire Dabreo of The London Acupuncturist to bring you some more information on what it is she does to help encourage a baby to turn! ...

Finding out your baby is in a breech position can wobble even the most pragmatic of mums to be, as this news can come with all sorts of implications for birth plans.  It’s often at this time I see women who have never had acupuncture before, keen as they are to get the baby head down.  So when Lydia invited me to share a little more information about how this can work I leapt at the chance.  Success in helping a baby turn is often about timing as well as approach so here’s the things you need to know:

·      the first approach an acupuncturist is likely to use is moxibustion, which is a herb used to warm a point on the little toe,

·      this is a treatment you do at home once you have seen an acupuncturist and it is done daily for 20 minutes a day, for 10 days,

·      bring your partner or someone who can help you do this for your first session, as it can be quite tricky to get into position.   It’s far more relaxing to sit with your feet up as someone else administers the treatment!

·      if you have high blood pressure then moxibusiton is not used, and needles are used instead.

·      this treatment is most effective when started at around 34 weeks.  Any earlier and the baby may well turn and turn again.  Sometimes you don’t find out until the 36 week check, but if you can get an appointment in quick then I strongly recommend doing so.

·      I often suggest scheduling a visit in with a specialist chiropractor or osteopath at the same time.  This ensures that the baby has the internal room to move  - there’s no point encouraging them to get into position if they physically can’t.  Chiropractors use something called Webster Technique and I have 100% strike rate at getting babies turned in my clinic when these techniques are combined.

·      It doesn’t matter what kind of breech presentation you have, transverse, incomplete, frank, footling, or unstable line, this treatment can be used

·      Acupuncture doesn’t just support ‘head down’ but ‘optimal position’.  If the baby is in optimal position for the shape of the pelvic brim, then labour is likely to be more effective (and crucially for first time mums, a bit shorter).  

·      ‘If the baby can turn, it will turn’.  One of my teachers said this to me and I believe it to be true.  Sometimes nature knows best and there’s a really good reason the baby won’t turn.

Some encouraging facts to bear in mind….

- only 3% of babies remain in breech position at full term

- 50% of babies who are breech at 34 weeks will turn with no intervention

- 75% of babies who are breech at 34 weeks will turn with acupuncture, effectively doubling your odds

Claire Dabreo is a seasoned acupuncturist who takes a whole body and mind approach to ensure optimum health and wellbeing.  Specialising in fertility, pregnancy and birth, Claire offers acupuncture to support a healthy, happy pregnancy and is experienced in working with pregnancy related issues.  She offers pre-birth acupuncture packages for the final weeks of pregnancy, as well as moxibustion for breech babies, and acupuncture for ‘late’ arrivals.

So if you are worried your baby is breech, or are looking for support from 36 weeks to help ensure your baby is in the optimal position for an effective labour and birth, consider acupuncture as one of the mothership’s most powerful, natural weapons.  For a directory of practitioners in London with specialist training go to www.ACTLondon.net

Some hospitals are re skilling their midwives by pulling together expert breech birth teams as more women want to to explore their choices for birth, breech presentation does not always mean an automatic cesarean section (if that is not what you choose). Further information on your choices around breech birth can be found at www.aims.org.uk.

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What on earth is a Mothermoon!?...

I put my hands up and confess that postnatally I fall into the category of those that try and 'do too much too soon'. I can recognise in others the benefit of just taking it slow, after all, there's no rush  …but do I take the advice myself? Nope.

After the birth of my first baby there was a definite rush to get back to normality, maybe I had the slight worry that perhaps I never would. And after the birth of my son I was equally guilty. There was no ‘sleep when the baby sleeps’ - I was far too busy up a ladder painting, as we had just had a loft conversion and the house still looked like a building site. I’m sure there is a photo somewhere of me sanding the walls down, probably whilst wearing mascara, the day after Bax was born! 

So my confessions are out, I can now feel at ease I’m not pretending to be someone I’m not. But having said all that, I can absolutely appreciate the need to take your foot off the pedal and take it easy. I met up with local postnatal doula Sarah Tessier to chat about birth and postnatal care over a coffee. Sarah puts together a great case why she believes every mother deserves to have a Mothermoon!!! 

Here are Sarah’s top 10 tips to have a great, healing postnatal period (guess what?... no sanding or painting involved!) and if you are wondering what on earth is a Mothernoon is … keep reading!

A mothermoon is the time for you to nurture and be nurtured, to nourish and be nourished. It’s a time for you to rest and recover so that you can focus on bonding with your baby and begin to find your way as a new mother.

Below are my top tips for planning your mothermoon and looking after yourself in those precious early days and weeks.

1. Have a plan. 

It’s common to write a birth plan outlining what’s important to you, what you want and don’t want so that you’re more prepared to handle whatever your baby’s birth throws your way. The same should go for the postnatal period. Think about things like what help you might need around the house, what emotional support you might need, how you’ll handle visitors and how you’ll make sure you’ve got lots of nutritious food to eat. Talk about it with your partner, write it down and share your wishes with your friends and family so they know how they can help. 

