Happy New Year

Happy New Year 

To all our mums, mums to be and their families (whanau).  Have a wonderful and safe time.

8 ways to manage labour pain

     "They don't call it labor for nothing. Having a baby is hard work, and part of that work is getting through the pain. But don't panic. There are more ways than ever to manage that pain, and you don't have to choose just one. "The trick is to have as many tools in your bag as possible," says Kim Hildebrand Cardoso, a certified nurse-midwife in Berkeley, California, and a mother of two. "You don't know what's going to work until you're in it, and what helps a woman at one point can change five minutes later." That's why it's important to keep an open mind and do your research. So take a deep breath (good practice for later) and prepare to enter the wide world of pain management."

Ways to manage labour pain

A Christmas Tale

Years ago when I was a staff midwife working in a London hospital, I worked the early shift on Christmas day.  My shift started at 7 am and was allocated to care for a lady who had been admitted about an hour before I arrived at the maternity unit.  This was her second baby so her labour was fast and subsequently delivered a beautiful baby boy at 10 am that morning.

"Congratulations, what a wonderful Christmas present" I said as I laid her baby on her tummy for skin to skin contact.  "You can call him ..........."  Before I could finish my sentence, the new mum interjected  "No way am I going to call him Jesus!"  she said cracking up laughing.  

I replied, "I was going to say Chris or Joseph".........

HAVE A WONDERFUL CHRISTMAS AND HAPPY NEW YEAR

Breastfeeding Naturally

An excellent series of videos for women who are going to, or who are breastfeeding their baby. They contain a wealth of information such as the benefits for mum and baby, early feeding after the birth, family/whanau support, problems that may arise, returning to work and much more.

Part one

These video are also embedded on our website as well

Breastfeeding Naturally - Part 1 - 7

Why do I have morning sickness?

Nausea and vomiting is a common but not well understood condition or pregnancy, is certainly not confined to mornings and in fact, it can be all day sickness.  Symptoms usually appear by 4-6 weeks of pregnancy and one of the signs that a woman suspects that she could be pregnant.
It can also be very debilitating and may not be well understood by family, friends and employers.

It is usually associated with rising levels of hormones that feed the early developing baby until the placenta is fully formed and by 12-14 weeks the symptoms have resolved.  It is extremely difficult to treat because of the potential harm that medications can cause.  

Certain foods, tobacco and smells can trigger the nausea and make it worse.   I came across an interesting study undertaken by two Cornell biologists, who suggest that morning sickness protects the mother and her developing baby. The researchers believe that it may explain why many women have an aversion to meat, certain vegetables, caffeinated beverages and tobacco in the early stages of pregnancy.  It is because her body is trying to protect the developing embryo from the toxins and chemicals that may be present in certain foods and chemicals.  The body is also protecting the mother’s immune system which is naturally suppressed at this time.


Had I known this when I had very bad morning sickness when I had my children, it would have made more sense of my situation, maybe not have made it easier to bear but understanding why I was constantly sick and ‘listening’ to my body.

There are some self-help remedies that you can do to help yourself

• Instead of three large meals a day, eat 6-8 smaller meals throughout the day.  A snack of dry toast or dry crackers before bedtime and before getting up in the morning, this will help to maintain your blood sugar levels to reduce the risk of nausea.
• Avoid highly spiced and fried foods, although the smell may put you off these foods anyway.
• Reduce your caffeine intake and keep tea and coffee to a minimum of 2 cups per day.
• Vegemite or marmite spread on toast or crackers for its natural Vitamin B6. Vitamin B6 is a natural antihistamine that may help to reduce the nausea.
• Ensure that you are drinking plenty of fluids, at least one glass of water an hour during the waking hours.
• Gentle walking after eating may help.
• Slippery elm (available at the supermarket) may help to reduce the nausea.  It is quite bland so mixing it with some honey will make it more palatable.   
• Sipping ginger tea or ginger ale made with real ginger.

Alternative therapies

•   Acupressure wristbands help some women
•   Acupuncture

If you are continuously vomiting and you are unable to keep any fluid or solids down, this is a much more severe form of morning sickness called Hyperemesis Gravidarum and needs to be treated immediately.  Please contact your midwife or gp who will be able to advise you.

Morning sickness may be protecting you and your baby

8 gifts never to give to a new mum

Having had the experience of being a first time mum, I also warn folks be wary what you say to them, even the slightest statement as innocuous as it may sound can knock their confidence.  Lots of support, love and food to put in the freezer its great.

Eight gifts no to give to a new mum 

What is an ecbolic? Do I need one?

What is an ecbolic?  Do I need one?

"My midwife has asked if I want a natural delivery of the placenta (whenua), or would I prefer an injection to deliver it?"

