Midwife to Mama – my birth story

The story of the day/night/morning I became a Mama

So many of you have shared your birth stories with me, and I’ve been blessed and honoured to have witnessed many strong women and their families become mamas and parents – so it seemed like a no brainer that I would one day share my journey in becoming a mama with you guys, and what a journey it was!

When thinking back chronologically on the two day saga I couldn’t have imagined the rollercoaster of twists and turns that were ahead for me. I did know this was a possibility heading in, which definitely made it easier mentally, but boy was it looooong. And yet, looking back, I’d say I have an amazingly positive birth story, and loved the wild ride it took to meet Syd.

TUESDAY FEBRUARY 20, 2018

40 weeks and 5 days in the throws of a February heatwave, a woman can only handle so much thigh chafe before shit starts getting real (TMI?). I’d had a couple of stretch and sweeps, was 3cm dilated and over it! I booked in for some labour inducing acupuncture with a fabulous woman in Brisbane (if you want her details, DM me on Insty), and a few hours later started feeling niggles.

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the day before labour began

That afternoon I started having regular, but not strong, tightenings lasting 50 seconds straight off the bat. I could talk, walk and smile through them so I did my best to ignore them and we went for our regular 9pm walk (to beat the heat!).

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When I got home they ramped up. The were 3 minutely, lasting 50 seconds and I had lots of back ache (munchkin was direct OP, meaning his spine was on my spine, not ideal). My midwife was kept in the loop and the plan was to call when I was ready to come in to be reassessed etc…..

WEDNESDAY 21st FEBRUARY, 2018

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6am and pretty excited!

4am rolled around, I hadn’t slept and I was ready for either some pain relief, a good ol’ bath, or something! I was assessed at 6am in the Birth Centre at RBWH and was STILL 3cm and effaced (kill me), his head was very low (good!). My contractions had not increased in strength but were lasting a good length and still 2-3 minutely, so we decided to break my waters and get this show on the road.

It worked a treat – contractions stayed consistent in timing and length, and improved in strength.

I laboured in the shower for two hours ( and smashed two bananas) and loved the water on my back. Sitting on the ball and bouncing away under the water was my JAM! To spice things up and keep things moving along (or I hoped would) I laboured on the birth mat, bean bag, used the TENS machine I had hired and the Gas and Air to good effect. Throughout labouring, my Calmbirth breathing that had been a big part of my later pregnancy daily routine was EVERYTHING. I didn’t see it as a coping mechanism in the end and more of a necessity in getting the job (having a baby!) done!

Being reassessed that afternoon, I was 4cm, Bub was still direct OP and his head had started to swell (this is called caput). He was super happy in there, going off his heart rate, so we moved across to the Birth Suite and I got an epidural (I was 6cm by this point) and planned to have a caesarean in the coming hours.

I surprisingly wasn’t disappointed by this plan. I thought I would’ve been, but I wasn’t. When you’re in the moment, labouring away, you realise that birth doesn’t discriminate, you can only control so much, and you really just need to go with the flow.

The epidural was a God send for me. It allowed me to relax, take a second and relax my body for a bit. It also was perfectly timed for Married at First Sight (see top right pic – shameful, I know…to my defence, Raoul loved it more than I did).

The birth suite was having one of those mental nights when all babies decide to kick a stink and all want out, so our caesarean kept getting bumped for Bubs’ that warranted a faster exit.

I was reassessed maybe an hour before we went for the caesar and was 6-7cm, he was still around the wrong way and the plan for the caesar was still in place.

THURSDAY FEBRUARY 22, 2018

Midnight came around and it was our turn  – Raoul got into his scrubs (the most animated I’d seen him in a few hours, I think he was fantasising Greys Anatomy style) and we were off.

My epidural was topped up in the anaesthetic bay before entering theatres and then we moved in, and I was transferred (I remember feeling it was more a ‘heave’ ‘ho’ type situation) to the operating table. I remember wanting Raoul and being nervous. Nervous excited, but nervous.

The clip that had been attached to our baby’s head (called a fetal scalp electrode – helps to monitor the baby’s heart rate accurately when they’re on the inside) was being removed by the registrar that was to perform my caesar.
She was quiet and then said, “do you want the good news or the bad news?”

I said bad news. She responded “the bad news is that we’ve just topped up your epidural, the good news is that you’re 9cm and your baby is lower and in an OA position” (this is a perfect pozzy!). I was then asked “what do you want to do? You’re prepped for a caesar, so you can still have the caesarean now if you want it….or….if you want to try for a vaginal birth I will support you in that decision…it’s up to you. I can’t guarantee that you won’t be back here in a few hours, but if you want to give it a go, I’ll support that”. – What a legend Doctor right there, yeah? Looking back I’m still so amazed and grateful that I had a Registrar on that night that was so woman-centred (it would’ve been 1000 times easier for her to have just done the caesar, I would’ve never been the wiser). I’m forever grateful to her.

