Category: Birth

 

All About Caesareans

As both a woman and a doula, I fundamentally believe it is the right of every woman to make informed choices about her body and the delivery of her baby, without judgement or feelings of guilt or failure.

Whether your baby is delivered vaginally, via elective or planned caesarean or emergency c-section, the important thing is mum and bub are healthy and safe.

Making a decision about the right birth for you begins with knowledge. If a caesarean looks like it might be on the cards for you, the good news is, they’ve come a long way in recent years. Let’s take a look at your potential options, and what you can expect.

Elective/Planned Caesareans

This is where having a caesarean has been discussed and planned prior to labour commencing. You might choose to have an elective caesarean for a number of reasons, including:

  • Pregnancy complications like pre-eclampsia or diabetes
  • Previous complicated or difficult delivery
  • Placenta praevia – where the placenta is blocking, or partially blocking the cervix

You may be advised to have a caesarean if your baby is in the wrong position for vaginal delivery—feet or bum first, or sideways. This can often be resolved by Optimal Maternal Positioning and Spinning Baby techniques which, if successful, may avoid the need for a caesarean. If you would prefer a vaginal delivery a doula trained in these techniques can give you advice on your particular circumstances.

If you are having an elective caesarean, you will likely have an epidural block to numb the lower half of your body, which will allow you to remain conscious during delivery. Your partner or support person will generally be allowed in the room with you.

Maternally Assisted Caesarean Sections

Many women report feeling excluded or distanced from the birthing process when having a caesarean. One way to avoid this is to consider a maternally assisted caesarean (MAC). This is exactly what it sounds like. In the case of planned or elective caesareans, it is possible to assist in delivering your baby via c-section, providing there are no extenuating or complicating circumstances.

Prior to the procedure your medical team will talk you through what is required. You will need to be instructed on surgical scrub procedures, and wear a sterile gown and gloves. Once the doctor has accessed the uterus, they will move the baby into a position where you can safely grasp them and bring them up onto your chest for skin-to-skin contact.

During the procedure you will be able to see what the medical team are doing. There will be blood, and sometimes getting a baby into the right position requires quite a bit of manoeuvring, so you and your partner need to be sure you won’t be distressed by this.

Your medical team will tell you if MAC is likely to be possible for you, and discuss how things may unfold in your individual circumstances.

If you feel assisting is too much, you can opt to simply have the c-section without the usual drape hiding the action, so you can watch as baby emerges from your uterus.

Emergency Caesareans

Sometimes, once labour has begun, it becomes clear a caesarean might be necessary. This may be the result of foetal or maternal distress, or stalled labour.

Having a c-section might not have been your preferred birth plan, but try and remember the only important consideration is a healthy mum and bub. How that happens is secondary, and choosing a healthy baby is not failure.

Emergency caesareans will generally mean you are not able to have skin to skin contact with your baby immediately after birth, since you will probably have had a general anaesthetic. However, once baby has been checked by the medical team, there is no reason your partner can’t have that wonderful bonding experience.

The Role of A Doula in Caesarean Sections

Whether you are having a planned c-section, or you require an emergency procedure, a doula can provide support during pregnancy, delivery and the postpartum period.

A doula will assist with keeping you and your partner calm and relaxed during birth, which can be particularly important during a c-section. They can take care of things like ensuring the music you have chosen is played or taking photos or videos. This allows you and your partner to concentrate on this wonderful experience without distractions.

If it is necessary to take baby to NICU, a doula will stay with you and provide support, while your partner goes with bub, which ensures peace of mind for everyone.

The Right Time

If you are considering an Elective Caesarean, you should think carefully about the timing of the procedure.

If medical factors allow, the optimum time is 39 weeks.[i]

The last couple of weeks of pregnancy is when your baby’s lungs fully develop, and the longer you can leave baby to develop in-utero, the better.

Whilst it is not always possible to wait, studies show baby’s delivered earlier than 39 weeks are more likely to experience respiratory problems, and may also experience learning and behavioural challenges later in life.

