Friday, August 20, 2010

My recommendations for achieving a natural birth

I am the mother of two boys. Both were born at home as this is where I felt most comfortable birthing. Both were very different experiences. I realise since having Niwha recently that in order to have a gentle, natural birth with no drugs and no intervention good preparation is necessary. These are my recommendations for achieving the natural birth you want no matter where you choose to birth.

Preparation:


1. Health and fitness – walking, swimming, pregnancy yoga and pilates, good whole foods. Limit sugar intake. Raspberry leaf (after 4-5 months), nettle teas (or a pregnancy tea that has both).

2. To ensure your baby is in a good position, sit upright with pelvis straight or tilted slightly forward. During labour, use an upright, even leaning forward position.

3. Watch videos of natural, positive births – search Hypnobirthing or Gentle birth on You Tube. Visualise your own birth – see it exactly as you want it to happen.

4. Practice breathing – breathing to fully relax, breathing long, slow and deep to assist you through contractions. Birth breathing – practice while having a poo – breathe in, as you breathe out, breathe down your back, imagining your breath is actually coming out your vagina. See the Hypnobirthing book for more detail.

5. Massage (or get your partner to) your perineum with almond, rosehip or st John’s wart oil every night for 6-8 weeks before your due date. See the Pink Kit or Hypnobirthing book for more detail on how to do this.

6. Avoid listening to any negative stories of birthing. Simply ask the person talking to tell you all about it after you have birthed your baby.

7. Research all the choices you have during your birthing.

8. Write a birth plan with your partner – have your ideal as well as what you are willing to compromise if you experience pressure from your medical attendants.

9. Ensure you have a lead maternity carer who will support your birth plan – you can change LMC’s at any time!

10. Remember that your due date is just a guess date. Your baby may take more or less time to grow to a point where they are ready to come into the world. Induction paths the way to greater often easily avoidable intervention.
Dealing with the pressure to induce – are you healthy and well? Is the baby still moving? Ask your LMC to monitor you and your baby more closely. If you receive huge amounts of pressure compromise by having a scan to check the baby – particularly the fluid around the baby. Ask that they do not estimate the size of your baby! They often get this very wrong with large overestimations and being told you’re having a 9-10lb baby can psych you out! A big baby is a healthy baby and if they are in the optimal position they will be no harder to birth!
If your waters have broken statistics show that there is an increased risk of infection after 18 hours. You may receive pressure to induce after 24 hours or less. Again, avoiding this will give you a great chance of having a natural birth. I was willing to go for 48 hours taking all the necessary precautions and using high doses of Vitamin C and taking Echinacea to boost the body’s defences against infection. After 48 hours I was willing to consider antibiotics, not induction. In the meantime use every natural induction method – walk, walk, walk, visualise your cervix opening, have a hot curry or take cod liver oil to get your bowels moving, use acupressure or acupuncture (this is often very effective!)

During Labour:
1. Use Naturo pharm Pre-birth. Rescue remedy to stay calm and relaxed.
2. Stay active. Move with and between contractions – see the New Active Birth book. Relax, laugh, eat, drink, go to the toilet.
3. Visualise and use affirmations to stay focused on the outcome you want and being relaxed. See Hypnobirthing for affirmations or make up your own – say them in the present (not future) and use only positive language.
4. Use water! Ideally a birthing pool that you can also birth in. Hot water takes pain away, helps you deal with the pressure in your lower pelvis and softens your vagina so it can stretch better.
5. Hot towels on your lower back (hang them over a oil column heater, they don’t need to be wet). Partner massage on the dimples on your lower back. Light touch massage – see hypnobirthing book – releases endorphins.
6. Use your breathing techniques, breathing up into your abdomen with every contraction. Remember that a contraction only lasts for a short amount of time. You can breathe through it and get a rest afterwards. During the final opening stage, before the baby is ready to move out of the birth canal contractions are closer together. You may say something like ‘I can’t do this any more’. Tell your partner that this means you are close to birthing your baby and not a sign that you need intervention! When you notice yourself saying this celebrate in the knowledge that you are close to meeting your baby.

