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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Dear Birth Support Person…

Dear support person – you have a fabulously important role to play!

I read an article this week on The Sydney Morning Herald‘s parenting offshoot website, Essential Baby. It was written by a Dad, for Dads, about their role in birth and how best to support their partner (see article here).

Mucous plugs, wedding ring indentation marks and encouraging mantras aside, the crux of the article, was about the importance of silent support and the safety of having a loved one by your side.

So we’re going to share with you a few birth tips as well, but firstly, a quick breakdown, hormonally of what’s happening in labour and birth.

Two hormones play a massive part in labour and birth, these being Oxytocin and Adrenaline. Oxytocin, otherwise known as the ‘love hormone’, is released in moments of bonding; hugging, kissing, breastfeeding, sex….and is also what brings on contractions, helping to dilate the cervix, move bub down the birth canal, as well as deliver the placenta.

Adrenaline on the other hand, is our ‘fight or flight hormone’, that mammals produce primally for survival. Fear produces adrenaline. And unfortunately, adrenaline inhibits oxytocin which can make labour slower, more painful, or panic the woman (and let’s face it, the partner)…potentially leading to intervention or increased pain relief?

So naturally, if you think about when Oxytocin is released, it’s at moments of intimacy; when you’re in a safe and private environment. So why would birth be any different? It’s not!  Enter dear support person – you have a fabulously important role to play!

A few tips:

  • Try to keep the room quiet (not the woman,though; trying to control her would be like trying to stop a steamroller in its tracks…not good, not good). But being mindful of phones…people coming in and out of the room and the volume of your voice (I’m particularly mindful of this, considering my boom-box voice, especially when I’m excited or stressed).
  • Keep the room dark – particularly for labour. As a woman’s cervix dilates, her pupils dilate, making her more light sensitive.
  • Touch her…not in a creepy, handsy way. You’re both in a foreign environment and and not having babies every day of the week, so it can be a bit unsettling to see her in pain, and frightening for both of you.
    Holding her hand, giving her a kiss (this is a great one – oxytocin booster, intimate, makes her feel safe, reduces adrenaline, and is a way to show her support), and massage are all ways in which to let her know you’re there.
  • When a woman is ‘transitioning’ into second stage of labour, the massages that she’s been loving…the baths that’ve been helping…the pregnancy ball rocking….the topic of conversation…the words of encouragement…ALL OF A SUDDEN, SHE MAY HATE!  When this occurs, don’t be upset or worried, see this as a sign of progress and that bub might not be too far off. Just being next to her, so when she opens her eyes she sees you there, can be all she needs in that moment in time.
  • Be her advocate. Know what pain relief she wants. If she has said 3,000,000 times in pregnancy that she doesn’t want an epidural, and someone keeps banging on about it and offering it to her, be her advocate.
    On the other hand, knowledge is key. I truly believe the best birth plan is no birth plan, but an informed pregnancy. If you both know the ladder of pain relief (blog post on this is on it’s way) then you’re able to take labour and birth as it comes, starting with non-pharmacological relief and slowly working your way up to the big guns.
  • Last but not least, know your limits. If you’re one of those people that are a bit queasy, hate needles or aren’t crash hot with blood, tell the midwife or obstetrician. Be proactive and have a chair (up the top end of the bed) ready, and sit down and support if you you start feeling giddy. No one needs you in E.D!

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(All photos published in this blog article, were taken by the talented Lindsey Kliewer)

Resources:

Do We Need Midwives? By Michel Odent (2015)

The importance of privacy in labour

Birth and Breastfeeding By Michel Odent (2003)

We must put the sex back into birth – Ted Talk, By Kate Dimpfl

Don’t take it lying down – evidence on birth positions

When you think of a woman having a baby and the position she assumes, what do you see? The evidence will surprise you…

When you think of a woman having a baby and the position she assumes, what do you see?
I’d always imagined what I saw portrayed in movies* and TV shows* – a woman labouring and pushing on her back. But is this the ideal birthing position?