I was swirling. I remember just wanting Raoul to make the decision for me. I wanted the caesarean because I was over it and wanted to meet our baby, and had mentally seen the finish line, but I also wanted the natural birth…for the recovery, for the babies of the future etc.

Raoul came into the room, beaming like a cheshire cat in his scrub hat, and I broke the latest news. He smiled and said, “the ideal was for a natural birth, let’s give it a go- I’ll support you if you want to go for it”. He made it sound simple, and easy to process, and he was right, we did want it. So we gave it a go.

I waited 50 mins on the table in theatres for the epidural block to come down to a safe level to leave theatres, to then spend 1.5hours in recovery being monitored further.

By 3am we were being wheeled back to Birth Suite and I started to vomit – fully dilated!

They gave me an hour for passive descent (meaning just keep doing what you’re doing, no directed pushing etc., and let baby’s head come down low enough that I then had the urge to push).

My epidural had in the meantime stopped working. Now from a midwife’s perspective, this is perfect timing to regain sensation so you can feel where to channel your energy when pushing and being able to listen to your body. I didn’t feel this way at all!!! I was furious!!! I felt I had been able to handle the ‘pain’ throughout the day well, working my way up with pain relief options. To go from 0-100000 on the pain scale didn’t seem fair and it was a real mind-fuck for me.

The anaesthetist came back but no luck. So with the epidural in situ, I was standing next to the bed and pushing upright – it definitely wasn’t working!

This is going to sounds horrif as a midwife, but I just wanted to get Bub low enough for the vacuum birth. I was beyond exhausted and ready to meet him. My midwife in the following days said I did exactly that, that I got him low enough and then demanded a vacuum (what a nightmare I would’ve been to look after!)

I did end up having a vacuum, and little Syd born at 5:16am. I’d cooked up quite the temperature at 38.6, and Syd was 38.8 so he went straight off to the nursery after a very quick little snuggle.

A few hours later, after a shower, I met him again, and he had a feed.

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Cooked him up with a temp, Syd went to special care for a few hours, skin-to-skin and first feed here

We left hospital 2 days later.

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Leaving with Syd Vincent – February 24th

It was an eventful few days but looking back I feel so incredibly lucky to have had the information, the preparation and the support to head into the unknown that is birth.
We all just want the best outcome possible at the end of the day.
My ideals changed so quickly in the moment – and I was okay with that. However I stand by my original ethos that the best birth plan is no birth plan at all and rather an informed pregnancy to make the best decisions you can in the moment. In the end, that’s what we did, and whether I’d had the caesar or not, I was happy that I had given it my all, and that’s all you really can do at the end of the day.

To that doctor – I have met woman-centred medical staff over the years, but never have I felt I’ve seen one so in the woman’s corner. Thankyou. You literally have changed my birth journey moving forward.

Raoul was also a champ – he gave a cracker massage, never wavered in support and knew exactly what to say at the right time. A+ !

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Third Time Lucky

What I learnt from two miscarriages and what midwifery qualifications can’t teach you…

It’s funny being on the other side, especially after a few false starts. Two, to be exact. Miscarriage is something that, being a midwife, I  should’ve been more realistic about, especially with 1 in 4 pregnancies resulting in miscarriage, but I thought, 26 and healthy, there would be no reason to consider the gloomy side of things.
Falling pregnant for us, was easy! 3 cycles = 3 pregnancies, which we were and are very grateful for, but getting the little rugrats to stick was the hard part for us.

Recurrent miscarriage is classified as 3 or more miscarriages, so a lot of the time investigations start after the third miscarriage…but being an impatient Gen Y’er, and lucky enough to be working with, and surrounded by midwives and obstetricians to help with the investigations, I got straight to it to see what was going on/if anything was going on…

One consult with a colleague, 18 tubes of blood later and I had been tested for every weird and wonderful anomaly+chromosomal testing you could consider, I got an ultrasound,my husband got sperm+chromosomal testing, and 3 months later when the results returned, everything was perfectly normal. This was good, but was frustrating – I was almost of the mentality, if something had been there, we could work at it and fix it, but nothing showed up….as a lot of the time it does. We put it down to environment.

I’m a stress-head and love working and keeping busy. I was working a job that required me being on call, working long shifts and keeping bizarro hours – all in all not really looking after myself. My healthy lifestyle choices would fly out the window because the reformer pilates class I was booked into, or the trip to the gym, was now kiboshed by a trip into the hospital, and once I’d returned I was buggered and we’d order takeaway.