Dealing with the pressure to receive interventions:
One great question to ask (or have your partner ask) whenever an intervention is suggested is ‘Is this a medical emergency?’ If not then intervention can be avoided.
State in your birth plan that you do not want to be ‘offered’ any pain relief or other intervention. State that you do not want other medical staff wandering into your room. Some anaesthetist’s walk in and say they are leaving soon so if you want an epidural you better have it now!! This is not true as there is always an anaesthetist around for emergencies. I’ve heard it said that for every ‘extra’ person in the room you can add an hour onto your labour! You have the right (and your partner) to ask unnecessary people to leave your birthing space.
Hold onto your waters! If your waters haven’t broken some LMC’s want to break them to get things moving. This is unnecessary and can cause problems. Many baby’s break their waters as they are born (or you or your LMC can break them as the baby is being born). Your baby will come in it’s own time – stay relaxed, rest (on your left hand side or in a slightly reclined position), eat, drink and trust your body and your baby.
Remember that every drug you have goes through to your baby. It can affect their breathing and ability to breastfeed. Birth is your child’s first experience in the world. It affects them personally in either a positive or negative way. There is soooo much you can do to make it a positive experience for your baby and yourself. If you are one of the 5% of people who really need medical help, then that is what we are privileged to have available here.

Recommended reading during pregnancy and early parenthood:

Liedloff, Jean. (1975) The Continuum Concept. In Search of Happiness Lost.
This is an absolute classic in the alternative parenting world. Jean’s writing style is really difficult but it’s a must read before you have kids.

Mongan, Marie. (2006). Hypnobirthing: The Mongan Method.
Highly recommended. Fantastic, beautiful, gentle and empowering way to birth your baby. 95% of women who use this method have natural, gentle birthing experiences.

Balaskas, Janet. (????). New Active Birth. A concise guide to Natural Childbirth.
Great book for staying active before and during labour and preparing to birth your baby naturally.

La Leche League International. The Womanly Art of Breastfeeding.
The bible for breastfeeding! La Leche League is an International group of volunteers who support and educate on breastfeeding and related things. Borrow this from your local LLL group – brylin@ihug.co.nz and linda@guru.net.nz are two LLL leaders in Dunedin. Ask to see a Lactation consultant before you leave the hospital regardless of how it’s going. If at home and you’re not convinced it’s perfect, go into the hospital and see the consultant or visit a LLL leader.
Remember that only a small percentage of women actually can’t breastfeed. Don’t give up, get help and only use formula as a last resort. Many women express full time if their baby can not breastfeed, instead of resorting to formula.

Weed, Susan. (1986). Wise Woman Herbal for the Childbearing Year.
Very 80’s book! Great natural, herbal remedy’s for every pregnancy, birth, infant related issue.

Gethin, Anni & Macgregor, Beth. (2007) Helping your baby to sleep: Why gentle techniques work best. Finch Publishing.
This is a great book for parents who want to make going to bed and sleeping a gentle and positive experience for their baby. Dr William Sears books are also recommended.

Also see my other blog posts for information on Raising a Nappy Free Baby and Baby Wearing.




Thursday, August 12, 2010

Niwha Stuart Hughes' birth story


At 38 weeks pregnant I was ready to have my baby (as many women are at that point)! I had a sore sacroiliac joint and had a horrible time attempting to go to a movie before my baby was born. I came home quite emotional for no real reason. Monday 2nd August was my husbands birthday and Eli decided that he didn't want to go to Kindy. I had to stay with him for more than an hour and he still sobbed when I left. He'd been settled at Kindy until now. That evening we had a very quiet family dinner to celebrate my husband's birthday, which was really a bit overshadowed by strange feelings from myself and Eli. That night my husband said, 'I really want to call your Mum and tell her to come down now'. She lives in Nelson and had a ticket to fly down that weekend. He had a feeling that we would need her earlier than that. My due date was the 11th August.


