dad's hand with baby hand

7 things Dads need to do to prepare for Childbirth

Having a baby is a team sport. You may feel from time to time that it is a solo effort, but research suggests that the more supportive dad is, the better the health outcomes form mum and bub. High levels of paternal involvement can even lead to improved cognitive and social development. So although mum is undoubtedly the star of the team, don’t underestimate your importance as a dad. From pregnancy, through labour, birth and postpartum, your partner and baby will need as much of your emotional, physical and practical support as you can give.

1. Get educated

The most important thing you can do for yourself, your partner and your new baby is to be educated. Don’t leave it to her to work out whether she wants a home or hospital birth, or to understand her options in pain relief. Research it. Figure out the pros and cons. Find out how labour works. Have an opinion. But be prepared to listen. And when I say get educated, I mean not just for birth, but for pregnancy and the postpartum period too.

2. Be prepared

When your partner is in labour is not the time to work out the best way to the hospital, or to discover your phone is flat So channel your inner boy scout and ensure you are prepared in every way. This might include:
– Helping your partner pack her bag in advance and ensuring you have a change of clothes and toothbrush in there too. And don’t forget the phone charger!
– Research the best route to the hospital or birth centre and do a dry run. You don’t want to find out there are roadworks, or a new no left turn sign while your partner is having a contraction
– Put the car seat in the car so that you are ready to bring your bundle of joy home. And while you’re at it, make sure the cot and change table are fully assembled and ready to go!

3. Be supportive

Offer both physical and emotional support, appropriate to the stage of labour – see Get Educated! Some practical things you can do:
– Prior to labour learn massage and acupressure techniques to provide relief. Practice them beforehand and learn which your partner prefers
– Make sure you understand the different stages of labour so you can coach mum appropriately
– Physically support your partner as she walks, showers or changes position
– Cool compresses, ice chips and heat pads can all make a big difference to comfort in labour. Make sure you have them available.
– Provide gentle cheering and encouragement when her spirit or energy is flagging

4. Be patient

Sometimes labour is a sprint, other times it is a marathon. Be prepared for the long haul. Take something to entertain you and your partner – music, an audio book, anything that will while away the time if things are moving slowly. And always remember it is much harder for the labouring mum than for you, so if you are tired or your back is aching – tell someone who is not trying to give birth to a human!

5. Be flexible

You and your partner will have agreed a birth plan, but you know what they say about plans. So be flexible and if the woman who said she wanted a natural birth suddenly demands an epidural – go with it. Always remember who it is that is labouring. Something else to remember here is that the labouring mum is under a lot of stress – don’t hold anything she may say against her.

6. Be an Advocate

There may be times during labour when your partner is not able to advocate for herself. This is where you need to step in and make sure her wishes are heard and, as much as possible, honoured. This applies to both the medical staff and, often, family members. If your partner doesn’t want family in the room, it is your job to keep them out. No matter how determined your mother is!

7. Be Grateful

Your partner has given you the greatest gift anyone can receive, so make sure you take the time to let her know how much you appreciate and admire her strength and courage. In both words and deeds. This is a time when a woman often doubts herself and feels vulnerable. Telling her how you feel is important, but showing her, by being extra thoughtful in the days and months after baby is born, can make the adjustment from woman to mum and couple to family that much more joyous or you all.

Help is at Hand

This might all seem like a lot. Luckily, you are not on your own. A good doula can provide you with all the tools, advice and support you need to be there for your partner through late pregnancy, labour, birth and the first months of parenthood, and to help you through the challenges of becoming a dad too.

If you are expecting or planning a baby and would like to find out about the ways having a doula as part of your team can help you, please give me a call on 0422 258 771 or contact me:

The Difference a Doula Makes

Recently I sat down with Hills District Naturopath Genevieve Mlotkowski to talk about her two very different birth experiences.  I hope you enjoy hearing Genevieve’s perspective on the benefits of having a doula.

If you would like to chat with me about having me as part of your birthing team, or about pregnancy, childbirth and postpartum in general, give me a call on 0422 258 771 or contact me:

big baby bullshit

 

Big Baby Bullshit

I don’t use that phrase lightly.  Because most of what the medical profession will tell you about birthing a big baby is just that – bullshit.  Our bodies are designed to grow and birth babies.  Yes, some are bigger than others.  But unless there are extenuating circumstances, your body is capable of bringing your baby into this world without too much intervention.

