Sometimes called birth partners or birth companions, a doula is someone experienced in childbirth, specially trained to give emotional and practical help, who can guide you and your partner through the process of preparing for birth and be with you both during labour, through birth and bonding with your newborn. She will meet with you several times during the pregnancy and will help you write a birth plan so that you are clear about your choices and she is familiar with your preferences on issues such as pain relief, breastfeeding etc. She will be on 24 hour call for three weeks before your due date.
A doula does not undertake any physical examinations or perform any other clinical tasks. She cannot make decisions for you but she can help you make your feelings heard.
She is independent and self employed and is working for you, not your caregiver or hospital and as such is able to provide continuity of care while hospital staff may go through one or more shift changes.
Having met her several times during the pregnancy she provides a familiar and reassuring presence to both the mother and her partner.
She does not replace the fathers role, her presence strengthens the father’s role and means that he doesn’t feel 100% responsible for his partner’s well-being – the doula is there to share that with him and it frees him to participate as much or as little as he wants.
The doula is very sensitive to the emotional bond and intimate connection between the woman and her partner and will work intuitively with the couple during the birth responding to their individual needs as the labour unfolds. At times this will mean she remains quietly in the background or will leave the room for a while to give the couple private time together: at other times, especially as labour intensifies, she will become more involved with guidance on position changes and may offer other comfort measures i.e. massage, relaxation techniques, reflexology etc. if appropriate.
Natal Hypnotherapy™ uses the natural state of hypnosis, deep relaxation and the power of suggestion to enhance your pregnancy and birth experience. Using hypnosis, you tap into the subconscious. (This is the part of your mind that is responsible for all your bodily functions including your heart rate, hormone production and elimination system, as well as the part which stores your emotions, fears and anxieties.) To deal with fear, overcome anxiety associated with pregnancy and labour, to increase self confidence and trust in your body’s natural ability to give birth. Using and applying hypnosis techniques can therefore greatly reduce, if not eliminate the fear and tension which leads to severe pain during the birthing process.
The subconscious mind does not know the difference between reality and imagination (ever had déjà vu or a dream that felt as if it was real?). Therefore through Hypnosis (similar to guided visualisation) you have the opportunity to "experience" a calm natural birth over and over again in your mind. In this way, once the actual birth begins, your body is familiar and comfortable with the rehearsed responses and so reacts accordingly. During the birth you remain relaxed, involved and in control, being conversant and alert of the experience. You will be aware of your body's contractions and will flow through the sensations using deep relaxation, breathing and your natural ability to tap into your body’s own pain killers (endorphins). Being able to enjoy the experience in a calm and relaxed way leaves no room for tension and fear which are the main causes of pain.
Imagine yourself labouring in a jungle. Suppose you saw or even thought you saw a tiger lurking in the nearby shadows. What do you think would happen? Would you have a conscious choice on what happens next? You may think you could control the situation, but your body would already have made the decision.
Simply believing there is a tiger in your birth space would instantly stimulate a healthy “fight or flight” mechanism. Labour contractions would slow down or stop and would not resume until you felt safe.
This fear activates the nervous system to produce adrenaline (danger hormone), which gives you the “umph” or power to prepare to fight or run away. Your cervix tightens (to prevent giving birth where it is not safe) and the increased level of adrenaline neutralises the oxytocin (the hormone responsible for contracting your uterus) and endorphins (pain killing hormone), so that the body naturally slows down or even stops the birthing. Experiencing fear during labour leads to your heart rate increasing, your breathing becoming shallow and faster (so reducing the amount of oxygen in your body and your baby), your heart pumping blood faster around your body so raising your blood pressure and blood being directed away from your uterus (and your baby) to your limbs, essentially to prepare you for action.
All this “fight or flight” preparation uses a great deal of energy. As our bodies were only designed to be in this heightened sense of preparation to “fight or flight” for a few minutes at a time, you can imagine that staying in this state for prolonged periods of time will be extremely draining, if not dangerous.
You may be asking, “what does a women giving birth in a jungle have to do with me?”. This is essentially about fear – fear of pain, fear of dying, fear of tearing, fear of losing control. Your nervous system does not know the difference between real or imagined danger or fear and so will respond in the same way to both - ever felt the rush of adrenaline and fear when watching a horror movie? Is the threat real or imagined?
