time flies when you're being a mum

Childbirth tagged with 'child birth'

How do you get a baby out? Well, there are about a million different ways to do childbirth and this aims to cover as many as possible!


05 Aug, 2012

So, I’m theoretically into my last week of my pregnancy – 39 weeks pregnant. I’m due next Thursday, 9th August, and I still have a piano and a sofa in my kitchen (well I did when I was writing this but then Mike’s family arrived to move everything so now I don’t). But, it’s over now. The floors have been sanded, they are dry enough to put pianos and sofas on top of and to top it off for the first time in about 2 weeks we have a bathroom door. The luxury! And, as my mum pointed out yesterday, the kitchen will feel MASSIVE when there’s no piano or sofa in it! Can’t beat her optimism.

The bathroom door – yes, there’s no doorknob and yes, it doesn’t shut but nonetheless, it’s a door!

In amongst all this mess I’ve been trying to remain calm in the hope that the baby will still come on time. I’ve also been thinking about natural methods of induction (in case babe needs a hand to feel ready), which has probably had the opposite effect of being calming.

It turns out that mums can get quite heated about the topic of getting your baby out! I asked Nuby if they wouldn’t mind posting a comment on their facebook page asking their mum fans what worked for them to bring on labour. The responses (all 209 comments!) ranged from sex and rasberry leaf tea, to NOTHING WORKED, to pull yourself together the baby will come when it’s ready so be patient, to, finally, it is irresponsible to try and encourage labour and Nuby should take the post down all together. The latter 2 comments made me feel like a bad person and I worried about it for the rest of the day and even had a cry that night (seriously sensitive man!!). Then after sleeping on it I felt a bit cross because if I have to be chemically induced at 42 weeks, then the baby isn’t “coming when it’s ready”. It’s being forced to come out in quite an aggressive way! I’m not going to go into the risks to mother and baby of being induced (you can read about that on many sites including this article on Baby Centre). But, here’s my two-penneth worth on the whole thing of natural induction…

My fear around physically having this baby is not about labour and the pain to me (although every time I get a twinge, muscle spasm, etc. I have started to think ‘Shit, this could actually be quite painful’! And, of course it’ll be more painful if I need to be chemically induced), it’s about making sure the baby comes out safely, without distress and is healthy. For this reason I want a natural birth and the likelihood of achieving this is reduced if you have to be induced. This is because there isn’t the natural build up of pain that you get when you go into spontaneous labour, and therefore the sudden pain means you are more likely to need an epidural. This, in turn, increases your likelihood of needing to have a caesarean (I’m finally going to write my birth plan this week so I’ll share that once I’ve put all my thoughts in one place).

I don’t want to put a dampener on things for anyone about to be induced because I know loads of people still manage to deliver naturally despite being induced and if it comes to it, I’ll be induced too. However, with my NCT buddies starting to go into the induction zone and with a week until I’m due myself, the old wives tales are starting to look tempting. I’d like to give them a chance to see if any of them will work to start getting this baby out the natural way.

All these tips come from my hero, Ina May*, of course,  and might seem stupid but I’m willing to give them all a try, perhaps you will too. All these recommendations are from the Midwifery Conduct of Care and are considered to be non-invasive or risky. So, as has been my aim throughout this pregnancy process to keep things light and calm, and hopefully distract from any neurotic thoughts – please pass the penis and let’s get stuck in. As it were.

Initiating Project Labour

1. You guessed it…Sex. As so elequently put by my midwife the last time Mike and I saw her – “plenty of sperm on the cervix” (imagine that in a really loud scouse accent and you got it – makes me smile every time, I’m going to miss my midwife!). Sperm is “the most concentrated source prostaglandins” (which is the hormone they try to mimic in many chemical induction medicines; however, the stuff in sperm doesn’t cause a hypersensitivity of the uterus (and other risks) that the medicines do) and is supposed to soften the cervix. Ina May noticed that the women who were bonking were much more likely to go into labour spontaneously at 40 weeks. Step it up Fellas. Avoid this technique if you have a history of miscarriage or premature birth.

2. Breast Stimulation. This was quite a surprise when I first heard about it at NCT but once I read about it it makes sense. Apparently, anyone who’s had a baby before will know that when they are breast feeding their uterus will contract back into place. Breast stimulation releases oxytocin, one of the main hormones required in labour (gosh, so technical!) and this causes the uterus to contract. Ina May says to try stimulating 1 and then if that doesn’t work go for the double twiddle (I’m paraphrasing)…

Now, a) my nipples feel weird and itchy anyway, b) the thought of either manual or aural stimulation feels a bit wrong and c) a friend of mine said that it makes your contractions more painful (I’ve not heard this anywhere else though). However, why not give it a shot? – it could work nicely in combination with point 1?! Cringe! According to Ina May, unless your partner is rubbish in bed, this is the most enjoyable method…she seems to be forgetting that we are massive now (and, therefore, are the rubbish ones in bed! – I feel like a cross between a beached whale and a turtle on its back. Lucky old Mike).

3. Caster Oil. Now then, this seems to have got a few mums’ backs up on the Nuby feed with a number of women stating how dangerous it is. My one issue with people saying “this is so dangerous, remove the feed immediately” is they haven’t said why it is or pointed to anything that adds to the debate, for example, an article which explains why it is dangerous. All I know is that Ina May, who has delivered thousands of babies naturally, says that there is little evidence to suggest that caster oil is dangerous…the oil acts as a laxative and if you’re full term this in turn can start labour. Nobody knows why it works and because there’s no money to be made out of it, nobody is willing to do any research into it. One study she does site is from a Birthing Centre in 1992 where 9% of 11,000 women used the caster oil method and there were no adverse effects (Rooks, J.P., et al., The National Birth Center Study. II: Intrapartum and Immediate Post Partum and Neonatal Care. Journal of Nurse-Midwifery, 1992; 7:301-30). If you do want to try caster oil, Ina May suggests adding one tablespoon to scrabbled eggs or juice (because it tastes rank) after a good night’s sleep. You can then take another tablespoon an hour after the first ‘if necessary’. Seems like quite a lot to me, so if I am going to try it I’d probably go for a lower dose.