 

What is a Big Baby

When we talk about big babies, we are not just referring to babies who look or weigh a bit more than average.  The medical term for a big baby is Macrosomic, which just means big body.  Let’s have a look at some of the statistics:

  • The average weight of a baby in Australia is around 3.4kg
  • Macrosomic babies are those weighing 4.5kg or more at birth based on WHO figures, although some medical professionals in Australia use 4.0kg as the benchmark
  • Around 1.8% of babies are considered macrosomic at birth in Australia

 

How do you Know if You’re Having a Big Baby

The short answer is you don’t really.  There are flaws in all the common ways we use to determine the size of a baby:

  • Ultrasound can be 10-15% off in estimating the size of your baby
  • Weight gain is not always a predictor of a large baby. It may be a factor if there are conditions like gestational diabetes, but it is not a given
  • Fundal height measurement can be distorted by the amount of amniotic fluid you have, the position of the placenta and the position of the baby

It is not until baby enters the world and you can pop them on a scale that you have an accurate idea of whether or not your baby is big.

 

What Makes you think Your Baby will be Big?

There are a few factors that could indicate you are potentially having a big baby – but again I stress, these are just indicators and are in no way a guarantee your baby will be macrosomic.

  • If you have gestational diabetes there is a chance your baby will be a big one
  • If you and/or the father of the baby are big people – and by that I mean tall, large framed or overweight
  • History of large babies. If this is not your first baby, and your previous bubs have been big, the likelihood is this one will be too.  The good news here is that you are probably well prepared!
  • If you are overdue. Babies tend to put on weight in the last few weeks of pregnancy, so if you are overdue bub will have had more time to bulk up
  • If you have gained an excessive amount of weight during pregnancy
  • Boys are statistically larger than girls

 

Can I Have a Natural Birth with a Big Baby?

Again, the short answer is yes.  Assuming there are no high-risk factors present, there is no reason why you can’t have your baby naturally.

You may come up against some opposition in attempting a natural birth if it is suspected your baby is macrosomic.  Many health care professionals will recommend you consider an induction or even a c-section.

Recent studies suggest, in fact, that the expectation of a big baby increases unnecessary interventions like episiotomies and forceps delivery.  Statistically:

Induction                 42% for expected big babies; 14% for unexpected big babies

C-Section                 52% for expected big babies; 17% for unexpected big babies

Maternal

Complications          17% for expected big babies; 4% for unexpected big babies

 

Risk factors may include gestational diabetes, pre-eclampsia and pelvic abnormalities.  If any of these are present they don’t necessarily preclude a natural birth, but you may need to have a frank discussion with your health care provider.

 

Preparing to Birth a Big Baby

If you suspect you are carrying a big baby, and want a natural birth there are a few things you can do to help make that a reality.

  1. Talk to your care team about your wishes. Doctors often jump straight to the need for induction or c-sections, but there is actually no evidence to support an improvement in maternal or baby health outcomes in going this route.  Let your team know your preference for a natural birth and stick to your guns.
  2. Try to maintain a healthy weight during your pregnancy and maintain a gentle exercise routine.
  3. Prepare your body before you go into labour. Perineal massage is one way to begin softening and stretching the part of your body that will be under the most pressure during delivery.  A good midwife or doula can give you instructions on how and when to start perineal massage.
  4. Optimal Maternal Positioning. OMP incorporates exercises, stretches, labour and birthing positions and massage to facilitate pelvic mobility and ensure the correct foetal positioning to help smooth progress through labour.  Look for a Doula with qualifications in OMP to help you during late pregnancy and birth.  These techniques can help whether or not your baby is macrosomic.
  5. Practice squatting. In a squatting position your pelvis can open up by nearly 30%, which makes all the difference when birthing a big baby.  In fact, whether you are having a big baby or not, squatting is a great way to deliver.  So get practicing.
  6. Stay upright during labour and delivery. The weight of your baby will help dilate your cervix, and guide your baby through the birth canal into the world.
  7. Remember, this is what your body is designed for. You’ve got this!