The majority of Australian women (78%), do indeed assume this position when giving birth to bubs, but when you look at the evidence to suggest this isn’t the optimal position for labour, why the disconnect? Of course, labour and pregnancy alike are exhausting, and I love nothing more than kicking my feet up (not pregnant!) at any given moment, so I see how women gravitate towards the bed…but what does the evidence for everything but the bed, show?

In 2012, a Cochrane study, Gupta et. al was undertaken assigning 7,200 women into two groups; upright positions for birth (birthing stool, kneeling, squatting, all-fours) and non-upright positions for birth (semi-lying, lying down with bed head up, side-lying or in lithotomy (on your back, legs a part) .

When comparing the two groups, the women assigned to upright positions were:

The result of this study concluded that women, without an epidural, should be encouraged to birth in upright positions due to the decreased risk of assisted deliveries (vacuum-assisted or forceps and episiotomy).

When breaking it down logically, being in an upright position – gravity is on your side; the weight of baby and the position of baby is better applied to the cervix…stimulating contractions…helping bub descend and move through the pelvis. Hey Presto!

A midwifery professor, Hannah Dahlen, wrote an article on The Conversation a few years ago, Stand and deliver- upright births best for mum and bub, that looked into why so many women in Australia, do indeed recline to have their babies. The short and simple may indeed be birthing unit design. Like most hospital rooms, the bed takes prime position (pretty convenient for the Midwives and Doctors). To their defence, many women do receive admission CTGs…so immediately they head on over to the bed, get comfy, and then…well 78%…

Being armed with the knowledge of positions to assume in labour, to help bubs work their way down, to relieve back pain etc., is worth investigating. Again, it comes down to what you want, so why not spice things up and try a few, this way you will find out what works for you.

 

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*Movies – Knocked Up, Father of the Bride II, Nine Months, Juno, What to Expect When You’re Expecting

*TV shows – Offspring, Love Child

Vitamin K: Prophylaxis or Poppycock

The Vitamin K injection, does seem to sometimes, albeit unfairly, get lumped into the vaccination category by some people. It’s not a vaccine. More info here…

So I’m putting it out there, I’m pro-vaccination (insert horror and all things evil). I believe in herd immunity, and I believe that vaccinations against nasties such as whooping cough and chicken pox are a good thing! The Vitamin K injection, does seem to sometimes, albeit unfairly, get lumped into the vaccination category, and therefore is shoved into the evil corner by some with all the other vaccines – so this post will be about debunking the Vitamin K ‘vaccination’ and rather putting out there all things Vitamin K ‘injection’ related. It is an injection. Not a vaccination!

Vitamin K is a vitamin that naturally occurs in our bodies and is essential in helping our blood to clot and prevent serious bleeding. Babies cannot produce this for the first few months of life….so consenting to the Vitamin K injection helps bubs have enough Vitamin K to clot their blood (and prevent HDN – a rare bleeding into the brain).

There have been no reported reactions to the injection within Australia, since its implementation 25 years ago. There are two ways in which to give a baby Vitamin K:

1. Injection at birth

2. Oral doses (more complicated- a dose at birth, another 3-5 days old, and at 4 weeks).

There are some medical contraindications as to why you wouldn’t give a bubba Vitamin K… these are if they are sick, premie or if their mama took medication throughout pregnancy for certain reasons (talk to your midwife or doctor if you’re at all concerned).

If you’re seeking more info, it’s a great topic to bring up antenatally with your partner, midwife, obstetrician or GP. Of course at the end of the day, it’s your baby, your call!

For adults wanting to increase their Vitamin K stores within the body, as it is great for bone health (Vit. K helps calcium absorption) eating varied leafy green veggies should do the trick; think spinach, kale, celery as well as carrots, blackberries, raspberries, blueberries, sundried tomatoes….

