7/16/2020 0 Comments My Breastfeeding Journey...Archer was born at 12.41am on New Years Day. We had the magic golden hour and tried our first feed. I was told he was latched well but looking back it didn’t feel the same as what I now know to be a good latch. We rested and woke to feed again but he didn’t latch. I was shown how to hand express colostrum into a cup and syringe feed it to him. Lucky I could get a lot out! We left the birth centre that same morning and were told to keep trying to get him to latch. Our midwife continued to see us daily at home. He soon lost more than 10% of his birth weight and we progressed to feeding him by a tube on my husbands finger as this encouraged him to suck when the syringe didn’t. He would feed and I would pump so that I could pump for every feed he was wanting and teach my breasts to keep up with demand. It took until day 5 for my milk to come in and we saw a lactation consultant that was provided from the main hospital. It was with her that he finally latched well and over the next couple of weeks the direct breastfeeding started to outweigh the tube/ then onto bottle feeds. Night feeds were more of a struggle because we were all so tired. We were stuck on the night time expressed feeds for awhile but I still remember one night in the nursery when he finally latched easy. My fiancé woke up, came in and found me crying so started his usual pep talk about how feeding was always improving and I was doing so well. He got pretty far into the speech when I sobbed ‘no, he is actually feeding!’ By 6 weeks post-partum we were doing great! We survived my partner going back to work, cluster feeds and growth spurts. I had a worry of him not latching though so I started to develop a good freezer stash. We fed through reflux and thought I would have no problems of meeting my 6month goal that I had set as that was when I was going back to work. At 3 months though Archer just stopped gaining weight. We saw various doctors for 2 months for them to come to the conclusion that he was healthy and just small. It was such a stressful time for me though. We used the entire freezer stash on ‘top up’ feeds. We eventually started solids at 5 months under Dr advice to try and have him gain weight. Due to the looming start of work deadline, no freezer stash and still needing to gain weight, we introduced 1 formula bottle a day at 5.5months. a friend took some beautiful milk bath photos to celebrate how far we had come from initially thinking we may not even get 1 feed! I still wasn’t ready to stop and continued to pump twice a day at work and direct breast feed whenever I was home. Between 6months and 11months I ended up with Mastitis 4 times which made my lazy boob an even lazier one and I decided to permanently ditch the pump in November before our wedding. At around 8months we switched to 2 formula feeds a day and celebrated another milestone by taking our own milk tub photos in a local park. Between life working full time, continuing to breastfeed, be a mother and plan our wedding, I lost a lot of weight. At our wedding I was less than my pre-pregnancy weight by around 2-3kg and holding Archer against my chest was physically painful. I really wanted to meet the 12 month goal but at 12 months I decided I was ready to ditch all but our right before bed feed until whenever Archer decided to self wean. I thought this would be 2 years or more but he had other ideas. At 13 months he began refusing the breast and all bottles/cups of milk. I began pumping again ‘just encase’ but he never changed his mind. My pumping was less than 30ml at a time, so I used the milk for icy poles for teething. To me it showed he probably had been comfort sucking rather than drinking at bed time for awhile. By 14months post-partum I completely stopped producing milk but used my weaning pumps to make some frozen teething treats and amounts to use on his breakfast cereal until around 14months. I also had a breastmilk ring made and put a photobook together for Archer of all our photos, including one of our ‘last feed’ The one thing I never expected from our journey was how strong and forever changing the emotions were. Especially the grief of ended when I have no doubts that was the best time for us both. Sometimes I even think I was completely crazy for feeding as long as I did. Even 2 years later when he gets a cold I guilt myself to thinking ‘should I have pumped longer to feed him through this!?’. I have been lucky to have so many wonderful people around me that have always been there to listen to me in these times. I will always be grateful for the sisterhood of support xx Image by Stephanie Reid
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7/7/2020 1 Comment My Birth Story with ArcherRead about my Pregnancy in my previous blog post! On December 31st I woke up and was 39 weeks pregnant exactly. I had a sudden urge to clean all the house windows. Something I have never done before and have not done since, but that day they had to be done. My fiancé sensed the crazy about to start and was also getting cabin fever, so asked if he could go to watch a fight at the pub with some friends. Maybe after we would even drop in at a new years eve BBQ before resuming our shut in? I made him swear not to get drunk but we both thought “2 or 3 weeks to go, there is no harm” I began washing the windows and flooded the garage in the process. The water was creeping towards a fabric backpack so I moved it. It was really heavy! I was already sweating from the hot summers day working outside so declared that it was time for a break and I did not want to injure myself so close to the birth. I went and sat down to watch a movie early afternoon. During the movie my stomach began squaring off, just like my midwife had pointed out just a couple of days ago as being Braxton Hicks. I still didn’t feel anything but began watching my stomach and not the movie. I thought I had just done too much. They happened every 5min for 30min or so when I message my friend and said ‘aren’t they supposed to be irregular? Is it Braxton hicks? Is it contractions??’ I was so confused but kept timing. After 1 hour and still not feeling anything, I decided to go nap just encase. But I could not. Id changed positions, drunk lots of water but they still continued every 5 minutes. Eventually I got out the yoga ball and started bouncing to see it anything changed. I was doing this when my fiancé returned home. He took one look at me and shouted, “we said we weren’t doing anything to start labour!” (by that he clearly meant he wanted the sex option if we were going to be trying anything off the list and was feeling jipped) My response was ‘I’m not trying to start labour. I am in labour’ his face was hilarious! He was shocked and then asked why I hadn’t called, and do we need to leave? I explained that I still didn’t feel anything but it was a regular movement every 5 min. for about 3 hours at that point. There will still no other signs of labour. We decided to eat early and go to bed super early. We still thought ‘this could go on for days but we will rest just incase tomorrow is the day’ We sat down to eat just before 7pm. As I walked to the table another squaring off happened but BAM I felt it in my back as strong as my period pain (for which I have often skipped work even with pain medication). I ate dinner standing up and then got in the shower. By that point it had been 3min apart but with feeling for 30-40 min. I had my fiancé call the midwife to see if we should be leaving soon (I had it in my head 5min apart for 1hour but I don’t think we had really gone over it with my midwife). As my midwife wasn’t on call he spoke to someone else. I was mid contraction so after he hung up and told me to leave in an hour, we had a disagreement on if she actually meant wait 1 hr or go in after 1 hr of the contractions…which would mean we leave very soon. My friend who was attending the birth was 1 hr drive away so we eventually decided to let her head to our house and we would leave when she got there. If needed she could just meet us at the birth centre as that was on the way to our house for her. My fiancé tried to pack my bag in the car but I wouldn’t let him leave my side. I was mostly in the shower on the yoga ball or squatting but also sat in the bath and on all fours on our bed before heading back to the shower. All fours was really uncomfortable to me! I went to the toilet and saw a spot of blood. I think this was my mucus plug/ uterine seal so I shouted out ‘yes I am actually in labour!’ I was in the shower when my friend arrived. I got dressed, We packed the car and left. The car ride was unpleasant as I couldn’t move. We also had another disagreement when my fiancé drove via the Leederville exit ON NEW YEARS EVE! Lucky there was no additional traffic at the time. We arrived at the birth centre between 10- 10.30pm. the midwife on duty said she would be the one there and they would call my midwife to come in when she thought I was closer to pushing. I didn’t want to have vaginal exams other than on arriving, so I had the doppler put on then my one cervix check. I was so disheartened to be told “you are just 2cm- maybe 3. You are going to be here for along time. I would send you home and I would if we were busier.” I was told I didn’t have to worry about a new years baby because he wouldn’t be born that soon. Lucky for me that I was the only person in the centre at the time and I told her I wasn’t getting back in the car. I wanted to get in the bath but was told I should wait until further along. At this point I thought I was going to end up with an epidural despite desperately wanting to avoid it. I was already tired from squatting for 3 hours and not having more than 2-3min between surges. I felt so defeated by this one comment and wished I hadn’t of had it done. I got in the shower on the ball again but loved that this shower had one nozzle on my front, one on my back, and enough space to have all of us there sitting together. I was so thankful to have my friend there. She was 7 months pregnant at the time but took it in turns with my fiancé to massage my back, hold the shower head on my back and they talked and laughed which helped his mood and mine. I remember coming out of the peak of my contractions to hear them laughing. it was a really good energy with the 3 of us. (well 5 including our 2 wombmates!) At some point my friend said ‘do you want to get in the bath now’ as I think she noticed things were picking up. The midwife filled the bath and I got in. I was still trying to find a comfy position when my membranes released so I was literally in the pool for about 5mins or less. It left like a spa jet on my leg. The midwife was brought back in and checked with a torch. She suspected meconium (when baby poos in the womb) but none of us could see anything. She checked baby heart beat with the doppler and my temperature, for the 2nd time since arriving, which were both fine. I was told I'd need to get out and possibly be transferred to the main hospital for further monitoring. I felt calm and ok but just didn’t want to have to lie down on a bed to move. As soon as my membranes released I had some non stop surges/contractions so stayed in the bath until I was able to move. I got out and a giant pad was put between my legs. I was told it would be checked in 5 minutes and nothing on there I can stay in the birth centre. I sat on the ball again and someone tried to towel me off. I felt suddenly hot and threw it off. I don’t think anyone else noticed or realised but looking back, I