If you go into the birth feeling and being frightened, your system will respond accordingly. This fear will lead to increased adrenaline in your body, which leads to increased tension in your muscles and your cervix with less “contraction” hormones being produced, so that your uterus is having to work much harder to flex and tighten. This subsequently makes contractions far more painful, in the same way that if you tense up when you are in pain, the pain becomes far greater.
All the while that there is fear in childbirth, your birthing body will not be allowed to flow easily through the natural progression of labour. In addition, the minute you introduce artificial hormones from induction, the body stops producing the right amount of natural hormones, including the wonderfully powerful endorphins or natural pain killers.
So how does being relaxed and calm make a difference?
By being relaxed during your labour, your body responds in a very different way to the fear scenario described above. When you are relaxed, your breathing is even and rhythmical; ensuring a high level of oxygen is entering your body. This oxygen goes through to your baby, ensuring that your baby remains calm and stable. Increased oxygen stimulates the production of oxytocin (hormone responsible for contraction) and endorphins. Your blood pressure remains at a healthy level, and as your body is limp and relaxed you conserve your energy, with all excess energy being channelled through to the muscle that is really working hard, namely your uterus. As the uterus has no resistance or tension from surrounding muscles, the contractions are more effective and more comfortable. As the labour progresses un hindered by artificial hormones, other natural hormones kick in including relaxin which allows the cells of the birth canal to relax, soften and stretch, so making the baby’s descent easier and more comfortable.
So how does Hypnosis work?
Hypnosis is a natural state, which we all experience many times a day. It is a time when your conscious, (analytical, rational mind) takes a step back and your subconscious (feelings, memories, emotions) comes more to the forefront. For example when you are day dreaming, reading a book and realising you have read the same thing over and over again, driving on a long journey and not remembering anything about the journey etc.
With intended Hypnosis, you purposefully take yourself into a daydream like state using music, soothing images and guided visualisation. Once the critical and analytical part of your mind also relaxes, you become more receptive to positive suggestions and affirmations. As the mind does not know the difference between imagination and reality, the more times you give yourself positive suggestions, the more real they become.
in summary, the key to a comfortable birth is to keep the levels of anxiety and adrenaline to an absolute minimum. Be keeping relaxed, focused and breathing steadily and rhythmically, your body will have the best chance of producing the right birthing hormones to enable you to birth your baby unhindered by chemicals of drugs. Tummy2mummy offer classes to help you prepare for your childbirth experience. The feed back we recieve is really positive, for class details see facebook page and web site.
While you are on maternity leave, you may be entitled to maternity pay either under your contract of employment or by law through Statutory Maternity Pay or Maternity Allowance, which can be paid for up to 39 weeks. The rules about maternity pay depend on how long you’ve worked for your employer, how much you earn and what your contract says.
For more information about maternity pay visit https://www.gov.uk/maternity-pay-leave
‘Yes! When you go into labour, if your midwife hasn’t met you before, your birth plan allows her to get to know your preferences. Try to have your plan ready by about 36 weeks, and go through it with your midwife. She’ll be able to advise you on whether it’s realistic in terms of the services provided – for example, whether there’s likely to be a birthing pool available.’ Writing Your birth plan will help you prepare you.
The Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives support the choice of labour in water for healthy women with uncomplicated pregnancies.
What is water birth?
A water birth is, as the name implies, giving birth in water. The idea is that the warm water replicates the feeling of the amniotic sac that has surrounded the baby throughout the nine months of pregnancy. A water delivery can be done at home, in a birthing centre or in a hospital.
During a water birth, both you and your baby should receive monitoring and medical care, just as you would in a hospital bed. While you are in labour, a special underwater device will monitor the baby’s heartbeat.
Some women stay in the water throughout labour and delivery. Others prefer to come out of the water for the actual delivery. If you deliver in the water, the midwife will gently lift the baby up to the surface and take the baby out of the water.
What are the benefits of a water birth?
There haven’t been many well-designed studies to confirm the benefits of water births. Some people, however, believe that water is a more comfortable and soothing surrounding in which to deliver.
Here are some of the potential benefits of a water delivery:
Water provides natural buoyancy, which makes the mother feel lighter.