For more information on Vitamin K please click resources and blog references below:

Vitamin K Royal Hospital For Women NSW

18 Foods high in Vitamin K for stronger bones

Vitamin K in neonates: facts and myths

Vitamin K for newborn babies Australian Government

image via theberry.com
image via theberry.com

The impact of 90 seconds on Bub

1/3 of a baby’s blood it outside of its body at birth. By waiting 90 seconds before cutting the umbilical cord, it has the ability to….

Delayed cord clamping was something I knew nothing about before studying midwifery. I thought, baby comes out…baby goes onto Mum’s chest…the cord gets clamped and cut. But there’s so much more to it!

Delayed cord clamping (waiting 1-3 minutes after birth) is recommended for all births of well babies, not requiring resuscitation, according to the World Health Organisation (WHO) guidelines (2012). This is something that can be carried out for both vaginal and caesarean births. Simply put, it’s waiting until the cord stops pulsing and blood transfusing to the baby is somewhat completed. WHO reported that 29% of all newborn deaths around the planet, are a result of babies not getting enough oxygen at birth (birth asphyxia). So if you consider the ability to increase your baby’s blood supply…increasing its oxygen carrying components (red blood cells)….it’s something to consider.

1/3 of a baby’s blood is outside of its body at birth- the rest is still inside the umbilical cord and the placenta, the way in which Bub has been receiving its oxygen and nutrients for 9 months. By delaying cutting and clamping the umbilical cord by 90 seconds it allows iron-rich, oxygen-rich, stem cell-fuelled blood to enter Bub’s little body. This has the ability to:

  • give your baby 30% more blood
  • give it a natural iron supplement – minimising childhood anaemia risks
  • increase their oxygen carrying cells – whilst they’re transitioning to life outside
  • 60% more red blood cells
  • transfuse stem cells – which prevent and repair damage throughout the body
  • improve systemic blood pressure
  • reduce the chance of baby needing a blood transfusion

Some people are worried that by delaying clamping, you’re giving baby “too much blood”, and there have been reports that delayed cord clamping causes jaundice. The fact of the matter is that since 1980, according to Mercer and Erikson-Owen’s, there has not been a randomised controlled study to show statistically significant findings in a link between increased jaundice levels and symptomatic polycythemia with delayed cord clamped Bubs.

So why isn’t delayed cord clamping happening all the time?! Personally, I believe the reason behind slow reimplementation of it is personal habit of practitioners as well as ‘patience versus intervention’. Living within a fast paced society, sometimes the hardest thing to do, is not much at all. We, as people living in 2015, are all trained for intervention. No one wanders lost (we have GPS and iPhones), we tap cards to pay for just about everything and have access to information (sometimes too much!) at our fingertips. We’re all about what’s next, what’s easiest, what’s faster, what’s quicker… but what if slowing down Bub’s first few moments, and allowing them the time to take a second to soak up as much nutrients as possible, before they’re officially their own little unit, is the first decision you have to make as new parents? It’s something worth reading up on, and making an informed decision about – and let your midwife of doctor know your view. After all, life is fast paced, should it have to start out that way?

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Image via journeyofparenthood

References:

http://www.who.int/elena/titles/full_recommendations/cord_clamping/en/

Alan Greene’s Ted Talk: //www.youtube.com/watch?v=Cw53X98EvLQ

Mayri Sagadi Leslie, 2015, “Perspectives on implementing delayed cord clamping, http://nwh.awhonn.org

Exercising Pregnant

Is it safe? How intensely can I exercise? What exercise in pregnancy friendly? We’ve got all the answers here!

Working out with a Bub on board boils down to the fact that exercise, whether you feel like it or not, is good for you (and Bub).

Research has shown that exercising throughout pregnancy helps to reduce headaches, anxiety, constipation, back pain, pelvic pain as well as increase your energy levels throughout pregnancy, plus it’s likely to wear you out, hopefully allowing you to sleep better during the night…meaning, more rest before Bub arrives…who doesn’t want that?!

Of course, there are going to be days where you just want to vege out on the couch, and that’s totally fine – try and plan out your week with some exercise in mind and stick to it. You’ll feel better off for it!