When I was newly pregnant, the first time, I pulled a few all nighters at the hospital, and we were particularly busy. I didn’t eat any food/drink minimal water for each of the shifts and we didn’t have breaks…not that I think this was the reason for what eventuated, but it just goes to again reinforce the pace at which I was moving and the fact that I wasn’t putting myself or my pregnancy first.
A couple of days later, I started a new role at the same hospital I had been working at, and as the heaven’s would have it, my first week on the job, I had a miscarriage. Not wanting to take anytime off (group practices rely heavily on being a team player…and I would be buggered if I was going to let the team down week 1!) I worked the whole way through….and did the second time as well, this time pulling a 12 hour shift, doing home postnatal visits, returning to go to the loo and instead ended up running for emergency caesarean… craziness. I ended up in hospital that night with falling blood levels and an operation at 3am. Stupid. Stupid. Stupid.

What’s the point to this article? A lesson of hindsight and how you can learn from my stupid ways.

Things I wish I had done sooner:

Prioritised myself and my health. Working within a big organisation you can be chewed up and spat out without even really noticing it. If you need a day off, you need a day off. Take it. Don’t be a martyr. I’m getting better at this. Third time around, I knew I was pregnant by 3.5 weeks (when I started vomiting all the time)…so I took the week off and veged on the couch watching movies, and as luck would have it (if you call moving interstate and packing up a house lucky when you’re 5 weeks pregnant) I was finishing up in this role a fortnight later. So I didn’t/haven’t looked for midwifery jobs in Brissie yet, I’m studying to educate Calmbirth for the moment and doing some freelance stuff.

Find a good GP. Going to whomever that was available at the local bulk-billed place when you need the quick medical certificate or script had always served me well, but not having a regular GP when it came time to pregnancy related stuff kinda screwed me. Having to show up to get your bloods taken to confirm falling HCG levels mid miscarriages by rando Dr’s that have no bedside manner and answer questions like “do you have any kids?” rather than “are you okay?” or “this sucks” was a kick in the head, twice… Go find one you like, and stick with them.

If you’ve had a couple of miscarriages and you’re wanting to investigate sooner that what a GP would normally recommend investigating or write a referral for, do it if it’s going to give you piece of mind. Even though it was third time lucky for us, just knowing that there was nothing showing up on paper was enough of a confidence booster a few months later to try again. Worth every penny! Be “difficult” and demand it. No harm in investigating, if this is what’ll keep you sane.

 

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Baking until Feb 2018

 

Pelvic Floor Exercises; no activewear required!

You don’t need activewear or a gym membership to strengthen these bad boys, just a little discipline. Here’s the 411 on why as women; before, during and post babies we should be activating our pelvic floor.

Pelvic floor exercises are something that, as women, we’re told about over and over again, but are we doing these quick and uncomfortable exercises as often as we should be…i.e. everyday?
I know I don’t, and dare I speak on behalf of women, I’m sure the majority of us aren’t doing them as often as we should be. A study conducted in the UK has shown that 66% of women didn’t know where their pelvic floor was and only 40% doing their pelvic floor exercises on a regular basis – not great stats when I’m sure 100% of us do not want to be urinary and/or faecally incontinent in the long run!

So here’s a quick 411 on all things pelvic floor and why they are important for women pre-baby, during pregnancy and post baby.

What is the pelvic floor?

Think of your pelvic floor as a sling of muscles that support the uterus, bladder and bowel. Everything that comes out from down below passes through the pelvic floor. These sling-like muscles attach at the front to your pubic bone and at the back to your tail bone, from the base of your pelvis.

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How do I do a kegel correctly?

To understand the muscles involved in pelvic floor exercises imagine needing to do a wee but not being near the toilet…that initial squeeze is the activation of your pelvic floor. How to do your pelvic floor exercises, see link below:

Continence Foundation of Australia

The Royal Women’s Hospital

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via pilatespod.co.uk
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via mutusystem.com

What’s the point pre-baby?

  • Provides bladder and sphincter control
  • Facilitates a strong foundation for when you do have a baby (think bowling ball sitting on your bladder…), to help minimise urinary incontinence
  • Can improve orgasms and sexual pleasure

What’s the point during pregnancy?

During pregnancy, the hormone progesterone softens and relaxes the muscles and ligaments within your body, enabling it to help bub manoeuvre its way through the pelvis and birth canal.

This progesterone also slows other things down in your body and a common problem during pregnancy is constipation, so drink lots or water, stay active and embrace a fibre-rich diet.