Water relaxes the mother, allowing her to concentrate on the birth.
Water relaxes the mother’s muscles, enabling her to move into different positions.
Water eases the baby’s transition from the womb to the world.
Water reduces tearing to the perineum - the area between the vulva and anus - and, possibly, to the vagina and labia, thus helping the mother avoid an episiotomy or stitches.
A water birth could shorten the first stage of labour and might reduce the need for pain-relief.
What are the risks of water births?
Of the relatively few studies that have been made of water births, many conclude they are as safe as conventional births. But a small number identify some potential risks in rare cases and these are summarised below:
In rare cases, the baby may gasp while still in the birthing tub and inhale water. Although it was thought that babies’ primitive reflex prevents them from breathing in until they are exposed to the air, However, at least one study into thousands of water births reported no cases of babies breathing in water.
There have been rare cases in which the umbilical cord snapped during a water birth and the baby needed a blood transfusion because of uncontrolled bleeding.
If the water in the pool is not clean, there is a possible risk of infection. There have been isolated reports of newborn babies catching infections after coming into contact with contaminated water during a water birth. Other studies, though, have found no additional risk of infection compared to other methods of delivery.
Who should not have a water birth?
Women who should not have a water birth include:
Those who have been diagnosed with an infection or excessive bleeding, or who have a pregnancy-related complication such as bacteria in the bloodstream or high blood pressure (pre-eclampsia).
Those with herpes, because the infection can pass to the baby through the water.
Those who are in premature labour.
If you are having twins or other multiples, or if your baby is in the breech position (bottom or feet first), ask your doctor whether a water birth is safe for you.
The baby may have his first bowel movement (meconium) while in the womb. Special care needs to be taken to prevent the baby from inhaling or ingesting any of the meconium in the water.
Preparing for a water birth
Before making the decision, talk to your doctor and midwife to make sure that a water birth is safe and appropriate for you. If so, check to see if your local hospital offers water births. Around 64% of UK maternity units offer birthing pools. If one isn't available near you, you could consider delivering at home or approach a specialist birthing centre.
You can rent a birthing pool or buy one. (see hire drop down box for details)
To ensure that your water birth experience is as safe as possible, do the following:
Pools must be cleaned properly and water must be no warmer than 37.5C (99.5F ).
Drink plenty of water during the delivery to prevent dehydration.
Have an emergency plan in place in case there are complications and you need to get to a hospital.
If there is any concern about your safety or the health of your baby, get out of the birthing pool.
The Midwifery team around you will support and guide you.
The simple answer is yes. You'll get good maternity care so it's extremely unlikely you'll have serious problems during your labour and birth.
You should feel especially confident if your pregnancy has been straightforward and this is not your first baby. Research in England says that you and your baby will be as safe with a home birth as you would be in hospital.
The home birth option in the UK is backed by the midwives' and obstetricians' professional colleges, which issued the following statement recently:
The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman’s likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.
There are many positives to having your baby at home. You'll probably feel happier and safer because:
You are more in control of your labour and can do what you like. You can move around and eat and drink when you want. No one else is going to be using the birth pool if you've hired one.
You're likely to end up with warmer memories of the experience than you would have of a hospital birth.
You're in a familiar environment with germs you're accustomed to!
You're more likely to get breastfeeding off to a good start.
If you're already a mum, your other children can stay close to you.
Bear in mind, though, that you may have to go to hospital. If you do, your midwife will sort it all out and make sure that the hospital is ready and waiting.
Most transfers are non-emergencies. For example, you may be an exhausted first-time mum who's decided that it's time for an epidural. Other reasons include:
You have a complicated tear that needs to be stitched up.
Your baby is showing signs of fetal distress.
Your labour is taking a long time.
When you're planning where to have your baby it's sensible to discuss what would happen in an emergency. How far you live from the hospital or how bad the rush hour is near you could make a real difference. Talk to your midwife about your concerns and ask her what would happen.
Only you can decide what would make you feel safe. Perhaps being at home and in control of your labour is what matters most. If so, you'll accept the small risk that you may need to be moved to hospital in an emergency. Everyone is different and your midwife and obstetrician should respect your wishes.
see articles for further information -
There is no set cure for morning sickness. You can try to find out what brings on the sickness though. It may be the time of the day – such as morning or early evening. It might help to rest or eat a small snack to boost your blood sugar level before these times (have some snacks by the bed to eat before you get out of bed for example).
