Some people might laugh at me when I say that labour can be comfortable and enjoyable. Maybe they think I am nuts. (I guess I am a little!) However, I can put my hand on my heart and say that the contractions, for both of my children, didn’t really cause me any real discomfort. I am by no means a warrior, nor do I have any super powers; in fact I am quite a weakling when it comes to muscle power in everyday tasks. What I did possess in the lead up to both labours was information, tools and techniques.
By information, I mean that I researched what to expect from labour and learned what my body had to go through in order to help my baby out of the womb and into this world. I did this by: reading books, attending the NHS Parent Craft classes and teaching myself hypnobirthing techniques in pregnancy that would become second nature during labour and birth.
By understanding what to expect and how to deal with birth, meant that I could go into the experience with a positive mindset. It made sense that the uterus contracts regularly to help ease baby gently into the birth canal. Nature doesn’t intend for this to be painful, but when we are scared we tense up and when we tense up the muscles don’t work efficiently because they have to work against the tension (creating the pain that people often associate with birth). If we relax and let go, these muscles can work more efficiently and without working against the resistance (therefore pain-free).
So how do you get to remain calm and confident as your labour-day approaches?
Become knowledgeable about the process of late pregnancy and birth. Understand what options may arise on the day and know, what the pros and cons are and what choices you can make. You can do this by going to classes in your area. The NHS often provides a range of free classes, or you can look up independent businesses that support women in pregnancy, such as pregnancy yoga, hypnobirthing and relaxation classes.
By understanding the biological changes within the body you learn to accept that this has to be. Working against it, only makes it harder for you. Try to figure out if there is anything that is worrying you about birth. Can you seek advice from someone who can help allay those feelings? Your midwife or an independent antenatal educator may be able to advise you.
Tools to help you relax during labour
There are a host of tools that you can use during your labour to give you comfort. Here are some examples of what you might find useful to use:
1. Rocking on a Birthing Ball / Bounding on a birth ball
Time spent gently moving back and forth on a birthing ball as you breathe deeply, can help you relax during labour. Rocking back and forth, side to side or rotating the hips, either in circles or figures of eight, can help encourage baby to descend lower into your pelvis. You can also try bouncing gently on a birthing ball. Always ensure that your hips are slightly higher than your knees, this will help tip the upper part of your body forward, which will then put the baby’s weight on the front part of your pelvis, allowing it to widen and give your baby more space to descend. Being upright in birth often speeds up labour.
2. Being in or under water
It is recommended in early labour to have a bath or shower. Who doesn’t like spending time under or in warm water? This enables relaxation. When you are calm and happy the body produces the hormone oxytocin, which is one of the major hormones that facilitate contractions. Try sitting in a shower with the spray against your back, or lying in a bath, in early labour.
If you choose to give birth in hospital, you can use the bath or shower in your room too, or if you want to use the birth pool for relaxation in labour, this is possible too.
Not all birthing centres or hospitals have a tub or shower in the room, so this is not always possible.
3. TENS machine
A TENS machine sends electrical pulses (on your back) which are believed to prevent pain signals from reaching your brain and stimulate your body to release natural, feel-good substances (endorphins).
Make sure you have your favourite, relaxing songs on your phone, tablet, or laptop. Don't forget your headphones, as maybe your taste in music isn’t the same as yours – and vice versa!
Wonderful smells help you relax and feel better, so take fragrant lotion or potpourri for your room to give yourself a lift.
Women who have attended hypnobirthing classes agree that this has helped them be focused, relaxed and it has reduced muscle tension and pain in childbirth (they don’t tend to labour like the scenes you see on TV. Hypnobirthing takes practice, so that the techniques that you learn become embedded and can be easily used during labour.
Breathing techniques help keep you relax and focus your attention. Visualising a beautiful scene in your mind, one that makes you feel safe and relaxed is also taught, so that you can focus your mind on this place when you have contractions. Read more about hypnobirthing classes.
Have your partner massage your arms, legs, or back during labour to help you relax and to decrease tension and pain.
8. Walking or Rocking
Walking, or even just pacing right by your bed, decreases discomfort while helping your contractions become stronger and more regular. Or you could try rocking back and forth with your partner while leaning on him.
9. Changing Positions
Don't stay in the same position for too long, and don't lie flat on your back. Instead, try sitting up in your bed or a chair, lying on your side, squatting and rocking on a birthing ball, or leaning forward over the back of a chair or your birthing bed. If possible being mobile during labour helps your contractions progress.
The important thing for now is to do your homework. Find out all you can about your options, talk to your health care provider, and trust yourself to make the decisions that will work best for you and your baby.
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Magical Baby Moments is a Romford-based company offering all expectant parents hypnobirthing classes in Romford and Upminster in Essex.
To help couples with different work patterns and external commitments, Magical Baby Moments offers hypnobirthing courses on weekends as well as week nights.
Weekend courses are a wonderful way to get all the information in one short burst. The weekend hypnobirthing course runs from 10am-4:30pm on Saturday and 10am-1:30pm on Sunday. Whether you are looking for a Romford Hypnobirthing Course or Hypnobirthing classes in Upminster, both settings are relaxed, friendly and welcoming. Groups are limited in size to enable as much interaction as possible; so that couples feel comfortable to ask questions
Hypnobirthing courses are beneficial any time from 20 weeks onwards. Don't worry if you are further along, it's quick and easy to learn the techniques and information to enable you to have an empowered birth.
