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What is hypno-birthing?

 

Hypnobirthing is simply a generic term that means the use of hypnosis for birth.  There are several different forms of hypnobirthing, which all work towards helping the mum have a natural birth.

 

We are all in hypnosis, without knowing it, about 60% of the day so this is something that comes naturally to us all. It occurs just before you fall asleep and just as you awaken.  Other examples include losing track of time when reading a good book or when watching something interesting on television or when you do anything you enjoy doing.  Have you ever driven from A to B, arrived at your destination and not remembered how you drove there?  If so, you were in the daydreaming state of natural hypnosis.

 

In essence, hypnosis is simply a state of heightened relaxation and altered awareness.  In hypnosis you are awake, aware of what is going on around you and you are in control.

 

Hypnobirthing is based on the work of Dr Grantly Dick-Read, an English physician whose principles provided the foundations of the National Childbirth Trust (NCT). He is famously quoted as saying; “In no other animal species is the process of birth apparently associated with any suffering, pain or agony, except where pathology exists or in an unnatural state, such as captivity.” He went on to conclude that fear and tension was responsible for 95 per cent of labour pain, which could be eliminated through relaxation techniques.

 

What does it involve and how does it prepare you for the birth of your baby?

 

Hypnobirthing is the intended use of hypnosis to allow you to tap into your inner resources, which we all have in our subconscious minds, to create feelings of well-being.

 

These feelings of well-being are created by using special breathing techniques to maintain calmness, positive affirmations, visualisation, colours for relaxation and healing and of course self-hypnosis which is created by using all these techniques.

 

Hypnobirthing helps you to:-

·         Put things in their true perspective.

·         Relax, stay calm and in control - in a calm, relaxed state your muscles and skin can stretch easily and naturally in a pain-free way.

·         Stay focused on the process that your body is going through and be in tune with what your body and your intuition are telling you.

·         Be healthy and sleep well.

·         Heal quickly and recover faster.

·         Bond with your baby.

·         Breastfeed easily, if you choose to do this.

·         Be happy and have confidence in your abilities as a mother. 

·         Get back to pre-pregnancy weight, shape and dimensions very soon after the birth.

 

How did you become interested in it?

 

I was a biology teacher for 35 years, 25 of them in a 6th form college teaching A level biology.  I trained as a hypnotherapist in 2000 because I had had a shoulder injury for 4 years that the medics could do nothing about.  I had previously learnt self-hypnosis and used this to heal the shoulder and deal with the pain. Thus with an understanding of the human body, and having studied hypnotherapy I combined these two areas of knowledge and created the Inner Power Hypnobirthingmethod for natural childbirth.

 

The Inner Power Hypnobirthing method takes you through pregnancy, the birth, bonding with your baby, healing quickly after the birth, having all the energy you need and coping as a new mum, breastfeeding easily and very importantly getting one’s figure back after the birth.

 

I teach couples very simply about the biology of the female body and the process of birth reassuring both parents that the female body is in fact beautifully designed to give birth. This natural ability seems almost to have become forgotten. My method, combining biology and hypnosis, returns power and empowerment to the mother.

 

It teaches you about the powerful mind-body connection so the tools you learn to have a straightforward, wonderful and magical birth experience can then be used for life to keep you calm and to cope with all situations.

 

Hypnobirthing can also help you if you have; nausea and vomiting in pregnancy, needle, doctors and hospital phobias; swollen extremities; placenta previa and to move the placenta to a safe place for the birth and to turn a breech baby.

 

Is hypnobirthing about using hypnosis to create a pain free birth?

 

No it is not just that.  It is about removing the ‘fear’ and helping mums-to-be to trust that their bodies are designed to give birth and to work with their intuition and instincts.  Inner Power Hypnobirthing helps the mother to be more relaxed and in control, coping with the contractions easily, so the birth process becomes a less painful experience, which of course is much better for both the mother and the baby.  I do not guarantee a pain-free birth because everyone has a different pain threshold.  However, some of my mothers do achieve this therefore a pain-free birth is indeed possible. 

 

I’d like to point out that I rarely talk about ‘pain’ for if you think pain then that is what you get.  So I always talk about contractions, and this then changes one’s feelings toward the birth.  I feel it is a real shame that many people call the contractions ‘pains’.  The contractions are not meant to be painful.

 

What can the birthing partner do to support mum during labour?

 

With hypnobirthing the birthing partner has a very important role in helping the mum-to-be to maintain her self-hypnosis so she is totally relaxed , and to help her with breathing exercises to keep her adrenalin low (this is the panic hormone) so she is in control at all times, working with her body which is biologically designed to give birth, and with her intuition.

 

When you are relaxed you cannot feel fear and when you are relaxed your body responds by producing serotonins (I call these the Happy Hormones) a morphine based chemical which is the body’s natural epidural.

 

In this way the birth becomes the magical, empowering experience for both the parents and the baby, and the ‘pain’ for the mum is at the minimum it can be. 

 

I actually find that the dads/birthing partners enjoy having a role to do as it makes them feel so much more involved in the birth process.

 

What do you find most rewarding in your career as a hypnobirthing teacher?

 

I like giving back ‘power’ to mums, helping them to trust that their bodies are perfectly designed to give birth easily and naturally.  I enjoy helping mums and dads feel, and be, more confident about the birth process and so they look forward to the experience with excitement knowing that they are going to be in control whatever happens.

All the great testimonials I have received from the parents reinforce my joy and fulfillment in doing a job I love and find deeply rewarding.

 

I have also published a book BIRTH MADE EASY, which is a complete hypnobirthing guide for the mum and her birthing partner as it comes with a free hypnobirthing CD.   Writing this book and getting it published has been immensely rewarding for me, as I want to give all couples the chance of learning hypnobirthing for under £10.