 

If you would like to chat about the likelihood of having a big baby and how you can manage a natural birth, or any other pregnancy, birth or postpartum concerns, please give me a call on 0422 258 771 or contact me:

 

Alison Hansen with Client and Baby

Let’s Talk about Birth

For many years in this country the traditional team of Midwife and Obstetrician has prevailed in the maternity model.  Sometimes a Paediatrician would step in after birth, or maybe even a lactation specialist if you were lucky.  But mums – and their partners – were largely left out of the decision on how they wanted to birth their baby.  Things are changing, but it’s slow progress, as is evidenced in the incredible documentary Birth Time[i], recently produced by Zoe Naylor, Jo Hunter and Jerusha Sutton.  A must watch for anyone contemplating having a baby.

What that documentary clearly highlights is the need ‘continuity of care’ in the maternity care model, which is a long way from what we currently have,

A few statistics

If you need convincing that the maternity model in Australia is broken, here are a few statistics:

  • Only 0.4% of women in Australia choose to have a home birth
  • Only 8% of women birthing in Australia even have access to continuity of care in pregnancy, birth, and postpartum
  • The Caesarean rate in Australia is now 34%. The World Health Organisation asserts a rate of 10-15% provides optimal maternal and baby health outcomes[ii]
  • 30% of women describe their birthing experience as ‘traumatic’[iii], which can often be linked to postpartum depression

These statistics are the result of the over-medicalisation of what is a natural process – birth.  And with medicalisation come legal implications and cost factors, and obstetricians and midwives who are constrained by this system.

What is Continuity of Care?

Pregnancy, birth and the postpartum period is an extraordinary time.  It can also be incredibly challenging and bewildering.  It is different for everyone, and every birthing mother brings her own concerns, experiences and expectations to the process.

The concept of Continuity of Care is based on the idea that every pregnant and birthing mum has one single point of contact, with whom she can develop a close and trusting relationship.  Someone who can take the time to understand those concerns, experiences and expectations and provide advice and care accordingly.  Someone who will provide the knowledge to allow mums and their partners to make genuine realistic choices, and co-ordinate or introduce specialist care if it is needed.

Continuity of care should extend from pregnancy, through birth and into the postpartum period.  If all these factors are in place, the opportunity for a ‘good’ birth is drastically increased.

What is a ‘Good’ birth?

A good birth is not just a birth where mother and baby survive the experience.  It should be so much more than that.  Ann Drapkin Lyerly is an obstetrician and bioethesist whose book ‘A Good Birth’ outlines five key factors for a ‘good’ birth.

  1. Feelings of personal agency – that you have a say in what is happening to your body
  2. Feelings of security – that you are confident the people around you are giving you advice that is in your own best interest
  3. Connectedness – that you have a shared vision for your birth and mothering experience with your support team
  4. Respect – that your support team respect your preferences and opinions
  5. Knowledge – that you understand what is happening, what your options are and what the potential outcomes might be

Yet Lyerly also found that women’s voices were increasingly being marginalised in their encounters with existing medical systems.

A ‘good’ birth is not necessarily one in which things all proceed according to plan.  The key is how the birthing mum is treated, according to Lyerly:

“Treating women with dignity and respect throughout the entire birthing process matters far more than whether or not the birth is able to proceed ‘naturally’.”[iv]

How a Doula can bridge the gap between what is and what is needed

If we agree a ‘good’ birth is where a woman feels empowered, knowledgeable and respected, and receives continuity of care during pregnancy, birth and postpartum, and that the current medical system does not provide that, how do we find a way to achieve it?

This is where the role of a Doula can bridge that gap, between what the system currently provides, and what is needed by birthing mothers.  In other words – continuity of care.  Which in turn provides the greatest likelihood of a ‘good’ birth.

A doula will:

  • work with a pregnant woman and her partner during pregnancy to ensure they are fully prepared for the birth of their baby
  • support the birthing mum and her partner throughout the birth and help ensure they understand what is happening, and what their options might be throughout
  • provide ongoing advice, guidance and support in the months of the postpartum period to help ensure there are no concerns around a range of things like breastfeeding, sleeping, postpartum depression and family dynamics, and recognising when additional expert involvement is required
World Doula Week – 22-28 March 2021

Women all over the world are starting to stand up for better representation, better treatment and a more balanced society.  What could be more important than bringing the way women are treated during pregnancy and birth into the spotlight?