Below I’ve answered some of the common questions I hear antenatally from women about exercise.

Is it safe? Yes! For the majority of women exercise is safe in pregnancy, it’s actually encouraged. The Journal of Midwifery & Women’s Health (2014) suggests daily exercise may reduce chances of problems cropping up in your pregnancy. Speaking to your health care provider (Midwife, ObGyn, GP) about what’s best for you, is your best bet.

How intensely should I exercise and for how long? Ideally, it’s to a point where you increase your heart rate and begin to sweat. You should still be able to talk whilst exercising (moderate exercise for 30 mins, is fab!) If you’ve never been one to exercise, take it slow and steady…and make sure you warm up. Walking before you get into whatever exercise you are doing that day is really important- no pulling any muscles please, your body is doing enough already! Oh, and take a water bottle- if you’re thirsty, Bub is too.

What sort of exercise is pro pregnancy?

– Walking
– Low impact aerobics
– Prenatal Yoga (make sure you’re in a class with small numbers, it’s important that you are in a class where your movements can be observed clearly by the instructor)
– Swimming is ideal in pregnancy, and you can totally practice your nice long deep breaths (great for labour!) …and it’s no impact- bonus!
– Dancing is not only great for the soul, but a great and fun way to exercise whilst pregnant. Zumba anyone?!
– Weights (light weights- and make sure you’re supervised!)
– Later in pregnancy, rowing machines and bikes at the gym can be a great option.

What to keep in mind If you’re not feeling 100% or something in your gut is saying, “take it easy today”, then take it easy- no one is going to judge you. You’re growing a human- it’s hard work!

What exercise should you steer clear of? Contact sports are a no go. These exercises put you and Bub at risk:

– Skiing
– Hockey
– Anything involving horses
– Altitude training as well as scuba diving
– Heavy weight lifting

It really is a common sense thing. If you’re at all confused or not sure whether a type of exercise is a good idea, ask a health professional that knows your pregnancy history.

When shouldn’t I exercise? If you’ve been advised not to or have pre-existing conditions that make exercising more risky. If in doubt, speak to a healthcare professional.

Who should I speak to about exercise? Your midwife, ObGyn or GP

Happy Exercising! xx

References:

Exercise in Pregnancy- The Australian Family Physician 2014

Exercise in Pregnancy- The Journal of Midwifery and Women’s Health

Breastfeeding Mamas

It’s important to be mindful of how nutrient rich your diet is. Keep W.I.I.Z. in mind!

Breastfeeding is a calorie burner, which is awesome for post bub weight loss…but because your body is working hard to produce milk for bub, it’s important to be mindful of how nutrient rich your diet is. Keep W.I.I.Z in mind – and add an extra 2-3 mindful snacks to your everyday diet.

Wine Water No.1 thirst quencher. Water unfortunately does not increase your milk production, but breastfeeding is hard work so keeping hydrated is important. Aim for: a glass of water with each meal, a glass of water whilst feeding.

Iodine plays a key role in helping your bubs brain become Einsteinlike. The iodine requirements of a new mum are almost double the norm! Meeting these requirements can be solely diet related, supplement related or a combo of both. If you are using supplements, before use please speak to your doctor. Good Food Sources containing Iodine: bread, iodised salt, seafood, eggs and dairy.

Iron plays a part in transporting oxygen around the body. If you’re low in iron, you begin to feel sluggish, fatigued and are susceptible to a weakened immune system. Good Food Sources containing Iron: red meat, chicken and fish (these all also contain protein and zinc). Green leafy vegetables and legumes contain iron.

Hot tip: If you’re wanting to up your iron levels and help your body absorb iron more easily, squeezing citrus fruits on your greens and vegetables, allows the body to absorb the iron more easily!

Zinc is a warrior for healthy skin, good immunity and reproductive health. Good Food Sources containing Zinc: meats, cereals, brightly coloured veggies and fruit.

Image via @KauailifeImage: @kauailife

Resource: Thanks to #thehealthymummy for all their fab info and recipes available online! x

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