My book is available on Amazon, Kindle and Apple iBooks and here

www.birthmadeeasy.co.uk

 

Does your work ever involve travel or has it taken you to any exciting places?

 

 

Yes, in July I attended the HypnoThoughts Live 2014 Hypnosis Conference in Las Vegas and I gave a two-hour presentation on Inner Power Hypnobirthing which was well received.  Las Vegas is a very exciting place – like a big Disney world for adults and experiencing an American Conference which was much larger than any UK ones I have been to, was very exciting for me.

Published in Birthing Styles
Thursday, 09 October 2014 22:00

How to Help Your Body Birth Your Baby

 

Your Estimated Due Date is getting closer, and you want to make sure you are 100% prepared for whatever your body and your baby throws your way. Here are some suggestions to help you birth your baby. All of these suggestions are interconnected, and work beautifully together to allow your body to do what it knows how to do – birth your baby!

Let your labor start naturally (and help it along if need be!)

In the world of labor and birth, this is key. Anxiety surrounding when your little babe will make his/her appearance is normal. Easing this anxiety will assist in making labor happen sooner and with less effort. The mind-body connection is powerful – especially when it comes to pregnancy, labour, and birth – so maybe baby is holding back for that one last date with your partner, for the nursery to be completed, or for you to mentally and emotionally be ready to welcome your beautiful bundle. And remember: there is no calendar hanging on the wall of your uterus. Baby has no idea when the ultrasound said she “should” arrive. Trust that your body and your baby will know when the time is right. 

Once all of these things fall into place, baby should arrive shortly! Well, maybe. Sometimes body and baby need a little push in the right direction.  There are PLENTY of natural ways that are said to bring about labor. Acupressure, acupuncture, and massage therapy can trigger your labour to begin naturally, as can several herbal and homeopathic options, but please seek the assistance of a professional for all of these options. Sexual intercourse and light activities may also jump-start your birthing experience, but be sure to get the go-ahead from your Midwife/OBGYN/Physician. If you have made too comfy of a home for your wee one and they just don’t want to come out, a pharmaceutical induction may be required. This can take many forms (Artificial Rupture of Membranes, prostaglandin gel, Pitocin drip…), but your body will most likely get the hint shortly and can take things from there.

Keep Moving

Once labor has begun: move, move, move! As much as possible and for as long as possible! Your baby is working hard, wiggling her way out of that tight womb, so help her out if you can. Your movements can be drastic and grand, like walking or swaying, or small and minute, like shifting a leg, gently rocking with your partner, or rolling to lie on the other side. Changes in movement are suggested every 30 minutes up until the Transition stage, at which time you do what you need to do, Mama!

Eat and Drink

How long do you normally go without eating or drinking anything? 3 hours? 5 hours? What about if you were going to the gym, or, say, running a marathon...wouldn’t you fuel your body properly for these activities? If you are going to labor for upwards of ten hours and then birth your baby, you need energy! Yet eating and drinking during labor is often discouraged. Your uterus is a muscle, and if it gets fatigued because of lack of fuel (food), it will not work as it should. I am not saying go and eat a turkey dinner, but eating and drinking as you see fit will do more good for your body than harm, and a zero tolerance policy for food and drink intake will set you on a fast path for fatigue. Be sure to throw some healthy snacks to nibble on into that hospital bag, or stock your pantry and fridge with easy-to-grab items for the most rewarding workout of your life!

Environment

It has been proven that certain environments are more conducive to successful birthing than others. An animal, if feeling threatened, will physiologically stop laboring and will continue only once they are no longer in danger. Your body--more specifically, the cervix--will not function as well as it could if you are feeling any one of a myriad of things: uneasy, stressed, anxious, worried, pressured, overwhelmed, uninformed, scared, upset. A calm, relaxed, non-intrusive environment, on the other hand, will allow your body to relax, open up, and welcome the experience of birth. Your physical birthing environment is as important as your mental birthing environment, so be sure to surround yourself with people you love and trust who also love and trust you, your body, and your preferences. You could also set up a playlist, bring a familiar blanket or pillow, or light some candles (or use the battery powered ones) to have full sensory control of your surroundings. 

Listen to your body

Finally, listen to your body. This is true for your entire labor experience, but most importantly as your labor is nearing its end. As your near the birth of your baby,an amazing physiological component called the push reflex will naturally kick in. I remember hearing about this reflex during my prenatal class and feeling so rewarded when I experienced it in my labor. My birthing body was taking over--all I had to do was surrender to the natural process, let it happen, and I would be holding my baby shortly. Breathing your baby down as opposed to pushing your baby out allows for a gentler and more comfortable birth (for both Mama and Baby!).

Having faith and trust in your body when faced with something it has never experienced before can be scary. But please have that faith and trust. Your body is beautiful, and it knows exactly what it is doing. 

 

Tuesday, 10 June 2014 14:34

Plan A, B, C, D . . .

When I was working on my birth plan I had a discussion with a coworker about making a plan. Her argument was that you can't plan a birth because there are too many unknowns. I countered that that was the very reason every woman needed a plan.  

This is not a birth plan:

I will start labor on my due date at 9AM after ten hours of sleep and a well-balanced breakfast. After four hours of early labor, spent watching TV and receiving a back massage, we will have an uneventful trip to the hospital. Upon arrival at the hospital, I will consent to a vaginal exam determining I am 6 centimeters, 80% effaced, and 0 station. An epidural will be administered promptly because there is a readily available and unoccupied anesthesiologist waiting for me. After four hours I will begin pushing and have my 7 pound, 7 ounce perfect bundle of joy after a mere five pushes. The doctor who attended me throughout pregnancy will be there to deliver my baby. There will be no tearing. We will be discharged by the next morning, only staying a night so that I can have the assistance of the nurses so I can sleep and establish breastfeeding. Before discharge my milk is in and our latch is perfected. While we were at the hospital my mother cleaned my house and has lasagna in the oven.