The NHS doesn’t really have an opinion that I can find (my usual go to place) and Baby Center say they wouldn’t recommend it as it can make you nauseous/diarrhoea-y. However, it should be remembered that one of the signs of labour is that you may well feel sick or need to empty your stomach (one way or another) anyway! Here’s more from the Baby Center so you can decide for yourself: Can Castor Oil Bring on Labour.

Either way, definitely check with your midwife.

4. The sweep. I have a sweep scheduled for Thursday afternoon and when I told my mum this, she first of all thought I meant the chimney (and by chimney I then misunderstood her and thought ‘chimney’ was a new/old slang for virgina) and surely we should have done that before getting the floors done. Then she thought I meant a sweepstake of when the baby was due.

Neither of these is the type of sweep I’m having. A sweep is when the midwife sticks her fingers up your doodah in order to gently separate the water bag from the cervix. I can’t get my head around the logistics of how this is achieved while you can have sex without dislodging anything…but there you go. The success rate is about 50% so not amazing and I guess it depends on how ready you actually are. The midwife just needs to be very careful not to rupture the water bag.

 

So there you have it, hippy midwife, Ina May’s recommendations to start labour. I’ll let you know how I get on. I also have a whole bunch of other recommendations from other mums and a couple of theories of my own to share…However, for this week I’m going to concentrate on getting the house ready so I can finally relax!

 

* Please note that Ina May is a Midwife from the United States with over 30 years experience in natural birth delivery. She has delivered over 1300 babies (including breech and big babies) and has experienced first hand that if a woman is prepared for labour, has faced her fears and technological interventions are kept to a minimum (i.e. only when necessary – her Caesarean rate is less than 2% (it is over 30% in the United States) and her forceps/vacuum rate is less than 1%) complications and difficulties are extremely rare. However, if you do wish to try any of the methods she recommends, speak to your midwife first to make sure that they are suitable for you and your pregnancy as everyone is different.
18 Jun, 2012

I’m now 32 weeks pregnant and every time a week passes, a new (often terrifying) thing is brought to my attention.

32 weeks pregnant getting ready for boxercise

Perineum. There’s a word I didn’t know before I got pregnant. It’s the bit between your vagina and bum hole, and up until now I only knew this area, affectionately named by VIZ (a vulgar yet hilarious magazine that hales from Newcastle), as “the Humber Bridge”. The reason it has recently come to my attention is because I’ve just found out that poor little bit can TEAR during child birth.

There’s an element of ‘surely there are worse things to be worrying about during labour?’ Such as the excruciating feeling of each contraction and making sure you’re baby comes out free from distress and as healthy as possible, etc. etc.

While this is true and a little bit of tearing will heal fairly quickly, I still don’t want it to happen to me. What’s more there are actually 4 degrees of tearing ranging from the superficial to full tearing all the way to your bum that can cause anal incontinence. As if pregnancy weren’t bad enough! Plus you are more likely to tear if it is your first vaginal delivery, so that would be me.

The good news is you can prevent it (in fact I know someone who did the following exercise and it worked for her), or at least reduce the severity of any tears. As you can imagine, it is not an especially glamourous procedure, but if it prevents anal incontinence…

Babycentre advises us to do the following from 34 weeks pregnant onwards (although now I’m 32 weeks pregnant, I might start sooner rather than later!):

  • Sit in a semi-reclined position in a warm, comfortable area, with your knees bent and your legs apart. Lubricate your fingers, thumbs, and perineal area with vitamin E oil (from punctured vitamin E capsules), pure vegetable oil, or personal lubricant. Don’t use baby oil, mineral oil, or petroleum jelly.
  • Place your thumbs about 1 to 1 1/2 inches (to or just past your first knuckle) inside your vagina. Press down toward the rectum and toward the sides at the same time. Gently and firmly continue stretching until you feel a slight burn or tingling.
  • Hold this stretch for about two minutes.
  • Now slowly and gently massage the lower part of the vagina back and forth, hooking your thumbs onto the sides of your vagina and gently pulling the tissue forward, as your baby’s head will do during delivery. Keep this up for three to four minutes.
  • Finally, massage the tissue between the thumb and forefinger back and forth for about a minute.
  • Be gentle — a vigorous touch could cause bruising or swelling. During the massage, avoid pressure on the urethra (urinary opening) as this can lead to irritation or infection.

I’m going to need to reread that a few times before I fully get it and I would also suggest that unless you want your fella thinking that this is some kind of come on, you should take yourself off somewhere quiet and do it on your own!

There are also things you can do during labour to prevent tearing. Namely, try to resist pushing until you are properly ready, which can mean giving the baby time to move slowly down the birth canal and giving the perineum time to stretch.

Also, it’s said that if you have an episiotomy, you are more like to tear badly, i.e. 3rd or 4th degree tear. I don’t personally want to have an episiotomy, or an intervention for that matter, but for more information about episiotomies so you can make your own mind up, see Babycentre’s piece on episiotomy.

Tearing is potentially the thing that can get over looked during the birthing plan, but if you do talk to your midwife/doctor about your wishes about intervention they should certainly be able to advise about how to reduce tearing during labour and help you on the day too.