Coping with labour naturally

• Choose a care provider and birth place that will allow you freedom in labour and plenty of support.
• Practice relaxation during pregnancy.
• Use affirmations and visualization during pregnancy.
• Choose labour companions who will support and encourage you - consider a Doula.
• Read inspiring birth stories during pregnancy.
• Labour at home as long as possible.
• Make your location as comfortable as possible.
• Keep your space warm and dark.
• Bring comforts of home to the birth center.
• Go about your daily routine during early labour - sleep if it's night.
• Eat and drink as you need to.
• Move. Walk inside or outside, use a birth ball, slow dance - movement helps.
• Surrender to the power of labour and the power of your body, embrace it.
• Play music that you love, that helps you move deeper into labour, or that soothes you.
• Stand and bear down on low support, or pull on a soft rope support if it helps.
• Be grateful that you'l be meeting your baby soon. Be grateful for your attendants.
• Vocalize -use deep, open moans. Relax your jaw. This relaxes your bottom.
• Know that you can do this.
• Visualize your body opening and your baby moving down.
• Keep peeing. This gets you moving and some women like labouring on the toilet.
• Try aromatherapy. Massage with essential oils in a carrier oil can be wonderful.
• Have an attendant use counter-pressure for strong back labor.
• Use a hot sock, rice sock, or aromatherapy stuffed animal to apply moist heat.
• Use cool washcloths or a frozen hot sock, rice sock, or aromatherapy animal for cold.
• Get in the shower.
• Get into warm water.
• Have an attendant give you a massage on your legs, or anywhere that feels good.
• Don't try to escape the pain - embrace it, go with it. Explore it, be curious about it, if it helps.
• Feel the love of those around you.
• Talk to your baby.
• Look in the eyes of your support team.
• Do what your body tells you to do. Breathe.
• Trust yourself.

The benefits of using water in labour.

Extract from “Water Birth” by Janet BalaskasHow water can help you in labour“The water looked very inviting and I was delighted with it when I got in. I had a fire burning and the room was candle lit, with soft music and lavender oil in a burner.”

The change in how a woman feels and behaves soon after entering a birth pool in a quiet darkened room can be remarkable. It seems to alter her state of consciousness and her concentration – sometimes dramatically – so that she very soon relaxes and sinks more deeply into herself and is able to let herself surrender to the involuntary rhythms of her labour. It’s as if she becomes sleepy, even dreaming.

In the ‘Birth and the Family Journal (Vol 8)’ Michel Odent writes: ‘The reason why kneeling or immersion in water during labour is so helpful is mysterious. What is clear is that water is often the way to reduce inhibitions… we observe that during such immersion in warm water, semidarkness is the best way to reach a high level of relaxation. Water may be a good way to reduce adrenergic secretion. Immersion in warm water with semidarkness may also be a way to reach alpha brain wave rhythms.

Water may be a symbol of mother, of comfort, regression to childlike needs and behaviour. Whatever way we want to talk about the effect of water during labour, one thing is sure.

The contractions become more efficient and less painful at the same time, so that sometimes the labour is very quick. Many women do not want to leave the pool because it is so comfortable. As a result sometimes the baby comes while the mother is in the pool.’

The benefits of water immersion, or hydrotherapy, in labour have been studied and assessed by many experienced midwives, researchers and doctors all over the world.

It is clear from common findings that including a pool of warm water in the birthing room adds a whole new dimension to the experience of childbirth. A recent study of 1,300 water births found that the use of a birth pool is rated very highly by women, whether having their first or subsequent baby and their enthusiasm is shared by midwives.

This echoes the findings of thousands of women and their midwives all over the world. There are some women who have had several water labours or births and have had such satisfactory experiences that they cannot imagine giving birth in any other way.

But just as every labour is unique, no two women will use a birthing pool in quite the same way. Moreover, a minority of women who try the pool do not find it helpful.