was in transition phase at this point. My friend offered me the gas and I took it. I hadn't ever thought of the gas nor wanted it but she could see that my 2 water options had just been removed and everything was building. I instantly felt dizzy after trying the gas and like I wanted to pass out so yelled out ‘lay me down lay me down’. I rested on the bed on my side. The midwife grabbed the pad, said it was clear and asked if I wanted to get back in the water. The gas kicked in and I felt like I could rest my legs finally so I said ‘20min rest then I will go back in and continue gas free’ She left the room and I continued to suck on the gas. Suddenly I heard myself do this massive deep groan. I thought my body was protesting to the side laying position but I kept saying ‘just 20min just 20min’ to myself. I saw my friend leave the room and thought ‘stupid! You can use the toilet in here’ and a combination of 'why are you leaving me!' I didn’t know she could see my body was pushing and went to get the midwife. My friend, my midwife and the original midwife entered the room. My midwife said ‘hey I almost missed this! His head has crowned and everything. She took the gas off me. I didn’t know until later but she was called with an update when my membranes/water released but was told don’t come in just yet- it will still be awhile. She decided no, id been to calm all pregnancy and left at that moment. If she hadn’t she would have missed things completely. I could feel a pressure as his head moved down, then moved back up, exactly as they explained in the birthing class. I was told to stop pushing and just breathe, even though I'd never actively pushed (that I was aware of). I was then told to try and do one push to help his shoulder. I was laying on my side and thinking ‘well tell me HOW I push? What do I do???” they just kept saying ‘push push’ so I decided well I heard its like pooping and maybe if I do poo they will realise they need to tell me what to do?' But I didn’t poo, he came out completely and was put on my chest. We didn’t know the gender and had 2 names to choose from. We had decided my fiancé would tell me the gender and we would decide a name, but as soon as I saw him I just kept repeating “Hi Archer, you did so well!” Eventually I asked “Well is it a boy?” and my fiancé just nodded and said ‘I guess the name is decided then!’. The one thing I did like about having a land birth over a water birth was that after his birth, I rolled to my back and we stayed there for a couple of hours. The birth centre policy is to get out of the birth pool for the placenta delivery, which when I had witnessed this with my friend, looked a little uncomfortable to move so quickly. While the waterbirth would have been great, I wasn’t disappointed that it didn’t happen for me. In my birth plan I had stated I preferred not to have a managed 3rd stage (injection to release the placenta) but after 1hr it had not released on its own so my midwife revisited the idea with me and I consented. I had the placenta encapsulated and we didn’t cut the cord until the placenta was birthed which allowed for optimal cord clamping. While I do think I had a great birth and am excited to get to experience it again, the 2 things that I want to change in my birth plan for the future is to not have the gas nor the injection. My aim was always to do it without and I now know there are things I can do to help that plan, such as making sure my team knows not to offer me any gas or pain relief, to trust and listen to my body rather than the cervix measurement, and I can change position or try hypnobirthing techniques to apply to the birthing of the placenta, not just use those tools for birthing the baby. Archer Patrick was born on 1/1/2017 at 12.41am and given his middle name from his grandfather. He was the 1st baby born in the birth centre for 2017 and the 2nd for King Edward hospital by 4minutes. My ‘pushing faze’ was noted as 16minutes and due to being 2cm in admission my ‘active’ labour stage was noted as ‘estimated to be 2hours’ Due to another birth at the centre 2 hours later, we were allowed to stay a little longer than the usual time frame of 6hrs as the paediatrician came over just once. We were home at 9am complete with Maccas Breakfast drive threw on 1/1/17. That night I sat in my loungeroom watching the news report the ‘first baby of the year’ born at 12.57am in midland. My midwife was disappointed we didn’t get to be the 1st and be interviewed on TV but we were very happy not to be! We called our families as soon as we got home, who all thought we were just breaking our silence to wish them a happy new year. I will never forget saying to my mum “it’s a boy” and she just said “yes I said HAPPY NEW YEAR TOO!” Despite not wanting a public holiday baby, I now can’t imagine a better way to have started our 2017. Breastfeeding Journey Story coming soon! Image by Bella Julie Photography
6/30/2020 0 Comments My Pregnancy Journey with ArcherIn April 2016 we (ok mostly me) decided we would start trying for a baby. We had been together 2 years, known each other for 10 years and been living together for 1. My partner was a student but had a job offer which would mean us moving to a small town down south at the end of 2016 or beginning of 2017. I wanted a summer baby and would be unlikely to find a job post move anyway but my partner would actually be earning money, so we decided to try for 2 months and if nothing we would wait a full year until a more “ideal” time. That 1st month however, my partners grandfather got really sick so a week was spent in a study-work-hospital cycle followed by him sadly passing away right before our 2 year anniversary. With all this happening we only got to “try” for our baby once and it didn’t feel right to force anything.
