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1st Entry: The first 12 weeks of Pregnancy
The first 12 weeks
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator.
I was going to write a diary with my first child… he is soon to be three.
Yes the plans we make, and they never seem to happen when a baby enters your world. I think of the cross-stitch only half done and how I was going to change the garden around. How we planned to extend our house. Well I guess that is getting there, with plans nearly finished. The GoYellow Home renovation site will come in handy. See http://goyellowlife.yellowpages.co.nz
I should be happy but with BU2 (baby number two) on the way the thought of builders and a baby doesn’t impress me.
To think over 10 yrs ago a doctor told me I may never have kids due to my endometriosis. Yes I am 12 weeks pregnant and already need for a different bra size, trouser size, a nap during the day and a toilet trip at 2am.
All is going well with the pregnancy and I don’t feel so sick this time around. I don’t get morning sickness more 9pm sickness. Eating dry cereal and flat ginger “beer” (with no beer in it) helps.
Problem is the tiredness and with a two year old and still working part time as a Midwife and Childbirth Educator it is hard to rest. But I am trying to look after myself by cutting down on junk food, and I’m getting enough exercise just by running after my son. It’s called the “two year diet”… have a two year old and you are sure to get fit.
I found the following book a great resource for my work as a Midwife.
Joan Donley’s Compendium for a Healthy Pregnancy and a Normal Birth
By Joan Donley
This book was written as a resource book about health for pregnancy, birth and the baby. It is written mainly looking at these areas but it could be used as a natural health reference for everyday life. The book provides a lot of references to other peoples wisdom, so this is not just a book on Joan's thoughts but a collection of like-minded people.
The first section looks at environmental hazards and the reasons why we should avoid certain drugs and chemicals. She uses a quote re fetal and brain development: ‘the brain and neuronal pathways have only one chance' This made me think (use my neurons) re the importance of health of pregnant woman more, as they are caring for the next generation.
The survival of intelligence depends on it. Pregnant woman need to look after themselves and see themselves as mothers even before the baby is born, and mother their unborn baby. Joan's references to statistics include that 360 NZ babies are born each year with impairments caused by maternal consumption of alcohol and that cigarette smoke contains an estimated 3800 chemicals.
The next section goes onto to review nutrition. Quote Joan used: 'The area in which a woman can exert the most influence over the outcome of her pregnancy is nutrition' (Plotkin 1994). We often forget the food we eat is the fuel for our body; cells need certain minerals and vitamins to function properly.
I have been taking a folic acid supplement. It is recommended to increase your Folic Acid intake before getting pregnant, and in early pregnancy as deficiency can cause possible congenital neural tube defects eg spina bifida.
The present recommendation is to take folic acid daily for 4 weeks before conception until 3 months post conception. Please speak to your LMC (Doctor, Midwife) re this.
Before getting pregnant I also checked my rubella immunity. If not immune you may wish to consider having the vaccine and then you will have to wait approximately 3 months before trying to get pregnant. You usually have to avoid pregnancy after any immunisations until advised otherwise.
After you realise you are pregnant then you will need to have antenatal (pregnancy) blood tests done. At the booking visit bloods are taken to check rubella immunity, find out your blood group and if you have any antibodies, your hepatitis status, full blood count (FBC) and a VDRL test for syphilis. You can request a test to be taken if you think you could be at risk of having HIV.
Having scans is a personal decision
What is Nuchal Translucency (NT) scanning?
Quote from Gisborne Radiology frequently asked questions page see: http://www.gisborneradiology.co.nz/faq2.htm
” Between 11 and 14 weeks of gestation you can have a test called a Nuchal Translucency scan. This test - only performed in this narrow time period, measures a skin thickness on the back of the baby's neck. Measurements taken during this scan may determine risk for foetal and chromosomal abnormalities. Eighty per cent of Downs abnormalities (Trisomy 21) are identified using this method. If after the NT it is determined you have an increased risk of Downs, your Doctor or Obstetrician may suggest you have further tests such as Amniocentesis or Chorion Villus Sampling (CVS).”
You must think though what you would do with the information they provide you with.
If the NT scan shows a high risk of Down’s syndrome would you want to terminate the pregnancy, if not think about the reason you are having the scan.
Finding a Lead Maternity Carer (LMCs)
Being a Midwife myself it wasn’t hard finding a Midwife. I do advise to book your LMC (Midwife, Dr) early, often between 4-12 weeks pregnant. In some areas Independent Midwives are booked up earlier than in other areas due to availability and popularity.
0800 MUM 2 BE (0800 686 223)
The 0800 MUM 2 BE Maternity Consumer phone line is run by the Ministry of Health.
The 0800 line has a person answering the phone between 9am and 2pm Monday to Friday. Voicemail is available to leave a message after hours and all messages will be responded to accordingly.
The 0800 line supplies lists of Lead Maternity Carers (LMCs) for requested areas. For maternity consumers requiring information regarding pregnancy care and other information contacts, the Your Pregnancy booklet is available.
LMCs and Medical Centres can obtain the Your Pregnancy booklet through their local Public Health Provider or order online at www.healthed.govt.nz
The phone line does not give counseling, midwifery or medical advice.