2. Stock the fridge. 

Making sure you’re eating plenty of nourishing food and drinking plenty of fluids is important and surprisingly tricky to do with a newborn to look after. There are lots of ways to plan to make sure you’re getting both of these things and not just living on toast, biscuits and cups of lukewarm tea. Batch cook some meals that you can store in the freezer and just pop in the oven to reheat. If you’re having a baby shower or mother blessing, instead of muslins and baby grows, suggest that people gift you with a dish that can go in the freezer, vouchers that you can use for meal delivery or organise a meal train.  

3. Gather your village. 

Lots of cultures around the world have customs that are focused on supporting new mothers. Family and friends come together to support a new mum and her family so she can focus on resting, recovering and getting to know her new baby. Whether it’s help from family, friends or a postnatal doula, gather your village and don’t be afraid to ask for help.  

4. Pull up the drawbridge. 

It can be so tempting to want to show off your gorgeous baby to everyone once they arrive, but think about limiting visitors in the early days. When you do have visitors, stay in your pyjamas, you’ll be less likely to play hostess. Keep visits short and sweet and have a rule that anyone who does come by has to do something to help out. They should also get their own tea and get you a cup too! 

5. Be kind to your body. 

Your body goes through an incredible transformation over the nine months that you grow your baby. Once you’ve done the amazing work of giving birth, your body changes once again. Think night sweats, swollen boobs and a roller coaster of emotions. Knowing what’s coming and how to cope with these things can make it all a bit easier to deal with. Your body has been through alot, take it easy and be kind to it and to yourself.

6. From womb to world. 

A mothermoon can help to recreate some of what life was like in your womb and ease your baby’s transition into the world. Spending time in a calm, quiet environment with few distractions and lots of time spent skin to skin allows you to get to know this little person and can help them feel safe, secure and more settled. 

7. Plan nourishing things for yourself. 

You need to look after yourself in order to look after your baby. Doing things for yourself to fill your cup can make a big difference to your well-being. It could be a lovely treat like a postnatal massage or closing the bones treatment or as simple as having a nap, a warm bath or having someone hold your baby while you drink a cup of tea while it’s still hot.

8. Emotional support. 

Just because you have a plan, doesn’t mean that things will be easy or go smoothly. You don’t know what you’ll find challenging or what unexpected situations will come up but having a plan in place will help you to weather the challenges when they do come up. 

9. You partners role. 

The arrival of a baby is equally life-changing to for partners. If you have a partner, talk about how you want them to spend their time while on parental leave and what support do they need. Also think about how this might all change once they go back to work. 

10. Gather your village and think in concentric circles.  

Who do you want in your innermost circle. Who are the people you are most comfortable with seeing you at your most vulnerable and potentially partially clothed most of the time if you’re breastfeeding. As you move outwards think about how others can help with things like errands, looking after older children, holding your baby so you can do something for yourself.

No two women or babies experience the postnatal period in the same way but by having an idea of what to expect, you can begin to think about what support you might need. Some things can be planned for while others are unknown until after your baby arrives. Having a plan will help you feel more prepared and help you have the start to motherhood that you deserve!

After baby number three arrives I will be hoping to have a bit of a Mothermoon...maybe- kids I hope you are reading this!?...they are 2yrs & 4yrs so unlikely! But, I will be taking the time to try to look after myself as much as possible, and accepting any help offered! 

Download Sarah's postnatal plan template here

To find out more about Sarah and her postnatal doula services and workshops: www.sarahtessier.com

Instagram: @sarahtessierdoula Facebook: Sarah Tessier Postnatal Doula

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Kristy Coleman's energy boosting tips for pregnancy!

Pregnancy can be a time when your energy level can reach an all time low, whether you are pregnant and running around looking after toddlers and older children or if it's your first time and you are generally feeling severe fatigue !

I knew I wanted to cover some tips to help anyone feeling a bit sluggish during pregnancy (including myself!) and I was conscious to ensure I had the best information to give to you, not just random google finds!

So, I got in contact with Kristy who is a registered nutritional therapist and focuses on using the latest evidence- based nutrition advice for you and your family. Kristy has special focus on nutrition for women for pregnancy and onwards, infants and children.  Kristy is full of practical advice about introducing your baby to solids, allergies and how to handle fussy eaters - as well as how nutrition can support pregnancy and postnatally. 

Kristy runs workshops at Takes a Village , including at Takes a Village and for Mumhood (for more information please visit www.kcnutrition.co.uk and to find out about up and coming workshops follow @kristycolemannutrition on Instagram).

So here are Kristy's energy BOOSTING tips for during pregnancy!

Finding out you are pregnant can be such an exciting time but pregnancy itself can leave you feeling tired, especially if you have been suffering from morning sickness, pregnancy insomnia or are nearing the end of pregnancy. All this might make you feel justified in choosing less healthy food choices (eating for two right?!) to get you through the rest of the day, which can end up with you feeling tired, sluggish and craving foods high in sugar – it’s a vicious circle. But, with the right nutrition you can give your energy a boost allowing you to confidently skip sugary options and nourish yourself and your baby.  

