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.

 

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/

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.

  

Leaking breasts can be an embarrasing problem when you're breastfeeding

What to do about ‘leaking’

I had an embarrassing moment in the supermarket once. I was breastfeeding at the time and had bought some milk in plastic bags. Unfortunately, one bag was leaking. This resulted in a trail of milk following my shopping trolley. A woman stopped me and said, “You’re leaking milk.” My first reaction was to clutch my breasts in horror and go bright red. I quickly recovered when I realised that it wasn’t me who was leaking!

Breastfeeding experts tell us all about the bonuses for mother and baby when it comes to breastfeeding, but they forget to warm moms about leaking. Leaking colostrum can start as early as six months.  It’s all connected to hormones made in a pea-sized gland in the brain called the pituitary. As soon as a baby is born, breastfeeding hormones called oxytocin and prolactin are produced. While prolactin helps to make milk, oxytocin stimulates the tiny muscles around the milk-producing lobules in the breast to contract. When this happens, it’s called the ‘let-down reflex’, and then the milk flows.

Women aren’t strictly aware of this sensation until a breastfeeding pattern has been established – unless it’s her second or third baby. Painless, this feeling is described as ‘pins and needles’ sensation. If you’re topless, your breasts literally ‘stand up’ before the milk starts dripping. It’s particularly embarrassing when you’re sexually aroused during love-making and you find yourselves feeling wet and sticky. Nursing breasts leak when it’s time for a feed, or mom hears a baby (any baby) cry or sometimes, even just thinking about her baby. Breastfeeding women who go back to work and have to sit through board meetings or are in the public eye, should be advised to wear breast pads inside her bra. These can be washable or disposable. They should be wide and cone-shape – otherwise, it looks like you’re wearing a pair of socks inside your bra.

Breast pads should be changed often to avoid getting thrush (especially when the pads are plastic lined) on your nipples because of the warm, wet and sweet environment created by the milk. Washable pads don’t have a plastic lining so they’re less likely to cause this problem. They’re also environmentally friendly.

There’s a wide variety of breast pads (washable and disposable) available on-line, with prices ranging from R59.99 (Clicks disposable breast pads – 36 in a box) to Avent washable (6) at R246,99. I went to Dis-Chem to see what they have available. Their range includes Bump (4 for R69,95) that feature: extra soft and absorbent/reusable/gentle on skin. Softi disposable breast pads featuring: ultra-absorbent / soft and skin-friendly / reliable (breathable protection) / contour shaped / 40 individually wrapped. Other brands include Madela: super dry, discreet, and super absorbent. Honeycomb boast ultra slim/discreet under clothing / super absorbent with a polymer that traps excess milk keeping the skin completely dry / waterproof/non-slip adhesive tape to ensure the pad is kept in place.

The online special I found and recommend is for Newchic Reusable pads at R75.86 (were R198.29) Visit www.newchic.com – and type in reusable breast pads to find them.         

 

24th September - Heritage Day in South Africa

Tell your children where they come from

On Tuesday 24^th September, we will be celebrating Heritage Day here in South Africa. I’m sure that many other countries around the world also celebrate their heritage. As parents, we need to use this day to remind our children (and ourselves) of our uniqueness, community and heritage. In our fast-paced, disposable, on-line, social-media-savvy world, there seems to be a disinterest in anything ‘old’ – like family photographs, artifacts and other memorabilia once handed down from generation to generation, now called ‘junk’ and donated to charity shops at best or thrown away at worst.

Our heritage starts with family. Little children love looking at old family photographs and hearing the stories about people they never have, and perhaps, never will meet. It also does you good to reminisce those days when you were growing up, telling your children about the things you used to do, and the games you used to play. You could even introduce them to some of these games on Heritage Day.

Our heritage is not only about our DNA, it’s also about where we worship – church, Sunday school, mosque or temple – where children learn to sit still and pretend they’re listening to words of wisdom that make no sense to them at all right now. It’s the park where we used to play, the schools we went to, the colleges, universities or places of work after school. This may have been the local service station or the dean’s office. All the same, it’s your heritage.

The Big Stuff regarding our national heritage are our historical buildings, museums, gardens and nature reserves, monuments, and statues that stand idle, forever waiting to remind generations of our descendants what their grandparents and great-grandparents did to secure our future.

I recently had the pleasure of meeting James Ball who was the speaker for a function at the Modderfontein Conservation Society. James started The Heritage Portal. I encourage you to visit this site on  http://www.theheritageportal.co.za to learn more about our heritage buildings and sites here in South Africa, and meet with enthusiasts who are prepared to protect and even restore some of these magnificent places.

Happy Heritage Day!