For more information on finding a Midwife see our Find a Midwife page on BabyWebNZ http://babywebnz.org.nz/find_a_midwife.htm
You will have the choice of a LMC who will be responsible for your maternity services. This may be a Midwife, GP or Private Obstetric Consultant. Some LMC's will provide all of your care during pregnancy, labour and birth, and postnatally, some may provide shared-care working with other maternity service providers.
The options of a place to give birth include:
Home Birth, Birthing Units, Maternity Hospital, and Private Maternity Hospitals.
Is important to have a LMC who understands and supports your wishes for your birth. There is going to be conflict if you have a LMC who doesn’t does think water births are safe and you want one.
Helen 21-9-2006
The information in this article is not a substitute for professional medical or midwifery care.
You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health.
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2nd Entry: 18 weeks pregnant
18 weeks and counting
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator.
The time seems to be going faster with my second pregnancy than with the first. I’m busy with my three year old son then a little person gives me a kick to remind me that yes they are in there and busy growing. I am excited about this pregnancy, I know how much I love my son and know I will love this child just as much. But you do have a realisation of what you are in for! With Jack I thought “how hard can looking after one baby be, I was a Midwife I had a lot of experience with babies”. The reality is different, when it is your baby you have to look after them 24hrs a day,
7 days a week and even when you are not looking after them for that time you are thinking about them.
Mothering...to take on one of the most emotionally and intellectually demanding, exasperating, strenuous, anxiety-arousing and deeply satisfying tasks that any human being can undertake...quote Sheila Kitzinger. From Ourselves as Mothers.
Antenatal Check (ante=before, natal=birth)
Visits are usually monthly until 28 weeks, fortnightly until 36 weeks then weekly. Possible other bloods tests that may be done are at 28 weeks a diabetes screening. If your blood group is Rh Negative then a blood test at 36 weeks, and a Full Blood Count (FBC) repeated if your iron levels are low. Also discuss Group B Strep Infection Screening and what guidelines do your LMC follow for this. If your baby is still breech (bottom down) after 34 weeks you may want to discuss options of trying to turn the baby, this may include an ECV external version (an Obstetrician manually turning the baby to a head down position)
Checking babies health:
FUNDAL HEIGHT fundus is the top of the uterus (womb) each cm above pubic bone= 1wk gestation
PALPATION is feeling the pregnant tummy to work out:
PRESENTATION part of baby nearest pelvic opening
ie head (cephalic/vertex) beech (bottom) shoulder
POSITION OF BABY inside the uterus, anterior towards front, posterior towards back
DESCENT of baby into pelvis, usually engages (head in the pelvis) for primigravida 36wks, for a multigravida it is later or during labour
FETAL HEART RATE normal is 110-160 beats/min
FETAL MOVEMENTS usually first movements (quickening) felt by the 18-20th week in a primigravida, 16-18th week in a multigravida.
Should feel >10 movements in 12hrs
Checking mother’s health:
BLOOD PRESSURE pressure which blood exerts against the walls of the blood vessels in the body.
OEDEMA fluid causing swelling
URINE (URINALYSIS)
PROTEIN indicator of pre-eclampsia or a urine infection
SUGAR indicator of diabetes
KETONES causes are diabetes, and starvation
During your visits to your LMC (Lead Maternity Carer) they will be asking you to make decisions.
It should be a partnership model that you have with your LMC: working together. With parenting, which I believe begins at conception, you will have to make a lot of decisions.
To make a decision you have to have information to base that decision on. The Concise Oxford Dictionary defines decision as quote 'settlement (of question etc), conclusion, formal judgment, making up one's mind, resolve, (come to, make, take, a decision): resoluteness, decided character.'
Life is made up of lots of decisions, being an adult is seen by society as a time when you have to make a lot decisions. There are many decisions that need to be made involving pregnancy, childbirth and the postnatal period eg when to tell people you are pregnant, if to have a scan or not, choice of LMC (Lead Maternity Carer), where to deliver your baby, name for your baby, 'the list goes on.
To make these decisions we need information. The information can come from different sources and it is up to the person to decide what information they believe, as not all information is helpful or factual.
Other people love to give advice especially when it comes to babies. This sometimes is helpful but often confusing. When you get told different things it becomes conflicting and you don't know whom to believe, so sometimes you just don't listen to anyone. But I do believe if is important to listen and make up your own conclusions, this may mean you need to do your own research, as in reading books, looking up the internet and going to Childbirth Education classes.
The LMC and childbirth educator has the responsibility to provide information and should try and do this in a non-biased way, basing their information on research, experience, education and health guidelines. Having knowledge on the different options available relating to pregnancy, childbirth and the postnatal period and providing sufficient information about the benefits and the risks of these options.
We may not always make what others believe to be the right decision, this is part of being human, but it is important that we are allowed to make decisions and that they are informed decisions based on facts. Informed decisions give us control and responsibility over our lives, this is why our brain will always be our most treasured asset as it enables us to think.
You may be interested in going to childbirth education classes; the biggest provider of these is Parents Centre who I also work for. Thus I can provide you with information on Parents Centre classes but there are also a lot of other childbirth education classes available so please talk to your LMC re what is available in your area.
Childbirth Classes
Childbirth classes usually start at 26+ wks pregnant. For more information on pregnancy classes see our Baby Friendly page on BabyWebNZ http://babywebnz.org.nz/baby_friendly.php
Parent Centre Childbirth Education Classes are 6-8 weekly sessions led by qualified childbirth educators. They usually held in the evenings and groups are small, up to 12 couples. It is also a chance to make friends with other new parents.
