Ways dads can help manage pain in labour

Many men find it very difficult watching their partner in the throws of labour, unsure what to say, what to do and how to help with the pain.

Pain in labour is normal, I read somewhere that we should change the wording, from pains to "energy surges."  The reason is because we associate pain with something abnormal, of course we do, because its the body's way of telling us that the pain being experienced is something abnormal going on inside the body.

Pain in labour is normal as it means that your body is preparing you for the work of birthing a baby and the ultimate of joy of your newborn within your arms is the end reward.  Your body produces endorphins, which are a natural but powerful pain killer, as strong as morphine but without the side effects.

There are many things a man can do to help.  Even if nothing is said, just being there with you, reminding you to drink or nibble on some snacks for energy, massaging your back, encouraging you when you feel that you cannot go any further and making you laugh.  

"Ina May said, “We are the only species that can doubt its ability to give birth.”

What a profound statement.

She correlated fear in childbirth with pain. As in, the more fear you generate, the more pain you will feel. How do you help eliminate fear in a birthing mom? You focus on the atmosphere in which the woman gives birth in. She should feel safe and secure, private, the lights should be low and she should have her loved ones nearby.

Ina encouraged moms to spend time with their partners during labor. Relaxing, breathing, talking, laughing, touching, kissing–all of these things help bring the blood down to the part of the woman’s body which is opening during labor. This kind of activity produces oxytocin, which stimulates endorphins and creates feelings of love and inhibits pain"

For more information and beautiful photography, please see the link below.

Ways dads can help manage pain in labour

Why exercising during pregnancy is important

Walking, pregnancy yoga and swimming are great ways to keep you and your body healthy during pregnancy, also eating healthy foods is very important.  According to a physiotherapist any strenuous exercise that makes you overheated and gasping for breath is not good, so please check with your midwife first before embarking on any exercise and start slowly and gently.

"There is a vast amount of literature that warns women about the risks and dangers of exercising during pregnancy, and comparatively much less about how and why it is important. Research conducted on the link between exercise and pregnancy indicates that global trends continue to show decreasing amounts of physical activity and increasing percentages of obesity during pregnancy. While pregnancy may seem like a good time to relax because of back pain, fatigue, swollen ankles, and the general stress that come with preparing for a life-altering experience, here are some great reasons to become active again.

The positive effects of exercising during pregnancy are not limited to the physical health of your child at birth. Exercise and pregnancy actually go very well together. Exercise during pregnancy has been proven to:

• Elevate mood and reduce the risk of postpartum depression
• Prevent excessive weight gain and obesity
• Reduce the risk of gestation diabetes and pregnancy-related high blood pressure
• Boost energy levels and improve sleep
• Improve general fitness levels
• Ease back pain and other pregnancy-related discomforts

Besides your own health-status, the short term and long term health of your baby is also improved. Research indicates that babies of women who exercise are better able to tolerate the stresses of labor and childbirth than non-exercising women. Even in early childhood, children of women who exercise during pregnancy show better development and weigh less than children of women who do not exercise. Exercising moms also play a part in the health of their baby’s heart: the more frequently the mother exercises, the healthier the baby’s heart (lower fetal heart-rate and higher heart-rate variability).

The Royal College of Obstetricians and Gynaecologists and American College of Obstetricians and Gynecologists both encourage pregnant women to participate in exercise, with an aim of maintaining fitness throughout pregnancy. Current guidelines suggest pregnant women engage in 30 minutes of physical activity (moderate intensity) a day. Even if women were previously inactive, starting during pregnancy is not harmful if they are careful and start slowly. Before beginning any exercise program, pregnant women should consult their health care provider for an overall health check, including obstetric and medical risks."

Link

Midwife led birth centers, a key to reduction of caesarean sections and costs

"With health care costs skyrocketing and approximately one-third of all hospital births resulting in cesareans in the United States, childbirth overseen in midwife-led birth centers is emerging as a safe and cost-effective alternative to hospital births, cites a new study conducted by the American Association of Birth Centers (AABC) and published in the Journal of Midwifery & Women’s Health, the official journal of the American College of Nurse-Midwives (ACNM).