During labour and birth the pressure of bearing down and pushing may stretch and weaken the pelvic floor, so having the foundation of a strong pelvic floor can benefit the efficacy of pushing. It’s also not a bad idea to look into birthing positions, as birthing in an upright position can increase pelvic diameter by 30% …working with gravity…making more room for bub (read our article on birthing positions here)

The benefits of doing your pelvic floor exercises (excerpt via huggies.com) :

  • The risk of uterine or bladder prolapse is reduced
  • Pregnancy, delivery and recovery time can be improved
  • Post-partum discomfort from perineal swelling and haemorrhoids is reduced
  • Perineal tearing and/or need for an episiotomy is reduced
  • Urinary incontinence/leakage during pregnancy and after delivery is reduced
  • A toned pelvic floor leads to more complete emptying of the bladder and bowel
  • Helps to avoid stress incontinence after delivery – small amounts of urine leakage when laughing, sneezing, coughing or lifting something heavy

 

How do I regain strength post baby, and when should I start doing my pelvic floor exercises?

Start doing those pelvic floor exercises ASAP. Some women may find in the days post birth that doing their exercises laying down is easier and they are able to engage the right muscles more easily. Give it a go!

Before baby and during pregnancy your pelvic floor strength will have been more toned and therefore your exercises will have been stronger and longer in duration. In the early days post birth it’s important to work up to it. Aim for a few seconds each day for the first week, and build up to it slowly.

Tools to help with pelvic floor instability and incontinence

If you’re one of those people that need a gadget to motivate you to do exercise, here are few to investigate:

http://www.epi-no.com.au/

http://www.kgoal.com.au/

 

 

 

 

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Birth and Bugs (the good sort)

What you need to know about seeding…

Anyone that’s had a baby, or watched “Call the Midwife” or “One born every minute” knows birth is messy…and when we say messy we mean that you don’t labour in your Camilla … there’s fluid, it’s primal, innate and magical all in one! And amongst all the vernix, amniotic fluid and blood, are microbes (good bugs), which babies born vaginally are exposed to whilst making their way through the birth canal.

This exposure to approximately 300 ‘good bugs’ from the birth canal helps to build a child’s microbiome (the army of bugs that protects us from germs, breaks down food for energy, etc.).

But what happens if you don’t have a vaginal birth, and have a caesarean? – Does this mean bub misses out on these good bugs?

Not anymore! Let’s talk seeding…

With one in three bubbas being born in Australia via caesarean, and by bypassing the birth canal, it means that they are therefore not exposed to the bugs, which is leading to the ongoing research debating the lower levels of autoimmunity of bubs born by caesar. So it’s great to hear that there are now methods out there for littlies to receive these good bugs regardless, hopefully increasing immunity for all! (Research is still pending on the efficacy of this in comparison to vaginal birth…but it can’t hurt, right?)

How is seeding done?

Seeding is carried out by inserting a sterile swab into the vagina (like a tampon), leaving it there for a little bit to absorb, then giving it a swirl and taking it out. When bub is born, this swab is put in your baby’s mouth and wiped across their little body immediately, trying to emulate a vaginal birth.

If this is something that’s of interest to you, please discuss it with your midwife or obstetrician, especially if you know you’re having a caesarean for whatever reason or thinking of going down the VBAC road.

References and Articles: (to come!)

Image via janabrasilfotografia and @birthwithoutfear

The Placenta; trash or treasure?

It’s plays one of the most important roles throughout pregnancy and then we chuck it?! What you could do with it, if you were to keep it…

Over the past 24 hours, the placenta (the organ that nourishes and oxygenates the baby whilst in utero) has been a talking point on social media. A photo published by a Brisbane photographer on Facebook (and Insty) (here) showed a little bubba still attached to the placenta, and the Maori traditions that would be practiced postnatally by his family. Which got me thinking…if this photo has received such broad recognition over something that I thought was known information, maybe the placenta and what happens to it afterwards, or ways to treasure it aren’t known?!

Let’s rewind briefly…the placenta is the huge bed of blood vessels that begins developing at implantation and imbeds itself into the uterine lining, with the umbilical cord stemming from here. Most commonly the placenta will attach to the top of side of the uterus – if you want to know where yours is out of curiosity, ask the sonographer at your next scan.
The health of your placenta is a result of lifestyle, age, nutrition, health (blood pressure, blood clotting disorders, substance abuse, smoking), etc.

After the birth of a baby, the placenta follows suit either physiologically or managed actively. Physiological management of the third stage is where the midwife and mother wait for the placenta to naturally come away from the lining of the uterus. This is method should be discussed with your midwife or doctor as there are contraindications. If you do intend to birth the placenta physiologically, a strong focus on initiating breastfeeding and skin-to-skin with baby has been documented to encourage this separation.
The other method of placental delivery is through active management (this is what is most common and implemented in Australia); whereby a mother receives an intramuscular injection with consent of a synthetic oxytocic hormone to help contract the uterus and clamp down the blood vessels…encouraging separation and minimising blood loss immediately after birth. This is the same drug that is utilised in inductions of labour to make a uterus contract.