Whichever hypnobirthing course that you choose, it will include 10- 12 hours of teaching time. You will also receive:
1) The Katharine Graves Hypnobirthing Book
2) Colour & Calmness relaxation tracks
3) Handouts that support the lesson plans
4) Support by phone/email up until the birth of your baby.
2018 Weekend Hypnobirthing Courses
These are all the weekend hypnobirthing courses taking place in 2018 with Magical Baby Moments:
You can book you place directly now via PayPal, by visiting out Classes page.
Read what couples who attended Magical Baby Moments Hypnobirthing course, thought of the course content and the hypnobirthing teacher.
What better way to get to know what people thought of the course than through their feedback: Go to our Testimonials and Birth Stories pages to read more, in the meantime, here are a few:
"We found the course to be easy to follow with great opportunities for discussion to develop our understanding to best prepare us for the birth of our first child. Feeling positive about the next steps..."
"The hypnobirthing experience has been very insightful and interesting. I no longer feel scared and anxious about birth and look forward to using the techniques I have learnt during labour. I would definitely recommend this course to expectant parents."
"This course has helped me change the perception around birth with the techniques learnt I hope as the partner I am able to assist in a much more relevant way."
Want to find out more about hypnobirthing before you commit to a course? Buy this book.
If you would like to find out more before committing to a course, then read this book The Power of Hypnobirthing: 10 reasons why it's for you , which explains what you will get from a hypnobirthing course.
It really is up to each mother, and the circumstances surrounding her pregnancy, as to which way she may want to give birth. There are two options for giving birth: a vaginal birth after Caesarean section (VBAC) or an elective repeat Caesarean section.
Most women can have successful VBACs without any complications. However, one of the risks that you will hear a lot about is uterine rupture. This is when the scar along the uterus from a previous C-Section opens during a vaginal delivery. It is very rare and affects less than 1 percent of pregnant women, but it is important that you know this risk.
Your caregivers will know that you previously gave birth via C-Section and will watch out for any signs of uterine rupture during your labour. During your labour you will be checked more closely and more often when you have opted for a VBAC. During your labour you'll be offered continuous electronic fetal monitoring. This will measure your baby's heart rate and your contractions. Your baby's heart rate can give caregivers an early sign that your uterine may have ruptured. Should this happen they will act quickly and offer you alternative care for your labour.
Because it is a riskier procedure, your doctor may recommend that you give birth in a labour unit. This may sound alarming, but they are mitigating the possibility of things taking a turn and there being a delay in your care. Of course, ultimately it is your decision where you prefer to give birth.
It is important for you to know that if you go into labour prematurely (before 37 weeks), VBAC is still an option.
Can I have pain relief during a VBAC?
Yes. You should be able to have the same pain relief options during your VBAC that you would have been offered during a vaginal birth. However, be aware that if you had an epidural, this form of pain relief would block out the abdominal pains in between contractions or sudden feelings of tenderness of your scar. Being numbed means that you may not be aware that you have symptoms of a uterine rupture.
You should be able to use a birth pool for relaxation – your caregivers can let you know if this is not possible in your case.
Many units have waterproof continuous monitoring systems (telemetry), to make it possible to monitor your baby whilst you are in the pool.
What’s the alternative to a VBAC?
If you’re unsure whether you want to have a VBAC, you could opt for planned repeat caesarean. This is usually booked close to your due date, unless your doctor can clinically justify your baby being born sooner.
If you have experienced any of the following, it may be advisable not to go through with a VBAC
It is recommended to speak to your caregivers and ask them specifically about you and your baby. If they present evidence, does that tie in with your medical situation? Don’t be afraid to ask questions.
If both VBAC or planned C-Sections are options available to you, you'll have plenty of time to consider the risks and benefits of each. Talk to your obstetrician about your previous birth(s). Find groups to speak with women who have been in your position, such as VBAC Empowerment & Support Group. Get varied opinions and experiences to ensure that you are comfortable with your decision.
What are the advantages of a VBAC?
A successful VBAC carries the lowest risk of complications. If you have a VBAC, you’ll avoid the risks associated with repeat caesareans and have a quicker recovery time. Looking after your child and your new baby following a vaginal birth will be easier on you.
Planned C-Section babies born before 39 weeks are more likely to have trouble breathing after it’s born, compared with a baby born at the same time vaginally. However, if you do have a repeat caesarean before 39 weeks, your doctor is likely to offer you steroids beforehand to help prepare your baby's lungs and reduce their risk of breathing problems. Again it’s up to you to decide if you want to take the steroids.
With a successful VBAC, you'll have a shorter stay in hospital and you should experience less pain and discomfort in the weeks and months after the birth.
If you‘re planning more pregnancies, then trying for a VBAC may help you to avoid future complications that are more likely after repeat caesareans, including placenta praevia, placenta accreta and hysterectomy.
Once you've had one successful VBAC, you're more likely to have another one in the future.
Are there disadvantages to having a VBAC?
There a no disadvantages to a VBAC, in as much as, there are things that can happen to a woman who gives birth vaginally. These can include:
Pregnancy itself can weaken your pelvic floor, so having a C-Section doesn’t mean that you won’t have pelvic floor issues in later life. It's important to do pelvic floor exercises, whichever way you give birth.
How do I decide whether to plan for a VBAC?
Take time to explore your feelings about the birth. Have you had the chance to talk about your previous birth(s). What is your body instinctively telling you to go for? Never ignore your intuition and gut feeling. Talking it over with your caregivers and your loved ones, may help. You may want to look online for groups that support women planning a VBAC, such as the VBAC Empowerment & Support Group on Facebook.