1. You may find that some smells set off your nausea, so avoid these particular smells if you can.
2. Wear travel sickness wristbands (elasticated bracelets that have a plastic button that presses on a particular place on your wrist).
3. Try nibbling ginger biscuits or sipping ginger tea, particularly first thing in the morning in bed.
4. Avoid large meals, but eat smaller more frequent meals and snacks.
5. If you are often sick, rinse your mouth afterwards with plain water to prevent the acid in your vomit attacking your teeth.
6. If the nausea is accompanied by severe vomiting to the extent you cannot keep food or drink down, you need to contact your GP or midwife as soon as possible.
There are some foods that could pose a risk to pregnant women, these include:
• liver and liver products
• soft mould ripened cheeses, such as Camembert, Brie and blue-veined cheese
• pâté (including vegetable pâté)
• uncooked or undercooked ready-prepared meals
• uncooked or rare meat (meat should be cooked so there’s no pink or bloody meat)
• cured meat, such as salami or Parma ham ?
• raw shellfish, such as oysters
• fish containing relatively high levels of mercury, such as shark, swordfish and marlin
• unpasteurised milk or dairy products made from unpasteurised milk
• raw or undercooked eggs or products containing them such as fresh mayonnaise
• alcohol – it is safest to avoid alcohol altogether
• food beyond it’s use by date. ?
It is recommended that the intake of certain other foods be limited, such as:?
• tuna – no more than four medium size cans or two fresh tuna steaks per week
• Oily fish – no more than two portions a week
• No more than two portions a week of sea bream, sea bass, turbot, halibut, rock salmon (also known as dogfish, flake, huss, rigg or rock eel), brown crabmeat
• caffeine – no more than 200 milligrams a day. Caffeine is present in coffee, tea, colas, energy drinks and chocolate
Prior to formal induction of labour, when women are 41 plus weeks pregnant, it is recommended that all women be offered a membrane sweep to assess the readiness of the cervix (neck of womb) for labour*. It may also help stimulate labour as it has been shown to increase the possibility of labour occurring naturally within the following 48 hours*.
A membrane sweep involves an internal vaginal examination by your Midwife or Doctor. They will place a finger just inside your cervix and, making a circular sweeping movement, will attempt to separate the membranes from the cervix*. This will stimulate the release of hormones that may start contractions. It will be uncomfortable but should not cause actual pain; you may also experience a mucus/bloodstained ‘show’ like a discharge, following this, which is quite normal.
*NICE guidelines (National Institute for Clinical Excellence). Induction of labour. June 2001.
From 35 weeks of pregnancy
Raspberry leaf was found to cause a relaxant effect on the uterus. It was believed that this relaxant effect caused the uterine contractions of labour to become better coordinated and more efficient, thus shortening the length of labour. It is also commonly assumed that women who take raspberry leaf throughout labour will have an improved second and third stage of labour. Consequently there is supposed to be a reduced risk of bleeding after birth.
•Provide a rich source of iron, calcium, manganese and magnesium.magnesium content is especially helpful in strengthening the uterine muscles. Raspberry leaf also contains vitamins B1, B3 and E which are valuable in pregnancy.
Raspberry leaf can be taken in tablet form, teabags, loose leaf tea. Raspberry leaf can be purchased from many health food stores
The following guidelines on consuming raspberry leaf during pregnancy have been taken from Parsons (1999):
•Tablets - you can Take upto 1500mg a day
•Teabags - up to 4 to 5 teabag cups throughout the day.
•Loose leaf tea - Bring one cup of water to the boil. Remove from heat and add one teaspoon of the herb. Stir, cover and let sit for ten minutes (do not boil the herb), strain and sip. Adding sugar or honey many improve the taste. 2 to 3 cups per day
According to the National Institutes of Health, evening primrose oil is high in prostaglandins and contains gamma-linolenic acid, a type of omega-6 fatty acid. Prostaglandins soften the cervix so that it is ripe to begin dilation and effacement as labour progresses; they are naturally produced in higher amounts by the body in preparation for labour and delivery. The use of evening primrose oil to start labour has been around for a long time, and many midwives swear by this technique when helping pregnant patients prepare for delivery. Evening primrose oil does not directly trigger the start of labour, but works by softening and ripening the cervix. This allows the baby's head to engage in the pelvis, encouraging dilation. It can prepare the cervix for delivery and make childbirth more comfortable for mother and baby alike.
