Tuesday 29 October 2019

Dads and labour




Preparing Dad for the labour ward
When I trained to become a midwife in the mid-’70s, dads-to-be walked up and down in the corridors or smoked in the waiting room while everything happened behind closed doors in the delivery room. Once mom had recovered and was spruced up and the baby had been bathed and swaddled into a bassinette in the nursery, Dad was given a peek at his offspring through a big glass nursery window and then allowed to give his wife a bunch of flowers. It was all very formal.

Luckily this had all changed by the time I had my first baby, and because I knew what to expect, I could talk my man through what was going to happen next. A few years later when I started giving pre-natal classes, I realised that it was just as important to prepare men for the labour room as it is to prepare women.

I can’t claim to be the instigator of educating couples. This had all started in the early 1940s when Dr Grantly Dick-Read published his book “Childbirth without fear” stressing that childbirth is natural and that pain is minimised when fear is taken away. This research was followed by the French obstetrician, Dr Ferdinand Lamaze and American obstetrician, Dr Robert Bradley. Only then, with much negotiating and the support of midwives and parents, maternity units opened their doors to men who now play ‘doula’ during the first stage, help his woman to focus during the birth and share the joy in the first ‘magic hour’ together. Some private midwife-run facilities go so far as to provide a double-bed for couples in their own private suite where they do everything for themselves with midwives on standby should they need help.

The move towards women choosing to start a family when she is older, escalating fertility treatments plus doctor’s fear of litigation when there are (even minor) complications has meant more c-sections (especially private health care). This also means that women (and their doctors) don’t feel the need for physical preparation before the birth – just as long as she knows how to cope with major abdominal surgery after the birth.

Where does this leave Dad? To be honest – pregnancy, babies and birth belong in the women’s department. Men learn to cope with pregnancy-related outbursts and emotional melt-downs, but when it’s ‘crunch time’ ie time to go to the hospital, reality hits them between the eyes like a punch ball. They’re not quite sure where to look or what to say or do. While some feel like obscure spectator’s, others jabber on with the nervous conversation or get in the way with cameras and video equipment. A few simply pass out. But they all feel drained and exhausted afterwards, wondering what just happened, how their lives have changed and what they can do to cope.

Top tips for dads:
  • Join in with prenatal classes where there is an opening for dads
  • Go with your partner to the doctor/midwife as often as you can – or at least for the first visit, the first scan, the hospital ‘tour’ and her last few appointments when she really needs your support, and you have the opportunity to ask questions
  • Read that parenting and baby magazines she conveniently leaves lying around
  • Work on baby’s room together and talk about how you are feeling
  • Talk to seasoned dads – and learn from their mistakes.

Like the picture? I found it on “100 powerful photos of dads in the delivery room to celebrate Father’s Day”. Open the website for more.
 

Friday 18 October 2019

Labour hormones and how they help


Make friends with your ‘labour’ hormones
Last week’s post focused on physical preparation for labour. This post is about making friends with your labour hormones.

The good news is that Mother Nature doesn’t leave you to cope with labour and birth on your own – hormones help you to do this. These are mostly oxytocin, relaxin and endorphins. Unfortunately, fear, stress and pain can block these hormones. Pain can increase fear to the point of panic that can quickly get out of control. That’s why it’s important to minimise fear so that you can make the most of natural hormones.

How can you do this?

  • Fear of the unknown – minimise this by reading, learning about childbirth (Lamaze, ante-natal classes) but please don’t google questions – rather ask your doctor/midwife
  • Choose a birth-partner: Baby’s dad, mom, gran, best friend, doula
  • Stay at home for as long as you can during ‘warm-up’ labour (or until contractions are 5 minutes apart) unless ….. you’re bleeding, your waters have broken or your gut tells you something is wrong
  • Fear is made worse by hospital smells and by what we hear and see. To create your own ‘comfort-zone’ – take your own pillows and blanket
  • Wear earphones and listen to your favourite music.

Keep comfortable:

  • Wear an old pair of loose-fitting pants so that you can walk around for as long as possible in early labour
  • Bring snacks and beverages
  • Have your birth partner rub your back with ‘smelly’ cream
  • Keep a wet face cloth handy and use it to keep feeling cool and fresh
  • Bring lip-ice and hairbrush
  • You don’t have to have a water-birth, but getting in and out of a warm bath helps
  • Squat on a chair or soft exercise ball
  • Humm, sing, chant your contractions away!