What are my chances of a successful VBAC?
If you needed a caesarean to give birth previously because of a uterine abnormality, then you may need to have a repeat caesarean. Each woman needs to be assessed individually. However, if you had a C-section because of something unique to your last pregnancy, such as a breech baby, pre-eclampsia or a low-lying placenta, you stand a good chance of having a successful VBAC. Having a supportive team comprising of both medical caregivers and family members, can hugely impact your chances.
VBAC success rates are lower if you:
Can I have a VBAC at home?
Yes if you want to. You caregivers will advise you as to why they may not recommend this.
Having a VBAC in hospital means that if your scar tears you can be treated straight away. A c-section should be done as soon as possible. If you’re planning to try for a VBAC at home, it may help to find out what the transfer time to hospital would be.
If your heart is set on a home birth, it's worth contacting a local supervisor of midwives or midwifery advocate by phoning your maternity unit. A senior midwife can take you through all your options and help you to plan the safest care for you and your baby.
Another option is to employ an independent midwife, but you’ll have to pay for her services. Use the Independent Midwives Association’s Find a Midwife service for a list of midwives in your area.
Case study, Joanne gave birth in Harold Wood Hospital in Essex
We asked a mum of three about her two VBAC experiences.
How did you decide to opt for a VBAC?
I decided for VBAC because I wanted to experience a natural birth and felt I had missed out!
When did you decide this?
I had wanted to do a VBAC even before I fell pregnant.
How were the antenatal midwives when you said you wanted to do this?
The antenatal midwives were very supportive, but they were always reminding me of the risk of my womb rupturing from the previous c section. I was advised that when I went into labour that I was to go to hospital straight away, so they could keep an eye on me because of the risks, especially uterine rupture.
How were the labour staff about you wanting to do a VBAC?
The midwives did not try and sway me, they were very supportive.
Were they spontaneous or induced labours?
The first VBAC in 1997 was induced at 41 weeks. I was induced repeatedly with a pessary, then eventually with the Synthetic Oxytocin drip.
I was very well-monitored during this labour. This labour lasted around 24 hours. I remember having the first pessary the day before. I was having contractions but then they would stop, that’s why I went on to have the drip. There was so much intervening because of being induced, this made it feel like it went on forever.
This birth was extremely painful! I was prescribed pethidine which made me very sick. I ended up having an epidural, then I went off to sleep. The birth when it eventually happened was a very good experience, I had no pain, the pushing was an unusual experience as I couldn’t feel very much, due to the epidural. I gave birth on the bed, in the normal laying on your back position with my husband next to me, he cut the cord. I was advised not to give birth in a pool because it was too risky.
I had trouble with the epidural afterwards. I bruised my coccyx bone and I was in terrible pain. The pain lasted for about a week.
My second VBAC in 2004 was spontaneous at 37 weeks. My waters broke when I was sleeping in bed, I felt a pop and then, a trickle of water, this was just before 6 in the morning, I remember changing the bed before going off to the hospital. On arrival at the hospital I was monitored but I’m assuming that because this was my second VBAC the midwives felt quite relaxed with me. I spent most of the day walking the grounds of the hospital trying to increase the intensity of my contractions. This really did help and I went on to have him at 1 o’clock in the morning.
I was left to fend for myself for this birth. I was assigned to a designated group of midwives, who were attached to my doctor’s surgery. When I went into full labour they were called and came to the hospital to deliver my baby (I’m not sure if they still do it that way anymore). I felt that they thought that because it was third time that I knew what I was doing. The midwives were more concerned for the first-time mothers, which was terribly unfair. When they realised I was dilating rather quickly they panicked, which was very bad because they should have been watching me more closely because of uterine rupture. However, when the midwife did turn up it was a very good experience. The birth was a wonderful experience, maybe because I knew what to expect, I gave birth with just gas and air, which made the whole experience very real! I could feel every pain and movement in my body, an absolutely unforgettable experience. I wasn’t afraid this time, I knew what was about to happen. I thoroughly enjoyed the whole experience.
What were the differences between the experiences?
The difference about the two experiences were to me, the unknown and then of course the experience of the knowing.
What would you recommend to mums to be thinking about opting for a VBAC?
I would definitely recommend a VBAC. Having a natural birth is an experience that is magical and it’s so much easier to get over. A C-section is a major operation!
If you are planning a VBAC, you can find more information on the AIMS website and their post on VBAC – On whose terms?
The Microbiome Effect by Toni Harman and Alex Wakeford is must-read. It is a fascinating account of emerging research that shows how vital bacteria are for human health. Our exposure to them during labour, birth and beyond helps develop the immune system. It talks about how C-Section deliveries impact the immune system. This in turn makes them more susceptible to non-communicable diseases.
Here is my synopsis for all birth educators and expectant parents. In this blog, I want you to understand the intricacies of a vaginal birth and the vital components that help your baby thrive.
The human body is made up of of trillions of human cells and microbes (bacteria, viruses, archaea, fungi etc). These cells and microbes live on and inside us. The bacteria inside our body help it work properly and give it the ability to fight off diseases.
There are aspects of today’s way of living such as diet, antibiotics and C-sections - to name a few – that are adjusting the diversity of microbiomes in the human body. Current research suggests, this change in the way we live is giving rise to many common non-communicable diseases. They include allergies, asthma, auto-immune disorders, diabetes, obesity and more.