The wrong reason to deliver earlier than 39 weeks is because it’s more convenient for the doctor or the hospital.

The Risks

As with any medical procedure, a caesarean section, whether planned or emergent, carries risks you should be aware of. It’s important to discuss these potential risks with your medical team at some time during your pregnancy, whether or not you are planning on a caesarean.

Knowing what the potential outcomes are will help you feel in control of the process, and studies have shown that this contributes to a positive birthing experience, whether baby is delivered vaginally or via caesarean.

Recovering from a Caesarean

However you look at it, this is a surgical procedure. Recovering from a c-section takes longer than recovering from a vaginal delivery. You will need to:

  • Take care of the wound site until the stitches or staples are removed and incision site shows new, pink skin
  • Avoid driving for 4-6 weeks
  • Avoid lifting anything heavy, like washing baskets or older children for 4-6 weeks
  • Avoid heavy housework, like vacuuming for 4-6 weeks
  • Ensure you consume plenty of water and fibre to avoid constipation as straining can cause damage to the wound site

Since recovering from a caesarean is longer than recovery from a vaginal delivery, it’s worth considering the support of a post-natal doula to assist you with chores you can’t undertake, and provide you with advice and nourishing food designed to assist with healing.

If you required an emergency c-section, it is even more important to monitor your emotional reaction in the days and weeks after birth than following an elective c-section or vaginal delivery. A doula can provide a great sounding board for your feelings, and is trained to identify if you are approaching overload.

A Word About VBAC

VBAC stands for Vaginal Birth After Caesarean. Whilst around 76%[ii] of women who have had a c-section for their first delivery go on to have caesareans for their subsequent deliveries, it’s important to know this is not always necessary.

With the right advice and support, it is possible to have a subsequent vaginal delivery, providing there are no complications. This is something you should discuss with your medical team during your pregnancy. If they are in agreement, a doula can provide you with advice on how to prepare yourself.

If you are pregnant and have been recommended to have a caesarean, or are considering one, and would like to chat about your options, please don’t hesitate to give me a call on 0422 258 771 or contact me here.

[i] safetyandquality.gov.au/about-us/latest-news/media-releases/high-rates-early-caesarean-sections-are-putting-australian-babies-unnecessary-risk

[ii] https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/labour-and-birth/method-of-birth

Celebrating World Hypnobirthing Day – 21 March 2023

I’ve talked about the medicalisation of a childbirth before. There is no denying that medical intervention has its place, and is sometimes very necessary. However, the large majority of the time, our bodies know what they need to do. Hypnobirthing harnesses the power of the mind over the body, to help this process unfold as it was intended.

Nowhere is the link between our mindset and the response of our body as evident as it is in childbirth, because the hormones produced by our brains have a direct correlation to our body’s ability to function.

If we go into birth with knowledge, not fear, and faith in our body’s ability to successfully give birth, we increase the chances of that exponentially. So let’s take a look at how Hypnobirthing can help ensure you take a calm, empowered, positive mindset into your birthing experience.

The History of Hypnobirthing

As far back as the 1920s Dr Grantley Dick-Read began to propose the idea of a ‘natural’ birth, which he wrote about in his 1942 book Childbirth Without Fear, where he discussed breaking the fear-tension-pain syndrome.

In 1989, as a result of her own birthing experiences, Marie Mongan founded the Hypnobirthing Institute, with the belief that:

“every woman has within her the power to call upon her natural maternal instinct to birth her babies in joy and comfort in a manner that most mirrors nature.”

In her book “Hypnobirthing – A Celebration of Life” Mongan laid out her ideas and techniques for birthing in a calm, relaxed and peaceful way.

What is Hypnobirthing?

While the name suggests hypnosis, this is only one aspect of hypnobirthing. In reality, the techniques used are all aimed at creating a calm and positive mindset, which results in physiological changes in the body to improve the experience of labour.