Contact your local Parents Centre in the telephone directory or call the Parents Centre national office on (04) 560 1990
Helen 31-10-2006
The information in this article is not a substitute for professional medical or midwifery care.
You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health.
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3rd Entry: 24 weeks pregnant
Twenty-four weeks and growing.
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator
Pregnancy is the biggest natural body change. The female body is designed for pregnancy, but even so having another little person grow inside can cause some discomforts. It is a time to look after your health. You have to look after yourself to be able to look after your baby, this does not just relate to pregnancy but also after the baby is born.
With my first pregnancy I was working a lot of nights and got run down and ended up in hospital with bronchitis at 38 weeks. Looking back I should have rested more and finished working earlier. This pregnancy my Midwifery job is more clinic work, which I am finding easier. Some women will sail through their pregnancy and others will find 40 weeks feels like 40 years.
I have listed some of the common pregnancy discomforts and some things I have found or heard are of help. Hormones and the increase in weight cause most of these discomforts. Everyone will put on a different amount of weight in pregnancy and a lot of LMC’s do not weigh pregnant women any more. How much weight you put on doesn’t always relate to the weight of your baby sometimes it is more to do with how many chocolate biscuits you have been eating.
I always feel hungry when pregnant. I put on 22 kgs in my first pregnancy and it all came off again after 6 months…fingers cross it is as easy to loose the weight this time around. I feel like I’m walking like a penguin already. Our fridge broke down and as it was going to take a week to get a replacement part so we got a hire fridge. When I told my husband that people who visited thought it was funny that we had two fridges he said, “tell them it is to store all the extra food you eat when pregnant. “There is an expected average weight gain of around 12 kg”. With 2 kg in the first 20 weeks then 0.5 kg per week until the birth.
This weight is from the growth of the baby, uterus, breasts, placenta and from an increase in fat storage (for breastfeeding) fluid around baby (amniotic fluid) and body fluid (blood etc)
Pregnancy Discomforts
Bleeding gums and increased salivation (saliva): Use a soft toothbrush and maintain good care of your teeth and gums. There has been research linking gum disease and other infections to premature births.
Morning sickness: Pregnancy often causes changes in taste, food cravings and also nausea.
It is called morning sickness but nausea can happen at any time of the day and is due to raised hormone levels usually in the first 12 weeks.
Small frequent meals and dry crackers, ginger or Acupuncture/pressure may help
Tiredness/Insomnia: Try catnaps during the day. Insomnia is common, normal and largely ‘untreatable' so allow yourself to stop being anxious about being awake – say things like 'well at least I'm resting, and its nice and cosy in this bed'
Constipation/Haemorrhoids: Your gut slows down to allow more nutrients to be absorbed for the baby but this can lead to constipation. Exercise and increasing the fibre in your diet often helps.
Kiwicrush found at most supermarkets in the frozen section is a natural laxative.
Leg Cramps: Stop feet flexing at night with a pillow at bottom of feet.
Some people say drinking a Banana smoothie (calcium and potassium) helps reduce this.
Backache: The weight of the baby can cause you to lean backwards to try to balance but this can put strain on your back in the area of your lumbar curve. Also relaxin hormone can cause ligaments to be more relaxed. This is why it is important to concentrate on good posture and not to do heavy lifting.
Gentle exercise eg yoga, swimming, walking and heat packs can help.
If your backache is pregnancy related you can see a physiotherapist for free with a referral from your LMC.
Emotional Changes: It is common to be more emotional and have memory loss
Varicose Veins or Swollen feet: Avoid constriction such as crossing your legs and rest with feet up.
Heartburn: This is related to relaxation of the opening at the top of your stomach letting the acid come back up.
Try a bland diet and sleep with extra pillow to keep the head above the stomach using gravity to stop gastric juices coming back up.
Take antacids only if prescribed by a health professional.
Stretch marks: Some woman will get stretch marks over the breasts, abdomen and legs. These red marks will go silvery white around 6 months after the birth but never fully go away. There is a lot of lotions that claim to reduce stretch marks but the often if you are going to get them or not is more due to your skin type.
Sweating: You will often hear people tell pregnant woman they will have an inbuilt heater and some days it will feel like that. Helpful during winter but not in summer. You think that a Midwife would know not to time being pregnant during the hottest months of the year! The hormone progesterone can raise body temperature and the extra blood supply to the skin leads to more sweating.
Health http://www.babywebnz.org.nz/directory_Health.php
Please always consult your Midwife or Doctor re health problems.
Ministry of Health provides access to health information such as pamphlets, fact sheets, booklets and posters. There is a lot of information and pamphlets covering health in pregnancy some topics they cover are:
Alcohol effects babies brain development and it is not known what is a safe level of alcohol consumption in pregnancy. The Alcohol Advisory Councils web site is www.alcohol.org.nz ph 0800 787 797
Smoking effects the placenta and the baby will get a reduced oxygen and food supply thus often being smaller when born. Babies exposed to cigarette smoke have a higher risk of cot death/sudden infant death syndrome (SIDS) If you can not stop smoking even reducing the number of cigarettes per day you smoke will help.