What is the third stage of labour?

The third stage of labour is defined as the period from the birth of your baby until the complete birth of the placenta/whenua and membranes (NZCOM, 2006).

An ecbolic is an injection of a synthetic hormone that is given into your thigh with the birth of the baby’s shoulders.  The injection can be either syntocinon or syntometrine, although the drug of preference tends to be syntocinon.  Birthing the placenta and membranes by this method is called ‘active management of the third stage of labour’ and used to produce uterine contractions to help control the bleeding from the placental site.

When is the injection necessary?

If you have your labour induced, your labour is augmented (given an intravenous hormone to make your contractions more frequent, you have an instrumental delivery (forceps or ventouse), Caesarean section, postpartum haemorrhage or you have a medical reason.  The recommendations are that you have an active management of the third stage.   Your consent is required for the injection to be given, although if there is an emergency situation, there may not be time to discuss it fully with you but your midwife will advise you.

Do I have to have the injection?

The New Zealand College of midwives recognises that women can expect a physiological third stage (where the mother births her placenta without the aid of an ecbolic) when there has been a straight forward labour and birth. 

During your pregnancy your midwife will discuss your birth plan and explain the options available to you.

Links

NZCOM - Third Stage of labour Consensus statement

Leaving well alone - a natural approach to the third stage of labour

9 months of pregnancy

A great video of 9 months of pregnancy, taken with 1000 photographs and recorded as a video.

http://www.petapixel.com/2012/11/23/9-months-of-pregnancy-1000-photos-and-a-4-minute-stop-motion-journey/

Restless leg syndrome in pregnancy.

I have suffered from restless leg syndrome (RLS) myself in pregnancy and quite a few ladies have asked me about .  This article explains the research done on RLS and some practical advice if you have the symptoms.  Always speak to your midwife or your G.P. if you have any concerns.

     “Most of the time, when a woman experiences RLS in pregnancy, it disappears after the baby is born,” said Dr. Mauro Marconi, the study’s author and a researcher at Vita-Salute University in Milan, Italy. However, our results show that having the condition during pregnancy is a significant risk factor for a future chronic form or the short-term form in other pregnancies down the road.”

There is a lot you can do to take care of restless legs syndrome yourself. Mild restless legs syndrome (RLS) can often be treated with lifestyle changes alone. The following daytime habits can help reduce the frequency and severity of your restless legs symptoms.

Sleep better by sticking to a regular sleep schedule.  Fatigue can worsen the symptoms of restless legs syndrome (RLS), so doing what it takes to get enough sleep is crucial. Try hitting the sack at the same time every night, allowing plenty of time for winding down (try warm baths or reading in bed).  

Exercise in moderation. Daily activity, including moderate aerobic exercise and lower-body resistance training, can significantly reduce the symptoms of restless legs syndrome (RLS). Swim, go for a walk, take the stairs, or spend a few minutes doing jumping jacks. Keep in mind that excessive exercise—like training for a marathon—can actually make restless legs syndrome worse.

Cut back on caffeine. Caffeine often makes the symptoms of restless legs syndrome (RLS) worse. Try reducing or eliminating your consumption of coffee, tea, soft drinks, and caffeine-containing foods such as chocolate.

Avoid alcohol and cigarettes. Many people with restless legs syndrome find that their symptoms improve when they stop drinking and smoking.

Consider dietary supplements. Check with a doctor or nutritionist to find out if you’re low on iron, vitamin B, folic acid, or magnesium. Deficiencies can bring on restless legs syndrome (RLS).

Lose weight. If you’re overweight, dropping the extra pounds can often relieve or lessen the symptoms of restless legs syndrome (RLS).

Try practicing relaxation techniques such as yoga and meditation. Stress can make RLS symptoms worse. Daily stretching and meditation can promote relaxation and alleviate restless legs syndrome (RLS).

http://healthland.time.com/2010/12/07/study-restless-leg-syndrome-during-pregnancy-may-recur/

http://www.helpguide.org/life/restless_leg_syndrome_rls.htm

Birthing Traditions from around the world

I have been very privileged to assist many women to birth their babies from all cultures and backgrounds.  One story in particular from when I was in the UK, I was caring for an Asian lady in labour.  Present in the delivery room was her mother and her sister.  The lady who was in labour did not make a sound but her mother and sister were beating their fists lightly on the wall and making quiet noises.  Later, I asked the mother what they were doing and she told me that they were taking the labouring mother's pain for her.  

This fascinated me because I had never seen anything like this, so when I told a midwifery colleague in the UK, she told me the story of a West African woman who wanted her newborn baby to be lifted up towards the heavens for the sky God to bless her baby and bring protection and good fortune to him.  