When we are fearful or anxious, not only do our bodies become tense, but our brains produce stress hormones like adrenaline and cortisol. These hormones can increase your perception of pain. Conversely, when we are calm and relaxed, our brains produce endorphins and oxytocin, which reduce pain perception and help move labour along.

Hypnobirthing techniques assist you in turning your attention inwards, allowing you to tune out peripheral activity and concentrate on the task at hand – calmly birthing a healthy baby.

Techniques

There are a range of techniques used in hypnobirthing. You may find some work better for you than others, or that certain techniques work at certain stages of labour. These techniques include:

  • Breath management
  • Self-hypnosis
  • Massage
  • Movement
  • Deep relaxation techniques
  • Acupressure
  • Vocalisation & Visualisation

Benefits of Hypnobirthing – Here’s the Science…

There are lots of anecdotal and quantified studies on the benefits of Hypnobirthing. The WA Government recently conducted a pilot study, which they have since rolled out to more WA hospitals. The results included:

52% fewer caesareans

40% reduction in morphine use

32% reduction in epidurals

15% fewer inductions

In the US, where more studies have been conducted, a 2010 study found that:[i]

                                         Hypnobirth             General

Caesarean Rate                       17%                  32%

Required Analgesia               <10%                  22%

Had Epidural                            20%                  76%  

Anecdotally, birth practitioners around the world have noted Hypnobirthing results in:

  • Reduced rates of intervention and the need for pain relief
  • Reduced rates of birth trauma and post-natal depression
  • Shorter labours
  • Higher Apgar scores*
  • Faster post-birth recovery for both mum and bub

An additional benefit of using Hypnobirthing techniques is they provide your partner with an active, positive role to play in the birth process, helping them feel more involved and useful.

Pre & Post Natal

Hypnobirthing techniques can also be used both pre and post-natally. In fact, Catherine Middleton, Princess of Wales, who famously suffered from Hyperemesis Gravidarum (extreme ongoing morning sickness) during all three of her pregnancies, used hypnobirthing techniques to help her manage her condition, as well as during labour.

These same techniques are also showing signs of success when used postnatally to assist in recovery from a traumatic birth, and from mild postnatal depression and anxiety.

How Do I Have a Hypnobirth?

There are a wide range of Hypnobirthing courses on offer through hospitals, online or in person. Hospital run courses are often very basic, and are generally aligned with hospital protocol. Private courses are more comprehensive and provide more in-depth birthing options. My personal favourites are:

Hypnobirthingaustralia.com.au

Calmbirth.com.au

Shebirths.com

If you would like to know more about how Hypnobirthing can help you achieve a calm, positive and empowered birth, I would love to chat. Give me a call on 0422 258 771. or contact me here.

*An Apgar Score is a scale on which the health of a newborn is evaluated, and it is taken at 1 and 5 minutes post-birth. It is a assessed over five criteria – skin colour, pulse, breathing, muscle tone and reflexes. Each criteria is scored out of 2, giving a maximum score of 10. A score of 7 or above is considered optimal.

[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744344/#:~:text=HypnoBirthing%20(the%20Mongan%20Method)%20was,with%20Mongan's%20own%20childbirth%20experiences.

International Childbirth Education Week – 25-31 January

Why It’s so Important

Ever since I became a Doula in 2018, one of the things I have been most passionate about is education. Not just my own ongoing education in the support of mums and bubs, but the education of my clients. This is why I believe International Childbirth Education Week is so important.

Study after study has shown that women’s satisfaction with their labour and birthing experience impacts both their health, and their relationship with their baby. It only makes sense, then, to ensure you are armed with all the information you need to make the right choices for you.

That’s not to say everything will always go according to your plans. But the better informed you are, the more able you are to change direction if necessary, and make different decisions with purpose and power, rather than from a place of fear or uncertainty.