Many women however, are very keen to get into the pool at the earliest possible moment (although we will see later that it is not wise to get in too early) and some are so comfortable that they want to stay in the water for the whole of the remaining labour and birth.

Others find the pool helpful for pain relief during labour, but feel the need to be on dry land for the birth itself. A further group may labour and give birth on land but use the pool for relaxation after the birth.

In a long slow labour, episodes in the pool can be useful for resting. The message is that water can be of benefit in a variety of ways.

“My labour was very short and intense. Near the end I wanted to get my head down to slow the pain down When I went into the pool I found that I couldn't get my head down lower than my hips as I had been doing out of the water, so I felt the contractions more strongly than ever. I got out because I missed the presence of my husband to cling to and overall felt very isolated in the pool.”


Privacy and non-intervention

One of the benefits of labouring in a pool is the sense of privacy that most women who use it experience. Enclosed in her private space, protected by the gentle barrier of the water, a woman can feel secure from unwanted contact and more in control of her body. She is free to turn her attention inwards and focus on the rhythms of her labour and what she needs to do to ride the powerful sensation of the contractions.

Although it is essential that regular fetal monitoring is carried out periodically while the mother remains in the pool, in practice there are fewer internal examinations and other procedures than in most labours on land.

And, significantly, this ‘hands-off’ approach seems to have no adverse effect on mother or baby as was noted in a study of 2,000 women in a hospital in Switzerland where water birth is offered as an option to every woman.

“I was glad not to need any stronger pain relief (I had an epidural for the birth of my first baby) and to give birth naturally feeling in total control in the pool and in my own home. I liked the fact that being in the pool meant that the midwives keep a hands-off approach and leave it up to you with no internal examinations and no breaking of the waters. It was so different from my first experience.”

Midwives who attend water births often have to develop different ways of assessing progress in labour. Instead of routine vaginal examinations to check dilation, the midwife relies on more subtle indicators, such as the woman’s breathing, vocalisations and movements.

In fact, many midwives feel that attending labours and births in water has added an extra dimension to their midwifery skills, including an extra sensitivity to changes in the mother without the need for manual confirmation.


Pain relief through water

“The pool helped the labour to progress rapidly… I was very eager to get in the water and found it a huge relief when I entered… the pool was very useful in coping with the pain, helping to focus me so I could concentrate on making the pain useful and positive.”

One of the main reasons that women choose to use water during their labour is for the relief of pain. There is no doubt among midwives experienced in its use, that immersion in water can provide dramatic relief of discomfort for a high proportion of women.

Various studies have confirmed this finding. For example a clinical audit of water births carried out in five birthing units in England, ‘supported the proposition that water birth is effective as a method of pain relief.’

In hospital birthing units that have a long-standing commitment to the provision of pool facilities and support from birth attendants who feel at ease with using water in this way, there has been a dramatic reduction in the use of analgesic drugs such as pethidine (meperidine in the US).

The study cited above found that only 3 per cent of women who used water in labour used pethidine as well, compared to 60 per cent of women who laboured on land. A reduction in the use of such narcotic drugs is welcomed by all concerned, as its is now widely recognised that they can have a depressive effect on both mother and baby’s central nervous system, especially in repeated or large doses

A systematic review of three randomised control trials exploring immersion in water in labour only (not birth) found that there was a significant decrease in the use of medical pain relief in the women who used a birth pool in labour – indicating that for some women the use of a birth pool provides an effective alternative route to epidural anaesthesia.

Epidurals have become very sophisticated and generally provide effective relief from pain and can be used very positively in some circumstances. You need to be aware that using a birth pool will not eradicate the pain in the same way as an epidural – but works indirectly by helping significantly through the benefits listed below, to make it easier for you to tolerate and manage the pain yourself.