How food affects our energy

When we eat or drink refined carbohydrates like white bread, white rice, cakes, fruit juice, sweets and cakes, they break down quickly into sugar, that sugar surges in your blood, which will provide you and your baby with an initial hit of energy but will quickly leave you feeling tired and wanting more (and quickly). Excess sugar (glucose) is stored as glycogen in your cells and liver, once these stores are full, excess is stored as fat. Whereas, if you ate a balanced meal or a snack rich in protein or slow releasing carbohydrates (think brown bread, brown rice, vegetables and whole fruit), you won’t get that surge in blood sugar, instead, energy from food will be released steadily across a couple of hours to provide you with a longer lasting source of energy without the dip and hunger that comes with sugar highs and lows.

Why is this important?

High sugar consumption during pregnancy is linked to greater pregnancy weight gain and excess consumption of fructose, found in processed foods and fizzy drinks, may increase the risk of your child developing adult obesity, high blood pressure and metabolic disorders. This doesn't mean that they will, it is just a risk factor. That said, it doesn’t mean you should deny yourself a little bit of what you fancy, but try to curb that sugar craving by making wise food choices. The key is moderation – think 80/20 for a balanced diet.

How to boost your energy with food:

Knowing how to manage your energy levels through food won’t just support you energy levels during pregnancy but will be just as important for when your baby arrives.

1.     Protein: while the thought of a croissant or a slice of jam on toast may seem appealing, it may leave you feeling tired and craving sugar later on. Try to ensure your meals aren’t pure carbohydrate by adding protein and healthy fats, such as avocado, olives, olive oil, oily fish). Breakfast can be particularly tricky if you’ve not been feeling great and/or are craving carbohydrate rich food, try nut butter or eggs, tomatoes/avocado on rye/sourdough toast.

2.     Simple swaps: swap white for brown (white bread and rice for brown) and have fruit in its whole form rather than juice.

3.     Snack well: choose these healthy and energy boosting snacks to keep sugar cravings at bay and sustain your energy throughout the day:

·       Oat cakes with tahini and sliced banana / avocado

·       Hard boiled egg

·       Grated carrot/carrot sticks (you can prep the night before) with hummus

·       Sliced apple and nut butter

·       Full fat organic yogurt with berries

4.     Preparation: get your snacks ready for the next day (and keep a stash in your bag), stock your cupboards and your freezer, for example, berries, spinach and ratatouille, and batch cook giving you extra meals for the next day or for the freezer.

5.     Make ready-made food more nutritious: add chicken stock, extra greens and protein, (such as lentils, chicken, and feta) to soup or have a side salad.

In addition to diet, exercise is another great way of boosting your energy levels. Unless advised otherwise, try to take a brisk 30 minute walk daily and try pregnancy specific yoga / pilates.

I am looking forward to bringing you more of Kristy's evidence based advice on nutrition during pregnancy & postnatally . If you would like further information Kristy runs a private clinic for one-to-one consultations and workshops, including at Takes a Village and for Mumhood (for more information please visit www.kcnutrition.co.uk and to find out about up and coming workshops follow @kristycolemannutrition on Instagram).

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Mama Sings - and why it's good for you!

The fourth trimester is a hot topic at the moment and i've spoken before about how I feel it is good to get out and about - when you feel the time is right! So when I had the chance to chat with Rosie who runs Mama Sings, I was more than happy to share the good work she is doing. Rosie puts a big spin on your usual baby music sessions, as they are just as much for the parents as the babies!

Rosie is a singer, songwriter and early years music practitioner who has been developing new music for young children for the past 3 years, and who loves to lead creative projects with both parents and their babies! 

Rosie also has 9 FREE lullabies to download that you can play to your baby in the 3rd and 4th Trimester! If like us, you have watched the Cinderella movie with Lilly James about 1000's times, you will be happy to hear Rosie has a lovely version of  'Lavenders blue' ( ....dilly dilly!!!!!).

Below is a Q&A with Rosie so you can find out more about Mama Sings!...

What is the idea behind Mama Sings and what inspired you to launch it ? 

I had Otis in 2016, and about a year later, decided to get my act together and bring together the various strands of my work and life, to create Mama Sings. Whilst I've been leading different music projects for years, including for little ones, a penny dropped when I had Otis. The desire to sing to him and with him was STRONG (and still is), and I realised that it's common to lots of new parents - singing suddenly becomes something you're doing every minute of the day, whether it be twinkle twinkle or making up a nonsense song to try and get your wriggly baby to stay on the changing mat. I also felt a bit stumped at times when looking for something nice to play to him, and though I'm a musician, felt a bit confused by the huge amount of 'stuff' out there on Spotify and Youtube but the quality was mostly pretty horrendous. I wanted to try and bring something fresh to the table that was as much about the parent, as the child.

What is it that makes Mama Sings different from other nursery rhyme sing song sessions!? What's in it for the parents, do they enjoy it too?