All the way through pregnancy, labour, birth and infancy, development happens in a particular order. When the birth process is interrupted with medical intervention, the primary layers of the immune system are disturbed too.
Research has also shown that the microbial profile of a baby born vaginally resembles that of its mother. This profile similarity continues with each generation that is born vaginally. However, this pattern is interrupted by a C-section delivery. In these instances, the child may not match the mother’s microbial profile and it may fail to inherit critical ‘keystone’ species of bacteria to ensure good health. C-sections could be contributing to key microbe species being lost, making us more susceptible to pandemics.
Other evidence suggests a correlation in C-section babies having a higher risk of developing asthma, type one diabetes or coeliac disease, and of becoming overweight or obese. This is not to say that all babies born this way will go one to develop any of these, they are simply more susceptible. What we don’t know yet are the ongoing repercussions of this.
For a long time, antenatal educators have discussed the benefits of a vaginal birth vs a C-section birth, but for many other reasons. One of these reasons is baby's ability to breathe with more ease straight after birth. In a vaginal birth, the birth canal compresses the lungs to expel the liquid that has been in them during pregnancy. Once the baby is born, they tend to breathe more easily. This is not always the case for C-Section babies born at the same gestation.
The Microbiome Effect looks into many other vital stages that a baby encounters during a vaginal birth. It reveals how a C-Section can impact his/her long-term health.
During pregnancy a baby lives in a near sterile environment and exposure to microbiomes is minimal. In a vaginal birth, once the amniotic sac had ruptured, a baby begins to be exposed to bacteria. This is when it comes into contact with vaginal, faecal and skin microbes. These enter the baby's eyes, ears, nose, as well as being swallowed through the mouth. This prenatal exposure is one of the main seeding events for the baby's gut. Once baby is born, it will come into contact with more bacteria. These encounters help to colonise the baby's gut.
Babies born via a Caesarean section, when the amniotic sac hasn’t ruptured, won’t come into contact with the mother’s vaginal or intestinal microbes. As a result. the baby’s gut microbiome composition will be different.
Babies born via C-section are recommended to have skin-to-skin contact and breastfeeding where possible. Why? Because this is the second major influx of microbes exposed to newborns. (Babies born vaginally are also recommended to do this too).
During skin-to-skin contact, and when a baby is looking for milk, it will open its mouth and suckle or lick the mother’s skin. Breastmilk provides essential nutrients for the baby's growth and development. This includes key immune components and sugars. The sugars provide energy for the baby. But it also feeds the bacteria in the gut, quickly colonising it. It prevents other harmful bacteria from taking hold. These events provide contact with the right bacteria to continue the development of the infant immune system. It learns to recognise friendly and harmful bacteria, and know what to attack, or not.
In contrast, a baby that is fed formula milk will only receive the nutritional benefits. This milk is missing prebiotics to feed the gut microbes. It also lacks the right bacterial species and immune components that the developing baby needs. These missing components could mean health implications later in life.
So what can we do about it?
As an antenatal educator, I feel it is my duty to inform my parents of the potential health implications of babies born via a C-section. Parents need to better understand the importance of vaginal births, as a way to ensure that their baby receives the necessary exposure to bacteria, which will help colonise its gut in the right way - to ensure a fully-functioning immune system.
There will always be world in which some babies need to be born via C-section. In these cases, there are steps the caregivers can take to help the baby receive optimal seeding and feeding. They can test mothers to see if they are suitable for “swab-seeding” (this is currently under a strict protocol). Babies should be passed to mum's chest immediately after birth, even if that means assisted. If the mum is unwell, the baby can benefit from aided skin-to-skin contact. It may even seek the breast for its first feed. This allows the baby to be exposed to essential bacteria and microbes.
This article only scratches the surface and highlights the key points of the book. I strongly recommend mothers to read it and learn more about it. Ask your midwife and/or obstetrician how much they know about this subject. If they don’t know too much about this subject, politely ask them to do their research. Your baby’s life is in their hands.
The Microbiome Effect is published by Pinter and Martin. It is available on their website: http://www.pinterandmartin.com/the-microbiome-effect
This is a very important question to ask? Is it your medical caregiver or you, the parents?
The answer is YOU.
It is up to you to choose where to give birth. Will it be a hospital, a birth centre or at home (read more about this in my blog: How to decide where to give birth: what are the options). You need to decide what type of childbirth care you want/need to have. This is either midwifery care, or obstetric care. Midwives will take care of women opting for a vaginal birth. This can start either spontaneously or it may be induced. A woman using obstetric care will usually have a more medicalised labour.
But here are some things to ponder when it comes to your baby's birth.
If you are not confident about what labour and birth may bring, speak to your midwife. You may also want to consider investing in an antenatal course such as hypnobirthing. It will arm you will all the information that you need about what to expect. It will give you lots of tools and tips to keep you calm, confident and comfortable during labour too.
For more information about course availability visit our hypnobirthing classes page.
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I'd like to think that there are lots of women out there having good birth experiences. Here are some tips on how to make your baby's birth special to you.
There is so much to learn when it comes to pregnancy, labour and birth. Sadly our stretched NHS midwives are unable to fully inform women of the choices in pregnancy labour and birth in antenatal appointments alone. In many Trusts there are limits on the number of people who can attend antenatal classes. Therefore more and more women are seeking out independent antenatal classes, such as hypnobirthing. A hypnobirthing course offers comprehensive antenatal education that gives parents the time to think about their birth preferences.