Summary of benefits of labouring or giving birth in water

Increases privacy
Provides significant pain relief
Reduces the need for drugs and interventions
Encourages a woman’s sense of control in labour
Facilitates mobility and enables the woman to adopt optimal positions for an active birth
Speeds up labour
Promotes relaxation and conserves energy
Helps to reduce tears
Is rated highly by mothers and midwives
Encourages an easier birth for the mother and a gentler welcome for the baby

Midwives: Starting a Trend & Saving the Birth Industry

06.22.12 My wish list to revolutionize the way we have babies here in the US, making it safer, more affordable and more available to all women

A recent article in the New York Times claims midwives have become increasingly popular healthcare providers because they’re a status symbol.  Apparently, upper middle class women are no longer too posh to push.  Instead, they’re posh enough to take over the childbirth market with demands for personalized, family centered and wellness oriented prenatal, labor and delivery care.  Hallelujah!  If midwifery care has become the hottest trend, I say there’s hope for the American birth industry yet.

Here’s a newsflash though.  Americans aren’t out in front on this trend.  Midwives rule the market in lots of countries including those where maternal health outcomes are the best in the world (and way ahead of the US), like Norway, Holland,  Ireland and Australia.  In other parts of the world where obstetricians are scarce (including developing countries like rural Africa, India and South America) and there are very few midwives, it’s the midwives who are saving women’s lives.

Not just certified nurse midwives either, but also certified practical midwives and trained birth attendants (AKA lay midwives).  They’re providing prenatal care and family health care, delivering babies and following up with postpartum and family planning care.  In countries like Uganda, for instance, there are obstetricians, but not very many and most women can’t get to where they practice and they don’t provide most of the routine, normal, healthy-mother services.  They focus on emergencies and complications.  Midwives are more readily available, though there aren’t enough by any means.

The Times article quotes Christy Turlington Burns, model, film maker, CARE advocate, entrepreneur and founder of Every Mother Counts, (a non-profit advocacy and awareness organization working to improve global maternal health conditions). Turlington Burns says, “I knew I wanted a natural childbirth.  When I met my midwife, her whole approach felt closer to home.”

That’s what a lot of women are looking for, partly in response to the backlash created by ever-increasing C-section rates and not-so-hot American maternal health statistics.  They aren’t necessarily looking for home births (and neither was Turlington Burns. She delivered in a birth center located within a hospital), however, or even all-natural births. Instead, they’re looking for alternatives to the cookie-cutter, baby factory, high-intervention model of care that’s been prevalent for much of the last couple decades.

Rather than being viewed through the lens that many obstetricians use that evaluates women as potentially risky,midwives tend to see women as probably normal.  Pregnancy and birth aren’t usually rife with complications.  Most of the time, for most women they’re, well, normal. That’s what midwives do.  They take care of normal women.  Can you use a midwife if you want an epidural?  Sure.  Certified Nurse Midwives that work in hospitals have easy-access to epidurals and if you need one, you can get one and still continue as a midwife patient.

In many parts of the world (including areas with the very best maternal outcomes) labor and delivery units are staffed with certified professional Midwife (CPMs), not certified nurse midwives (CNMs).  Here in the US, there’s a strong preference and bias towards CNMs.

What’s the difference?  Certified professional midwives go through an intensive training program usually via a university program and take a test that certifies their education and skills meet all the same requirements as certified nurse midwives. The difference is, their course of study doesn’t include nursing school.  Instead, they become the specialists in out-of-hospital birth settings like birth centers and home births. In a few states here in the US, CPMs also do hospital births).

There are some advantages to having a nursing background as CNMs do, but it isn’t always a mandatory element when it comes to choosing an excellent midwife.  In fact, in many nurse midwifery programs, the nursing piece is covered by only a one-year boot camp nursing education that prepares them to function in a hospital setting. CNMs are generally considered the experts at providing hospital births though many also deliver in birth centers and at home.  The biggest advantage of having that CNM versus CPM title is that CNMs are generally more accepted and respected by obstetricians and hospital administrators and they can practice legally in all 50 states.