Something to remember about labour pain:

This type of pain is not destructive pain caused by disease or injury. Labour pain is functional pain mostly caused by resistance. Oxytocin, relaxin and endorphins helps to minimise this resistance and ease the pain. Make sense?

Remember that there is no pain between contractions (not like period pain that just goes on and on …)

How do hormones help?

Oxytocin – also called the ‘love’ or ‘bonding’ hormone activates the ‘reward centre’ of your brain. It also:
  • Controls fear, helps you to trust
  • Keeps you calm, controls your blood pressure
  • Initiates bonding and mothering instincts
  • Improves appetite (especially after the birth)
  • Helps to make and release breast milk (after the birth)
  • NB: Decreases fear
  • Helps with healing.

Relaxin:

Besides improving blood flow, this hormone relaxes pelvic ligaments and softens the pubic bone allowing the baby’s head through during the birth.

Endorphins:

This is a ‘natural morphine’ opiate or pain-relieving hormone that comes from the brain. Providing that a woman is relaxed, endorphins are released during contractions in bigger doses as she nears the end of the first stage, goes through ‘transitional’ and ‘second’ or ‘birthing’ stage. Endorphins can even help to put a woman into a trance during this difficult stage so that her only focus is to push her baby out – irrespective of circumstances!

This ‘endorphin’ high also helps a woman cope during the first few days after the birth or until breastfeeding hormones are flowing. Women lucky enough to experience natural birth are often less likely to struggle with the ‘baby blues’.

Picture source: ‘Everything you need to know about a birthing doula’ by Genevieve Howland: https://www.mamanatural.com/birth-doula/


Saturday 5 October 2019

When you're afraid of giving birth ...




Getting ready for labour

We’ve grown so used to electrical devices; wouldn’t it be nice if they could do the work of having babies for us? What about having a c-section you may ask? Surely, it’s an easier option than natural birth?

Having had two natural births and two emergency c-sections, I can honestly say that having a natural birth was (I wouldn’t say easier) but there were fewer implications, and I recovered a lot quicker. 

OK. I had a few advantages. I was younger than 30, healthy, active, the right weight for my height, a non-smoker and I exercised in my third trimester. I was also a qualified midwife and read everything I could lay my hands on, so I had an idea of what to expect. I also realised the importance of being prepared, staying active for as long as possible in early labour, and being in control of my contractions (not them in control of me).

There’s more to having a baby than we realise. Babies help to fulfil our role as women. They make us mothers. Labour and birth help to build self-confidence (yes, I can do this) and babies give women a sense of purpose – nurturing and loving unconditionally.

As your birth date edges closer, it’s perfectly normal to worry about labour and birth. Unchartered territory, breaking your way into the unknown when it’s your first baby, can be frightening. Google can be your worst enemy when other women tell you horrific stories and you’re tempted to research these to make sure they don’t happen to you. Your doctor may seem abrupt when you ask questions – and answers in medical jargon will just make you more confused.

I am going to write four blogs on how to take ownership of your body and your baby in preparation for the birth. This first in the series will deal with the physical preparation. The others will cover emotional preparation (making friends with your hormones), spiritual preparation (connecting with your baby) and finally, something for dad.

Physical preparation.

You wouldn’t think of running a marathon without the right shoes, or proper preparation, right? Giving birth is going to be your marathon. If you’re attending birth preparation classes, make sure they include an exercise programme and not just parenting talks. If you’re going to a gym, ask your instructor about pregnancy exercises. Alternatively, you can ask a physiotherapist to recommend an exercise programme, or you can google you-tube exercises like https://www.parents.com/pregnancy/my-body/fitness/pregnancy-fitness-intense-work-outs/ - but, please check with your doctor first.

As your baby grows, and your belly gets heavier, your back may ache, your tummy muscles stretch and hurt and your pelvic bones feel uncomfortable. Wear comfortable clothes and flat shoes, sit up straight when you’re working at your desk and do exercises like squatting, yoga stretches on all fours, walking and swimming (when this is possible).

Set aside a time each day to do your exercises. Play your favourite music, light candles if you like, don’t rush, and enjoy doing them. The book I would recommend reading is ‘New Life – a book of exercises for pregnancy and childbirth’ by Janet and Arthur Balaskas. You can download more information about this book (and others written by Janet) on https://www.amazon.com/Arthur-Janet-Balaskas-New-Life/dp/0283985089

To find out more about childbirth education classes, midwives, doula’s and breastfeeding consultants in your area (South Africa), go to the Expectant Mother’s Guide: https://www.babytalk.co.za/activities/expectant-mothers-guide/ to order your copy.