From here the placenta, the membranes and the umbilical cord are inspected by a midwife. Unless otherwise indicated (by certain factors throughout pregnancy, birth or birth outcome) the placenta will be discarded, unless the parents want to keep it*.
*This may be something to consider antenatally if you’re thinking about going down this road. From my contact with a few hospitals, I know that they will not keep your placenta refrigerated for you whilst you are at the hospital, so organising a way in which to get it home, and keep it refrigerated until you’re ready to carry out whatever you see fit, is worth a little advanced planning.

So for anyone wanting to somehow use or honour the placenta (I’m aware of how hippy dippy this sounds, but I couldn’t think of another word) here are a few to consider:

Lotus Birth is where the placenta is left attached to the baby at birth until the cord falls off on its own. Sometimes being covered with salts, herbs (rosemary and sage are often used), the placenta is then wrapped up, nappy style, so it’s not intrusive (or offensive) to some guests that may want a snuggle with bub. This is the downside to a lotus birth – so both partners need to be on board with the process for it to not hinder physical interaction with bub.

Placenta Encapsulation is when the placenta is steamed and cooked at a low temperature, dried and encapsulated into what look like ground vitamins. They are tasteless and are a way of receiving nutrients that have been suggested to:
-Help balance your hormones
-Replenish depleted iron levels
-Assist involution (the uterus returning to its pre-pregnant state over the 6 weeks post birth)
-Reduce postnatal bleeding
-Increase milk production
-Decrease the chances of postpartum depression

After speaking to other midwives one shift, a few stressed the importance of seeking out well practiced and known placental encapsulators. So, make  sure you do your research beforehand and be sure to ask questions about the conditions and hygienic methods implemented throughout the process. Websites like, http://www.placentaservices.com.au/new-south-wales.html, work as directories for verified service providers.

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image via placentanetwork.com

 

Placental Burial is the burial of the placenta under a tree or in a garden. The nutrients of the placenta are said by green thumbs to make a great fertilizer too, which is a bonus! If you do intend to plant it in the garden, make sure you bury it deep in the ground…no one wants an animal on the hunt for it…not good, not good! Also, if you’re worried that you may end up moving one day, it can always be planted in a large pot. That way the placental plant can move with you.

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image via lisamckaywriting.com

 

Placenta Piccie – The name says it all really. Paint and dye are used to highlight the blood vessels to be printed onto paper. A keepsake that can be as colourful or monochromatic as you see fit.

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image via shaunaowensphotography.com

 

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In all it’s glory! Image via Pinterest

 

What did you do with your placenta? Was it trash or treasure? x

To VBAC or not to VBAC?

The benefits and risks here…

There’s been lots of VBAC discussion on our Instagram feed over the past couple of days. I wanted to have a greater handle on the recent facts and stats, so I was read an article on The Conversation by Hannah Dahlen last night on vaginal births after caesarean sections (VBAC) (read it here).

With nearly one in three women in Australia giving birth via caesarean, I feel like I am only really just now starting to hear more and more about VBAC’s. Yes, as Midwives we are taught and study this but anecdotally I hadn’t come in contact with many women asking for a VBAC, but more so of midwives asking women if they knew about a VBAC being an option and did they want to consider it.
It’s lovely to hear more women, through the channels and power of social media discussing topics like this, sharing birth stories and channelling positive empowering pregnancy energy.

It is important to mention that “most Australian women (84.4%) have a caesarean for subsequent births after a caesarean. Only 15.5% of women have a VBAC. In private hospitals, this rate is even lower, at 11% “(Hannah Dahlen)… however of the women that do attempt a VBAC, 70% of these women are successful in giving birth vaginally and do not need a repeat caesarean section. Which is nothing to sneeze at, right?

Yes, a repeat caesarean section is a decision that is solely that of the couple after an informed conversation with their health practitioner, and fabulous advancements in research now mean that babies are not separated from their mamas (health of mum and bub permitting) and there are things like seeding available for women (vaginal microbes wiped onto babies as they are born via caesarean so to simulate as best possible the antimicrobial goodness bubs receive from the birth canal) and skin-to-skin and breastfeeding support happening in theatres and recovery; facilitating the mother-infant dyad.

But if you’re a low risk, healthy mama, and want the option of a VBAC, and want to know more, continue reading!
It’s a conversation worth having antenatally with your midwife or obstetrician!

Benefits of a VBAC?