 

Okay, I hope with all of my heart that every woman can have a birth like that - simple, easy, painless, textbook (whose textbook?!).

 

My birth plan included rules like don't eat near me, let me roam freely (I ended up spending about 24 hours laboring on my toilet because it felt like I was trying to poop a railroad tie past three feet of rebar) I only wanted one cervical check, and don't rupture my membranes. I made rules because I didn't want any interruptions - we forgot to unplug our house phone and it rang mid-contraction and now when it rings I am filled with the same rage I was that morning.

I planned a homebirth but had a hospital transfer plan, and a Cesarean Section plan. 

It was important to me to labor unmedicated but wanted an epidural in the event of a transfer to the hospital. When we transferred I was glad I had pre-planned an epidural otherwise my birth team and I would have been on different pages: they might have encouraged me to continue unmedicated, oblivious to my wishes. Quite the opposite, a mother might think to herself that she believes she can have all-natural childbirth but fails to let her partner and care provider know - at 3AM she might discover a needle in her back not because she was tired, but because her husband was. Afterwards, she might be left yearning for what she knew she was capable of. With every intervention comes risks and benefits: it is important for every woman to know where she stands prior to entering the delivery room, lest she be faced with a decision when her limbic system has taken over.

 

Some important items to consider in a birth plan:

What methods of pain relief would you like? A hot shower? Massage from your doula or partner? Epidural? Nitrous oxide? A TENS machine? Be sure to know and understand the risks and benefits of each.

If augmentation of labor is suggested, what will you do? How do you feel about synthetic oxytocin? Do you know and understand the risks?

Who would you like present in your labor?

Do you want to eat and drink freely?

Do you want an IV?

How frequently do you want your baby monitored in labor?

How frequently would you like to be checked for dilation?

Your doctor might offer to rupture your membranes, how will you respond?

Under what circumstances would you consent to a Cesarean? Vacuum or forceps delivery? Know and understand the reasons for each - some are genuine emergencies, sometimes it is simply impatience.

Would you like to be encouraged to labor and push in different positions?

When would you like the umbilical cord clamped and cut? Do you want immediate skin-to-skin?

Erythromycin is often put in the newborn's eyes - is it necessary for your baby?

Oral or injectable Vitamin K? When and where will the baby's first bath be?

 

Knowing how you feel and letting your birth team know ahead of time will ensure your wishes are known. Things can change in a second, and so can your plan. Planning ahead will help you be more flexible - augmentation may have been off the table, but when someone mentions an impending Cesarean you will be able to weigh the risks and benefits and alter your plan accordingly and with genuine informed consent.

 

Remember this is your birth, your baby, your body. You have the right to refuse and the right to request. You are the boss.

 

 

Published in Birthing Styles
Tuesday, 20 May 2014 08:45

Birth Trauma Resources

 

In Westernized cultures, a healthy baby and healthy mom are generally accepted as a good outcome of pregnancy and birth. Frequently, the actual birth experience is not given much consideration. More often now, however, it is being realized and accepted that the birth experience may affect a mother's ability to breastfeed and bond with her baby as well as her overall confidence in being both a parent and a woman.

The raw emotions that a new mother feels are often put on the back burner because she has much more to worry about now that her baby has arrived. These emotions may also shaded by well-intentioned people who remind the mother that she should be proud that both she and her baby are doing well. The mother may be numb due to the utter shock, disbelief, and denial of what occurred during the birth. Whether there was actual physical or psychological trauma during the birth or the mother is just severely disappointed that she did not achieve the birth she desired, these women tend to be ashamed of their feelings and afraid to tell anyone. Sometimes the effects of a traumatic birth don't display until well into the second half of the baby's first year. In some instances, the effects are not apparent until after the child's first birthday or, if the mother is breastfeeding, until after the child is weaned. 

There is a name for these feelings: Postpartum Post-Traumatic Stress Disorder. About one-third of mothers will develop PPTSD1. Symptoms include flashbacks and nightmares of what happened, distress when reminded of the situation, and avoidance of anything that may be a reminder of the event. All of these symptoms may or may not be accompanied by symptoms of Postpartum Depression. If you are experiencing any of these symptoms, it is important to keep in mind that you are not alone. There is support.

The following are resources to keep handy in case you or someone you know needs somewhere to reach out for support: 

Phone Numbers

  • Postpartum Support International 1-800-944-4773
  • Pre and Postnatal Depression Advice & Support 0843-28-98-401

Websites

Online Forums 

Books 

  • Rebounding From Childbirth: Toward Emotional Recovery by Lynn Madsen
  • Birth Crisis by Sheila Kitzinger
  • In Search of the Perfect Birth by Elizabeth McKeown
  • Traumatic Childbirth 
  • Cheryl Tatano Beck, 
  • Jeanne Watson Driscoll, and Sue Watson
  • Coping with Birth Trauma and Postnatal Depression by Lucy Jolin
  • Birth Trauma: A Guide for You, Your Friends, and Family to Coping with Post-Traumatic Stress Disorder Following Birth by Kim Thomas
  • Birth Matters by Ina May Gaskin

Articles

 

Sources:

1 American Friends of Tel Aviv University. "One in three post-partum women suffers PTSD symptoms after giving birth: Natural births a major cause of post-traumatic stress, study suggests." ScienceDaily. ScienceDaily, 8 August 2012. <www.sciencedaily.com/releases/2012/08/120808121949.htm>.