Place of birth
Decide where you would most like to give birth. The choices are:
Some people quickly make assumptions on each of these settings. When you look at them in a pragmatic way, the differences are minor. However, the outcomes on the birth experiences can be significant. Make yourself a chart and list out what you want/don't want from birth. Decide which of these settings provides the best place for you to achieve the birth that you want.
Make sure you find out what labour and birth involves. It's good to find out the most common scenarios and learning what the risks and benefits are. I recommend, that you research natural births, induced births and c-section births. Read up on how labour evolves in each of those scenarios. After this exercise you will have a firmer idea about which birth you prefer?
There are many ways a woman can be supported during birth.
Natural forms of support include:
Medicalised relief includes:
Find out the risks and benefits of the medicalised pain relief options and the impact they have on both the mum and the baby. Decide from there what you are comfortable with taking. Also list those that you may prefer not to use unless needed on the day.
Learn how to relax
Once you are in control of your experience. You are more likely to be comfortable and calm. This is key to helping you relax. Simple breathing techniques; calming visualisations; positive birth statements or affirmations, are easy ways to help you feel calm and relaxed.
Learning what may happen will give you the confidence to deal with any situation that arises. If you are well informed and know your choices you are in a strong position to take control. When you make your own decisions, you will feel empowered and comfortable. These are huge steps that lead towards a positive experience of labour and birth.
Would like help learning techniques to remain, relaxed, focused and in control? Do you want to find a comprehensive antenatal class that informs you of all the common scenarios? Then hypnobirthing classes, for you and your birth partner, will help you to achieve that.
Magical Baby Moments' hypnobirthing classes not only teach you relaxation techniques, but they also covers many aspects of labour and birth. We cover topics such as:
Read more in the classes section.
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Here are some things you should think about to help formulate your ideal birth:
1. Where do you want your baby to be born – hospital, birth centre, at home?
2. How do you feel about being induced/having your waters broken?
3. Do you have a preference to only being seen to by women?
4. Would you mind any students being present during your labour and birth?
5. Do you want to be active during labour, such as being able to walk around? (ask your midwife to use the wireless monitoring if you need it, formally known as telemetry)
6. What labour techniques do you want to use? Hypnobirthing, water birth, listening to music etc?
7. Do you know what pain relief you would/wouldn’t like?
8. How do you want your birth partner to support you?
9. How do you feel about medical intervention? Detail your list in order of preference.
10. How long do you want it to be until they cut the umbilical cord? Read about Optimal Cord Clamping.
11. Do you want your partner to cut the umbilical cord?
12. How do you want to find out the sex of the baby - be told/see for yourself?
13. Do you want your baby delivered onto your stomach?
14. Do you want to do skin-to-skin contact straight away?
15. Do you want to try to breastfeed straight away?
16. Who do you want to get the baby dressed?
These are just some pointers that will help you decide what is right for you.
If you want some extra help, go the NHS website to download a birth plan template.
Be sure to write it down and attach it to your maternity notes. Make sure that your birthing partner knows where it is so that they can relay your preferences to your midwives.
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Birth is a woman’s right and how she chooses to go through her pregnancy and how to give birth should always be in her control. If you're on your first pregnancy, no doubt you have been reading countless books, been getting advice from medical professionals and recommended by family and friends what you should do.
During pregnancy, there are tests and scans that are usually carried out. Having them is not obligatory. You can say ‘no’; tough many don’t realise that there is a choice. Rarely are parents told of the risks and benefits of each test before having them carried out.
The medical professional is there to advise and inform you of your choices; however the ultimate decision should always lie with you. Here are some considerations that you might want to think about:
Where to have your antenatal check-ups
Your antenatal care can be provided in a number of ways. You could book your appointments at the local Children’s Clinic, you could be assigned a visiting community midwife at your local doctor’s surgery, or you may have your antenatal care directly with the hospital at which you will give birth. Ask about each option to find out which option would best suit you.
Dating Scan – the rigidity of it
Often women will calculate their due date based on their last menstrual cycle. Then at the first scan, which is around 12 weeks into her pregnancy this date is likely to alter. Note that scans aren’t always accurate and the due date can often out between 3-5 days. If they measure the baby bigger, then this would give a mum an earlier expected date, which at the end of pregnancy means an earlier date for potential pressure for an intervention/induced birth.
It’s worth noting here that the World Health Organisation states that a baby is at full term from 37 weeks and if born at this point usually doesn’t need medical assistance. Yet it is also perfectly normal for a woman to give birth around the 42 week mark. So the rigidity of a single day is nonsense when you think about it. Only 4 per cent of babies are born on their due date, and the majority of babies are born after their due date.
Also be aware that having scans is not compulsory, in fact some might argue that as they don’t alter the course of pregnancy, is there really a need for them at all? For many women, they provide reassurance that the pregnancy is progressing well, however for others, the results of a scan can bring unexpected news. How does this alter how the woman feels in pregnancy? If you would like to read more about Ultrasounds, I recommend the book written by the Association for Improved Maternity Services (AIMS) called Ultrasound? Unsound
Gestational Diabetes test
Gestational Diabetes is a high blood sugar condition that women can get during pregnancy. Between 2 and 5 per cent of pregnant mothers develop this condition.
Only about 30 per cent of women who test positive on the glucose screen really have the condition. If you test positive on the screening, you'll need to take the glucose tolerance test (GTT) – a longer, more definitive test that confirms whether you have gestational diabetes, or not.