At 11.45pm that night my waters broke. I didn't wake my husband. I text Mum and asked her to see whether she could get down here as soon as possible. I called our midwife to let her know that my waters had broken and that I had one small contraction and a bit of the shakes. My

waters were pink with vernix so all normal. My husband woke up and I told him. 'Great' he said. We bought the pool in and started to fill it, but I wasn't having any contractions, just leaking lots of fluid! I had told our midwife I would call when things got going. She was pretty sure things would happen quite fast. By 1.30am we stopped filling the pool and went back to bed. There wasn't much sleeping going on with the anticipation and a contraction every hour or two.


No work or Kindy for the boys in the morning. Eli was very excited at the site of the pool in the lounge and it was a struggle to keep him and his toys out of it! Our midwife was due to visit in the morning anyway. It was good to see her and confirm that the baby and myself were all good. Mum was on the first flight down here. She ended up circling above Dunedin for an hour due to fog and was the last person in the shuttle to be dropped off so she was itching to get here. Contractions continued at 1-2 hours apart for the day. Our midwife came back late afternoon and found the baby had moved down a lot further during the day. Yeepppeee. Late afternoon after another walk contractions were about half an hour apart. I had a full dinner, but didn't feel like dessert! Any food went straight through me so I knew my body didn't want to cope with any thing else. Some of the contractions were good ones and I had to stop what I was doing and concentrate on the hypnobirthing slow breathing and visualising the vertical muscles of my uterus pulling up and the horizontal muscles around my cervix relaxing and opening out and up so the baby could move down.


As soon as Eli was asleep contractions started coming 5 mins apart. I used a Swiss ball and the hypnobirthing sleep breathing to fully relax in between contractions. I was visualising my baby in the optimal birthing position and moved into a position on my knee and leaning forward

onto the couch. Mum started timing contractions at 7.53pm and I called the midwife. She asked me to call after the contractions had been 5 mins apart for an hour or dropped to less than that. At the time I thought, a whole hour, really! I should have clicked then that I was progressing really fast. Our timing of contractions wasn't great. Mum was using the clock on the phone and I sometimes forgot to tell her I was having a contraction. I was slow breathing through each contraction and it mustn't have been that obvious to anyone else that I was having one. So sometimes the contractions were 2-3 mins apart and other were timed at 6-7. Sometimes a contraction was very strong and other times it was not and over with quickly so I didn't know if it 'counted'. Well it had pretty much been an hour when my husband called our midwife again. He told her I was keen to get in the pool. She asked me to hold off and she was on her way. My husband relayed the message and added 'but you do what you want to.' As my waters had been broken for 20 hours I didn't want to get in to soon either. However soon after my husband hung up I had a very obvious bearing down contraction. It was sooo intense. It felt like my uterus had lifted up and slammed the baby down against my vagina. I almost swore and had to pull myself back into a focused slow breath. I said 'That was a pushing contraction'. After the next one I could feel the baby's head pushing against my vagina and I said 'Text the midwife and tell her this baby is coming, but not to speed.' Then I said 'I'm getting in the pool'.


I got in the pool and my husband pushed record on the video camera and stayed with me. He used light touch massage and massaged the dimples on my lower back, both were really good. A one stage he started reading me some of the hypnobirthing affirmations. After the first one, I said 'I'm way past that' and after the next one I said 'shut up'. We laughed and he said 'good they're in the fire.' Mum tried to get Eli up

to be there for the birth, but he said he didn't want to. A couple of intense contractions bought the baby's head to crowning. I felt with my hand and smoothed around his head. I relaxed and enjoyed the break before the next contraction that I knew would birth the head. After his head came out I said to my husband 'The heads out'. He replied with 'ahem'. I little bit shocked and nervous I think, but he had complete confidence that I could birth our baby successfully. The midwife still hadn't arrived. I felt around the baby's head and waited for the next contraction that would bring him out. As the rest of his body was born I moved from my knees bringing one foot forward and supported my baby out. I turned him over, felt over his body and looked at him under the water before bringing him out and to my chest. My husband asked what sex he was and I replied that he was a boy.