 

 

Published in Birthing Styles
Monday, 17 March 2014 06:48

I Wish I'd Known: 7 Tips for New Moms

I like to think that I went into my birth about as well educated as a first time mom could be.  I was one of those women who read everything she could get her hands on.  Now, looking back, I see how little I really knew.  Sadly, most of that was simply because I didn’t look into the right subjects.  I focused my time and energy on normal pregnancy and birth coping information rather than thinking about any complications I might potentially face and how to handle them, challenges I might encounter during and after birth, and everyday mothering.  Now, having been through it, there are 7 things I wish I’d known before I went into my first birth.

1.  Educate yourself on variations and common complications of labor.  

Yes, most births are a natural, physiological process.  However, the unfortunate reality is that sometimes complications do arise.  A 2008 study found that “...nine out of 10 women giving birth suffered complications ranging from ectopic pregnancies...to perineal tears during delivery…”(1)  That’s 94.1% of women!(2)  Even if you don’t require a medical intervention to correct a deviation, you need to know how to handle it naturally and what steps to take if primary interventions fail to work.  

If you equip yourself with knowledge of “common” complications, you will be empowered to address them confidently.  I recommend reviewing and learning the definitions and consequences of meconium staining, amniotomies, posterior position, back labor, vacuums, c-sections, hemorrhage, episiotomy and tearing.  Don’t let this knowledge scare you.  Use it to empower yourself.  In the event that one of these complications occurs, you will not regret having a working knowledge.  

It didn't occur to me to research complications beforehand, and I had no idea what was happening when I was struck by back labor.  Because I didn't know what it was or what to do for it, I ended up with an epidural, a vacuum extraction, an episiotomy and a 4th degree tear - some of which I may have been able to prevent if I’d just known more about common complications.

2.  Be prepared to advocate for yourself and ask questions during labor.  

Ask what is going on with your body when you are unsure or need some extra reassurance.  Ask why procedures are being performed.  Talk to your care providers and let them know what kind of birth you would like to have before things get too intense.  Make sure your partner knows to speak up for you if you can’t.  It's one of the most important things they can do to support you during labor.

Remember, no matter how in-line with your beliefs about birth they are, your healthcare providers aren't mind readers!  If you want something during your labor, you need to ask for it.  If you are denied, find out why.  Sometimes you simply have to be persistent and speak up to get what you want.  Studies have found that women have higher rates of satisfaction in their birth when they felt they had some control in the process.  With that in mind, don’t be afraid to advocate for yourself to help achieve a more satisfying birth experience.

3.  Don't set your heart on anything for your labor and birth.  

Know your preferences and be prepared to advocate for them (unmedicated birth, getting to move during labor, no episiotomy, etc.) but don’t set your heart on any one thing.  Before my birth, I thought I was open to whatever course my labor would take, but part way into it I realized that I had set my heart on something: getting to labor in water.  When I wasn’t allowed in the tub, I was devastated.  Laboring in water had been my key pain relief and relaxation plan. Denied that, my whole process was derailed.  I suddenly felt unprepared and afraid, which was doubly unnerving because I had told myself over and over that I would be open to my body’s process.

Because I was so determined to get a particular thing in my labor, I set myself up to be disappointed.  Being open and accepting of your body’s unpredictable course and outcome will help you avoid birth trauma.  Instead of setting your heart on a particular “kind” of birth or coping technique, be truly open to a variety of options.  Pursue the course you want but know that birth rarely goes as planned.

4. Pick your battles.  

Sometimes doctors, hospitals or nurses aren't always perfectly in line with the way you envision birth should be.  When this happens it is essential to decide what’s important to you during your birth and to concentrate on those few issues.  You can't fight every little thing you disagree with; it's simply not realistic. To achieve a minimally stressful birth, know what you will and won't let slip.

Is it hospital policy to monitor baby for an hour or so when you check in? Maybe it's not your ideal but you can probably live with it.  If they want to continuously monitor a healthy baby, however, it may be worth fighting if you want freedom of movement.

Does your doctor routinely induce women without true medical reason?  That’s a battle worth fighting, but if your nurse wants to give you some Pitocin immediately after birth to help prevent hemorrhage, do you really want to stress over it?

The bottom line is you need to accept that it probably will not be realistic to “get your way” in every aspect of your care.  Instead, decide what things are truly important to you, and don’t sweat the small stuff.

5. It’s easier than it sounds - caring for your newborn, that is.  

Reading articles on how to care for your infant is great, but it can undermine your confidence and make everything sound much harder than it is.  So many people told me how things “fall into place” and you “just know what to do” after the birth of your little cherub, but of course I didn’t believe them!  I stressed and studied and read and watched videos and wondered how on earth I would take care of a precious baby.

But you know what?  Things did fall into place.  I did “just know”.  To a certain extent, just like everyone said, mothering is instinctual.  Changing a diaper in real life is far easier than reading how to do it or even watching a video!  You just start trying things when baby cries until something pacifies her.  Knowing the basics like safety and general care of baby is necessary but stressing that you won’t know how to care for her and over-studying is not.  If you would like some reading, I recommend Dr. Harvey Karp’s book, The Happiest Baby on the Block.

6.  Read about baby sleep and sleep training before your bundle of joy arrives!

Do you want to let your 6 month-old cry-it-out (letting babies cry it out younger than this this is not a good idea), or are you determined to take a more attachment parenting approach to sleep?  Trust me, riffling through a book in the middle of the night as you frantically bounce a crying baby is not the route to go!  Knowing different options and strategies to try will help ease the stress of teaching your baby (a hard enough task as it is) to sleep at night.

With the arrival of our angel, I thought I wanted to take a “no tears” method of sleep.  And for about seven months, we did.  She slept like a champ through the night from birth to about two months.  I thought I was hot stuff for “training” my newborn to sleep a solid six hours straight every night!