How will I know if I might have gestational diabetes?
A routine urine test will show a lot of sugar in your urine. If midwife notices this, she may want you to be tested for this. Even if the results are normal, you may be screened again at 24 to 28 weeks, just to be sure.
If you are diagnosed with Gestational Diabetes, your pregnancy will move into the ‘high risk’ category, which in turn could mean birth choices being taken away from you; such as no longer being able to give birth in a birth centre or midwife-led unit. The reason for this is that with gestational diabetes babies can grow bigger than the expected range for birth and the health system would prefer to monitor you in the labour ward, where facilities are on hand should they be required.
This is why it is important to maintain a healthy diet throughout pregnancy, so that your blood sugars remain in the normal range. Avoid sugary foods and drinks before midwife appointments to avoid unusual readings that could lead you along this path.
Where to have your baby - hospital, midwife-led unit or home birth?
In the UK, the NHS, in fairness, is trying hard to normalise birth (read about the Better Births Initiative). While many births still take place at hospital, the NHS is working towards making it less of a medical procedure and more of the wonderful experience that it should be treated as. The NHS is investing in more birthing centres, many of which are within a hospital setting. The centre usually has a more hotel-like feel rather than the medicalised setting that a labour suite tends to have. The centres are managed only by midwives, which is why they only accept women with low-risk pregnancies.
Women who are considered high-risk would be in a labour ward, where obstetricians are available to help, should any emergencies arise.
In recent years there has been a push for home-births. In the Better Births Initiative link (above) it states: ‘Birthplace research shows that healthy women with planned births in midwife-led units and at home were more likely to have a normal birth as compared with obstetric units.’
Home Births are intended for women who have had low risk pregnancies and where midwifery care comes to your home to help you in give birth to your baby.
So is where you birth really a choice? What if you did have factors that put you in the high-risk bracket…are some of those choices no longer available to you? Each woman’s circumstance is different, so speak to your midwife about your plans for birth to see how they can accommodate your preferences.
Should I take their advice for an induced labour or can I wait for labour to start spontaneously?
As your due date approaches, your midwife is likely to say to you something along these lines. ‘If baby hasn’t arrived before so-and-so date then we will book you for an induction’. Please stop her right there and simply ask the question, ‘Why? What medical concerns do you have for me or my baby?’
According to the National Institute of Clinical Negligence (NICE), an induction should only be suggested to mothers when there is a clinical justification – read the NICE guidelines. If all is well and your baby is happy where they are and you both just happen to be past the due date, this is NOT a reason for induction. However, many women just aren’t aware of this.
Because it has become so routine in our modern society, women seem to accept this as the way it has to be, without questioning why. For those who haven’t read up on their choices, they may easily accept this information and just say to friends and family. ‘I’m going to be induced on so-and-so date.’ But what they are not told is what the medical reason is for this. The late arrival of a healthy baby, with a mother who is not presenting any medical concerns, is not a clinical justification.
Quite often women aren’t talked through what an induction really means, how this type of labour feels, compared to a spontaneous labour, and what risks are involved during an induced labour. In many cases an induction leads to a C-section. I often wonder if these outcomes could have been avoided, if they had been given more time for a natural labour to start.
Just think back to when you first fell pregnant? Did you calculate your own ‘due date’? Perhaps this date was a day, or more, later than your hospital due date… are they therefore rushing you to have your baby unnecessarily early? You, your body and your baby have done just fine for 39+weeks so why do they think that your body wouldn’t know how to go into spontaneous labour when it is ripe and ready?
So what can you do? You are fully within your rights (because how you birth is YOUR choice) to decline induction and be asked to be monitored more closely in the days after 40 weeks has passed, to ensure that both you and baby continue to be well. For extra reading, look at the AIMS booklet on Inducing Labour: Making Informed Decisions
The choice of how your labour plays out is in your hands - it doesn't need to be totally managed by the midwife, neither do you need to be left totally alone. It can be a blend of many things. Here are some things to consider:
In the hospital you may be asked to sign consent forms when you are in established labour, say for example agreeing to an epidural. It may be worth discussing these options with your midwife in early labour and tell her what you are open to or not. Get those consent forms signed before you enter the bubble of established labour, when the last thing you are going to care about is admin! You will have a bigger job at hand.
A vaginal examination helps the midwife establish how far your cervix has dilated. Other than that, it serves no purpose. It is possible for the cervix to constrict in labour if a woman is feeling tense or vulnerable. So if you are not comfortable with having an examination, the cervix may react and present tighter than when you relax your body; therefore giving a misleading dilation stretch. Though not very likely, there is a slim chance that by having a vaginal examination infection and bacteria is introduced into the vagina. An expectant mother is well within her right to decline all vaginal examinations, if that is her preference.
Breaking your waters vs spontaneous rupture of the amniotic sac
In an induced labour, after the pessary has taken effect, if labour isn’t progressing as they would like, the next step would be perform an Artificial Rupture of the Membranes (ARM), also known as an amniotomy. This is usually carried out by your midwife. The membranes will be ruptured using a tool, such as an amnihook or amnicot. This is carried out in the belief that it will speed up and strengthen contractions.
In a spontaneous labour the membranes can rupture at any point in labour. In rare cases a baby is born with amniotic sac still intact, this is called ‘en caul’.