This is when we were a bit nervous as he didn't breath spontaneously. I sucked his mouth and nose as I had seen women do on the 'Birth As We Know It' DVD and waited. I mentioned that we might need oxygen, just not knowing how long it would take him to breath on his own. I knew the cord was still attached and would be providing him with something. My husband rubbed his stomach and I sucked his mouth and nose a number of times before he gasped and cried loudly. We laughed with relief and I bought him to my chest again. It was still a few seconds before he started to breath continuously, but once that started we all relaxed and laughed. We kept him warm with face cloths and I kept him in the water as much as possible. He indicated that he was keen to feed, so that is what he was doing when the midwife arrived 11mins after he was born. She was very pleased that all was well. My mum said 'missing the birth must happen every now and again does it?' She said it was only the 3rd time in 25 years that she'd missed a birth. 'Keeps me humble' she said in her wonderfully humble way.


It took a couple of hours to birth the placenta as I just couldn't be bothered! Figured it would come out when it was ready! I was keen to birth it in the pool, but the water was getting cold and I was struggling to feed my baby and keep him in the water and warm. I got set up on the couch and after a couple of half hearted attempts to birth the placenta over a bowl I finally did. The placenta looked good and healthy. We were unsure how long we would leave it attached as we were considering a lotus birth. We decided to cut it.

We were in bed by 1am-ish at which point Eli woke up and asked what I was doing. When I said I was feeding the baby he was soooo excited. He wanted to sleep next to him and was not impressed when we said he had to get back in his bed. He wasn't going back to sleep so my husband and Eli swapped with Mum who was in the spare room. She slept in Eli's bed and in the morning my husband and Eli came back in. The family bed had 3 generations in it for a wee while that morning. It was lovely.


Niwha Stuart Hughes was born about 9.15pm on Tuesday August the 3rd. He weighed 6.4lbs, 2.8kg. Almost 2 pounds lighter than Eli who was 8.3lbs! Wow never thought I'd grow such a little baby. He is healthy and strong, just skinny. He was 50 cm long which was not much shorter than Eli. Head circumference 34cm.


Below is a 6 min clip of the birth from crowning to first cry. It is G rated. No gore and not too much nudity. Look forward to writing a post on preparation for a natural birth. My birthing experiences have shown me just how important physical and mental preparation is in having a successful natural birth.




Thursday, July 22, 2010

Hypnobirthing


Ok, so with Eli's birth in mind I was quite scared at the idea of giving birth again from the moment I discovered I was pregnant. I was slowly coming around to the idea and realisation that what happened was so rare and bizarre that it would not happen again and chances are I'd have a great birth this time when I was introduced to the book Hypnobirthing: The Mongan Method by Marie Mongan.

I must admit that it sounded a bit out there for me. I had all the standard prejudices around hypnosis but was open to reading the book. The book is fantastic. Great history around birthing particularly Grantly Dick-Read's work in the 1800's. He came up with the Fear-Tension-Pain Theory. The theory explains that when someone is fearful it creates tension in their body due the flight/fight response and tension leads to pain. In the context of birth any tension centers around the uterus as a birthing woman is fearful of the pain, experience or idea of having a new baby. Tension in the uterus means that blood to the area is restricted and the baby is pushing against hard muscles causing pain and obviously a Failure To Progress, which funnily enough has the same acronym as Fear Tension Pain (FTP). Obstetricians who have performed cesarians on women who have Failed to Progress have found the muscles of the uterus to be white. So the main objectives of hypnobirthing are relaxation, visualisation, imagery, affirmations to create a calm, gentle, even painless birthing for you and your baby.