Then, around two months, she started to fight going down for the night.  I had to nurse and nurse and nurse her until I could lay down in bed with her and let her sleep with me.  Eventually, she began to wake up when I would lay down with her and be ready to party.  Evenings became incredibly stressful, with me dreading bedtime.  I was at a loss.  I didn’t know what kind of sleep training to try because I didn’t really know my options.  I was so bleary-eyed and dazed that the last thing I wanted to do during the day was read about baby sleep.

Eventually, stressed to the max, my husband decided that it was time for us to try the "cry it out" sleep method, and it turned out to be the right choice for us. Our daughter now knows how to put herself to sleep after milk and snuggles and then comes into bed with us sometime in the middle of the night.

For some fantastic tips on getting your baby to sleep, try Dr. Harvey Karp’s The Happiest Baby’s Guide to Great Sleep: Simple Solutions for Kids from Birth to 5 Years and The No-Cry Sleep Solution by Elizabeth Pantley.

7. Be ready to fight the guilt.

Don't worry if you don't know what I am talking about.  You will once you are holding your little bundle and are suddenly faced with your new life as a mother. Mommy guilt is feeling guilty about everything no matter what.  For example, after I had my daughter I felt guilty for resting while she slept, but if I got up and did something I felt guilty for not resting.  I felt guilty for letting someone else watch her so that I could spend some uninterrupted time with my husband, and I felt guilty for neglecting him if I didn't.  I felt guilty if I didn't use all natural products on my baby, but I felt guilty for spending a ton of money on them if I did. Get the picture?  You can't win.  All my mom friends talked about the guilt.

If you can't avoid the mommy guilt, you can accept it.  You will not be perfect.  Ever.  Period.  What you will be is a mother - a kind, loving, responsible mother who makes the best decisions she can in the situations with which she is faced.

Studying for your birth and parenthood is vitally important, but it is even more important to prepare for the right things.  Having been through it once before, I know now what I should have devoted my time to researching.  Birth doesn't always go the way you want it to and you need to know how to handle it when things go awry.  You need to be ready to advocate for the birth you want and ask questions about your labor.  Even as you take control, you also need to be open to the course your body takes, even if it doesn’t perfectly match your expectations.  Deciding ahead of time which battles are worth fighting will help with that, as will avoiding stress over how to care for a newborn.  Studying up on sleep training can be very worthwhile!  Finally, and most importantly, remember that the only measure of a mother that really matters is that she makes her baby feel loved.


(1) http://www.nationaljournal.com/healthcare/most-u-s-births-have-complications-study-finds-20110520

(2) http://www.hcup-us.ahrq.gov/reports/statbriefs/sb113.pdf

 

Published in Mom's Recovery
Friday, 15 November 2013 01:38

I'm Pregnant: What Now?

You’re pregnant! Congratulations! Maybe you’ve been trying for a long time, or maybe you’ve been taken completely by surprise, but either way, there’s a lot to do! We’ll trust you to handle the fun stuff like shopping and showers; here’s the low-down on the logistics: 

First Trimester (conception through week 13)

 

The first trimester is all about making sure your body is a good one to live in for both you and your baby. It can be tough to keep up with it all, especially when common early pregnancy symptoms make doing healthy stuff like eating well and exercising really hard. Just remember that small steps are bigger than no steps, and even small victories are victories! Places to begin:

 

- Pick up something to use to record information and ideas throughout your pregnancy. You don’t need the fancy baby book just yet, though. Just start with a notebook and use it to keep track of anything you experience: test results, things you want to ask your doctor about, ideas for names, etc.

 

- Start taking a prenatal vitamin, if you aren’t already. Even if you’re just a few weeks along, there’s already some crucial development going on in the nervous system, and it’s important to have adequate amounts of things like folic acid to make sure this development gets off on the right track. This is important for most pregnancies, but especially so if your diet doesn’t have a good variety of fresh fruits and vegetables. If you’re just planning to get pregnant, it’s a good idea to start taking your prenatal vitamins before you start trying. If you’re not sure what you need, your doctor or pharmacist can point you in the right direction.

 

- On that note: start trying to eat well. You probably don’t feel too great, either because the nausea has set in or because you’re exhausted, and both of those things make getting a balanced diet difficult, but do your best. Eat frequent small meals to keep your stomach calm (having an empty stomach makes the nausea worse) and try to make those snacks the healthiest thing you can tolerate. If the healthiest thing you can tolerate is “well, plain toast has grains in it, right?” don’t worry, but do your best.

 

If you’ve been smoking, drinking, or consuming other drugs, it’s time to work on quitting. If you’re worried you won’t be able to do it on your own, talk to your doctor or an addiction center for a plan that you can stand by. Try not to worry if you were doing any of these things for several weeks before you found out you were pregnant. Just know that the sooner you quit, the more you reduce your chances of harmful side effects for you and your baby.

 

Exercise: Birth is hard work, and apart from that, recent studies have shown that regular exercise, even if not especially rigorous, leads to better birth outcomes and healthier babies. If you’re new to this, chat with someone about working out a healthy and realistic exercise plan throughout your pregnancy. Your medical caregiver is a goodplace to start, but other options include nutritionists, personal trainers, or workout instructors, as long as their practice specializes or has some training in pregnancy (ask for credentials, though—there are special considerations for different stages of pregnancy, and it’s important that whoever gives you advice knows what they are).

 

Doctors, Midwives, and other Medical Care: regardless of where you live and what kind of birth attendant you’re planning to have, you’ll probably need what’s known as confirmation of pregnancy to start going through the next “official” steps, like getting a provider referral, handling insurance, and getting services if you need them. Your family doctor or general practitioner can usually do this, but if you don’t have one, any walk-in clinic should also be able to help. If you’re worried about the cost, sliding-scale clinics like Planned Parenthood offer reduced fees to uninsured patients (in both the US and Canada) and may even be able to provide your early prenatal care while you look for an OB or midwife. Your first prenatal visit may also involve a pelvic exam and PAP smear, a breast exam, and some blood work to test for STIs and other potentially harmful conditions. If you need a referral for other providers, they can usually offer this as well.