The safety and efficacy of child birth centers has been supported by well established evidence featured in The National Birth Center Study II. Most birth centers utilize midwives as the primary care providers, working collaboratively with physicians, hospitals, and other maternity care professionals in a team approach to maternity care. Midwives are health care professionals responsible for the pregnancy, labor, and childbirth care of the women they serve.

AABC President-Elect and founder of Charleston Birthplace, Inc. Lesley Rathbun, CNM, FNP, MSN describes a birth center as “a homelike facility existing within the health care system with a program of care designed in the wellness model of pregnancy and birth. Birth centers provide family centered care for healthy women before, during, and after normal pregnancy, labor, and birth.”

According to the study, of the 15,574 women receiving care in 79 midwife-led birth centers in 33 states from 2007 to 2010, 13,030 women (84%) gave birth at birth centers, while 2,544 women (16%) gave birth in hospitals."

Link

To midwives the world over : we are all resolute in our commitment to the health of woman and her family.

The love hormone (oxytocin) in childbirth and bonding

We have already discussed the wonderful effects of oxytocin, also known as the 'love hormone' already in this blog, this is an interesting article that readers may find helpful, especially student midwives.

"Researchers have found a new role of “Oxytocin” while working on one of the brain’s areas, in which biochemical messages are transferred from brain cells to the blood stream and from there to the body. Oxytocin is a hormone involved in childbirth, breastfeeding, mate-bonding and mother child bonding.

Three dimensional structure of the neurohypophysis

This research has been done by Dr. Gil Levkowitz of the Weizmann Institute and collaborators and published in the recent journal of Developmental Cell.

The area of study, known as “neurohypophysis”, is located at the base of the brain and works as an interface between the nerve fibers and blood vessels. Here, the hormones are released from the neurons to the blood vessels regulating some of the most important body’s processes like balance of fluids and uterine contraction in childbirth.

Levkowitz said, “The messenger helps to build the road for transmitting its own future messages.”

According to researchers, this research can open new ways of research on the regenerating ability of some parts of the brain.

Reference:

Gutnick, A. et. al. (2011). The Hypothalamic Neuropeptide Oxytocin Is Required for Formation of the Neurovascular Interface of the Pituitary. Developmental Cell, 21(4), 642-654."

The new role of oxytocin

Breaking the taboo - Breastfeeding in real life.

Beautiful pictures of women breastfeeding in public. Thank you to the photographer for normalizing breast feeding.

"An honest collection of photographs has sought to break the taboo that persists about breastfeeding in public.

Photographer Stacie Turner's series 'Breastfeeding In Real Life' shows scores of new mothers, not in billowy clothing on a mountaintop, but in the real world, when they're often nursing one child on a park bench or at a mall while 'trying to fish crackers out of a diaper bag for another kid' in an old T-shirt with spit up on it.

A strong advocate for breastfeeding, the Connecticut-based mother of 7-year-old twins began taking pictures of other nursing moms five years ago in a 'conscious attempt to normalize' the act."

"The resulting series transforms the everyday into something empowering."

Normalizing breastfeeding.

Hypnosis in labour.

Birth hypnosis is a childbirth method to help reduce pain and fear in labour.  This information has been obtained from the links below.

Hypno-what?

"Birth hypnosis is a method of relaxation that women can be trained to use during labor and delivery. Hypnosis may bring to mind images of a cartoonish man dangling a stopwatch in front of someone’s eyes, intoning, “You are getting very sleepy.” But in reality, it’s not like that at all.

Hypnosis, or hypnotherapy, is described as a state of deep relaxation (both physical and mental), thereby allowing the person to focus on a feeling or a thought by blocking outside distractions. There are several different hypnotherapy methods, but most will teach the mom-to-be to induce a state of self-hypnosis that allows her to visualize her cervix opening up and her baby descending through the birth canal.