Anyway there is more to it than that and I strongly recommend a read of the Hypnobirthing book. So now I was really interested in the philosophy and skills that hypnobirthing had to offer. The woman who recommended the book to me had recently arrived in Dunedin, New Zealand with her family and is a Hypnobirthing instructor. She wanted to run a course for couples she had met. Unfortunately (fortunately for us) we ended up being the only couple interested and I was already in the second half of my pregnancy. So our instructor was happy to run it just for us. There were pro's and con's to that, but ultimately it was a fantastic course. As well as the skills of relaxation, visualisation, imagery and a really positive view of natural birth we also had the opportunity (created for us by our instructor) to process Eli's birth and have time together with this new baby pre-birth. It was a great opportunity for my partner to understand what I was trying to achieve and ways that he could support the process and be involved in the birth of his child. The fact that the course is run for couples is a great thing.

I would recommend a hypnobirthing course to anyone. Great to get it right the first time and if the first time wasn't ideal it's great for setting you up to have a more ideal birth the second time. As part of the course we watched 'Birth as we know it,' a fantastic DVD created by a Russian midwife. Also highly recommended.

I really hope that the hypnobirthing instructor here in Dunedin continues to offer courses to couples and that midwives around the world start to adopt the philosophy and skills of this wonderful technique.

Look forward to writing a post on my birth experience to come and how hypnobirthing helped me.

Monday, June 21, 2010

Eli's birth story 3 years on!


I've never written Eli's birth story as it's been hard to deal with. I'll try to keep it short!

Eli was in a good position for his birth. My waters broke at about 10am and I went into labour at 8pm that night and he was born about 2am. Labour progressed smoothly and reasonably easily. I was at home, the pool was full and warm and I utilised it in the later stages of my labour. Eli's heart rate was good. I opted to let the midwife use the Doppler so I didn't have to get out of the pool. When I shared the feeling of an urge to push I was encouraged to feel for the babies head. I was fully dilated and it was obvious that I had experienced transition. When I felt for Eli's head I described it as soft and squishy. The midwife was a bit puzzled by this and assumed that his waters hadn't broken completely. I followed the next urge to push and Eli's umbilical cord prolapsed (a loop fell out of me).

For those who don't know, this is a major emergency. As Eli was attempted to birth he was cutting off his own oxygen by compressing his cord. My husband was the only person to ask a question about this rare ( between 0.14% and 0.62%) event in our antenatal classes! In class we were told head down, bum up, keep the cord safe and moist etc and get to the hospital. Well that just wasn't going to happen. I was fully dilated, ready to birth and needed to get Eli out fast! My husband called an ambulance without a prompt. We all knew this was serious. My midwife looked at me and said 'We need to get this baby out now'. I said 'Ok, I'm pushing.' I pushed regardless of contractions, as hard as I could. Our backup midwife arrived, thinking she was coming to a swift moving, easy birth. My yells were the first indication to her as she got out of her car that things may have changed. She helped me out of the pool as our LMC (Lead Maternity Carer) had decided that an episiotomy would help get my baby out as fast as possible. At one stage I was told to have a rest and refused. As our LMC got the anesthetic ready I yelled 'Just cut me'. So she did and it hurt, but I wasn't going to risk taking any more time!

Eli was born in 12 minutes from the moment his cord prolapsed. He was blue and limp and not breathing very well. But he was breathing! He was alive. Many babies don't survive a prolapsed cord. His heart never stopped, though it got as low as 6o beats per minute (I think?). To sum up, the ambulance arrived, we went to the hospital, nasal oxygen helped Eli instantaneously and he had a few hours in Neonatal Intensive Care Unit NICU (at 8.3lbs he was by far the biggest healthiest baby there!). I was stitched up, while my husband stayed with Eli. We were convinced to give him antibiotics 'in case' of infection, grrrr! I wasn't allowed to feed him for 10 hours while his breathing was monitored. He was on a glucose drip. We were allowed home after one night in hospital.