  • Greater chance of uncomplicated births in the future
  • Recovery is a lot quicker – due to no abdominal surgery
  • Reduced risk of blot clots
  • Skin-to-skin, mother-infant bonding, breastfeeding etc. may be established quicker.
  • Shorter stay in hospital

Risks of a VBAC?

  •  uterine rupture may occur. Statistics are about 1 in 200 VBAC’s there will be a uterine rupture (the scale of which varies drastically from slight rupture to the uterus opening up completely…which is very much cause for concern and can have dire outcomes).
  • “In terms of the baby’s safety, guidelines on VBAC just released by the United Kingdom’s Royal College of Obstetricians and Gynaecologists (RCOG) state that the risk of a baby dying during labour and birth is extremely low and is similar to the risk for women having their first baby”(Hannah Dahlen).

Do VBAC outcomes differ based on hospital setting?

Some hospitals in Australia offer VBAC programs for mothers that have had 1 caesarean section…other hospitals have programs that offer women the option of a VBAC after 2 caesarean sections.

Does a VBAC mean I have to labour differently?

Continuous cardiotocograph monitoring (CTG) may be implemented to keep a close eye of the wellbeing of bub. Protocols may vary from hospital, state, obstetrician etc., so this is a good question to ask your midwife of doctor so you know what to expect.

So if you’ve had a previous caesarean section and are unsure as to your personal situation and your options, asking lots of questions to you midwife or obstetrician,  and regardless of whether you choose to try for a VBAC or choose an elective caesarean, just asking questions helps to make informed decisions.

Image via Hannah Tallo of a VBAC mama
Resource: hyperlinked article (first paragraph) The Conversation, Hannah Dahlen

 

 

Birth Perceptions; the power of language

Language carries weight and power. We have a question for you…

It could be argued that the time in a woman’s life where she will seek, question and be influenced by information the most is during pregnancy. Pepper in hormones, lack of sleep and a tiny touch of anxiety about the impending birth and you have a woman that is susceptible to the weight and power of language.

We know that words have the ability to empower us, and also destroy our confidence. Statistically, we are more likely to say stuff we regret or that might be less thought out when we are under pressure, feel out of our depth, are in an unfamiliar environment or anxious (welcome to a birthing room).
As midwives throughout our training we focus on woman-centred language, and ways in which to support and empower women giving birth, including ways in which to make the birthing environment feel safe and reassuring. This is all well and good, but reassurance from a loved one, and/or support partner is invaluable, and may hold more weight physically and emotionally for some women.

So….we’re throwing this one out to you guys….what words of empowerment; from either your midwife, doula, obstetrician, loved one, or support partner, got you across the line? What do you remember most vividly?  Keeping in mind that language is not always verbal. Physical language is also telling.

Sharing is caring! We’d love for you to comment below (short and sweet, or long and lengthy, you pick) and share in the positivity and empowerment of birthing language.

 

 

Image source : @birthwithoutfear  @southcoastmidwifery @kassandranicole

 

The year that was, and the year ahead

For all the lovebirds contemplating or expecting a bub next year, have a squiz at the Chinese gender calendar. Are you having a boy or a girl?

Just a quick shoutout to all the gorgeous peeps that have been along for the Winnie Wagtail ride for the past 5 months. We’re thrilled the whirlwind that was 2015 is coming to an end and can’t wait for 2016!

Whilst we contemplate New Years resolutions, and get stuck into the bubbly, for all the lovebirds contemplating a bub for next year (the year of the monkey) have a squiz at the Chinese gender calendar. This is not evidence-based, but said to have been discovered in a tomb over 700 years ago, it is supposedly over 90% accurate. My husband and I backtracked friends, family and siblings, and only twice was it incorrect from our experience. It’s a bit of fun for guessing your baby’s gender, or planning ahead (with 50/50 odds, and this supposedly higher, you can’t really go wrong!)

Link to calendar here

 

 

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Two sides to every story: The ECV

Kim Kardashian-West brought breech babies into the spotlight recently…here’s the 411 on ECV’s and what you need to know

As I’m sure your social media feed has already informed you, Kimye have welcomed their second bub, a baby boy named Saint.

A couple of weeks ago a mum-friendly website posted an article, “Kim Kardashian’s baby is no longer breech after a “painful and scary” medical procedure”, (read it here). It was admittedly 95% Kim’s words extracted from her website about having a breech baby and attempting to turn the baby externally, through what is called an ECV (External Cephalic Version).

Kim goes on to explain how ‘she was prepared for an emergency caesarean…her waters could break… and that it was more painful than childbirth as she wasn’t given drugs.’
I believe this article missed an opportunity in this article to explain; What an ECV is? What are the risks? What is the success rate? Can you use pain relief?  Are their alternative remedies or avenues available to explore for turning a baby from a breech position to a cephalic position (head down)?