 

If your usual doctor doesn’t provide maternity care or you’re hoping to work with a midwife or other provider, you’ll need to start looking right away. This is true whether you’re planning on an OB, a family doctor, or a midwife. In some areas, people find themselves wait-listed even when they’ve started making contact in the first weeks of their pregnancies, so don’t put this off, especially if you’re looking for care from a practice that’s in high demand or want to give yourself more than one option. This is especially true if you’re seeking midwifery care.

 

Find out what your insurance will cover in terms of prenatal care, your birth, and postpartum. You may need to add to your current plan to get full pregnancy and birth coverage, which can take time. If private insurance isn’t for you, find out what your options are for government-funded prenatal and birth care. In most cases, having some amount of coverage will save you money on the overall costs.

 

- See the dentist, especially if you’ve had dental concerns prior to pregnancy. Pregnancy can weaken your teeth, so good dental hygiene and regular check-ups are especially important during and just after pregnancy.

 

- If you know you're going to take a prenatal class, don't worry about taking it at a specific time in your pregnancy. Although some programs ask you to wait until a particular point in your pregnancy, if you feel like you need more information now, look for a class you can take now. Knowledge matters, and there is no wrong time.

 

 

Second Trimester (weeks 14-26)

 

The second trimester tends to be the easiest on the symptoms front for most people, so take a breath and catch up! Once you've gotten a few good meals down and are feeling a bit more energetic, it's time to tackle the next set of tasks:

 

- If you haven’t already, start researching your birth options. Pick up a few books and start thinking about the kind of birth you’d like to have. Ask your friends if they have any favorite books or if they had a prenatal class they just loved. If you aren’t sure where to start, I highly recommend books by Penny Simkin, Ina May Gaskin (especially if you’re hoping for an unmedicated birth) and Ann Douglas (who writes good guides in both US and Canadian editions). Unless you’re very comfortable with the medical model of birth, skip the What to Expect books. They’ve got good information, but tend to assume you have a doctor that you trust completely, which doesn’t suit everyone.

 

- Consider meeting with a financial adviser—this may be a service provided by your bank, or you can find a private adviser. They will help you set up your budget to make sure you save enough to get through on reduced incomes during parental leave, help you redistribute your existing income to meet the expenses of a new baby, or discuss how having a baby will fit into your other plans for your financial future. This can be a stressful step, and it’s one most people put off, but in the end you’ll probably be better off with some professional advice.

 

Talk to your employer about parental leave plans as soon as you feel comfortable (if you're worried, know that it's usually best to tell them before someone else does), and look into your government-provided options for leave and benefits. Now is the time to figure out the timeline for applying for benefits, even if you don’t have to do the actual applications for a while.

 

If you’re planning to hire a doula, start looking now. This will give you time to interview several options and plan together, as well as leaving some flexibility if you are worried about costs. You generally want to finalize these plans sometime near the end of the second trimester or beginning of the third.

 

Start thinking about your birth plan. It’s perfectly ok to start with a checklist to guide you through your research and information-seeking phase, but your final document should be more personalized. Talk about your plan with all members of your birth team, including your medical caregiver. Include some details about what you’d like to have happen if your plans change: how you might make a cesarean a better experience, for example, or what accommodations would make it better for you if your planned home birth needs to be transferred to the hospital. Discuss these plans with your team, as well.

 

If you are living abroad or your baby will have dual citizenship, contact your embassy or consulate for information about this process. It is often time-sensitive, and if you don’t live near the embassy, you may need to plan for a visit.

 

Find out what you need to do to set up your baby’s health insurance, whether government-issued or private. Some plans cover baby’s first few weeks of well-baby care under your coverage; others require baby to have their own coverage once you’ve left the birth site.

 

- If you're having a home birth, ask your midwife or doula for advice on finding supplies. Either or both of them may have some items they can provide, but most of the time, you'll need to stock up on at least a few supplies, and if you're hoping for a water birth, you may need to arrange a tub rental. Give yourself plenty of time!

 

 

Third Trimester (week 27-birth)

 

You've made it to the home stretch! You're probably getting ready to meet your baby, but there's still just a little left to do:

 

- If you haven’t taken a prenatal class yet, do it now. If you’re going with a private prenatal class, arrange a tour of your birth location or your backup location, if you’re planning a home birth. You don’t want the first time you walk through the doors to be when you’re in the midst of labor. If a traditional class doesn't suit you, know that there are options for online classes, individualized classes, and other options, but I strongly advise against neglecting this important step. Even if you're perfectly content to go along for the ride and do what your caregiver thinks is best, knowing what to expect makes a big difference. A good prenatal educator will take input from the class on what their information needs are and will help make sure they're met. As an added bonus, keeping in touch with other members of your prenatal class means you'll have a built-in group of parents who are going through the same stages you are. That support will be important later on.

 

- Make your postpartum plan. Talk about it with your partner, family members, and other supportive roles. Build up your network, and talk with family and friends about who can help you and how they can help. Consider tools like MealBaby or the services of a postpartum doula, nurse, or other support person, and make a list of resources in your area that you can turn to for support if you have issues. Key points for this are breastfeeding (both peer and professional support options), 24-hour nurse hotlines for help with questions, a few support options for if you face postpartum mood disorders, and support for any special needs you anticipate you or your baby might have after the birth. Tack the list of phone numbers, websites, and/or email addresses on the fridge to have handy if you need them.

 

- Find a pediatrician for your baby. If you already have a family doctor, they may also be able to take on your child. If not, you’ll want to look for a pediatrician or a family doctor soon. Many states and provinces have systems in place to help connect you to providers. Also ask your pregnancy caregiver if they have any advice.