Last year, I fundraised for an organization called Shanti Uganda, which was opening a birth center staffed by midwives in a rural area of Uganda.  They’ve been providing high-quality care for over a year now and just celebrated the birth of their first twins last month.  In addition to providing patient care, they also provide ongoing education to Ugandan women and children and healthcare providers who want to work with pregnant women.  In fact, this fall they’re doing a ten-day intensive doula training workshop that’s open to anyone with a passion for pregnant women.  If you or someone you know wants in on this, click the link and go for it.  It could be the adventure of the lifetime and the beginning of a great career.

So back to that New York Times article - if what it takes to put normal childbirth in high demand is for it to become a status symbol, well then, so be it.  Here are a couple other items on my wish list that I think could revolutionize the way we have babies here in the US, making it safer, more affordable and more available to all women, not just status-seekers:

·      Open more birth centers focused on normal childbirth located in or near hospitals.

·      Respect that midwives are really, really good at what they do and that includes CPMs, CNMs and     even some non-certified midwives.  They deserve the support and respect of the OB community.

·      Provide more pain relief options to American women, including Nitrous oxide (AKA laughing gas which is available to women all over the world except here in the US), so we have more to choose from than just going all natural or going for an epidural.

·      Add a safety net for women and midwives who want to try home birth by making it easier, friendlier and less adversarial to transfer to a hospital if an emergency arises.

·      Make it easier for all women to get good quality prenatal care whether they live here in the US or somewhere else in the world.

 

Jeanne Faulkner, R.N., lives in Portland, Ore., with her husband and five children. Got a question for Jeanne? Email it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.

Yoga Mama

Kristy Nel and Claire Stephenson, both Prenatal Yoga teachers, have many years of experience in teaching Yoga and currently offer Prenatal Yoga classes at Genesis Clinic on Thursday evenings from 17h00 to 18h30.

They have this to say about the benefits of Yoga for pregnant women.

“Recommended by most doctors and midwives, prenatal yoga offers a multitude of benefits to both mother and baby throughout pregnancy, 

during birth and beyond: 

• Joint exercises - perfect for poor circulation, swelling/water retention and excellent to improve mobility. Also enhances squatting and other birthing positions.

• Gentle Stretching - maintains supple and toned muscles, stabilizes blood pressure levels and alleviates heartburn and lower back ache.

• Breathing - balances the autonomic nervous system which regulates the major systems of the body and controls hormonal secretions. Deep breathing increases the intake of oxygen to both mother and baby. 'Birthing breaths' aid in the preparation for a calm birthing.

• Yoga Nidra - during this relaxation technique and one gains the equivalent of 4 hours deep sleep. Yoga Nidra also promotes inner communication with your child and assists in releasing any impressions associated with the fear of birthing.

• In addition, by developing a deeper awareness of your body, a powerful connection between a mother and her child is established.”

Yoga Mama will be at the Genesis Clinic Open Day 

on the 1st of September.

www.prenatalyoga.co.za

Woman's Day

Have you ever wondered why we cel­eb­rate Woman's Day on the 9^th August in South Africa? It has noth­ing to do with hon­our­ing women just because we need another "Mother's Day", this day com­mem­or­ates the 9 August 1956 when women par­ti­cip­at­ing in a national march peti­tioned against pass laws ... (For any­one who does not know the his­tory — "pass laws" were legis­la­tion that required African per­sons to carry a doc­u­ment on them to ‘prove’ that they were allowed to enter a ‘white area’ dur­ing the Apartheid regime).

On this day in 1956, over 20 000 women of all races and ages from every corner of South Africa marched together towards the Union Buildings in Pretoria. These brave women were march­ing in protest against the pass laws that pro­posed even fur­ther restric­tions on the move­ments of women.

We celebrate these pioneers of feminism as women all over the world are still struggling for their right to equality and choices that they are restricted from making, in all aspects of their lives.

In the ‘birth world’, we have the feminist pioneers of birth – Ina May Gaskin, Gloria Lemay, Michel Odent, to name but a few. In the same sense, these birth pioneers advocate for pregnant and birthing women; in that they should not have restrictions imposed on them regarding their choice of labour and birth, obviously with the safety of the mother and child in mind.  Whilst we value the ways that obstetrical science has made birth safer for women with high-risk pregnancies, low-risk pregnancies and births show that the midwifery model of care is as safe as hospital birth with a gynaecologist, often with fewer interventions and post-birth complications.