Avoid any drugs unless they have been prescribed, and always let your doctor or chemist know you are pregnant. Even avoid vitamin supplements and homeopathic remedies until you have consulted with a health professional. It is recommended to take folic acid supplements in early pregnancy, as what you can get via your diet is often not enough.
Avoid x-rays during pregnancy unless they are medically needed.
High intake of caffeine has been linked to small babies and miscarriages
Do not try to diet when pregnant, your baby will need good iron and calcium supplies. If you are on a special diet your LMC can refer you to see a dietician.
Helen 14-12-2006
The information in this article is not a substitute for professional medical or midwifery care. You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health.
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4th Entry: 30 weeks Pregnant
Thirty weeks
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator.
Baby Names
I was looking at the web site http:/babycenter.com and noticed it listed the top 100 names for USA in 2006 for girls it was Emma and for boys it was Aiden. For NZ 2006 girls it was Olivia and boys Jack. I have been thinking about names of late. One of my friends who are a teacher said it was hard to find names for her children because she didn’t want to give them the same name of any children who she had looked after that she had bad memories of. Allot of babies get called by a nickname or just “baby” for along time. You need to send in a birth registration form for your baby before 2 months of age. It states the name must not be offensive and or more than “100” letters or resemble an official title or rank. So I guess Queen or King are not allowed. If you need help with this after the birth you can ring The Department of Internal Affairs on Free phone
0800 22 52 52.
Birth Plans
I see birth plans as preferences and options you are considering for your birth and your baby. I’m not too sure on the word “plans” as birth can be unpredictable and have heard woman say that when they got into labour they had different thoughts on what they wanted than before. Birth plans do mean that you sit down and think about the options and then discuss these with your LMC so you can work in partnership to create a birth experience that you want, knowing you can change your mind at any time. Also they help with making informed choices. Some of the things you may include in a birth plan are:
Birth
Planned place and type of birth eg home, birth centre, hospital, water birth, Caesarean Section
Support people and other people present eg would you be happy to have students.
Labour Aids (things to make you feel comfortable eg wheat heat packs)
Positioning for Labour
Pain Relief
Who will deliver the baby
Who will cut the cord
Do you want to Video or take photos
Do you want a mirror to watch the birth of the baby
Delivery of the placenta; do you want to push it out yourself or have ecbolic injection
Do you wish to keep the placenta
Do you want to keep cord blood.
Baby
Skin to skin contact in which the baby is placed directly onto your chest after the birth.
Feeding
Vitamin K
Metabolic Screening (Guthrie Test)
BCG immunisation
Hepatitis B vaccine (if Mother has Hepatitis B)
Sex
I am finding sleeping harder now as can no longer lie on my back and haven’t been able to lie on my stomach for ages so that limits me to being on my side. I put a pillow between my knees for added comfort but find I just get comfortable then need to get out of bed and go to the toilet again! Due to my tossing and turning and my husbands snoring we are now in separate bedrooms which is fine for me especially as I have gone off the idea of romance
The females sex drive may change during pregnancy due to tiredness. The males
desire may change due to concerns for his partner’s health and the baby's. But to be reassured
with a normal pregnancy, it is safe to have intercourse. It will not harm your baby, as there is a mucous plug at the cervix a bit like the cork in a bottle. The baby is protected within the uterus in a bag of amniotic fluid that is mainly water. It is always important to protect yourself from catching sexually transmitted diseases especially if you are not in a monogamous relationship
If there have been concerns during your pregnancy then you may have been advised against intercourse. This would be if you've been treated for premature labour, a shortened or dilated cervix, leaking amniotic fluid, placenta previa, or bleeding, or if you have a history of recurrent miscarriages.
In the third trimester (after 28 weeks) you may have to experiment with positions that avoid the female lying on her back and putting weight on the pregnant abdomen eg: Lie side-by-side in the spoon position.
Helen
The information in this article is not a substitute for professional medical or midwifery care.
You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health
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5th Entry: 36 weeks pregnant
36 Weeks
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator
It is hard to think that soon this baby will be born. Around term which is 40 weeks (280 days) from your last menstrual period, is when most babies are babies are born. I have started to semi prepare with getting out the baby clothes, putting a few things in a bag and booking a car seat capsule from Plunket. I have also been talking to my three year old son about babies so he knows what to expect and bringing him along to the visits with my Midwife. He told the baby off the other day when I told him that the baby was kicking me he said “naughty baby”. He seems happy with the idea of being a big brother though has told me the baby isn’t allowed to play with his trains.
At the visits with my Midwife she listens to the baby and checks the position, it has its head down towards my pelvis. She also wants to know if I have any warning signs which could be of concern.
Warning signs of pregnancy
Notify your LMC (Midwife/Doctor) if you experience any of the following:
*Stomach Pain
*Preterm (<37 wks) contractions
*Vaginal bleeding
*Premature rupture of membranes (waters breaking)
*Offensive vaginal discharge
*Change in normal pattern or reduce movements from the baby
*Generalised swelling, headaches or visual disturbances (seeing spots)
*Unwell, vomiting or diarrhea
*High temperature
*Painful or burning when pass urine
*Constant itching and dark urine
*Persistent severe leg pain/cramps with swelling of the leg
*Accident involving injury to your pregnant stomach (abdomen)
*Fainting or persistent dizziness
Exercise
Exercise helps with sleep, increases fitness and energy levels and increases muscle tone.