 

- Talk to your provider about your finalized birth plan, and update it as needed if anything changes in your pregnancy. Leave a copy to be kept with your records, and have extra copies on hand to take with you to the place of birth. Even if you are planning a home birth, it’s good to be prepared in case you need back-up care.

 

- Get your car seat installed properly so it's ready when you need it. If you're not sure about your installation, have it checked. There are many local resources for this. Consider baby stores (the store where you bought the seat might be a good option), public health and safety offices, or even your hospital. If they don't have seat check programs of their own, they can almost certainly refer you to somewhere that does.

Monday, 11 November 2013 05:30

Natural Pain Relief – A guide to choices

There are many benefits to choosing natural pain relief during labor and birth, benefits for you and the baby. Labor can be shorter (compared to that of an epidural labor for example) and the recovery time can be smoother. Neither you nor baby will be left with the effects of some medical drugs that may leave you both sleepy and ‘spaced out’. Using natural pain relief can also help you to feel more in control during labor and fill you with empowerment which can help emotionally during labour as well as after the birth when reliving the experience. 

Aromatherapy – Smell is a powerful sense! It can remind us of childhood, a favourite day or moment in our past. It can make you feel safe and secure, relaxed or wide awake and refreshed. During labor and birth try using essential oils in an oil burner or on a tissue. Ylang Ylang, Lavender, Frankincense, Neroli and Chamomile are just a few that can help by reducing fear, relaxing body and mind and even promoting a happy attitude; they relieve depression and anxiety. Many can be used during pregnancy too to aid different ailments but do research this before hand and seek advice where appropriate from an aromatherapist; some oils cannot be used during pregnancy. It is also important to buy quality grade oils to get the best effects. There is some great information here about essential oils.

Breathing – Effective controlled breathing is very important during labor. Breathe long and slow through the pain, always being mindful of your breathing to keep in a relaxed state and to also avoid feeling sick and dizzy. 

Meditation – This really takes breathing to the next level and encourages an almost trance-like state where you go beyond the pain using visualisation methods. This can be harder to achieve than many other methods mentioned here but can greatly reduce pain if accomplished. Meditation is another branch of ‘hypnotherapy’ and ‘hypnobirthing’ mentioned below. A great way to stay focused is to repeat affirmations and connect with your baby.

Hypnotherapy – This is a form of self-hypnosis using visualisation and deep relaxation to conquer specific fears and concerns regarding labor and birth. This can be especially useful for those attempting breech and vaginal birth after caesarean section (VBAC).

 Hypnobirthing – This is a technique incorporating breathing and visualisation practices to have a more positive birth experience. This is a book and CD offering a fantastic hypnobirthing package.

Water – Just like a warm bath can ease menstrual cramps, being immersed in warm water can help ease labor pains while also relaxing the mother. You can choose to hire or buy a birthing pool (or a big paddling pool) to labor and give birth in. Baths are generally too small for the actual birth but can be used for much of labor if you prefer. Even a shower can be used as some find the warm water pulsating on the back or stomach during contractions helpful.

Keep moving and birthing positions – Anything goes here! Squatting is a useful position, especially during the final stage of labor as it opens up the pelvis to allow baby more room, this will also help mum to feel more comfortable. Also walking through contractions, being on hands and knees and even hanging from a strong bar, door frame etc. can all help one to handle the birthing pain!

Massage – Either to alleviate pain or even just to help mum relax. During posterior labor, a birth partner massaging the laboring woman’s lower back very hard during a contraction, helps combat some of the sharp pain.

Acupressure – This links quite nicely with massage. You can do this yourself but having a pair of extra hands will enable you to feel the benefits while having contractions. Points of the body are pressed during contractions and labour to help ease pain. Try to locate these specific points during pregnancy as a guide for labor; they should not be pressed hard during this time, as they can affect pregnancy and even bring along an early labor. Read more about it here. 

Heat – Using warm water, a hot compress (a cloth soaked in hot water and rung out for example) or a heated wheat bag placed either on the lower back or the stomach can really help ease discomfort.

Be vocal! – Women all labor differently and while some are quiet laborers many are not. It really does depend on the mum-to-be but being noisy can help them to get baby out! Low belly growls and hums can be particularly effective during a contraction. Or even try singing!

Healthy Pregnancy – This won’t come as a shock to you, labor is HARD work! The affect it has on our body is akin to that of running a marathon. With this in mind you must ‘train’ yourself to run that marathon of birth! Eat well (eat for energy not for weight loss), exercise daily but gently (yoga and walking are highly recommended) and try to keep a positive attitude throughout. Use those months of pregnancy to prepare for birth. The pain may still be there but your tolerance and endurance will be increased. Here are 10 tips to a healthy pregnancy

Reduce fear – During labor our clever bodies produce endorphins to help us deal with the pain. Fear makes your body produce adrenaline which counteracts the effects of the endorphins; fear makes muscles contract and pain stronger.  Reduce labor fear as much as possible during pregnancy and then try to relax (as much as is humanly possible) during labor. Of course that is easier said than done but making strong decisions during pregnancy about the birth will help you feel empowered, in turn this may help you control the fear. Here is an interesting read written by a midwife about fear during the birthing process.

Keep your goal in mind – You chose to use natural pain relief for a reason, keep that in mind when things get tough. It is very helpful to have a birthing partner (whether your midwife, husband/partner, doula etc.) who understands your choices and will help encourage you, especially during the later stages of labor when tiredness may become a factor.

Remember that the pain you feel is a positive pain (I wouldn't recommend saying that to a laboring woman, I will not be held accountable for her actions!); it is a means labor is coming to an end. It is the natural and intense waves that are helping your body push that little life out. As you ride the pain think about how your uterus is working together with your baby, in harmony, so that he can join you.

3 things that the internet, books and movies cannot tell you about labor and birth.