I thought I would share with you some folk lore and traditions from around the world because not only is birth a normal life event, but also a very sacred and spiritual one. I feel very honored to be a midwife and to be chosen by the woman at this very special time in their lives.

In Cambodia the baby’s placenta, which traditional Cambodian healers call “the globe of the origin of the soul,” must be buried in the right location and orientation to protect the baby.  For the Navajo (a Native American tribe),  burying a child’s placenta within the four sacred corners of the reservation ensures that he or she will be connected with the land and will always return home.   In many cultures, the women will birth surrounded by the female members of her family and she and her baby will be fed and nurtured for several weeks postpartum.

When my journey brought me to New Zealand and I began to have an understanding of Maori culture in that the whenua or placenta also means 'land' reinforces the special relationship that the newborn has with the land of his/her birth.  

I would love to hear the stories from other cultures and midwives around the world.

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Belly Painting

Some of these designs look awesome :-)

http://www.guardian.co.uk/lifeandstyle/2012/oct/17/bump-painting-pregnancy-trend

A USB pregnancy test? Funny April Fools

I know we are not in April but I thought this article was so funny. 

"The cleverly named p-Teq USB Pregnancy Test Kit requires users to pee on a stick, just like all the other home pregnancy tests on the market. But that’s where the similarity ends. Uncap the other end of the wand to expose a USB connector to insert into your computer.

“According to ThinkGeek, the p-Teq’s mass spectrometry software analyzes hormones including human chorionic gonadotropin (hCG), which rises in pregnancy; hyperglycosylated hCG (hCG-H), which aids in detecting pregnancy before a missed period; and luteinizing hormone (LH), which helps predict ovulation. P-Teq’s technology is more sensitive than existing pregnancy tests and indicates precise hormone concentrations in a woman’s urine"

http://healthland.time.com/2011/04/01/high-tech-pregnancy-test-april-fools/

Laughing your way through labour

They say that laughter is the best medicine, and that is certainly true.  This dad made a rap song when his wife was in labour.

"Expectant dads out there may even want to go the all-out comedian route. Advises Midwifery Today: “Even a forced smile releases endorphins, the body’s natural pain medicine that is similar to morphine. When we are with a birthing woman who is in pain, it may help to tell some good jokes — or even some not so good ones, especially in early labor. Carry a joke book in your birth bag!”

Read more: http://healthland.time.com/2012/01/25/dad-raps-about-wifes-labor-contractions-can-humor-ease-the-pain-of-delivery/#ixzz27RaHPqMC

Past your dates?

Lots of women ask what they can do to get labour going when their expected date of delivery goes past.  Some women try sex, hot curry, sex and a hot curry :-), a long walk, nipple stimulation.  We do not recommend the taking of castor oil to try and get your labour started, it can cause nasty stomach cramps, diarrhoea and you still end up not going into labour.  

This interesting article discusses the folklore.

"“There are all kinds of obstetrical folklore and old-wives tales out there,” says Jonathan Schaffir, associate professor of obstetrics and gynecology at Ohio State University and lead author of the study, published in the June issue of the journal Birth. “If it’s not something perceived as being harmful, patients think there’s no downside. Even if it doesn’t work, it’s something to pass the time.”

http://healthland.time.com/2011/06/22/sex-spicy-food-etc-half-of-pregnant-women-try-obstetrical-folklore-to-induce-labor/

Fantastic news for our sister midwives in the United States

"This is fantastic news to hear that more babies were birthed by midwives in the United States.  

“If this trend continues, it will bring us more in line with the rest of the world in giving midwives a central role in prenatal care and birth,” says study author Eugene Declercq, professor of community-health sciences at the Boston University School of Public Health. “Given that other countries have lower costs and better outcomes, it would be a positive thing for this country.”

Read more: http://healthland.time.com/2012/06/25/midwife-mania-more-u-s-babies-than-ever-are-delivered-by-midwives/#ixzz27A4TAGTL

A special Waterbirth

I wonder if the lady in the pool is her midwife?  Beautiful birth of a baby dolphin.

Why Oxytocin is the most amazing molecule in the world

Found this very interesting article online.  


"Oxytocin helps women get through labour by stimulating uterine contractions, which is why it's sometimes administered (as Pitocin) during labor. It's been known to promote delivery and speed up contractions. After birth, mothers can establish intimacy and trust with their baby through gentle touches and even a loving gaze. In addition, mothers can pass on oxytocin to their babies through breast milk. And it's worth noting that fathers can reap the benefits of oxytocin as well; new dads who are given a whiff of oxytocin nasal spray are more likely to encourage their children to explore during playtime and are less likely to be hostile."

http://io9.com/5925206/10-reasons-why-oxytocin-is-the-most-amazing-molecule-in-the-world

Interesting article

Here is an interesting article I came across.