In May, right after the funeral we went to China for our 2nd anniversary and both my partner and my best friend had been saying ‘your pregnant for sure’ because I had been grumpy but I did not believe it all. I had no sore boobs or ‘normal’ symptoms, my period was late but that was normal for me to have it be irregular and we had had lots of added stress with granddads passing. I also thought that for sure with Murphy's Law that my painful cramps would appear just Intime to hang around for our little trip. I did have a moment of nausea on our very turbulent flight but half the flight could be heard vomiting! Later in the week I found myself unable to finish a meal which was really strange but I didn’t test in china then not understand the result. Plus I did not think I was pregnant at all- there is no way we would get pregnant from 1 time right. There was just no way. The day we came home I did a blue dye test and there was the faintest line. I thought it was just an evaporation line and not a positive so sent a photo to my friend saying “See- I'm not” the reply was “no- you are! Get a digital test”. I rolled my eyes and went and got one hours later to prove her wrong. To see the ‘yes’ made my eyes widen and my friend just say ‘I told you so’. I started thinking of a cute way to tell my partner but at some point that day he said ‘oh did you get a test’ and I just had a goofy grin that gave it all away. From that day I woke up every morning and said “happy healthy baby, happy healthy pregnancy, happy healthy mumma, happy healthy birth” From being at my friends waterbirth year earlier I already knew I loved the birth centre for its relaxing environment and I had a major fear of getting an epidural so I liked that it wouldn’t even be an option for me if I went there, but I could still transfer to the hospital easily if I changed my mind. I was always the 'sick and unhealthy' friend cancelling on my friends, being off school etc though so I was really determined to have this be the one thing my body was capable of doing. We did a tour of the birth centre at around 14weeks followed an hour later by our public hospital options (for me private wasn’t an option due to money and the high c-section rates these hospitals did have). The difference in the 2 environments and the way the staff spoke to us on these tours just completely made the decision for us that birth centre was the way to go. They told us our midwife would be mostly visiting us at home anyway so we were left with no barriers or concerns about parking and the longer distance to the Birth Centre. Our family, friends and strangers, were not on board though. They didn't know anything about the birth centre or physiological birth but had determined that birth was scary and painful and that I wasn't capable of going drug free (because apparently strangers can tell that by looking at you) so everyone I spoke to projected their birth fears and myths onto me. I quickly left social media to focus on the birth I wanted and knew I could have and had evidence to support. Nothing was going to cloud the amazing experience I'd had of witnessing my friends gentle, calm waterbirth previously. It was also amazing to learn that one of my friends was pregnant with her 5th baby and due 8weeks after me and another with her 3rd 16 weeks after me. So I had ‘Pregnancy Buddies’. Throughout my pregnancy I became more physically active then I had ever been. I did pregnancy belly dancing from 14weeks, pregnancy yoga from 18weeks (I was so UNACTIVE before that I even hated yoga), walked daily and also joined a water aerobics class. Yoga had great benefits and taught us all about breathing and positions for labour. I desperately wanted to do HypnoBirthing but at the time the cost was too high for us. Since then I have learnt that my birthing experience is more important than what my wedding day was. I wish I could go back, shake myself and yell 'SPEND THE MONEY, YOU ARE WORTH IT!' I read the book and had the mindset of a HypnoBirther. I had been doing affirmations and blocking out negative stories and not even realising it. My pregnancy went very smoothly and easily. I had no morning sickness. I dry renched maybe 2 or 3 times total. So we began a ritual of waking on a Friday morning (my ‘turn over day’), reading the weekly report from the pregnancy app on the size of baby, then using a doppler my friend loaned me and eventually taking a bump date picture. It was magical for the 1st time to hear the heart beat at 10weeks to have been just us and no technician. We had had a dating scan at 8weeks and saw a heartbeat but weren’t played any audio. This was also helpful to find the area to aim the doppler. My partner didn’t believe me at 1st but took my pulse as we listened and his expression said it all. No concerns came up in any of the check ups. Baby was head down from the 20 weeks scan and he didn’t move out from this position. I was never uncomfortable or waiting for it to be over. My midwife was always commenting on how calm I was and saying 'Are you SURE you don't have anything your worried about or want to discuss??' My son wasn’t overly active but had a set movement pattern that I go used to quickly. I had no uncomfortable rib jabs but did over do it one day and hurt a muscle in my ribs. It went away just in time for the pelvic pressure to start, but it was never unbearable. Especially with regular Yoga and Chiropractic care to help. My partner had a theory that labour wasn’t going to start soon because I wasn’t complaining yet. At 28 weeks we did some maternity pictures. I had my belly painted by a great artist who later painted my belly cast that we did ourselves at 38weeks. We set up a 3d ultrasound, as being considered low risk, we weren’t due to have anymore scans after 20weeks but wanted a chance to see baby again. At this appointment my partner proposed. It turns out my midwife had been in on it as well. I had booked a place and forgot then name, so she had been trying to get it out of me to tell my partner. He ended up calling lots of places to see where I had booked, many wouldn’t say anything due to privacy. In the end he found the place and instead of them labelling my sons heart or foot etc, the technician put ‘will you marry my daddy’. I turned into a blubbering mess, covered in ultrasound gel and with my belly exposed in our engagement photo! I was excited and looking forward to meeting my baby. But had it in my head that 1st time mums usually go into labour at 41w3d on average. So I worked until 38 weeks. I would have gone longer but my workplace shut down for Christmas and I would have needed a 2nd Dr clearance for them to have let me. I didn’t want to sit at home bored- yoga and swimming had also stopped for the holiday break. We also learnt that the job offer my partner had had fallen through so I wanted the chance to save as much money as I could. On boxing day we decided to have our phones off to anyone except our midwife and my friend who would be attending the birth. We both stopped any social media and focused on the last time we would get having it just be the 2 of us. We went on some dates and just spend lots of time together. I wasn’t aware of Braxton hicks until my 38 week appointment (which was actually done at 38 and a half weeks due to the holidays) when I had one while my midwife was measuring me and pointed it out. She asked if id noticed that happening the past few weeks but I said no as I didn’t feel anything while it was happening. We joked that I would probably have a new years baby because she wasn’t on call over that time for and I was desperate to NOT have a holiday baby. She gave us the list of natural induction methods so we could actively avoid each and every possible one of them! Myth or not, I wasn’t taking any chances but we decided that we would allow ourselves to resume life as normal with hot curry and beach walks after Jan 2nd 2017. (due date was 6th Jan) We went to a float tank experience just after Boxing Day. The pamphlet said it could start labour but my midwife said ‘no go for it, it will leave you feeling relaxed but that’s all” She left saying ‘ I don’t think I will see you for a 39 week appointment. Have a good new year’s eve and see you at the birth centre’ I just smiled and nodded thinking she was joking….. Birthing story coming soon! 5/6/2020 0 Comments The 5 Love Languages of BirthYou will hear over and over again that Oxytocin, the love hormone, is essential in birth. Therefor it is essential to know how to make the birthing person feel loved. Just as we all think, feel and learn in different ways, we show our love in different ways. Knowing how you and your partner give and receive love can help you to understand each other, improve your relationship and assist in the birth environment. It can also help the relationships you have with people around you or with your children. Below I have listed the 5 love languages with examples in everyday life, then how they can be applied during birth.
Words of Affirmation * Giving compliments. * I appreciate you because... * Saying 'I love you'. * Birth Affirmations. Acts of Service * Housework such as cooking or cleaning. * Offering to run errands outside the home. * Make sure birthing person is eating & drinking. * Help to set up the birth environment. * Buy or set up the Nursery during pregnancy. Gifts * Purchasing or making gifts they like. * Picking flowers. * Choosing their favourite juice over your own etc. * Keep a surprise gift aside for birth and give it in early labour (a "push present"). Quality Time * Spend time together without phones or distractions. * Meaningful conversation. * Eye contact. * Allow full focus to be on the birthing person. *Only leave the birthing person when asked by them. Physical Touch * Hugging. * Kissing. * Massage. * Birth positions that involve the partner. Want to know more? Hypnobirthing classes can provide you with a tool kit of ways to help during birth and incorporates many of the love languages. Head to the 'Contact' tab to book in. You can take a quiz and find out what your love language is with the book "The 5 Love Languages" by Gary Chapman or at 5lovelanguages.com Whoops.... I edited this list too many times. A new updated list can be found here: hartleysmeadow.weebly.com/blog/independent-midwives-in-perth-western-australia Watch any birthing scene in a movie or tv and women are laying on their backs. With 68% of all Americans labouring this way it certainly is common. However, just because something is common doesn’t mean it is evidence based or beneficial to the birthing person. There are many benefits to mother and baby by moving off the bed and into an upright birthing position.
Why are we on our backs? It started with a King wanting to watch his mistress birth as a perversion, but the trend really took off when royals began using pain medications during birth. Doctors were needed to monitor the drug’s side effects. More and more women were birthing with a doctor to access pain medication and turning away from female midwifes. The Doctor wanted easier access for THEMSELVES, combined with the inability to move or interventions being required with the pain medications. Women moved out of the upright birthing positions they had been instinctively moving into since the dawn of time and onto their backs. What’s wrong with being on our backs? Think about how we poo. Would laying on your back be a comfortable or easy position for you? Would it cause you to strain and push harder from being in this position? Now think of baby, being pushed up hill through the birth canal - no wonder it leaves women red faced and strained. Unlike a poo however, babies’ weight can lead to reduced blood flow and oxygen to both the baby and the uterus. Lack of oxygen can put baby into distress and have the uterus work less effectively. The same as if we don’t get oxygen to our muscles when running. Most women are told to avoid being on their backs during pregnancy for this reason. Back laying can also press on the tailbone, reducing its ability to create space within the pelvis for baby to descend. In addition to the physical aspect, back positions tell birthing women to ignore their instincts and leave them exposed to others. This may leave mum feeling disempowered. Benefits of Upright Birthing Positions *Gravity aids baby’s decent *Increase space in the pelvis by up to 30% *Decrease in the need for medical assistance such as vacuum, forceps or episiotomy (up to 21%) *Baby is less likely to become distressed *Pushing phase is generally shorter *Reduced need for epidural & caesareans Positions Standing Allows baby to work with gravity and take pressure off the back. Birthing person can stand alone, against a wall or against their partner. The position allows for full access to the belly and back for massage, heat packs or water use (such as in the shower) Squatting Squatting can help to open the pelvis and shorten the birth canal. A partner can support the birthing person under the arms to take some pressure off the legs if needed as this position can easily become tiring. Hands and Knees This position involves being on all fours on the floor. Variations can include arms resting on bed, ball or partner. It takes pressure off the spine and may help babies oxygen levels. Sitting Sitting allows the mother to remain upright but rest arms and legs. It can be done on a birthing stool for access during birthing phase or on a ball to allow for hip movement. Side Laying Is great for when a rest is needed, or an epidural is used. It takes the pressure off the spine and can be used with a peanut ball. For birthing, the partner, mother or medical team can support the upper leg. Ultimately, go into a position that just feels right to you. Your body knows what to do when given the opportunity! Partners can encourage this by placing a bag on the bed and knowing some of the above positions to suggest. The medical team is capable and WILL adapt to any position you choose to birth in. References: Get me out: A History of Childbirth from the Garden of Eden to the Sperm Bank by Randi Hutter Epstein https://evidencebasedbirth.com/evidence-birthing-positions/ https://www.cubmama.com/ thebump.com 10/22/2019 0 Comments Questions to ask your OBFinding a birth team that is on the same page as you with your birth preferences is so important. Here are some questions to think about as you interview Obstetrician's. Remember that OB's are trained in high risk births and surgery. If you are wondering if they may be the best care option, see my previous blog Birth Options in Perth.