Eli is a happy, healthy, clever almost 3 year old so we were very lucky. On visiting Eli in NICU and learning of his birth a consultant doctor at the hospital said of the birth, something along the lines of 'It was a strange happening within a rare event'. It was reassuring to know that. I had done everything I knew (and I'd read a lot!) to have a healthy, safe pregnancy and birth and I felt pretty disappointed at what happened. Put in perspective I had a live and healthy baby!!!!

Well this post started off as a post on Hypnobirthing as now 33 weeks pregnant with our second child my husband and I have just finished a hypnobirthing course. The greatest benefit of the course was the opportunity to finish processing Eli's birth and go into this one without fear.

We are having this baby at home, in the pool and it's all going to be great! We have the same midwives and I know this one will happen the way I envision it.

Now that this story is told I'll post about Hypnobirthing! :)

Wednesday, April 28, 2010

Protecting your child from injury or being overprotective?

It has been a horrendously long time since I last posted on my blog. Always lots to write about, not always the time to write it!
So here we go. My son has be proving himself quite the daredevil lately. Mostly on his bike - I will add a clip of a rather good downhill, with a good crash at the end, when I get to the computer this clip is on! And here it is...

video

Just yesterday day we had our first tree climbing experience. Well Eli has been climbing trees with his Dad a couple of times a week during their lunch break together while I finish work. So it was really just my first experience tree climbing with Eli. Not that I climbed the tree. I was invited to join him, but at 25 weeks pregnant I decided I'd stay on the ground. Not as climbing fit as I was when pregnant with Eli, teaching multipitch traditional rock climbing at 25 weeks pregnant!

Anyway, I milled around on the ground, trying to be in good 'spotting' positions in case of a fall without looking like I was trying to protect him. I trust his ability to know what he can and can't do. He does push the limits as is good for everyone and yes one day this might have a significant consequence. I believe the consequence is worth it for developing a confidence, skillful person who is aware of his body and what it is capable of.

At quite a young age he climbed to the top of our gate, resting his knees on the top cross bar. The kids up the road who he was trying to watch (most probably join them) came running down yelling that Eli was on the gate. My husband wandered out the sliding door to find him precariously perched. He wandered back inside to get the camera, saying 'You should see this.' As he was out taking photo's and this movie. Myself and a friend who was visiting came outside. As much as we tried to be nonchalant about what we saw, Eli released where he'd put himself, panicked and tumbled over the gate landing flat on his back on the grass. A bit winded and in a bit of shock there were lots of tears, but nothing more. I breathed a sign of relief that he'd gone forward and not backwards onto the concrete!
video

So, should we have plucked him off as soon as we saw him? Should we have supported him down? Or was what we did ok? The kids walked off in a bit of bewilderment as the realised that we didn't share the panic and fear that they did. Maybe we should have?

Needless to say, since then he has been most careful about what he climbs up! For a while he freaked out when he'd climbed something and wanted down. We continued to refuse to help though we did offer advice and sometimes a spot as he found his way down.

I feel confident and happy in the way we have dealt with Eli's 'sticky situations'. My feelings come from a number of philosophies. Jean Leidloff's, Continuum Concept talks about trusting kids innate ability to keep themselves safe. Also their ability to cope with a bit of pain and suffering and the knowledge that they can come to their parents/caregivers for comfort if they need it. Most of all my belief in Experiential Learning as one of the most powerful types of education. Eli learnt after falling over the fence that there are consequences to climbing past your ability and he hasn't done it since. He pushes the limits and is well aware that there maybe a consequence to doing so. We could not have taught him that more powerfully than through the experiences he's had. Yes, we teach him the danger of the road. Explaining why there was a squashed, dead bird on the road one day was helpful for that lesson! We supervise him when he's using a knife etc, but we don't 'protect' him from these dangers!

There is a risk in everything. To not expose your child to a physical risk is to expose them to the risk of being fearful, scared to put themselves out there and not learn their limits. A bit of physical risk is worth it in my opinion.

Anyway, enough babble from me. Love to hear your thoughts! Anna :)