While the risks are very low, there are risks associated with ARMs. It is a blind procedure, therefore, there can be no certainty that the midwife won’t end up rupturing vessels that are part of the overall blood supply to the baby. An already compromised baby may be put at further risk by an amniotomy; as the uterus could become hyper-stimulated.
In addition to this, if when the waters break the baby doesn’t align correctly within the pelvic inlet, they maybe might find it hard to get into position. When this happens, the cervix dilation can stall and labour doesn’t progress as it should do. Most hospital’s policies are that they would like babies to be born within 24 hours of the ARM. If a woman’s labour shows signs of stalling, other forms of induction and augmentation will be offered, before the 24 hour deadline approaches.
Your baby should be monitored at least every four hours in early labour and every 15 minutes in established labour. A midwife will listen in to the baby’s heart rate, either with a hand-held Doppler or with a continual fetal heart monitor and check that baby’s heart rate does not decelerate during contractions. When a baby’s heart rate dips during contractions, it is a sign that the baby is in distress. They will continue to monitor you and the baby very closely and advise if alternative action necessary.
Confined to the bed vs being mobile
When a woman spends most of her labour on a bed, her movements are restricted, her body could be in the exact same position for long periods of time. If this happens to be more lying down than sitting upright, she is not using gravity to her advantage and she could be slowing the labour process down without realising it.
A woman, who wants to encourage a smoother labour, keeps mobile. Those movements encourage the baby to descend more rapidly and result in shorter labours, often without complications. Antenatal educators advise all mothers to be active and upright in labour and to only use the bed when it is absolutely necessary.
Natural vs medicalised pain relief
There are two types of pain relief; see the options below:
Some people consider hypnobirthing as a natural form of pain relief. Hypnobirthing itself doesn’t promise a pain free labour, but many women who have learned hypnobirthing, who have practiced the techniques and have worked on preparing for birth with a positive mindset go on to experience wonderful births.
Giving birth; should I lie, sit or squat?
Unlike the films and soap operas, giving birth on a bed with your legs astride is not the only position to give birth. The sitting position on a bed can inhibit your baby’s entrance into the world and it can be more challenging for the mother to give birth in this position. Lying down flat, means that you are not letting gravity help you and somehow your baby has to venture into your birth canal horizontally – this isn’t very efficient.
Consider being more upright, think about adopting a squat-like pose, where you are able to bear down, allowing the birth of the baby to be smoother. This could be sitting on a birth ball with your hips higher than your knees (encouraging the upper part of your body to tip slightly forward). This position puts the baby’s weight on the frontal part of the pelvis; potentially allowing more space. This is because your ligaments are looser during late pregnancy and your pelvic capacity can widen.
You could also think about being on your knees and leaning across the back part of the bed (moved into a vertical position - like the back of a chair). By leaning over the bed, you are allowing your bump to tip forward, whilst still having movement and flexibility in your hips. This position also works well if you are in the birthing pool.
Coached birthing vs mother-led birthing
You may have visions of the midwife encouraging you to ‘push’ your baby out when the time comes. Media will have you believe that labour is all about pushing, pain and panting – this is inaccurate. A mother doesn’t need to experience that to birth her baby; there are gentler ways to aid your baby into this world. Simply by listening to your body and responding accordingly; through gentle Down Breathing, as taught in KG Hypnobirthing, allows your baby to descend to the rhythm of your body.
Natural expulsion of the placenta or Synthetic Oxytocin injection
It is entirely up to you whether you prefer the midwives to administer Synthetic Oxytocin into your system to help aid the detachment of the placenta from the uterus wall. If you have had an unmedicalised labour up until that point, you may well choose not to accept the injection to start with. It is extremely likely that your body will do this of its own accord. If you have had an augmented labour, then your body may then need a little help in expulsing the placenta, with the help of this hormone substitute. Ask your caregiver if they feel it is necessary when the time comes, or perhaps wait to see how your body reacts after birth to decide for sure.
Cutting the cord / Optimal cord clamping
In the UK today, optimal cord clamping is encouraged for all babies in all birth situations, whenever possible. Ask your midwife what the policy is in your Trust. My hope is that they will say ‘until the cord stops pulsating’. If they don’t say this, then maybe this is something that you need to have in your birth plan. Nature intends for the baby to have all the blood from the placenta after birth. When the blood has drained, the umbilical cord starts recoiling and the placenta begins to detach from the uterus wall. At most this takes a few minutes. During this time the baby is enriched with all the stem cells and blood that belongs to him/her, that they would otherwise be deprived of, if the cord were to be cut sooner. Did you know that a baby can weigh 200g more if the blood is passed from the placenta, than if the cord were to be cut immediately? This blood belongs to your baby, so ask your caregivers to ‘wait for white’ (the colour the umbilical cord will be when the blood has passed through). Find out more: Wait For White
Skin to Skin
It is encouraged that the baby goes directly to the mother straight after birth. Decide if you prefer to have the baby wiped down first or whether you are happy for baby to come directly to you. This is known as Skin to Skin. This period is extremely important for many reasons:
After being nine months in a warm, dark pool of water, where the sounds are all muffled. It is quite a stark contrast to come into this world. Where people are excitedly talking about the new arrival, where the lights are bright and this beautiful wet baby is starting to feel cool air on its skin. The best way to soothe the baby is to place it directly to the mother’s chest, where her body heat can warm the baby, where the sound of her heartbeat and other bodily noises can be heard again; offering comfort and where a significant part of the microbiome process can be introduced (this is one of the early milestones in which you can colonise the gut with important bacteria from the mum and helps to build the baby’s immune system).