Such a great question!! When I lead sessions and projects, I definitely sometimes sing nursery rhymes, but I so also believe that the parent is so often overlooked...  My whole vision is that parents understand the power in their own voices and sing more with their kids (being a 'good' singer really doesn't come into it!) - as this is such a powerful thing; a great tool to add into the mix of parenting a baby/toddler, and a lot of fun for everyone. So engaging parents in the sessions is something I always try to do! I tend to introduce songs that are a bit different - repetitive but a satisfying sing, with harmonies that build for example...sometimes songs in other languages. And also I introduce songs that I've written, that aren't your standard kinds of nursery rhymes...  

Can you tell me more about the benefits of singing to your baby? And do you think babies really do respond to singing before they are even born?

Ooo where do I start... babies start to hear sounds at around 24 weeks. As the mother's voice is the most consistent sound to them, we know that they recognise it, it's comforting and equates to love, comfort and protection - and they definitely do hear our voices in utero, as newborn babies show a preference for their mother's voice. We sing lullabies to our new babies the world over, and have done for millennia. It's a universal language, and we subconsciously match the early preferences of our babies through our vocalisations... not surprisingly then, it helps foster bonding and secure attachments, especially in mothers suffering with postnatal depression and anxiety, where a study last year showed a much quicker rate of recovery in those mothers that did regular singing with their babies. It's all clever stuff!! With a slightly older toddler / child, a song regularly gets me out of a sticky situation!! I think singing can be a really lovely part of the birth preparation process, with lots of parallels to hypnobirthing - and can really help you bond with your baby in utero. 

Helping to make toddlers , babies and their parents smile sounds like the cutest job in the world, what do you love most about it?

I do love what I do, and am even more passionate about it as time goes on - and going through the whole experience of pregnancy, birth, fourth trimester as well as being a parent now to an active toddler reinforces how singing can really be an antidote to stress! I've also been leading a big project this year which is all about songwriting with parents, which has been lots of fun and really satisfying, to create new songs for people to sing and use at home. I think the most satisfying bit of my work is more when I know that what I've done in one moment, has inspired a parent or child outside of the project, that they're singing a new song, or making up silly ones of their own!

Can you tell us more about your community music projects?

I've been leading music projects for other fab organisations that work with children and young people for 10 years or more, but have recently really zoomed in on early years. I've led projects for Breathe Arts Health Research recently who are amazing and run a singing project for mothers suffering from post-natal depression. I've also been doing a lot of songwriting with parents of under 2's - which is a project of my own design called 'London Rhymes' with Creative Futures which is really important to me. The BEST songs come out of these sessions, when it's a collaboration with other musicians and with other parents - and it's sooo much fun. I believe that parents are naturally pretty creative, we have to be with some of the situations we find ourselves in!! We all have a unique experience of parenthood, but there are definitely some universals... I'm passionate about the role that singing can play in the everyday, and not just in the 'music class'. 

For more info about Rosies work check out mamasings.com

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Planning a Home birth ? - But what if...

Sometimes when you tell people your decision to have a homebirth it may just occasionally be met with a  raised eyebrow, questions about your sanity or even hostility by some!! This reaction is often based on someone’s assumptions about the safety of hospital births and the ‘riskiness’ of home births, rather than fact.

So what is it like when things don’t go exactly to plan on a home birth and the ‘what if?’ actually happens!!!...

I’ve spoken to Jen Bradshaw who is a full time mum of two, nanny and trainee counsellor. Jen had a planned home birth and was faced with one of the very ‘what if’s?’ many people worry about and she had to transfer into hospital…

Why did you decide to have your baby at home rather than in hospital?

Before I had my son, my husband and I talked about it a lot. One of the first issues was that he really doesn't like hospitals and I knew I needed him to be on form to support me through the labour. I then started looking further into it, my sister in law had had both of her babies at home so it wasn't completely alien to me. I fell in love with the idea that I could be in control, that it wasn't a medical procedure, that women had done this for thousands of years so why couldn't I? I knew I wanted a water birth and that I couldn't guarantee this in hospital. 

Your homebirth ended in a transfer into hospital – does this mean you had a negative experience? 

Absolutely not! With Camille I had a post partum haemorrhage which admittedly isn't ideal at home. However, I knew exactly what was happening the whole time and had total trust in the team I chose to have with me. The actual birth was absolutely perfect and exactly what I wanted, what happened after would have happened whether I was in hospital or at home and I was perfectly safe either way. I remember Camille birth with absolute pride and extremely fondly. 

Jen breast feeding Camille in hospital after her home birth

You used an independent midwife, alongside your NHS care, what made you decide to use an independent? 

I had some NHS care throughout, after my 12 week scan at the fetal medicine centre I had my 20 week scan with the NHS. I also am blood group B Negative so have to have Anti D injections during pregnancy and after if the baby is positive blood group. My independent midwife was able to do all my other care which was fantastic. I chose to have this for two reasons; firstly, she came to my house and the appointments were to suit me and secondly and more importantly, it gave me consistency of care throughout my pregnancy and labour, she saw me from day 1 until 6 weeks after the baby was born and knew everything there was to know about me. I could call or text her if I felt anxious or if something had changed and she would be able to advise me. Obviously after I had Camille I went into a hospital where the NHS care was fantastic. 