It is good to try to exercise 20-30mins 3-4 times a week, though even 10 minutes a day of walking can be beneficial
When pregnant choose low impact exercises such as walking, yoga, stretching and swimming.
Remember to drink (water) and avoid over exerting, exercise which causes pain, contact sports, bouncing movements, over heating or getting short of breath
Some woman may be advised not to exercise if they are unwell, if there is any risks of premature labour, any bleeding, if you have high blood pressure or if your Midwife/Dr advises them not to.
Pregnancy Health Practices
In the childbirth education classes we cover some of the different health practices
that are available. Instead of having me tell people about these I decided to put together a pregnancy health day in Wellington recently and invite different health practices to come and talk. There are other health practices that are available but we were only able to accommodate seven speakers, which included the following:
Kate O'Connor (Acupuncture)
Mukti Legerska (Yoga in Daily Life Centre)
Joanna Clouden (Pilates)
Jennifer Cox (Lactation Consultant)
Kath Sinclair (Pregnancy massage and shiatsu)
Catherine Falconer (Naturopath/Herbalist)
Pip Heard (Physiotherapy)
The following is a summary from the speakers of the information, which was provided.
Kate O'Connor (Acupuncture)
Acupuncture treats illness, prevents disease and promotes health and well-being. It is safe, effective and drug-free and compatible with conventional medicine. It can successfully treat many of the ailments relating to pregnancy and is effective in preparing the body to work at its optimum functioning for birth.
Treatment with acupuncture is achieved by the use of very fine needles inserted into particular points in the body and thereby altering the flow of Qi, or energy, which flows through channels along the limbs to the internal organs.
Mukti Legerska (Yoga in Daily Life Centre)
Yoga will improve your fitness and facilitate labour. It balances the
body, emotions, mind and soothes the spirit. It will help you to access
deep resources of energy, through relaxation, postures and breathing.
Joanna Clouden (Pilates)
During pregnancy our bodies adapt to changes in spinal curves and hormonal effects. Today, we recognise that pregnancy makes physical and emotional demands on you, and exercise is one way to help you stay as healthy as possible. A well-balanced exercise programme can minimize the discomforts typically associated with pregnancy and may allow for an easier delivery of the baby with a faster post-natal recovery.
There is a growing body of research that demonstrates that moderate physical exercise during pregnancy is not only safe but also beneficial for both the baby and the mother-to-be.
One option for improving your well being during pregnancy is a “core”, “stability” or “pilates” programme. With an emphasis on good core control, muscle balance and postural alignment.
Jennifer Cox (Lactation Consultant)
An International board certified Lactation Consultant (IBCLC) is a breastfeeding specialist qualified to prevent, recognize and resolve breastfeeding problems. For a private consultation there will be a charge otherwise there are often Lactation Consultants who you can see for free at Plunket Family Centres.
Kath Sinclair (Pregnancy massage and shiatsu)
Massage and Shiatsu are both great ways to help reduce stress, alleviate some of the discomforts of pregnancy and promote general well-being. They are very relaxing which is important when many pregnant women work for most of their pregnancy or have other children to care for. It helps prepare both the expectant mother and baby for birth and the postnatal period.
Benefits of Massage during Pregnancy
· Relieves many normal discomforts of pregnancy, such as back pain, leg cramps, headaches, nausea and sore swollen ankles and feet.
· Aids circulation which eases the load on the heart, helps to check blood pressure, and brings more oxygen and nutrients to body cells (yours and your baby).
· Relaxes tense muscles, especially in the back, shoulders and legs.
· Helps relieve depression or anxiety caused by normal hormonal changes.
· Soothes and relaxes nervous tension, letting you sleep more easily and deeply.
· Maintains the body in good condition, enabling a faster return to normal after birth of your baby (or babies).
· Helps relieve the tension that often occurs when coping with the major changes and adjustments of parenthood.
Shiatsu - Works by balancing the energy in the body. It is done fully clothed and is deeply relaxing
Catherine Falconer (Naturopath/Herbalist)
Keeping well energised and in good health during pregnancy will have a profound effect on your stamina for birth, nutrients for breastfeeding and your recovery after birth.
As a Naturopath and Herbalist I will be able to advise you about diet. During a consultation health issues are addressed and a maintenance plan is formulated. My focus is on optimum health for you and your baby and preventing any foreseeable problems.
I treat:
· Complete preconception care
· Anxiety/depression
· Constipation/Haemorrhoids
· Nausea/Fatigue /Insomnia
· Poor immunity
· Recovery after birth
Pip Heard (Physiotherapy)
Physiotherapy services are available both privately and publicly in New Zealand
and cover a wide range of musculoskeletal complaints that occur during and immediately after pregnancy. Common pregnancy conditions helped by physiotherapists can include Carpal Tunnel Syndrome, Low Back Pain, Pelvic Pain, Incontinence issues, and TENS machine use to name a few. The Hospitals also provide loan of specialised braces and provide some hydrotherapy and stretch class services. Pre or Postnatal women are encouraged to seek assessment from a physiotherapist with a referral from their LMC.
Helen
The information in this article is not a substitute for professional medical or midwifery care. You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health.
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6th Entry: 40 weeks pregnant
40 weeks or 280 days.