Of course by Kim Kardashian-West publishing her experience (as is her right), and the media reinforcing it without a counter argument, or without any evidence-based research to back up what she is saying, I believe this is doing women (who may find the whole childbirth thing scary enough as it is) a disservice.

So below we’re breaking down what is an ECV with some evidence based research (we can’t promise it’ll be as entertaining and dramatic!):

What is Breech?
Breech is the name given to a baby that is head up, bottom (or feet) down towards the vagina. This accounts for approximately 3-4% of pregnancies. This fetal position is regarded as higher risk for the baby regardless of the mode of birth (Cochrane Review 2015). 

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Image via nlm.nih.gov/medlineplus

 

What is an ECV?
External Cephalic Version aims to turn the baby from a breech position to a cephalic position, by pressing gently on the mothers stomach.

Andrew Bisits is the Director of Obstetrics at the Royal Hospital for Women, Sydney, Australia – a tertiary academic hospital which oversees 4000 births per year. He’s been in obstetrics for 30 years and has a strong interest in breech pregnancies and vaginal breech birth.

Below is Andrew Bisits performing an ECV:

Who performs an ECV?

Obstetrician’s perform ECVs. This is not under a midwives scope of practice in Australia.

What are the risks?

An excerpt from the Cochrane Review 2015, External cephalic version for breech presentation before term (review), concluded that ‘compared with no ECV attempt, an ECV commenced before term improves cephalic presentation (head down) at birth. Beginning an ECV between 34 to 35 weeks may have some benefit in terms of decreasing the rate of non-cephalic presentation (babies not head down), and risk of vaginal breech birth. An early ECV may increase the risk of late preterm birth.’

The review also highlights the importance of careful discussion with women about the timing of an ECV so that informed decisions can be made.

The overall complication rate of ECV’s according to evidencebasedbirth.com was 6%, and the rate of serious complications (placenta abruption or stillbirth) was 0.24%

What is the success rate of turning bubs?

According to BabyCenter the success rate of an ECV is 58%. If the baby is in a transverse lie (sideways), the success rate increases to 90%. This website also reported that the ECV was more likely to work if it wasn’t a woman’s first baby.

Can you use pain relief for the procedure?

Pain relief, such as nitrous oxide (happy gas) inhalation during the procedure decreases the level of ‘severe pain experienced by some women’ and appears to be safe for both mother and child, with no effect on the success rate of ECV or the perinatal outcomes (Burgos et al. 2013) –
Source: nitrous oxide for analgesia in external cephalic version at term: prospective comparative study.

Having seen ECV’s performed, how uncomfortable a woman finds the procedure varies. Not everyone will find this more painful than childbirth, yes uncomfortable, but not traumatising pain. Talking about viability of using pain relief would be a question to ask your obstetrician before commencing the procedure.

Alternative methods for trying to turn babies?

Speak to your healthcare providers about the potential benefits of massage, acupuncture, swimming, positions etc.

Can I have a vaginal breech birth?

Vaginal breech birth has become a lost skill over the years, and many doctors will choose (and believe it safer) to perform as caesarean section. It is important to discuss the risks and your personal pregnancy situation with your healthcare provider, however there are some obstetricians that will support vaginal breech birth.

Can I opt for a caesarean section and not have an ECV?

Of course, it’s your pregnancy and your baby. This is also a good conversation to have with your obstetrician and midwives.

 

 

WinnieWagtail-PrintLogoMiniEvidence-based info for parents-to-be.
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Food Bloggin’ NYC style!

Heading to NYC? Our fave haunts around the concrete jungle…

Howdy from NYC… it’s been 2 months since the last article (slight hiatus with finishing up uni and galavanting around the US having way too many margaritas!) so I thought I’d better pull my finger out and start things up again.

This is a totally unrelated baby post today but more of a foodie entry for anyone travelling to, or planning on a trip here in the future. My husband, Raoul, and I have literally eaten our way around Manhattan and Brooklyn for the past 3 weeks (5 day juice detox ordered for when we get back…wish me luck!)
Prepare for lots of fezpot food shots of yours truly, Raoul got carried away playing photographer…just look at the food!