You were suffering from SPD in your pregnancy, can you briefly explain what this is ,and what it meant for you?

When you are pregnant, your body produces a hormone called relaxin which helps your pelvis to spread to allow you to give birth. When you have SPD - symphysis pubis dysfunction (sometimes referred to as PGP -pelvic girdle pain) your pelvis spreads to the point it becomes unstable which can be incredibly painful. People get it to varying degrees from mild discomfort to an inability to walk. I was closer to not being able to walk at the end of my pregnancy, one of the risks with overdoing it is that while your ligaments are stretchy you can do yourself permanent damage. I spent the last 4 weeks of my pregnancy in bed mostly as moving was incredibly difficult. I had regular osteopathy which did help but ultimately the only thing that makes it go away is having the baby! Some of the hardest things to do are spreading your legs in any way (even walking) which can make giving birth a little tricky. This is another reason I felt most comfortable being at home, a water birth allowed the weight to be taken off my bump which meant the pain was greatly reduced and it allowed me to be in control of how my legs were split (as opposed to lying on a bed where your legs might accidentally be spread too far). I ended up giving birth squatting in the water which is what felt most comfortable for me at the time. 

Please tell us your birth story..

With my second child, there was no doubt in my mind that I wanted a home birth. I had attempted a home birth for my first but as the little monkey was back to back, we ended up transitioning to hospital to have him. At the time, independent midwives were able to work in the UK and I was fortunate enough to have a wonderful one who had been with me through both pregnancies. I had suffered badly with SPD(PGP) with my second pregnancy and this resulted in being bed bound for the last 4 weeks of my pregnancy. This only strengthened my desire to have a home birth as I wanted minimal intervention, to give birth in water if possible as I had loved the water experience with my first and had read that it offered great pain relief for the SPD also.

I realised on my third trip to the loo in the middle of the night that I was probably in labour, I lay back in bed and listen to a hypnotherapy session. Only after that and a hot shower on my back did I wake my husband and ask him to contact the midwife! She arrived between six and seven in the morning and sat with my through a few contractions. They were a bit all over the place and not very strong. When my son woke up, we packed him off to my husbands aunt for the day and Jamie set about putting the pool up. My first labour was very long and I was desperately trying to stay active to keep the contractions going, however this time I just wanted to lie down and my midwife reminded me that I needed to listen to my body. We snuggled up in bed while the pool filled up in the lounge and watched some friends. I felt very calm and safe, I used hypnotherapy to work through the contractions and they very quickly ramped up.

My midwife returned and after seeing one contraction suggested I got into the pool! My husband was my absolute rock throughout; he held me through some contractions and rubbed my back. We had the music on the whole time and the room was calm and quiet. I am unusual in that I prefer to have a number of people around to support me through labour, it is long and tiring for everyone and it is important that everyone is supported. My mother, mother in law and sister in law were with me, taking turns to pour water, offering water to drink, cool flannels, just being there. The stories I had read about water helping with SPD were not wrong, the SPD meant I was in constant pain and the water took the weight off my bump in a magical way. My husband actually thought contractions had stopped when I got in the pool as I was so still.

Jen in her birth pool with husband Jamie supporting her

The labour was quick and I had Camille in the pool unaided at 14.49.  The birth was exactly what I had wanted and I was over the moon, I had a healthy baby girl who was completely covered in vernix! I had opted for a physiological third stage, this means no immediate injection of oxytocin to encourage the uterus to contract. I also had wanted delayed cord clamping but as the cord was fairly short and we were in water, after 10 minutes I asked for it to be cut as I was finding it hard to not drop Camille back under the water! After ten minutes I felt the urge to push again, having had an epidural the first time this was new to me. My midwife was a little surprised it was so quick but told me again to listen to my body. The placenta came easily but was unfortunately followed by a postpartum haemorrhage.

Jen and Jamie in the pool after Camille was born at home

My team were wonderful, the doting grannies took Camille and wrapped her up warm. I was lifted out of the pool and laid on the plastic sheeting on the floor. Someone wrapped me in lots of towels. I knew exactly what was happening and everyone communicated well. My midwife stopped the bleeding with oxytocin but an ambulance was called nonetheless. Though this was clearly not what I wanted to happen, I didn’t panic at any point, I in fact asked if there was anything I could do to help was told quite firmly just to lie still! When the paramedics arrived they administered another drug to prevent further bleeding and I was transferred into hospital. I had to have some blood clots removed, was given more oxytocin to ensure my uterus closed and fluids for good measure. Naturally, I was disappointed to not be at home, but I gave birth in exactly the way I had wanted to and at the point that I needed intervention, my midwife was amazing, my family were amazing and the paramedics were amazing.