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator
You may have your EDD (estimated date of delivery) circled on the calendar but it is only an estimate and less than 5% of babies are actually born on this day! Babies do come early, so be ready in advance. Think about putting down a plastic covering or towels over your bed mattress and car seat in case your waters break while sleeping or driving. If planning a hospital birth you may want to bring:
-Snack food and drinks for the labouring woman eg Muesli bars, bottled water and food for the support people
-Labour causes you to get dry lips, thus a chap stick is helpful
-Heat packs good for back pain. With heat pack/wheat bags remember to have a glass of water in microwave as they are a fire risk and do not add oil to the heat/wheat pack
-Massage Oil, lavender scented oil is relaxing
-Calming music and a player
-Hair tie if you have long hair
- Remember to have film in the camera
-Money/phone cards, have a list of phone numbers of who to call after the birth. Most people will ask you the sex of the baby, time of birth and weight (kgs and pounds)
Bring pen and paper to write these kinds of things down.
Cell phones aren't allowed to be used inside hospitals, as interfere with some equipment
-Comfortable cool clothes eg a sarong, big T-shirt
You will often still look pregnant for about a week after the birth so also have clothes which will fit after the baby is born. Bring in old knickers as you will bleed (like a heavy period) and have to wear pads. Tampons are not recommended as increase the risk of infection and your Midwife will want to know what your blood loss is like. If you have a Caesarean Section you will want large granny knickers so that the elastic doesn't sit over your scar!
-Sandals/slippers as feet swell. Your feet get cold during labour so bring warm socks.
-Have your Antenatal record with you. Also remember to take this with you if you are going away when pregnant so if you need to go to another hospital they will know about your pregnancy checks.
-Leave valuables/rings at home if going to the Hospital may get lost or stolen
-Maternity bras, at about day 3 your breasts will become large and heavy with engorgement of fluid. Some woman leak breast milk and need to use breast pads.
-Postnatally a tri pillow is handy for breast feeding.
-Most hospitals don't provide clothes for the baby so bring in 2-3 sets of clothes. This may include singlets, stretch and grow, woollen jersey and hat, socks, mittens and booties (ones with ribbon ties don't tend to stay on)
Ask your Midwife if the hospital supplies nappies. Babies will need 6-8 changes per day. You will legally need an approved infant car seat to take baby home in. Know how the car seat works before putting baby in it. Have baby warmly wrapped with a blanket around them when going outside.
I have planned to have my baby in a Hospital but this is a personal decision and I have nothing against homebirth. The New Zealand Home Birth Association estimates that around 75% of pregnant woman could safely give birth at home.
Homebirth
Homebirth is a birth service that is available to people in Aotearoa New Zealand. Other choices are birth centres and hospitals.
Homebirth is a free service as is all antenatal, pregnancy and postnatal care up to six weeks by a public lead maternity carer (LMC).
Homebirth is an option to any woman without complications in their pregnancy or labour, if complications arise then it is recommended that they would need to go to Hospital.
Not all Midwives and Doctors will provide the service of attending a Homebirth so it is important to find out which Midwives do, and to be happy with your choice of LMC as you will be working in partnership with them.
The midwives who do conduct homebirths will bring with them equipment needed to assist in the delivery or if there is complications.
The Midwife may have a TENS machine to help with pain relief, if not these can be hired from some chemists or via the physiotherapy department .
The Midwife may also carry Entonox gas.
The birthing woman or couple will often be asked to provide the following:
Washing up bowl
Towels
Sanitary towels
Torch/spot light
Container to put the placenta in
Hot water bottle or heater to warm baby clothes and towels
The room needs to be kept warm for when the baby is born, and running water is helpful (cold and hot)
A working phone, though the most midwives carry a mobile phone so emergency services can be contacted if needed.
The couple should also have arranged care of any other children they have in the house, and prepared them for the delivery.
They need to decide where in the house the delivery will take place and be prepared (eg plastic sheets) and any items needed to assist in the comfort of the labouring woman (eg pillows, drinks and snacks).
Labour
When labour starts there are no flashing lights to say this is labour. With some people it can take awhile for the fact that they are in labour to sink in, as it can just start with a few cramping pains like period like pains and for others it can start in a rush and you go straight into full on strong contractions.
Signs and stages of Labour
There are three signs of labour, which can happen in any order:
-Contractions: become more frequent and often are in a regular pattern, usually painful and do not go away with rest.
-Show: When the cervix (the neck of the womb) opens a plug of mucous, sometimes with a small amount of blood, may be passed. A show may happen during labour or up to 2 weeks before contractions start.
-Rupture of membranes: Usually there is a small gush if your waters break by themselves and the head drops down to act like a plug, and you will continue to leak small amounts of sweet smelling clear fluid. In 15% of labours waters break before labour. Let your LMC know if the fluid is green in colour as this is from the baby doing a bowel motion/poo (meconium) which is a sign of being distressed.
First stage of labour (early, established and transition phases)
Early/latent Labour
How you may feel:
Unsure is this labour?
Restless
Physical changes:
Contractions begin then become more regular (10-30mins apart)
Start off feeling like period like cramps then get stronger, like a tight rubber band getting pulled around your abdomen.
Some people feel it in their back also.