  1. What does it feel like?
  2. How long it will take?
  3. What will happen?

We want to know in absolute detail because we need to prepare ourselves.

So we read books, attend courses, and use google extensively to research information around subjects of the signs of labor and the stages of labor. Surely, we will find the answers there? Well, yes, we find all the answers and more. However, at some stage we realize that all we really know is what it might feel like, how long it might take, and a deeper understanding of what might happen.

So we read birth stories and watch birth movies and every single one is different! How scary is that?

So is there anything that we know for sure about labor? YES THERE IS……

Every labor is unique, individual and variable.

Let me say that again, in case you did not get it the first time.

Every labor is unique, individual and variable.

In other words – we can tell you a whole lot of facts, but afterwards there is a good chance that you will look back and say “well that never happened to me. Did I miss something? ”

Like Josie who attended my birth preparation classes and called me after her baby was born to update me. “I never had early labor” she said, “it was just BAM, straight into active and 3 hours later he was born.”

Physiologically all the things that happen in early labor must happen in order for labor to progress. However, the way we experience them on a physical level is unique, individual and variable. In Josie’s case, she never experienced anything physical until she was in active labor- at which time she made her way to the hospital to find that she was already 7cm dilated. Her body had been making physiological changes for hours (possibly days) before that – without her being aware of it. She was so chilled and relaxed that she never took much notice of it and so labor progressed smoothly; and in her case pretty quickly.

The problem with learning the facts is that a lot of them focus on the physiological changes like the dilation of the cervix. Although these signs are important, they are measured by invasive procedures like vaginal examinations (these are usually done at the hospital by your midwife or doctor). Wouldn’t it be great if a sign board flashed up saying “Well done, you have just completed early labor and you are now entering the active phase? Sharp turns predicted for the next 8 hours. Expected time of arrival 16h45 “

Well yes, that would be helpful. Lovely in fact. But totally inaccurate. For instance if you were Josie, you missed the early labor sign board and active labor for her was 3 hours not 8. For Sarah, there were sharp turns for 8 hours which turned into a steep uphill battle and resulted in emergency evacuation.

So let’s take a look at what happens on a physiological level and some of the variables in each stage.

EARLY LABOUR

How long might it be?

8-12+ hours is the average of very mild, not much happening, is-this-really-it type sensations.

What is happening in your body? What physiological changes are happening that would cause the sensations you might feel?

Your cervix is soft, ripe, and yielding. You may (or may not) experience backache or period like cramps lasting anything from 15 - 45 seconds and usually at irregular intervals. You may notice that your belly hardens and feels tight during surges. Your cervix responds to the surges by starting to shorten and open. According to the stages of labor, dilation of up to 4 cm happens in “early labor” sometimes without you even noticing it.

What might you feel?

Confused - is this it? Or is it just more Braxton Hicks? You might feel a combination of excitement and fear (of the unknown).

What should you do?

If it is the middle of the night or early hours of the morning, roll over and go back to sleep – if you really cannot sleep through the surges then get up and distract yourself, go for a walk, watch TV or find something to do that takes your attention away from just waiting for the next surge to time it. As long as possible – ignore it until it is impossible not to. At that stage you should be nearing or possibly in active labor - which for some women is the longest or most intense phase of labor. Others find pushing and birth to be the most intense.

ACTIVE LABOR

How long could it be?

6-8+ hours is the average but it can be as little as 2 and as long 20 (sometimes more).

What is happening in your body? What physiological changes are happening that would cause the sensations you might feel?

Your cervix is probably soft and open to at least 4 cm, possibly more.  You might be feeling slight pressure over your pubic bone if your baby is low and well engaged. This is great as the pressure of the baby’s head over your cervix helps it to dilate.  Your uterus has established a good rhythm of regular surges that are doing the work of opening the cervix and nudging the baby down.

What might you feel?

By this stage you would normally be experiencing regular surges lasting at least 60 – 90 seconds and coming at regular intervals of at least every 5 minutes or less. You will find that you need to breathe through the surges to stay focused and talking during surges is hard and feels unnecessary. You become quieter and more serious, more inwardly focused – deep down you know that this is real labor. You might also be experiencing backache if your baby is in a position that exerts pressure over your sacrum.

What should you do?

If you are having a hospital birth, this would be a good time to go or at least be ready to leave, depending on how far the journey is and what road conditions are like. If you are at home, call your midwife and make sure you have everything ready. You might think about getting into your tub at some time during this stage.

Most important is to consciously relax using your breath - long, full, deep breathing through surges and easy breathing between surges. Remember that the spaces between the surges are every bit as important as the surges themselves – they are a time to rest and recover. Stay focused and present.

Use visualization techniques to “see” what is happening in your body while you “feel” it. Allow your instinctive brain to take over and let your body do what it knows how to do. Move your body, work with the sensations and use them as a feedback to know how to move and what positions feel good and “open.” Let go and surrender to the power of labor. Let go of how long it might take. Let go of what might happen and let what is happening happen. Be in your body. Connect with your baby.

If you are able to let go and let flow then active labor establishes a beautiful rhythm of strong surges that nudge the baby down and at the same time pulls the cervix up to its widest diameter. Once that happens you can follow those same instinctive urges to breathe or push your baby out into the world.

In order to allow labor to unfold in its own unique, individual, and variable way we need to trust:

  1. The process of labor
  2. Our bodies
  3. Our partner
  4. Our midwife/doula/doctor
  5. Our place of birth

We also need to let go of any ideas of what should happen and just allow whatever is happening to happen whilst understanding that the physiological changes are accompanied by changes in your behaviour, your attitude, your breathing, and your activity.

By listening, trusting, and responding to these changes you will instinctively know that things are moving along. You will know that it is time to call the midwife or get to the hospital.

 

Published in Birthing Assistance

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