My mother in law brought Camille into hospital were we had some skin to skin and she had her first feed. If I were to have more children, I would give birth at home again without doubt. My midwife has said that given my history she would recommend no physiological third stage, which is understandable!

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Women do not 'fail' at birth.

I'm always in awe of midwives knowledge, especially those who challenge the status quo and push back on the 'well, that's just how things are done around here' approach.  I wanted to share an article on 'the anterior cervical lip' - which is about a woman's urge to 'push before full dilation'.

I sent this article to a close friend who had a difficult experience with exactly this  - the article gave her great comfort to know that perhaps her body wasn't lying to her after all, and her body certainly did not 'fail' her!

Her birth was going incredibly well for the duration and she was managing perfectly well in the birth pool, until she was instructed to get out. The birth centre only had one birth pool, the midwife had finished her shift for the day and staff on the night shift had called in sick. This meant she wasn't 'allowed' to stay in the pool due to staff shortage, so at about 8cm dilated she was told to get out and plonked in a wheelchair.

Back on dry land she had a powerful urge to push, but she was instructed not to because it was 'too soon' - as when she was examined she was 'only 8 cm'.  In order to stop her urge to push ( which was impossible for her) she was told she 'must have' have an epidural, which she reluctantly accepted - and it all went a bit out of her control from then on.

This story is not intended to scare anyone, its the reality of someone's experience and if your birth centre only has one birth pool perhaps it will encourage you to ask questions so you can consider all your options and make informed decisions.

I thought the article 'How to ruin a perfectly good birth' written by midwife Dr Rachel Reed may just help someone else who has perhaps had a similar experience with regards to 'early pushing' and they are looking for more information.

Dr Rachel Reed writes her blog to stimulate thinking and share knowledge and it is not written to give advice, and if like me you are not medically qualified, Rachel still manages to get her message across without using medical jargon! 

Further reading - Pushing : leave it to the experts

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A little stretch and sweep?

I wanted to start to write on the subject of induction of labour - a decision you may face in the later stages of your pregnancy, or even before.

With my third baby due in June and with a history of slightly ‘longer’ pregnancies, the topic of induction of labour is already starting to creep into my thoughts. The word ‘longer’ is definitely the wrong word when it seems to be my natural length of pregnancy, but I will use it to keep things simple!

Induction of labour can seem a huge topic, and the idea can be overwhelming at first. Otherwise, it may feel like  ‘no big deal’ to you,  just a pretty obvious next step if your pregnancy goes beyond what your particular hospital advises, and at least you get to know the baby is coming, right?

Perhaps a comment or text from family or friends makes you feel that medically inducing your labour is the automatic next step. People say ‘They don’t let you go over more than 10 days though, do they?” or something along those lines, which then sets your brain off into overdrive!

Or maybe it’s the pressure you are putting on yourself to ‘deliver the goods’. Everyone is eagerly awaiting the date you specified, because no one likes a late delivery, do they?  When the date comes and goes, you start to feel you’re a massive fraud…. cue demanding text message… ‘So… where is THIS BABY!’

If you check out the NHS online information for induction of labour to help you make your decision, it can seem that the answer is pretty black and white. You may read between the lines and come up with the conclusion ‘oh yep, it may hurt a bit more for me, but it’s the best thing for my baby’. However, there is far more to it than this.

An absolute must read for any pregnant woman is “Inducing Labour” - Making Informed Decisions by Sara Wickham for AIMS (the Association for the Improvement of Maternity Services). The information in this booklet can be a real eye opener and provide a great deal of support when you are faced with deciding whether you actually need an induction.

AIMS ‘provides independent support and information about maternity choices and raises awareness of current research on childbirth’- the association actively supports both parents and healthcare professionals. It’s all up-to-date research, evidence-based and written in a way that is really simple to digest and gives you all the information from both sides so you can make your own decisions.

I wouldn’t wait until you’re 40 weeks to read it, as your midwife’s pen is poised and waiting to write down your decision in your maternity book… read this book well beforehand, so you have had time to think and you can then discuss with your midwife if you need to.

With my third baby on the way in June this question of inducing labour, (or more accurately, the pressure I may face to artificially induce my labour) is already starting to slightly weigh on my shoulders.That is because of my own experience of induction, plus the knowledge I have through my Hypnobirthing teacher training.

My personal history is that I decided to agree to medical induction for my first labour, the reason being I was just over 41 weeks - a decision I wouldn’t have repeated, given the chance again.  For my second baby I agreed to a total of 3 sweeps, and I waited for spontaneous labour, which started naturally at 42 weeks + 5 days.

For baby number 3,  I’ve totally accepted the fact that it is very likely that my natural gestation is around the 42 weeks + mark,  as baby number 2 was born with absolutely no signs of being ‘overdue’ at all (longer fingernails, cracked skin, meconium staining, no vernix, ‘big’ baby etc).

The question I am asking myself now is - will I accept a sweep when it's suggested at 40 weeks, or before?  A sweep is likely to be the first step to inducing labour that you are offered, and it will probably be just at your midwife appointment, as it’s now pretty routine. Basically, the midwife or doctor will sweep their finger around the opening of the cervix in a hope to stimulate contractions.