"Women who fear childbirth just got something else to worry about: a recent Norwegian study found that women who were scared of giving birth ended up spending more time in labor, about 8 hours versus 6.5 for women who weren’t afraid."


We know that women who are more tense do experience more pain.  


Read more: http://healthland.time.com/2012/06/29/why-women-who-fear-childbirth-end-up-spending-more-time-in-labor/?iid=hl-main-lede

Rural Midwifery

Rural Midwifery

As a midwife working in Northland, our area can be pretty vast and wild, none so much as when you get lost :-)  I was visiting a lady last week who lived quite a way out, however, I took a wrong route and spent 40 minutes trying to find her house.  As my pathway took me further and further into remote rural countryside and  my iPhone could not connect to google maps,  I began to reflect on my midwifery journey and I saw this stunning New Zealand landscape, I just had to stop and take a photograph.

It assisted me in reconnecting with my midwifery practice and the places we go to be 'with woman' and how lucky we are to practice in New Zealand where our skills are recognised and valued.   

Hospital check list

Ladies often ask what they should bring with them when to go in to hospital.  This list is a guide and if there is something that you think should be added to make your stay more comfortable, please feel free to contact us.

FOR YOUR LABOUR

• Birth Plan
• Your maternity notes
• Dressing gown
• Slippers/Socks (your feet can get cold)
• Toiletries (hairbrush, toothbrush and paste)
• 1-2 old baggy t shirts to wear or nighties/pyjamas
• Massage oil
• Lip Balm (your lips can get quite dry in labour,e specially if using entonox)
• Snacks and drinks for you (eg.Sports drink/glucose lollies, muesli bars, bananas)
• Snacks and drinks for your partner
• Small amount of cash (there is a locked drawer available on the postnatal ward for your use at Whangarei hospital but please do not bring in large amounts of cash)
• Hair ties
• Music eg. iPod or MP3 player
• Watch
• Camera or video camera (dont forget batteries and charger)
• Mobile phone and charger
• Arnica/Rescue remedy
• Pillow or blanket from  home

FOR YOUR HOSPITAL STAY

• 2 -3 Feeding bras (buy these later in your pregnancy because your body changes very rapidly)
• 2-3 packs of maternity sanitary pads (tampons are unsuitable) for when you go home.  While you are in hospital these will be provided.
• Breast pads. - Your milk will come in on day 3 and there will be leakage, so they are for your comfort
• Front opening shirts, this is to make it easier when breastfeeding your baby
• Granny undies - in case you have a caesarean section (more comfortable than bikini undies)
• Comfortable undies
• Comfy loose outfit and shoes to wear home

TO PACK FOR BABY

• Car seat for going home
• 2-4 baby grows and singlets to wear in hospital
• Light blankets (depending on summer of winter) or muslin wraps x 2
• Hat, booties, wrap and blanket for the trip home.

Otaika Road Midwives

Because you and your whanau are so important to us, the Otaika Road Midwives have re-vamped our reception area to make it more comfortable and informative.  Our ladies can now enjoy a relaxing and educational environment where you can watch pregnancy related videos and DVD's while your children are playing.

We look forward to seeing you soon.

Happy International Day of the Midwife

Happy International Day of the Midwife. May we continue to support each other and learn from each other. May we also remember our Sisters who have gone before us and have passed on their wisdom and knowledge to us.


To all Midwives and Mothers out there who have supported us in our struggle to regain our ancient art of midwifery, thank you all and for putting your trust in us.  

To Midwives across the world, Happy International Day of the Midwife.  We are all united in heart and spirit.

Advice to new midwives

A colleague recently asked me a question,  "If I could impart only one piece of information to a new midwife, what would it be?"


Without a moments hesitation I replied, "Treat the woman and her family as if she were the only one."  I believe a pregnant woman is at her most vulnerable time in their life especially if she is expecting her first baby.  She has never gone this process before, her body is changing rapidly, she may be experiencing morning sickness, she may be shocked at even being pregnant, she may have fears of what the pregnancy, the birth, or a new baby may bring.  


Give the woman and her partner time, answer their questions and be honest if you cannot, let them know that you will seek the advice of someone who may know the answer.  Share information with them through the pregnancy and although we cannot walk their journey for them, we can be there for them and to support them.  


They have given and entrusted us, the midwife a very special and sacred privilege, and that is to bring their newborn baby in to the world.  In other words, treat them as you wish to be treated yourself or how you would wish a midwife to treat your daughter/daughter in law/family member/friend.  

He aha te mea nui o te ao? 
He tangata! He tangata! He tangata!

What is the most important thing in the world?
It is people! It is people! It is people!