This method does not work over night. You should not expect to use the oil before bed and wake up in labour. It doesn't work that way. The oil needs to be used for a few weeks to gradually ripen the cervix.
From 36 weeks gestation (Do not use before 36 weeks)
Make certain your membranes are intact. The introduction of any substance into the vagina, or through the cervix, after a tear or rupture in your membranes may result in a serious infection that could put you and your baby at risk.
Take two 500 mg capsules of evening primrose daily one orally in the morning. Then insert a capsule into your vagina before bed each night throughout the last few weeks of your pregnancy (it may help to pierce the capsule before inserting). This should be done immediately before bed, as your body heat will dissolve the capsule and the oil will leak out of your vagina if you walk around.
This will help slowly ripen and soften your cervix, but will not cause you to go into preterm labour.
You can also use evening primrose oil as part of a perineal massage. Have your partner help you with this, if possible. Numerous studies, including one published in the American Journal of Obstetrics and Gynecology, show that daily massage of the perineum during the last month of pregnancy reduces the likelihood that an episiotomy or tear during delivery.
Group B Streptococcus (GBS) is a normal bacterium which colonises up to 30% of adults in the UK, without symptoms or side-effects. GBS can cause infection, most commonly in newborn babies before, during or shortly after birth. GBS can more rarely cause infection in adults (typically women during pregnancy or after birth, the elderly and people with serious underlying medical conditions which impair their immune system).
GBS is not a sexually transmitted disease and treatment of the woman and of her partner does not prevent re-colonisation.
In newborn babies, there are two types of GBS disease: early and late-onset. Roughly 80% of GBS disease is early-onset, occurring in the first 6 days of life and usually apparent at birth. Early-onset GBS disease is normally characterised by the rapid development of breathing problems, associated with blood poisoning. Late-onset disease - which usually presents as GBS meningitis - occurs after the baby is 6 days old and, normally, by age 1 month but, rarely, up to age 3 months. After age 3 months, GBS infection in babies is extremely rare.
GBS is also a recognised cause of preterm delivery, maternal infections, stillbirths and late miscarriages. GBS infections are rare in adults, especially so for men and women who are not pregnant.
Overall, without preventative medicine, GBS infections affect an estimated 1 in every 1,000 babies born in the UK. Each year, based on 700,000 babies born annually in the UK, approximately:
• 230,000 babies are born to mothers who carry GBS; 88,000 babies (1 in 8) become colonised with GBS; 700 babies develop GBS infections, usually within 24 hours of birth; and
• 75 babies (11% of infected babies) die.
Of the survivors of GBS meningitis, up to one half suffer long-term mental and/or physical problems, from mild to severe learning disabilities, loss of sight, loss of hearing and lung damage (in around 12% of the survivors, the disabilities may be severe). The great majority of survivors of early-onset disease do so with no long-term damage.
Testing low-risk pregnant women for GBS at 35-37 weeks of pregnancy - using reliable enriched culture method (ECM) tests - and offering intravenous antibiotics in labour to women whose babies are at higher risk of developing GBS infection*, will prevent more GBS infection in newborn babies than using the current prevention method of offering intravenous antibiotics in labour to women with recognised risk factors.
Without testing low-risk women for GBS carriage, many of those whose babies will be at risk of GBS infection simply won’t be identified and so no preventative medicine can be given. ?The result of an ECM GBS test is always good news. If it’s negative, then it’s hugely unlikely your baby will develop GBS infection. If it’s positive, although it does mean that your baby is at a raised risk of developing GBS infection, it also means that you can consider taking simple straightforward steps that have been proven to be extremely effective at minimising that risk.
• Pregnant women whose babies are at higher risk of developing GBS infection are those where GBS has been found during the current pregnancy from a urine culture or a vaginal or rectal swab; those delivering prematurely; those who have previously had a baby with GBS infection; and those with other recognised risk factors.?