Many believe it’s a bit of a non-event and no harm can come of it  - so, if anything, it might just save you the pressure of further more invasive induction methods, which I think many caring midwives are hoping for you when they do it!

But - it is still a form of inducing labour,  so you still need to question why you are doing it and if it’s right for you. Women have reported crampy sharp pains after sweeps, and believe it has then gone on to affect their labour negatively -  some say it brought on false labour.

The risks of a sweep which are listed in the AIMS booklet are:

·      Discomfort

·      Bleeding

·      Irregular contractions

·      May only bring labour forward by 24 hours

This absolutely does not mean you will experience all the above if you decide to have a sweep but they are the risks, and sometimes you may not hear of the risks. It is good to also know that it may do absolutely nothing to induce labour and just leave you feeling a bit sore. You may feel that you don’t have a chance to think during your midwife appointment if you would like to have a sweep or not, so it’s best to consider before.

“ Routine use of sweeping of membranes from 38 weeks of pregnancy onwards does not seem to produce clinically important benefits. When used as a means of induction of labour, the reduction in the use of more formal methods of induction needs to be balanced against women’s discomfort and other adverse effects (Boulvain et al 2005:2).

 

I question myself whether the sweeps I had did affect my labour,  as although I had an incredibly positive experience and did everything I could do to facilitate a swift labour, after my final sweep at 4pm I did then experience quite crampy sensations immediately afterwards and into the evening (which then did turn into labour)

Whether my experience would have been different if I had left well alone I don’t know, or perhaps if I hadn’t had the sweeps I would have then been faced with the question of how much further I wanted to continue into the pregnancy.

My feelings now are that when the time comes if I’m fit and healthy and so is the baby, I may just leave well alone…

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'Little Me London' guest blogger!

When Tiffany Wright from the parenting blog 'Little me London' www.littlemelondon.com got in contact to find out my reasons why I chose to have my baby at home I was up for the challenge to put together my Top 10 reasons, and I struggled to keep it under ten to be honest!

A home birth may not be on your list of things to do, and these reasons are not to say I’m right and you’re wrong, but just to give you a bit of insight into why so many women, like me, choose to have a home birth. And of course Hypnobirthing is not only if you are planning a home birth... a My Hypnobirth course can support you wherever and however you decide to have your baby!!

When I first told people my plans to have a home birth, some looked at me as if I was completely mad, so I started to become a bit selective about who I mentioned it to.  Luckily for me I had enough people around me giving the thumbs up in support, and after all it was my choice. Home birth can get a bit of a bad press as being reckless or selfish, but that couldn’t be further from the truth…

1) Home births are less painful!!!!

Basically home births hurt less! When you are completely relaxed, free from any tension and feel safe, labour can be efficient and manageable. Like many others I’m sure, I feel at my most relaxed in my own home, probably nice and cosy on the sofa - so to give myself the best chance of a calm, swift labour that’s the room I chose to have my baby in!  

Oxytocin is the love and labour hormone, and it is directly affected by your emotions. It is produced when you feel safe, relaxed and somewhere private. A warm dimly lit room, which is quiet, without lots of distraction going on, is perfect to produce tons of oxytocin. In this environment you will also maximize your endorphin production too, which is the body’s own pain relief, so the winning combination for a smooth birth!

2) It’s the best VIP care in my opinion!!

It is known that continuity of care has a huge impact on a woman’s experience of birth. Women who have the support of a doula (someone providing emotional support through pregnancy and labour) are shown to progress better, have shorter labours, less need for pain relief drugs and fewer interventions – such as episiotomies, epidurals, forceps, ventouse, and C-sections. Isn’t that just incredible, all that just because of good emotional support? It makes you think, doesn’t it?

If you have a home birth with the NHS you have two experienced midwives looking after just you, which you wouldn’t get in hospital. The famous birth expert Ina May Gaskin often talks about her observations of cases when labour progress actually reverses, so instead of dilating the cervix closes back up, and this usually happens at the presence of a stranger in the room, which interrupts labour and has an effect on the mother’s hormones. So I was happy to know that at home I wouldn’t have my midwife swapping shifts during my labour, and I would get that continuity of care!

3) No worrying about the right time to turn up at the hospital!!

There is always the worry when is the right time to get in the car and make your way through traffic to the hospital. Most first time parents are known to arrive at the hospital too early and have to go back home again, only to return later! Having a home birth, I found it incredibly comforting to know I was in for the night. I find it difficult to drag myself out for the evening at the best of times!

Any interruptions during labour slow progress down, as it’s all to do with the adrenaline you produce by changing your environment, and adrenaline is your worst enemy during labour. So by staying at home I knew I would avoid all these interruptions and added time. Of course if you are a Hypnobirthing mum you will be able to keep that adrenaline at bay and maximize oxytocin hormone even whilst waiting at a red light!

4) I wanted first dibs on the birth pool!