Benefits of Childbirth Education

Some of the key practical benefits of good childbirth education are:

  • Increased maternal confidence during labour, delivery and postpartum. Knowledge is power, and when a mother knows what to expect, and how she might be able to approach it, she is more confident and empowered in her choices.
  • Decreased fear and anxiety about childbirth. Fear and anxiety have been shown to increase complications during labour and birth.
  • Lower levels of medical intervention, including induction, use of analgesics and labour interventions like forceps, vacuum delivery and emergency caesareans.
  • Better navigation of the maternity care system. Knowing what your viable options are allows you to take control of how your labour and birth will be handled.
  • Increased likelihood of vaginal delivery. Whilst having a c-section is sometimes necessary, vaginal delivery has been shown to not only positively impact the health of the baby, but leads to shorter hospital stays, less likelihood of infections, and faster healing times.
  • Better understanding of pain management, and the impact on mother and baby, allowing for informed decision making.
  • Increased likelihood of breastfeeding, which has benefits for both mum and baby, not to mention the convenience it allows.

What Do I Mean Education

These days, there are an infinite number of ways you can educate yourself on just about any subject, including pregnancy, labour, birth and postpartum.

When I talk about education, I don’t just mean attending Childbirth Classes at the hospital or Baby Health Clinic. Some of the important things you need to understand include:

  • What happens to your body, and that of your baby, during each stage of labour, birth and the postpartum period.
  • The difference between the biomedical model and the humanised model of childbirth, and their relative merits.
  • What your options are in terms of the type of birth you would like. Gone are the days when women went to hospital and were told what to do. These days there are myriad options, from the full biomedical model, to birthing centres, home births, water births, free births and more.
  • Understanding your options in pain management and potential interventions.
  • Knowing the medical and technical terms for what is happening to your body, so you can understand what is happening and what the potential impacts may be on your labour, delivery and postpartum.
  • Being in a position of knowledge from which to choose the support people around you during your birth.

The most important thing is to choose reliable sources for your research. Some resources I would recommend include:

Homebirthnsw.org.au

https://calmbirth.com.au/

https://hypnobirthingaustralia.com.au/

https://shebirths.com/

https://www.rachelreed.website/childbirth-physiology-course

And there are a couple of great podcasts you can check out:

https://www.melaniethemidwife.com/podcasts/the-great-birth-rebellion

https://podcasts.apple.com/au/podcast/the-midwives-cauldron/id1523178579 

The Importance of Caregivers

According to a recent study from Spain the factors most important in influencing satisfaction with the experience of childbirth are:

  • Personal expectations
  • Caregiver support
  • Quality of caregiver-mother relationship
  • Involvement in decision-making[i]

This shows how important finding the right caregivers – whether that be a doctor, midwife or doula – is to the experience of childbirth. Your caregivers should not only be experienced and qualified, but should share your philosophy on labour, birth and the postpartum experience.

So while researching childbirth, research caregivers as well, and don’t be afraid to ‘interview’ them – after all, they will have a vital role to play in one of the most important times of your life. A good place to start is professional organisations, as well as friends and family who have recently had babies.

If you would like more information about how a doula can help you gain the knowledge you need to make informed choices about your labour, birth and postpartum journey, I would love to chat. Give me a call on 0422 258 771, or contact me here.

[i] Hodnett, E. Pain and women’s satisfaction with the experience of childbirth: a systematic review.

Birth Story – Isa

My husband and I already had two children, and we had thought our family was complete. Not only did I suffer from Hyperemesis Gravidarum (extreme morning sickness), but both my births had been C-sections, and the first had been really traumatic. We were so sure we were done my husband had a vasectomy.

But a few years ago my family started feeling incomplete. I felt there was another soul wanting to join us, and this conviction just got stronger and stronger until I couldn’t ignore it. We decided to have one more baby.

Because of the vasectomy we had to do IVF, and we became pregnant right away. Unfortunately, we lost that baby, but on the next attempt we again fell pregnant right away.

I really wanted to have a home birth, but I was considered high risk because of my two previous c-sections, and I couldn’t find a midwife who was prepared to take me on. I was a bit surprised to find out 0.7% chance of a uterine rupture is considered high risk[i]. I had done my research, and was frustrated that I was being robbed of my right to choose the birth I wanted.