During World Doula Week is a great time to start a conversation with your friends and family, watch Birth Time, and think about how you or your loved ones will choose to move from womanhood to motherhood.

 

If you would like to talk about having a Doula provide continuity of care during your pregnancy, birth and postpartum period, please give me a call on 0422 258 771. or contact me below:

 

 

[i] https://www.birthtime.world/

[ii] https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1

[iii] https://www.birthtime.world/

[iv] https://www.birthtime.world/

Breathing in Childbrith

The Importance of Breathing in Labour

Breathing during labour might sound like the most natural thing in the world – after all – we do it all day every day.  But there are some real benefits to learning specific breathing techniques that will help you during all stages of your labour, right up to bringing your baby into the world.

A great deal has been made over the ‘right’ way to breathe when you are in labour.  Ever since Lamaze came up with his childbirth breathing techniques in the 1960s, childbirth educators have been refining how you might best manage your breathing through all the stages of labour right up to delivery.  Breathing is important during labour.  But it’s worthwhile understanding why it’s important, what benefits it can bring, and how you can make it work for you.

Why Breathing is Important

The breathing techniques developed by Dr Lamaze in the 1960s were broadly aimed at three outcomes:

  1. Reducing fear of the unknown by providing information on what to expect
  2. Learning how to relax and become aware of your body, thereby reducing pain
  3. Distracting the mind from the discomfort by concentrating on conscious or deliberate breathing

The early breathing techniques were very prescriptive and specific.  Over the years these techniques have given way to a much more individualised approach to breathing during childbirth, but the reasons behind managing your breathing remain the same.

While there are definitely some types of breathing more suited to particular stages of labour, the most important thing is breathing in a conscious and deliberate pattern that works for you.  There is no one-size-fits-all solution.  This is why it’s important during pregnancy to prepare yourself with a range of different techniques that you can use when you need to.

 

Different Breathing Techniques

During the course of labour, you will have the need for a range of different breathing techniques, depending on whether you are in the very early stages and wanting to relax and conserve energy, the transition phase where managing discomfort is paramount, or the delivery phase, where guiding baby gently into the world is your focus.

Soft Sleep Breaths – similar to the slow gentle breaths you take just before you fall asleep, this technique is used between contractions to conserve energy, focus and relax.

Blissful Belly Breaths – aimed at managing discomfort during contractions

Cleansing Calming Breaths – during probably the most uncomfortable phase of labour – transition – these breaths are used between contractions to maintain focus and calm.

Gentle Birthing Breaths – these are the breaths you use during the second stage of labour, when you are delivering baby.  Rather than straining and pushing this breathing technique will help you bear down in a relaxed way.  There are a number of benefits to both you and baby in using this technique.  Baby has a much gentler birth, your tissues (especially the perineum) have a chance to stretch slowly, resulting in fewer stitches, and you are less likely to suffer afterwards with haemorrhoids.

 

Practice makes Perfect

One of the most important keys to being able to manage your breathing during childbirth is practice.  In the weeks leading up to the birth, practice the different techniques that feel most natural to you, so that when the time comes they are second nature.  It’s a great idea if your birth partner practices with you so that they can support you and help you focus during labour.

 

Additional Comfort Measures

Most of the studies that have been conducted around the benefits of deliberate breathing during labour have incorporated other complementary medicine techniques such as acupressure, meditation and massage.  When combined, there is clear evidence these techniques improve the experience of labour, reduce discomfort and reduce the incidence of medical interventions like epidurals and stitches.

Incorporating these additional comfort measures into your birthing plan and preparation will set you up as best as possible for a positive birth experience.

 

Where do I Learn to Breathe?

Most childbirth classes will offer include training in how to master breathing during labour.  They may use the techniques I outlined earlier, or the might take a slightly different approach.  Whatever approach you decide to take is entirely up to you – there is no right or wrong.

A doula can help you understand a range of breathing techniques, will work with you to determine your preferred approach, and help you and your birth partner master the techniques before labour.

 

If you would like to understand the different breathing techniques and when to use them, or you would just like to chat about the type of birth you envision for yourself and your baby, I would love to chat with you.  Call me on 0422 258 771 or contact me below: