Wednesday 31 December 2014

What to pack in your hospital bag for a relaxed, natural birth.

In August 2014, the Yahoo Contributor Network was shut down. All the copyrights to articles thereon were returned to their authors, so I decided to publish certain articles of mine, originally written for Yahoo UK on my own blogs. This is one of them.

Towards the end of pregnancy, as it becomes the focus of the nesting instinct, one bag and its contents never held such importance. What will you need? What is a waste of space?
If you are planning a home birth it is useful to have a bag with all the things you might need during and immediately after the birth. Everything is then in one place should you need someone else to find it for you, and if you do have to transfer into hospital, you won't have to pack a bag during labour, or rely on someone else to - and inevitably end up with the wrong pyjamas.
Pyjamas aside though, hospitals are alien environments, and your bag can become your own little slice of home. This is why they are so important to us.
Birthing women naturally seek out that which is comfortable and familiar. Feeling safe and secure is vital for the physiological progress of birth. Oxytocin, the hormone that drives contractions, is released more freely, and birth progresses more smoothly, when a woman's basic nesting urges are respected.
So how can we honour this is a hospital environment?
Lighting - Hospital lighting tends to be bright and flat, perfect for medics who need to see well to do their job. Counter-productive to labouring women, as oxytocin production is inhibited in bright environments. Some hospitals have lights that dim, if yours doesn't, take a small lamp with you. Even a bright desk lamp (a small one will pack down well) can be draped with a muslin to diffuse the light. Battery operated tea lights can also be used to great effect. Then turn off the main lights and relax.
Music - If you enjoy relaxing to music, take a small player and a collection of your favourites with you. If you are using hypnotherapy, it may even be possible to buy the background music from your hypnotherapy CD to help transport you back to that peaceful mindset. Moving around is great in early labour. Dance the baby down into your pelvis, stomp out the discomfort of your contractions. Don't just stick to gentle music, take something you will find entertaining and uplifting too.
Aromatherapy - Hospitals can smell strange, antiseptic and generally unhomely. Aromatherapy for birth is a huge topic, but even the most basic blends can be very beneficial. Clary Sage is excellent for promoting the progress of your labour, and breathed deeply during contractions provides some pain relief. Lavender is good for relaxing. The best vector for aromatherapy in birth is a flannel, or sponge, dipped into a small bowl of water with a few drops of the oil. This is easily removed if you suddenly decide you no longer like the scent.
Pillows - Useful for birth, and for nursing afterwards, there is nothing more comforting than your own pillows or bean bags. Use them to keep you in a comfortable, upright position if you tire during labour. Remaining upright helps the baby descend into the pelvis and promotes contractions. Sitting on a birth ball, or the edge of a chair, leaning forwards onto a pile of cushions, is restful without slowing your labour.
A massage ball - Lower back massage can give great relief in labour. A small hand held massage tool can turn any birth partner into an expert masseur.
Food - If you are planning on a natural birth, you will be able to sustain yourself through labour by snacking regularly, although some interventions will require you to stop solids in case you need an anaesthetic. You may not feel like eating for a period when labour is very intense. Regardless, once the baby arrives you will be ravenous, and hospital catering rarely hits the spot! Take a range of foods, as you cannot be sure what you will fancy. Oat based snacks like flapjack are great for slow-release energy, fruit or smoothies can be refreshing. It's good to have some drinks you enjoy too, or a bottle of squash to flavour your water.
There is also a point in labour when women often find themselves needing a last burst of energy before they start to push. Chocolate, or spoon-fed honey are commonly used here, but as a doula I once supported a woman who dosed up on jelly beans!
Your birth plan - Your plan is a written statement of your preferences in terms of your treatment. If you are planning a natural birth it is likely that some of these preferences with be different to the hospital's default policy. It may be the case that your health care professionals do not read it, however, should you not be in a state of mind to discuss your treatment your birth partner can point to your birth plan and advocate for you with authority.
These basic ideas will get you started, but remember, as the mum to be, you have the right to choose the circumstances of your birth. Anything that makes you, as an individual, feel safe, relaxed and loved will be valuable, even your favourite pyjamas.

Wednesday 17 December 2014

How sleeping with my baby saved my sleep

In August 2014, the Yahoo Contributor Network was shut down. All the copyrights to articles thereon were returned to their authors, so I decided to publish certain articles of mine, originally written for Yahoo UK on my own blogs. This is one of them.

It was 2am and I was desperate. It was my first night home with my newborn son, three days after he was born by emergency caesarean section. My milk still had not come in, delayed most likely by the trauma of the surgery and the side effects of the painkillers. He would not stop feeding.
I knew that this was normal, I knew that he was topping up his marble-sized belly with rich colostrum, whilst triggering the production of the milk that eventually came nearly a day later. This was small comfort when I was exhausted. Every time he stirred, rooting around in his Moses basket, looking for me, I woke, rolled myself out of bed, tentatively, flinching at the pain in my fresh scar, picked him up, lay him on my mattress, and nursed him until he fell asleep; whereupon I dutifully, gently returned him to his little bed.
Over and over. Every hour, or even less.
I rang the midwives on duty at the hospital, and I am forever grateful that my call was answered by an individual who was willing to give me advice that many will not. "Let him sleep with you". That's it. That simple.
A few weeks earlier I would never have done it. My husband had joked that the baby would sleep in our bed. I told him no, no way, it's not safe.
When I was discharged from hospital I had been issued with, amongst several trees-worth of leaflets, a copy of the UNICEF safe sleeping guidelines . In reality sharing a bed with your baby is safe as long as certain precautions are taken. A breastfeeding mother, who naturally will sleep lightly, no drink or drugs, no heavy bedding, no way for baby to fall out or get trapped, no other children. With the advice and support of my midwives, I accepted that this was the best choice for us. When I later did more research, I was astounded at how far my preconceptions were from the truth. Evidence suggests that this is a safe choice and in some cases even a preferable one.
So that night I brought my new son into my bed. I fed him lying down, and dozed, when he finished he would roll onto his back to sleep. When he was hungry again he would snuffle around until I helped him latch on in my half sleep. I would not need to leave my bed and painfully lift him out of his moses basket, I would not even need to wake up completely. I found myself, as controlled studies have also demonstrated, checking on his temperature and breathing instinctively, without being fully conscious.

My first child did not sleep through the night until he was 18 months old. This was never a problem, he was right beside me in bed, all I ever had to do was nurse him, or cuddle him and he would settle back to sleep without either of us fully waking. Once he was sleeping through, we introduced him to his own bed, in his own room, which he thought was a great adventure. I missed his little snoring body next to me at night, so did my husband, but not for long, because just a couple of months later, his baby brother was born.
When I was expecting my second child, I did not make up the Moses basket. I did not assemble the cot. I knew that from the outset both of us would sleep better, and be happier if he was in bed with me, so once again, I made the bed baby-safe in readiness.
My second baby slept in my bed from his first day, in the hospital I refused to have him in the plastic tank, ringing the bell for someone to pass him to me every time he needed me. He lay curled up against me, resting peacefully. I discharged myself after one night because it was the hospital staff that were disturbing my sleep.
This time around, the midwife who discharged me made it clear that it was their policy to advise against bed sharing under any circumstances. But I knew baby number two would be sleeping with me.