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.


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 – and 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.