If for whatever reason mum is unable to do this, then the Birth Partner could do this. Isn’t it much nicer than having the baby in a cot nearby, or being held by strangers, when there is no need?
Breastfeeding is a personal decision, and from experience I know that it isn’t as easy as it seems. What your plans may have been before you baby was born, can be very different from what you actually experience. However, breastfeeding is considered beneficial for the following reasons:
Partners being able to stay
This varies from hospital to hospital. It seems crazy that when a woman who is in a vulnerable situation and needs support, is not allowed to have her partner stay with her. There must also be an emotional impact for the partners to be sent away, when it comes to bonding with their baby. Discuss this with your midwife, as to what the guidelines are for your hospital. Sometimes you can pay for a private room; this option may be attractive to you.
These are just some considerations to decide upon, that can help you create the right birth plan that is for you.
If you have any questions, feel free to email: Magical Baby Moments at email@example.com
Magical Baby Moments offers group hypnobirthing courses in Romford and Upminster, and private courses across Essex and London. Check to find out upcoming dates.
For all expectant parents preparing for labour. You need to know:
But before we jump into what choices might be available to you for pregnancy, labour and birth. Ask yourself how often you research options. Say for example when buying something. Do you do comparisons between different models, providers, services etc. Once you have gathered enough information you will then make a decision on which one to buy. Am I right?
So why is it that so many couples go into labour and birth not fully understanding the process, their choices and their rights? Often expectant mums will put their trust in their care providers. They believe that they have their best interests at heart. Ultimately they do. Be aware of hospital protocols, bureaucracy, red tape and senior management that constrain our caregivers. The days are long gone when they focused only on giving care to expectant mums.
Going in blind could leave you open to helplessly being carried along by the system. You could miss out on the birth that you had hoped for.
Quite often I hear, ‘Oh, I had to be induced’ or ‘I didn’t know I had a choice’ or ‘I just did what they told me’. When I dig a little deeper, I find out that they weren’t aware (at the time) that there were alternatives. They weren’t presented with the real picture of what their options were. They weren't given a choice.
An example: Induction for ‘post-dates’ in a 'low-risk' pregnant women.
It is very common in the UK for women to be induced between 41 and 42 weeks gestation. Often the mum will hear this: ‘If your baby hasn’t arrived by next [Wednesday], we will book you in for an induction.’
Many will accept that this procedure as best for mum and baby. They may not be told about the pros and cons of accepting an induction. Very rarely will they be told about the pros and cons of declining an induction. Parents should know both sides of the story for each option to be able to make a fully informed decision.
Common reasons that parents hear are:
These phrases will scare a mother and her birth partner into accepting an induction. Why? Because it has been presented as the better option. But is this the case?
In the UK the 'due date' is set at 40 weeks, guided by the date of the last menstrual cycle and by the dating scan at 12 weeks. This is a 5-week window, not a single date in a given month. For a baby to be born around the 42 week mark is perfectly normal. The World Health Organization states babies are usually born between 37 and 42 weeks.
So take a moment to think. When a woman accepts an induction before the 42-week mark, is her baby ready to be born? Or is she interrupting pregnancy and the final growth stages of her baby? Why would you want to do that if you and baby are both well and there are no medical concerns? If you feel strongly about not wanting an induction, you can decline. Ask for extra monitoring during these final days.
‘Informed choice’ is one of the many topics discussed in a hypnobirthing course. Before your baby is born, it is important to understand the most common options for labour and birth. You and your birth partner can then think about which are your preferred options. Knowing your choices and understanding the risks and benefits, will give you the confidence and calmness to deal with any situation. You will then be able to look back on it as a positive birth experience that you were in control of.
Remember, giving birth is your right. How you want it to be, is entirely up to you. The caregivers are there to support you for a happy, healthy and safe delivery. They are not there to force you to do anything you are not comfortable with.
Your hypnobirthing teacher will explain to you the common scenarios that might occur. This will help you and your birth partner decide on your preferences. Then, if/when a situation arises during the course of labour, you will:
1. Be aware of what options are available
2. Instinctively know what your preferences are about those options
3. Confidently decide which choices feel right for you and your baby
It therefore becomes a positive birth experience to look back on, regardless of any twists and turns in the process. Because no matter what the outcome of your birth experience is, you know that:
Would like to approach labour and birth with calmness and confidence? Would you like to be prepared to be able to take control of your birth journey? If you live near Romford, Essex, try KG Hypnobirthing with Magical Baby Moments. Contact Christine on 07764 680 215 or email firstname.lastname@example.org.
If you want to read more about what a hypnobirthing course entails download the first chapter of The Power of Hypnobirthing: 10 reasons why its for you by filling out the form on the home page.
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If you're pregnant and looking for an all-encompassing antenatal course that not only teaches you about late pregnancy, labour, birth and beyond, but also teaches you how to approach labour with calm confidence, then book yourself and your birth partner onto a hypnobirthing course with Magical Baby Moments.
A hypnobirthing course is a comprehensive course that takes you through what to expect, and how to be prepared, for labour and birth. Find out what is covered by reading the course modules.
"I would definitely recommend a hypnobirthing course with Christine. It has helped me prepare for a stress-free labour."
Romford Hypnobirthing Course - Evenings
The Group Evening Hypnobirthing Course is a four-week programme taking place in Rush Green, Essex. The lessons run between 8pm and 10:30pm. If you prefer a weekend course, check for availability on the website.
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