1. Are you available for my Estimated due month? (38 weeks to 42 weeks) While they may be happy to take you on regardless, is their own holidays going to lead for a push for intervention to fit them? Would it make you uncomfortable to have a different OB for part of your care? If you are a private patient paying for continuity of care and this isn’t available, does this make public or midwife care more appealing? (some OB’s may not be willing or be obliged to give this information but it is worth asking) 2. Who is the back up for if you are called to another emergency while I am in labour? Will you be comfortable with this person/back up plan? Is this person also in line with your birth plan? What will your OB do to ensure your comfort and continuity of care. 3. What are your individual c-section rates as well as those of the hospital? WHO (World Health Organization) recommends a rate of 15%. If the OB has a high number- does this mean they are inexperienced in physiological birth and how to support this? If a caesarean is part of your plan, high numbers and experience can be reassuring. 4. What are your induction rates and what do you consider a reason to induce? Similar to the above- does this OB know how to support an uninterrupted birth process? Are their reasons to induce labour evidence based or on a case by case basis? Will they assume, or pressure you to have baby by a certain date (linking to question 1, they may also may not make themselves as available to you on the assumption you will have for sure had baby by x date) 5. Are you trained and feel comfortable supporting a vaginal breech delivery (or other variations such as twins)? Breech is a variation of normal and does not necessarily mean a planned c-section is required however most medical providers have lost this skill and it can be a push for intervention. OB’s are unlikely to support this and it would mean a transfer. 6. Third stage labour management and options? Just as you have options in the management of the birth of your baby, you also have options in the delivery of the placenta. Do they know how to support, and have experience in, an intervention free third stage? 7. Postpartum care plan and support- what services or care is available or provided? Having a postpartum plan is as important as a birth plan. What services and support will the OB continue to provide or refer you to? Is there a lactation consultant or physiotherapist they can provide? What visits or checks will be done and at what time frame? 8. How many of your patients have a physiological, intervention free, birth? Is this person the best option to support something they have never seen or rarely seen? Unfortunately, the number of women having an intervention free birth is on the decline in Australia. Are they doing anything to increase or support physiological birth? 9. What are your thoughts on hypnobirthing, doulas or birth photography and will you be supportive of me using these? These questions are not to ask the OB permission but whether their philosophy matches your own. If they say no you may not be on the same page. Best to know before you butt heads down the line or pay deposits. Are they tolerant or all for these tools and know how to work as a team to ensure the birth experience YOU want? 10. Are you supportive of and able to perform maternal led caesarean/ gentle caesarean if the need arises? This request may need to be discussed or set up in advanced or only available in certain circumstances. It will require the OB to be aware of these techniques and supportive of the care plan. 11. What kind of monitoring options are available to me? Continuous monitoring can have the mother feeling as if she is confined to the bed, limiting birth position options as well as other research to suggest they do not increase the number of better outcomes in low risk pregnancy. Does this location have wireless monitoring to allow you to move around or support intermittent monitoring? 12. How are you supportive of me creating an ideal physical birth environment? Can you take control of the room, bring birth balls (if not provided), play your own music or have essential oils in the room etc? Does this location provide some comfort measures such as birth balls, low lighting and water? Are they open to putting medical equipment out of view? 13. Should I write a birth plan? What things should I include? If the answer is ‘you don’t need one because I will take care of everything’ they are saying that you don’t get a say or an input. Find someone who is asking you what the preferences are not telling you how it will be. And a question for you to ask yourself… What vibe did you get from this OB? If you love to laugh and joke but they seem too serious, do they seem hard to answer questions or talk too much and irritate you? They may seem silly compared to how many degrees or experience they hold but having someone that you are open to speaking to and will make your birth space feel safe and supported. Pay attention to that intuition that tells you if something just seams off- no matter how well recommended this person may be. Remember that this is your individual experience and what suited your family member or friend may not be what best fits with your birth preferences. 9/27/2019 2 Comments Birth Options in PerthWhen you first visit your GP to confirm your pregnancy, they may ask if you have private health insurance and refer you based on this information, but there ARE other birthing options available to consider, each with their own individual differences. It is essential to look at all your options to try to achieve your desired birth outcome. Before choosing your place of birth or our provider, take a moment to think “what does my ideal birth look like?”. Once you have that image, lets explore who and where can provide that to you. If you were to plan a vintage bathroom makeover, would you pick the builder that has no or little experience in vintage bathrooms but does great modern kitchens? We need to place the same importance on finding our ideal birth teams.