Cervix is thinning (effacing) and starting to open (dilatation)
Established labour
How you may feel:
Hot and sweaty
Find it hard to get comfortable
Want to move around
Need reassurance and support
Physical changes:
Contractions are stronger more painful and closer together (5 minutes apart)
Your body will be working hard, like climbing up a mountain with a heavy backpack (in this case a heavy frontpack!). Try to use visualisation eg
Think of the wonderful view you get from the top of a mountain.
Think of the contractions as waves on the ocean.
Think of your wonderful baby you will see at the end of this.
Cervix is opening more 3-4cm+
Transition
How you may feel:
You may feel you are rowing up stream and not getting anywhere.
This is time when you become fed up and annoyed.
Do not want to do this any more!!
Very verbal or quiet
Feel can not cope, as there is little time to relax between the contractions
Need reassurance and support
Physical changes:
Contractions more painful and last longer (60 seconds)
Your body may shake; legs cramp and you may have waves of nausea.
Second Stage of Labour
The pushing stage
How you may feel:
Urge to push and feeling of pressure in your bottom.
Some people find pushing feels productive.
Find it hard work, are tired and want to rest but unable to.
Realization that you will soon see your baby
Physical Changes:
Cervix is fully dilated (10cm)
Push with contractions
Lots of pressure in your bottom, like you are constipated and need to go to the toilet!
Stretching/burning feeling as the baby's head pushes on the perineum just before the head is born
Birth
How you may feel:
Amazed at this beautiful baby
Deep emotions
Relief that the baby is out
Feel happy on a natural high
Exhausted as if you have just run a marathon
Want of touch hold and feed your baby
A Birthday party, your babies Birth Day!
Third Stage
The Placenta
Physical Changes:
Placenta separates causing bleeding
Uterus Contractions to slow down bleeding
Labour Aids
It is a good to work with your body during labour. One of the ways you can do this is to try to remain in an upright position, thus gravity will help the contractions push the baby into the birth canal.
Think about the things that help you cope when you are feeling stressed or uncomfortable and use these during your labour. Eg music, warm baths, massages, dim the lights, and heat packs
Partners will find it hard to see the person who they love in pain, but by being there you are helping.
Remember there will be an end to the labour and the pain of the contractions do not harm the labouring woman. In between the contractions you will be able to rest, as you will feel tired. Think about what the contractions are doing, they do have a purpose. The human body is the most amazing thing, we have to have trust in its ability and remember woman have been giving birth for 1000's of years. Also think about your beautiful baby you are going to see at the end.
Labour often starts with period like cramping pains and these become stronger and closer together. As they get stronger you will have to stop what you are doing during a contraction and be in a supported position. You will have to concentrate on breathing through the strong contractions. You do this by focusing on your breath; you may find it helpful to breathe in through your nose and slowly out through your mouth. Think about relaxing yourself as you do this. Some woman find it helpful blowing out through pursed lips.
Breathing in labour
Some people will say that you need to learn to breath for labour and others will say that you find on the day the best way to breath and learning techniques before hand will only confuse you.
Either way breathing is an important part of body function, and many people use breathing techniques to help them, for example when playing the trumpet, singing, yoga and swimming.
Breathing happens automatically, it would be tiring if you had to keep reminding yourself to breath. But you do have control over your breathing and can use this to help yourself, for example slowing it down and concentrating on your breathing when you are feeling stressed to help calm yourself. When someone is hyperventilating telling them to concentrate on their breathing and slow it down will help them to relax and gain more control. You should avoid holding your breath for long periods as this can make you feel faint. This is why you may hear people saying, 'remember to breath'.
Janet Balaskas Book New Active Birth has a section on breathing in which she talks about how breathing can help you tune in with your body rhythms. Also about the importance of breathing deeply to fully expand our lungs so your body cells can receive the maximum benefit of oxygen, which is needed for their function.
She talks about deep breathing in through your nose and out through your mouth.
The Pink Kit has information about techniques to help with birth, see the add for this on the childbirth directory page of www.babywebnz.org or visit www.birthingbetter.com. They talk about breathing effectively to reduce tension by breathing in deeply and slowly through your nose, to fully expand your lungs, then relaxing and letting go of tension with the breath out.
They also teach techniques to direct the breath to an area for eg to the area of discomfort.
The Auckland Home Birth Association 'A guide to healthy pregnancy and childbirth' talks about keeping your breathing regular (in a pattern). Then in transition when labour becomes more intense using shallow rapid breathing if needed.
The New Zealand Pregnancy Book by Sue Pallon talks about breathing in through your nose feeling your chest expand, then slowly breathing out through your mouth with lips just slightly open. Taking one long slow breath at the start and end of each contraction as a starting and finishing breath.
Panting is when you breath in and out quickly and is used to stop people pushing at the end of labour as the babies head is being delivered to give time for the perineum (skin between vagina and anus) to stretch. This can help reduce tears in some cases.
Massage
I am not trained in massage, this is a guide from my experience from looking after woman in labour.
Massage helps relieve muscle tension. It is helpful to practise massage techniques before labour. You can also give your partner/support person a massage and show them how you like it done. During labour some women love stroking massage using the flat of your hand or pressure over areas that are uncomfortable eg pressing firmly over lower back tension spots (you can use a rolling pin to do this also), others will not want anyone to touch them at all. You have to communicate how and where you like the massage, 'harder, softer, lower, higher, stop, don't stop'
To avoid skin irritation use talcum powder, pregnancy massage oil or a good vegetable oil, you may like to warm this. Having soft music or aromatherapy may help relax you also.