“The name is quite deceiving,” explained Bethany, who is expecting her second child. “It's more like meditation. I took classes where I basically practiced visualization and relaxation techniques. You definitely get into a zone, but are fully aware of everything going on around you.”

Breaking the cycle of fear

"Birth hypnosis works by breaking a soon-to-be mom’s connection with her fear of childbirth — and the pain involved. Fear can lead to muscle tensing and fight-or-flight symptoms that can impede the progress of labor, and you definitely don’t want anything getting in the way of progression of labor and eventual delivery of your baby. “You are taught that if you allow either pain, fear or tension in, it'll lead to the rest,” shared Heather, mom of two. “So taking their teachings and listening to positive affirmations can calm your fears, which will release tension which will help your body work more efficiently and in turn you'll be in less (or no) pain. It's about trying to get your body and mind to work positively together for the best end result.”

Tiffany used Hypnobabies for her home birth and loved the course and what it taught her. A doula from a nearby community holds courses for parents-to-be where they can learn the techniques themselves. “The most beneficial part for me was the constant reminder that I was doing what my body was meant to do,” she happily remembered. “I had a calm peaceful birth at home and there were times I fell asleep on my birth ball.”

More about birth hypnosis

A New Zealand site

What is an Induction of labour?

What is an Induction of labour?

Induction of labour is the process of starting labour artificially, rather than waiting for the mother to go into labour spontaneously.  Approximately 20% of women in New Zealand have their labours induced.  The aim when inducing labour is to make the process as much like a normal labour as possible.

Why would I have my labour induced?

Induction of labour is carried out when it is felt that your baby would be better off out of you than inside.  This means that something that is making continuing the pregnancy risky - either for you or the baby.

There are many reasons why women may be advised to have their labour induced or started before the body has gone into labour spontaneously.

The most common reasons for induction are:

• Overdue or post dates - When a pregnancy continues after 40 weeks, there is a risk that the placenta will work less well and therefore not supply sufficient nutrients and oxygen to your baby, therefore putting your baby at risk.  Because it is not possible to accurately predict which placentas will not continue to function well, induction of labour is recommended between 41-42 weeks gestation. 
• Pre-eclampsia - when your blood pressure has risen, you have swelling on your ankles and feet and where there is protein in your urine.
• Reduced growth or reduced movements from your baby.
• Diabetes
• Spontaneous rupture of membranes (your waters break) prior to going into labour.

A stretch and sweep of the membranes

Before an induction of labour, your Midwife will offer a sweep of the membranes.  This is a procedure where the Midwife will perform a vaginal examination and the cervix is examined and 'swept', using a circular, sweeping movement to separate the membranes from the cervix.

Benefits

•  Increased possibility of labour starting naturally within 48 hours.
•  Possibility of not needing a formal induction of labour.

Risks

• The procedure may cause some discomfort but will not cause any harm to you or your baby.

Why is labour induced?  

There are several ways this may be achieved.

Artificial rupture of the membranes (ARM)

During pregnancy a fluid filled membrane sac surrounds and protects your baby while he or she is inside the womb.  In preparation for labour, the cervix (neck of the womb) softens and shortens.  This is called 'ripening of the cervix.'  and either before or during labour the bag of membranes break, releasing fluid.  This is known as 'your waters breaking.'

One way your labour may be induced is by artificially breaking your waters (ARM), this can only be done if your cervix is soft and has started to dilate (open).  If your labour does not start following an ARM, you may need to have an intravenous drip put into your arm and an artificial hormone called Syntocinon is started o make your womb contract.  

Breaking your waters should not be painful, it may be slightly uncomfortable.

Benefits

• Labour occurs.
• Labour may be shortened marginally.
• Information gained regarding the well being of your baby.  The water surrounding your baby should be clear in colour, if the water is not clear, your Midwife will monitor your baby more closely.