Midwife lead care Midwife lead care is an excellent care model for low risk pregnancy. It is associated with lower instrumental delivery, lower c-section rates and higher rates of spontaneous full term labour. Having a midwife allows for continuity of care by having the one midwife, or a small group of midwives, to attend to your care. Your midwife lead care options in Perth are: Midwife Group Practice (King Edward and Armadale). Publicly funded. Community Midwife Program (homebirths or selected hospitals- King Edward, including Birth Centre, Fiona Stanley, Kalamunda & Armadale.) Publicly funded. Independent or Private Midwife- homebirths, King Edward. Private homebirth midwifes are usually equipped or trained for more diverse birth variations than CMP. Private billing but part rebate from Medicare. Obstetrician Obstetrician’s, or OB’s, are trained surgeons and trained in high risk pregnancy. When an OB takes on the care for a low risk pregnancy, they have a higher rate of intervention than their public or midwife counterparts. They are the only care providers that can perform a caesarean section should it be required. GP Shared care Care plan including tests and check ups are performed by the GP then transferred to hospital care in later stages of pregnancy. This is a good option for remote locations where hospital access is limited or if you have a great preexisting relationship with your GP. Not all GP’s are able to provide this service. Private Hospital You may choose to go to these hospitals without health insurance and pay the full cost. It is worth noting that even with insurance, there may be out of pocket costs dependent on your policy. Private hospitals boast that the experience is like a hotel with good food, nice linen and private rooms. Private hospital care has higher intervention and c-section rates. Past rates are available online (see page 46 on the below link) Current SJOG rates are posted monthly on their Facebook pages. https://ww2.health.wa.gov.au/~/media/Files/Corporate/Reports%20and%20publications/Perinatal%20infant%20and%20maternal/WA_Mothers_Babies_2015.pdf Our Private Hospitals in Perth are: Joondalup Private- bath for labour only Glengarry Private St John of God (SJOG)- Midland, Mt Lawley, Subiaco, Murdoch – bath for labour only Public Hospital Public does not mean a lower standard of care. Private rooms for laboring and birth are usually the hospitals preference. Staff in attendance will be who is on duty at the time. Our Public Hospital’s in Perth are dependent on postcode: Armadale – water birth options if an appropriately trained midwife is on duty at the time Bentley King Edward Main Hospital- 2 baths available for laboring only. Family’s can bring their own birth pool if this is approved by their own consult team. King Edward Family Birth Centre- Waterbirth available Fiona Stanley- water birth options if an appropriately trained midwife is on duty at the time Osborne Park- bath for labour only Joondalup Rockingham Midland Birth Centre King Edward Family Birth Centre Located outside of King Edward Hospital with a connecting tunnel into the hospital should a transfer be required. A birth center is run on Midwife lead care and care is provided by one assigned midwife. There is a Low risk medical requirement. It offers a Home style environment where the birth partner can stay in your own private room. Water birth option in one external suite with additional blow up pools available. Falls under the Public health system so there is no cost to parents. Discharge after 4hours (dependent on circumstances). Catchment area does not apply but does require to register early due to popularity. 4 suits and 1 inbuild birth pool. Fiona Stanley Located inside the main hospital on the same ward as other birthing suites. 3 birth suites, 2 with inbuild pools. Low risk medical requirement. The rooms have modern equipment including positioning blocks, however it currently holds a high transfer rate. Home birth Home birth, as the name suggests, takes place in the birthing persons home. Care is provided by one midwife, either through the CMP or an independent. This birth options allows the birthing person to be in an environment that is most familiar and comfortable to them. Statistically home births are safe options, with countries who have high home birth rates, also having lower c-section rates. A relationship is usually made with a nearby hospital should the want or need arise. A full list of Independent Midwives in Perth can be found at my blog post HERE Freebirth Freebirth is when a birthing person intentionally makes the decision to birth without any medical person present. This absence of care may be limited to the birth or may extend to pregnancy and prenatal care. This option allows for all decisions to be made by the birthing person. While it is possibly the lesser known about or taken option, there are still some local and international support groups and podcasts on the topic. Doula A doula will assist with your emotional support and continuity of care through pregnancy, labour and postpartum. They are a great addition to any care model or environment. Doulas are able to assist in all of your birth options and locations, however, some doulas may have preferences to work with specific birth teams or settings. Some hospitals or OBs may express that they “do not work with doulas”, however it is your right to have support persons of your choosing, and medical professionals that will work with your birth plan or requests. All of these care options will allow you to take a tour or meet with the person before committing to that care model. You can find hospital tour information on individual websites. |
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