In the end I decided to go with a freebirth. This means a birth without medical or midwifery assistance and a pregnancy with minimal medical checks. This meant I was taking on the responsibility of any decisions, but I was comfortable with that.

During my research I had discovered Doulas and looked around for one that I connected with, which is how I found Alison. She was very supportive of my choices from the beginning.

It was a very nice pregnancy. I only had a couple of medical appointments, which made it very low stress and relaxed.

I finally went into labour at 41 weeks and 5 days. I know if I had been birthing in a hospital that wouldn’t have been allowed, because they’re too scared of things going wrong, But my baby knew what she was doing. It was nice that I could wait until she was ready.

For three nights I laboured during the night, with contractions 10-20 minutes apart, only to have the contractions stop when the sun came up. On the third night, around 4:30am the contractions went to 5 minutes apart. I waited until 7am to call Alison, in case they stopped again, but they didn’t, and Alison came right over.

Around 11:30am my waters broke in a big gush and I had the urge to push. After 5 hours of pushing my baby still wasn’t born. My husband could feel her head, but she wasn’t moving any closer.

In the end we decided to call an ambulance. When they arrived they agreed to wait half an hour in case something happened. When there was still no progress a second team arrived, and they advised me I would need to go to hospital as this was the protocol.

As they were getting me down the steps to the ambulance things started to happen. Maybe the movement shook something loose, I don’t know, but my baby started to move, By the time I was at the doors of the ambulance my baby’s head was crowning. Alison asked if I could go back inside because she knew I really wanted a home birth, and the baby was almost there, but because of those medical protocols I had to go to the hospital.

No sooner was I in the ambulance than her head came out, and she was born on the trolley on the way from the ambulance to the birthing suite. I was disappointed not to have had a home birth, but was also at peace with the decision to call an ambulance when we did, because it was my decision, not someone else’s.

I had wanted to experience the golden hour and delayed cord clamping, but because there was meconium in the amniotic fluid, even though it was not on the baby, the hospital wouldn’t allow it. I finally met my baby properly while they were stitching up my first-degree tear, which wasn’t ideal, but I had my healthy baby, and I had managed a vaginal birth after two c-sections, which I was very grateful for.

I went home after two days, and I must say, the ambos and the nurses could not have been more kind or supportive.

But the real standout was Alison.

She is honestly one of the most beautiful and caring people I know. During the pregnancy and labour she could not have been more supportive. Not just of me, but of my husband, who tends to freeze in stressful emotional situations.

After I was taken away in the ambulance, she stayed at my home and cleaned everything up so that I came home to a clean and tidy house.

Once I was home Alison’s postpartum care was brilliant. She still comes around with delicious, nutritious meals, as well as giving me massages. We even had a belly binding ceremony.

We have no family in Australia, and honestly, having Alison is like having birth mum. Her care and support are unconditional. She always knew exactly what I needed, and was there to provide it. I feel like she will always be part of my family now.

I only wish doulas were more well known. Every mum needs one. It shouldn’t be a luxury, or optional. Everyone should have one. It makes such a difference. Having a baby takes such a toll on your body, and society is still very patriarchal in the belief you should ‘get back to normal’ as quickly as possible. A doula, especially a postpartum doula, helps nurture you through.

For me, I’d like to see the medical industry update their ideas, and support women who have had a one or more caesareans if they want to try a vaginal birth. I am so grateful I got my natural birth – it was so empowering. It felt amazing to know that my body did that.

With Alison as my doula, I knew she was there for me and my baby. She doesn’t focus on the fears, but on the positive and the natural. I always felt she had my best interests at heart – I always felt ‘she’s got me’.

My family really is complete now, but if I was ever to have another baby, I would absolutely want Alison by my side.

If you would like support in your journey to motherhood, please give me a call on 0422 258 771, I would love to chat. Or contact me here.