Breakfast

Five Leaves
This is a bustling little brekky joint that’s easy to get to from the subway and is situated in Williamsburg. Heath Ledger’s Australian/American cafe realised posthumously, is an awesome little spot. They’re famous for their Ricotta Pancakes w/ honeycomb butter, banana, blueberries & strawberries, served with 100% pure maple syrup…however on day 2 we were hesitant to go all out gun blazing and opted for an equally satisfying savoury alternative to share. Pictured is the sage scrambled egg panini and the grilled 7 grain toast topped w/ crushed avocado, green onion & radish.
Address: 18 Bedford Ave, Brooklyn, NY 11222
Phone: (718) 383-5345

 

Coffee

I’m not a coffee wanker, but I totally became one (and it pays to be) in America! Favourite haunts over the weeks were:
Sweet Leaf (135 Kent Ave, Williamsburg (347) 725-4862)
Five Leaves (18 Bedford Ave, Brooklyn, NY 11222)
Dominique Ansel (189 Spring Street, NY) Famous for their cronuts (apparently there’s a line in the wee hours for those bad boys), we just stuck to the coffee, which they were surprisingly great at.
Variety (146 Wycoff Ave, NY) Best “Americano” coffee we had.
Cafe Grumpy (Lexington Passage, 89 E 42nd St, New York, NY 10017) The closest we came to Aussie coffee over the three weeks.

Note: Flat whites over in NYC seem to be cappuccinos?? So if you’re after a flat white, it’s a cap.

Lunch

Amish Market
Down in TriBeCa near World Tower, we were fanging for some clean food. The Amish Market has heaps of salads (hot and cold) available. You can mix n match – and pay on weight.
Address: 53 Park Pl, New York, NY 10007

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Westville
The food was so good in this West Village haunt that we ate there two days in a row. For dinner we had the grilled salmon salad and the fish burger, and the following day we shared the marketplace green vegetable plate. All delicious. All reasonably priced. Decor is nothing to harp on about, but it’s in a great location near the West Village shops and a short stroll from Bleeker Street.

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Melt
If you’re up for an all out American blow out, this is the place. We’d been walking for 6 hours and I was on the verge of tears my sugar levels were so low…this was ridiculously evil and delicious.
Address: 135 W 50th, NY


Saxon & Parole
Great brunch spot on Bowery. Great cocktails (yes, at brunch) and service was great.
Address: 316 Bowery NY

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via saxonandparole.com

Greenwich Project
Another great West Village spot. Salads, Burgers, Booze. All delish. Worth a visit.
Address: 47 W 8th New York.
Phone: (212) 253-9333 (booking is probably wise)

Dinner 

Mexicue
After a massive day traipsing around Manhattan (ugh I even hate how that sounds!) we did count down to Happy Hour, twice!, at this pumping Mexican restaurant. $5 Margaritas (the best Margarita I’ve ever had) and $2 Fireball (chilli, cinnamon in tequila) shots. Word to the wise…maybe eat more before the 4pm drink fest kick off, so your night isn’t as short lived as ours. You really want to be able to kick on from here. The smoked chicken tacos were delish, black bean nachos was really tasty, too and the guac could feed an army! Great bang for your buck. (345 7th Ave · (212) 244-0002)


Bareburger
Best. Burger. All. Trip. Just. Do. It.

They are a chain, so they are dotted around the place. No photo because we were starving, exhausted post 22hr flight and with luggage.

Margarita
We found ourselves in Little Italy and spoiled for choice. Stumbled upon this hidden gem. Great Caprese and the pizza was great too! Friendly wait staff and funky Italian music. Worth a visit.
Address: 197 Grand St, New York, NY 10013

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Saigon Shack
The pictures speak for themselves – the turnover of tables is insane…you’re not here for a long time, just a good time. Fab Pho & Salad bowls! Bring Cash!
Address: 114 Macdougal St, New York, NY 10012

Treats
So I’m definitely a savoury gal, but I married the world’s biggest sweet tooth, so we strike a happy yet very dangerous medium…

“This Pie is Nuts”(@thispieisnuts)
We were here over Thanksgiving, so naturally we had to try a good ol’ American Pie. This is a brand that’s purely natural, vegan, paleo certified and gluten free. One of the greatest treats we had. No nasties, just goodness. Lots and lots of goodness.

Magnolia Bakery
An obvious one. Just walking in made me all Sex and the City giddy! Ventured away from the cupcake and we got the mini Apple Crumble to share. Yum and very weather appropriate. There’s actually a couple of spots you can pick up their goodies, but the original site is just off Bleeker St. The park across the road is littered with people catching rays eating sugary goodness. Do it!

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We ate at literally a billion other places, all really good! We only had one disappointing meal all trip which was at a place called The Burger Joint (Cnr Macdougall W8th). Not into a public shaming, but this was a shocker (that we had heard good things about). Fries were feral and can definitely be missed.

 

Looking forward to getting back next week (soaking up the some Summer sun) and getting stuck into some writing, too. We have some great stuff coming your way in 2016, so keep your eyes peeled and ears open. xx

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