There’s no need to worry about who is diving into the birth pool first if you’ve hired your own! You may have heard about the hard and fast rules of when you are ‘allowed’ to get into a birth pool but this is mainly because midwives have the difficult job of juggling the resources amongst the women. So if you are in the pool and another woman comes in further dilated than you, she is going to need that pool! I decided, rather than playing the dilation lottery, I would be much more at ease knowing my pool would be waiting for me!

Being in a birth pool makes labour easier as the water supports the weight of your body, which means your circulation is good so oxygenating blood can flow to your uterine muscles, and also means more oxygen for your baby. It can be said that the pool can be too relaxing sometimes which can slow progress, but if that were the case you could just hop or clamber back out onto dry land!

5) I DIDN’T want access to an epidural!!!!

I had already been there, done that and got the t-shirt with this one …and it was a lousy fit. So I actually didn’t want an anesthetist and an epidural knocking around the place!

‘But you don’t win a medal for going without an epidural” - no you don’t, but it it’s widely accepted that efficient ‘pain relief’ doesn’t necessarily equal maternal satisfaction. It was pretty comforting knowing I would avoid all the possible complications that can go with it.

If you did decide you wanted an epidural, you would tell your midwife and she would arrange for you to transfer into hospital. Even if you were in hospital already you would have to wait for the anesthetist to be free, so depending where you live the waiting time could be about the same. In terms of ‘pain relief’ at home you would have everything available that you would find in a midwife- led unit or Birth Centre. So gas and air, and pethidine can be arranged (I would definitely do your research with the latter as it crosses the placenta, but it’s there if you wanted it).

You could use hydrotherapy and hire a birth pool, which is said to be as good as a shot of pethidine, and I believe them! Also, you would be able to use a TENS machine and of course, Hypnobirthing is the best preparation for birth in my opinion!

6) I wanted to avoid interventions!

‘Where you give birth can affect many things, from how likely you are to have a caesarean to how comfortable and confident you feel’ - Which? (Birth Choice)

For me, because I had already had a birth that was medically induced with interventions that followed, it was super important for me to give birth where the chances of medical intervention were lowest and this is shown to be at home, (Birth Place Study 2011). I was doing everything I could to prepare for a natural labour for my baby so it just made sense for me to be at home, simple.

7) But what if you have to transfer to hospital??!

The most common reason to transfer from home to hospital is for ‘failure to progress’ a couple of words that are pretty damaging for a woman in labour to hear! But anyway, ‘failure to progress’ by definition is not an emergency. Home birth midwives are always experienced and I knew I would have two caring just for me – that would mean no popping to the next room or to the neighbours to check on their progress! That meant if things were to go ‘wrong’ they would pick up on it immediately and I trusted them. When things go wrong in labour it is very often a slow build up with signs along the way, and believe me your midwives would be on it if there were any signs.

8) What about all the mess?  Your place ends up slightly tidier than before!!

The assumption that birth is a messy affair is wrong! It’s really not that messy and your midwives bring plastic sheeting to cover your sofa, bed, floor or wherever! So after you’ve done your bit of giving birth, you can sit back and relax and your midwives (probably with a bit of help from your birth partner) will tidy everything away and help empty out your birth pool! I swear our place was in a bit of a better state after they had left, as if nothing had ever happened - apart from the newborn baby demanding our attention 24/7!!

9) No overnight stay on the postnatal ward (whoop … Mexican wave!)

This is a hard one to grasp if you haven’t had a baby already, but skipping a night or a week on the postnatal ward is pretty bloomin’ amazing.  Even if you had your own private room on your own private ward, nothing beats the bliss of cuddling up in your own bed after you’ve given birth! It’s much nicer to be flicking through the take away leaflets than faffing around desperately trying to get someone to sign your discharge papers!!! I also had this feeling that if I was in hospital there would be something that I or the baby would be kept in for- this was probably a bit of a hang-up from my first experience.

10) Benefit for the baby

Last but definitely not least - if you are planning to have a home birth you are most likely aiming for a natural birth and all the health benefits that go with it for your baby, such as helping their breathing by clearing out the amniotic fluid from their lungs and supporting their future immune system. Also being at home meant we would both avoid the risk of picking up a hospital infection.

I knew that if I were calm and relaxed my baby would get the benefit, so entering the world calm and alert and this is what I wanted. If you were planning to breast-feed it usually goes a bit more smoothly when your baby is wide awake and not sleepy from any drugs that might have been in their system (but of course not always, and we can all struggle!). Oxytocin is again one of the main hormones behind successful breast-feeding and it flourishes in all the same circumstances as birth and conception!

“The freedom to have a homebirth – whoever you are, wherever you live and whatever your situation – is much too precious to give up as if it were nothing.”

– Ina May Gaskin

Further reading :

https://www.nct.org.uk/birth/encouraging-straightforward-birth-what-do-pregnancy

https://www.nct.org.uk/professional/research/pregnancy-birth-and-postnatal-care/birth/birthplace-study

https://www.aims.org.uk/Journal/Vol12No3/infection.htm