Risks

• Very rarely the baby's cord could come out (prolapse).  Midwives and Doctors are trained not to attempt an ARM if there is a risk this may occur, they are also trained to managed the emergency situation should it happen.
• During the vaginal examination by the Midwife, if your cervix is favourable, or has opened enough for your waters to be broken (if intact), a small instrument called an amnihook can be used to break your waters.  This is called 'artificial rupture of the membranes' or ARM.

This may be all that is needed to stimulate the uterus to contract and go into labour.  When your waters are broken, whether spontaneously or artificially, fluid will continue to drain out until your baby is born.

Prostin Gel

This is a drug intended to soften, shorten and open the neck of the womb (cervix).  It is put into the vagina next to the cervix at six hour intervals until you are in labour.

Once this process starts to happen, labour often follows naturally.  However, there is no guarantee this will happen and you may to have an ARM in addition to the prostin gel.

Benefits

• Labour process is started.

Risks

• Your baby's heartbeat will be monitored on the machine (CTG) before and after the insertion of the Prostin gel, so you will unable to walk around for the short time while you are being monitored.  Once your baby has been monitored, you will be able to get up and walk around but you will not be able to leave the hospital until your baby is born.  The Prostin gel is given six hourly.
• Prostin gel may cause vaginal irritation.
• It may cause 'period' type pains in your lower abdomen and backache.  During this stage, showers, warm baths, heat packs and massage may help.  If necessary, the Midwife can give you pain relief such as paracetemol.
• It may not work with the first dose and several doses may be necessary.

Syntocinon infusion (Oxytocin)
This hormone is similar to the one produced naturally by your body and is given to stimulate contractions.  It is given via an infusion pump into a vein in your arm, also called an intravenous drip.  This would only be given if your waters have broken either spontaneously (naturally) or artificially (ARM).

Benefits

• Labour may be shortened.

Risks

• Loss of mobility.  An intravenous drip will be inserted into your hand or arm and your baby's heart rate as well as your contractions will be monitored on the CTG.
• Your contractions are monitored on the CTG and the dose of syntocinon will be increased or decreased according to the number of contractions you have in a ten minute period.
• The need for pain relief may be increased.

Please speak to your Midwife if you have any questions regarding induction of labour.

The first Tiger Cub born in 17 years at the London Zoo

Well done Melati :-)

London Zoo has welcomed the birth of its first tiger cub in 17 years following a top secret operation.

The birth of the baby Sumatran tiger last month was captured on hidden cameras and is the result of careful monitoring by zookeepers.

The pregnancy was kept under wraps by zoo staff, who monitored mother tiger Melati from a distance using CCTV.

Melati's pregnancy lasted for a total of 105 days and it only took her a mere six minutes to give birth to her baby.  Zookeeper Paul Kybett said: "We are simply over-the-moon about the birth of the tiger cub; it’s a momentous occasion for everyone at ZSL London Zoo and a real cause for celebration.

"We were nervous about the pregnancy, as it was Melati’s first cub and we didn’t know how she’d react. When it came to her due date, we were all watching our monitors with bated breath.

Link

A newborn baby's scent fosters bonding with mum

This is a very interesting article.  I loved snuggling up to my newborn infants as their aroma was just so unique, now I understand why.

"The scent of a newborn baby really does tap right into the pleasure centers of a woman’s brain, whether the smell comes from her own baby or someone else’s, scientists have discovered. The new findings have been described in a study just published in Frontiers in Psychology.

“These are the areas of the brain that are activated if you are very hungry and you finally get something to eat or if you are a drug addict and you finally get the drug you were craving,” says study co-author Johannes Frasnelli, a postdoctoral researcher and lecturer in the department of psychology at the University of Montreal."

“Apparently nature has provided us with a tool that helps with the bonding between a mother and her newborn child. It’s very strong.”

Link