[i] https://vbacfacts.com/2021/08/10/uterine-rupture-classical-incision-vbac/

 

The Benefits of Using Herbal Remedies in Pregnancy, Childbirth and Postpartum

Creating new life is the most natural thing in the world. That doesn’t mean it comes without challenges and difficulties. But it is my belief that many of the challenges, both physical and emotional, can be eased by the use of the natural herbs and remedies women all over the world have been using to heal and nourish their bodies for centuries.

That’s not to say there isn’t a role for the medical fraternity. Of course there is. But in the normal course of events, with a medically standard pregnancy and birth, herbal remedies provide a safe, effective solution to the normal stresses, strains and discomforts of pregnancy, birth, and the postpartum period.

Little Yarrow

Early on in my time as a Doula I recognised the importance of understanding the use of herbal remedies, not just as external concoctions and teas, but as central ingredients in creating healing and nourishing postpartum foods.

I searched for somewhere I could learn what benefit specific herbs could bring, and how to use them. This is when I came across Little Yarrow Herbal Medicine.

The Little Yarrow Apprenticeship is focussed on providing an understanding of the properties of a range of herbs and ingredients, and when and how to use them safely.

This incredible course has enriched my ability to provide my clients with the best possible care during their pregnancy, birth and postpartum period.

Uses for Herbal Medicine

Many of the ingredients we use in Herbal Medicine have multiple benefits, and by combining them in the right way, we can provide relief for a range of normal pregnancy ailments, taking into account five key goals:

  1. Enhancing nutrition during pregnancy and postpartum
  2. Strengthening the uterus both before and after birth
  3. Supporting the nervous system to alleviate stress, anxiety and exhaustion
  4. Easing minor ailments that are part and parcel of the changes occurring in your body
  5. Preparing for birth, and healing afterwards

Herbal Medicine can help in ensuring these goals are met.

Pregnancy

Some of the common ailments women experience in pregnancy, which can be alleviated by herbal remedies, are:

  • Constipation
  • Anxiety and stress
  • Headaches
  • Heartburn
  • Insomnia
  • Nausea
  • Haemorrhoids and varicose veins

Birth

For some women birthing is quick, for others it’s a slow process. There is no right or wrong. Herbal remedies can help when a woman experiences:

  • Nausea
  • Stress and Anxiety
  • Labour pains

Postpartum

Pregnancy and birth takes a toll on your body, and it is important not to put too much pressure on yourself to ‘get back to normal’. That said, you don’t need to suffer unnecessarily with aches and pains which can be soothed with simple, gentle treatment. Herbal remedies can help you during your postpartum period with:

  • Healing tears and wounds of the perineum
  • Aching muscles
  • Increasing and enhancing milk supply
  • Breast feeding issues like mastitis and cracked sore nipples
  • Supporting uterine health by relieving heavy flow and cramping
  • Supporting energy and mood

Herbal Remedies from a Doula

Since completing the Little Yarrow Herbal Medicine Apprenticeship I have developed a range of teas, soaks, meal and snack recipes which incorporate the remedies I learned about. These nourishing and healing recipes help my clients feel great and recover from the strain pregnancy, birth and the postpartum period puts on their bodies.

If you wish to use my services as a Postpartum Doula a range of food is included in the package. However, you can also purchase many of my products here. (link to shop page)

I prepare all my products, meals and snacks by hand in small batches.[1]

 

A Simple Recipe[2]

I would like to share with you a simple infusion recipe you can create yourself at home that will help boost your mood during both pregnancy and postpartum.

3tspn Lemon Balm

3tspn Passionflower

3tspn Chamomile

Brew as a strong tea, leaving for 15 minutes in hot water. Strain before drinking.

Whether you feel you would like to include the support of a Doula in your pregnancy, birth and postpartum experience, or you would just like to experience the benefits of some of my herbal remedies, I would love to chat. Please give me a call on 0422 258 771 or contact me here.

[1] I have a NSW Government Food Authority Food Safety First Certificate for food preparation.

[2] Whilst all these herbs are safe for use in pregnancy, it is always a good idea to check with your health care professional when trying something new.