The labouring woman should try to stay in an upright position during the massage and try to think about her breathing, slow breaths in through your nose and out your mouth.
Start the massage with the neck and shoulders, work down the back using long rhythmic stroking movements and small circles. Avoid pressing over the spinal column, as this will be uncomfortable.
Helen
The information in this article is not a substitute for professional medical or midwifery care. You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health
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7th Entry: Baby
Baby
By Helen@babywebnz.org
www.babywebnz.org
A Mother, Midwife and Childbirth Educator
People see babies in different ways some people look at them as though they are an alien from another planet, as though they are all the same or something to be feared. I disagree with all of these ideas. Babies are just little humans, like adults they need food, sleep, play and love. As for being all the same, no they all come with their own personalities.
Information about babies and their needs:
Clothes
- Nappies, blanket and warm clothes/hat.
-Lots of bibs are handy if you have a baby that spills a lot
-Mittens that stay on as new babies often scratch their own faces
-Newborn babies need one more layer of clothing than you do. Check their temperature using your 2 fingers down their front or back (in-between shoulders), this gives you an idea of their core (central) temperature.
Safety
-A baby car capsule is for birth-6mths and is rear facing going in the back seat of your vehicle.
-If using a Heater it should have a thermostat, some gas heaters give off toxic fumes
Food
-Breast milk is all babies’ need in the first 6 months
-Weight may go down (up to 10% loss) in first 3 days, and then they regain their Birth Weight in approx 10 days. All babies are different so talk to someone if worried.
-Rough guide re weight is by 6 months the babies weight would have doubled, by 1 year baby will be 3 times Birth Weight,
-Growth indicators for newborn babies:
Baby Feeds around 8 times a day
Urine clear colour and have 6-8 wet nappies/24hrs
Alert when awake, increase weight and length
-Relate babies to yourself, eg you sometimes take a short or long time to eat your meals.
-Wind can cause abdominal discomfort in babies and it is important to try winding them after feeding. It could be due to the baby feeding fast and also sometimes diet related if breastfeeding. Cabbage, leeks and onions can sometimes cause wind.
Try positions that put some gentle pressure on their stomach eg over your shoulder or across your knee, and rub their back at the same time. If after trying for several minutes and they won't bring up wind or they are asleep put them down. If they wake again 15 minutes latter try winding again then. If it doesn't come up one end it will come out the other latter, yes babies do fart.
Sleep
Research says newborns normally cry a total of 1-4hrs/day usually pre feed and pre nap (for 10mins) and often have personal fussy time often late pm. Babies may take up to 10 minutes to settle off to sleep, may grizzle and cry before hand
-If baby is crying consider are they hungry, have wind, wet/dirty nappy, too hot/cold, uncomfortable or lonely and wanting a cuddle. Listen to the cry if very distressed? the cause and if worried seek advice from a health professional. If it is Colic, this usually appears at the second week, often worse early evening and babies draw up their legs with the discomfort
-Newborns sleep approx total of 16-18hrs/24hrs, sleep needs decrease over the first year.
-Signs of being tired: jerky movements, grimaces, grizzling, making fists, yawning, rubbing eyes, staring vacantly into space or crying
-Signs of wanting a feed: hand to mouth movements, fussiness, sucking action or sounds, cooing or sighing and nuzzling at breast
-A bath in pm tires them out and may help them go off to sleep more easily. If you don't have time you don't have to bath them every day just give their face then bottom a wash
Nappies
-Leave the cord out of nappy to allow to dry
-Motions to start with are called meconium which is green/black colour and last for the first 1-2 days then it changes to a mustard colour, formula feed babies have light brown/clay coloured motions
-Expect about 6-8 wet nappies/24hrs. Until toilet trained (around 2-3yrs old) you have approx 7000 nappies that will need changed!
Health
See the back page of your Well Child Health book for child sickness danger signals. Remember to ring 111 for an ambulance. The phone number for the National Poisons Centre is 0800 764 766
-Good idea to have a thermometer to check babies temp if you think they are unwell, (digital ones go under babies arm-pit)
-Jaundice is yellowing of the skin and eyes caused by a build up of waste products (bilirubin). It can make babies sleepy and at high levels is dangerous. Your Midwife or Doctor will monitor this and the baby may need to go under phototherapy lights if the levels get too high.
-Common minor health problems include:
Infection around the fingernails called paronychia, often try cleaning with alcohol wipes from the chemist and let your Midwife or Doctor know about this if it doesn't get better as sometimes your baby may need antibiotics.
-Sticky eyes can be due to a blocked eye duct. Try gentle massage of the duct with your finger. Clean the eye with normal saline solution from the chemist and drops of breastmilk into the eye can help also as this has a natural antibiotic in it. Again see your Midwife or Doctor if doesn't improve or if the discharge is yellow or green in colour or the eye is inflamed.
-Thrush may be present in the mouth or the bottom of babies. If breastfeeding it can be passed from the babies mouth onto your nipples. Thrush is a fungal infection that will cause discomfort.
-If wanting immunisations these usually start at 6 weeks of age, Hepatitis B and BCG vaccines can be given to newborns, which are at risk of catching these.
Helen
The information in this article is not a substitute for professional medical or midwifery care. You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health
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