From a feminist perspective, it’s all about taking the power back. Women are powerful and smart and amazing enough to make these choices for themselves. We can rely on the help and expertise of doctors, midwives, and doulas to walk with us through our journeys in birth — but it’s essential that we’re put at the forefront of the decision making process. The power of birth is systematically being taken away from us by a culture that believes that our bodies and minds are fundamentally flawed to the point where birth is no longer a natural process, but rather a medical one —and that absolutely makes birth a feminist issue. Our babies and we deserve so much better.

We believe that Genesis Clinic embraces this philosophy, in that a woman has the right to have the birth she chooses, with the expertise care of the midwife and back-up of the gynaecologist. 

Have a wonderful Woman’s Day!

Did you know that it is World Breastfeeding Week - 1-7 August ?

Genesis Clinic supports breastfeeding for various reasons:

Why Breastfeed?

IF I NURSE FOR A DAY...

Breastfeeding your baby for even a day is the best baby gift you can give. Breastfeeding is almost always the best choice for your baby. If it doesn't seem like the best choice for you right now, these guidelines may help.

IF YOU NURSE YOUR BABY FOR JUST A FEW DAYS

He/she will have received your colostrum, or early milk. By providing antibodies and the food his brand-new body expects, nursing gives your baby his first - and easiest - "immunization" and helps get his digestive system going smoothly. Breastfeeding is how your baby expects to start, and helps your own body recover from the birth. Why not use your time in the hospital to prepare your baby for life through the gift of nursing?

IF YOU NURSE YOUR BABY FOR FOUR TO SIX WEEKS

You will have eased him through the most critical part of his infancy. Newborns who are not breastfed are much more likely to get sick or be hospitalized, and have many more digestive problems than breastfed babies. After 4 to 6 weeks, you'll probably have worked through any early nursing concerns, too. Make a serious goal of nursing for a month, call La Leche League or a Lactation Consultant if you have any questions, and you'll be in a better position to decide whether continued breastfeeding is for you.

IF YOU NURSE YOUR BABY FOR 3 OR 4 MONTHS

Her digestive system will have matured a great deal, and she will be much better able to tolerate the foreign substances in commercial formulas. If there is a family history of allergies, though, you will greatly reduce her risk by waiting a few more months before adding anything at all to her diet of breastmilk. And giving nothing but your milk for the first four months gives strong protection against ear infections for a whole year.

IF YOU NURSE YOUR BABY FOR 6 MONTHS

She will be much less likely to suffer an allergic reaction to formula or other foods. At this point, her body is probably ready to tackle some other foods, whether or not you wean. Nursing for at least 6 months helps ensure better health throughout your baby's first year of life, and reduces your own risk of breast cancer. Nursing for 6 months or more may greatly reduce your little one's risk of ear infections and childhood cancers. And exclusive, frequent breastfeeding during the first 6 months, if your periods have not returned, provides 98% effective contraception.

IF YOU NURSE YOUR BABY FOR 9 MONTHS

You will have seen him through the fastest and most important brain and body development of his life on the food that was designed for him - your milk. You may even notice that he is more alert and more active than babies who did not have the benefit of their mother's milk. Weaning may be fairly easy at this age... but then, so is nursing! If you want to avoid weaning this early, be sure you've been available to nurse for comfort as well as just for food.

IF YOU NURSE YOUR BABY FOR A YEAR

You can avoid the expense and bother of formula. Her one-year-old body can probably handle most of the table foods your family enjoys. Many of the health benefits this year of nursing has given your child will last her whole life. She will have a stronger immune system, for instance, and will be much less likely to need orthodontia or speech therapy. The American Academy of Pediatrics recommends nursing for at least a year, to help ensure normal nutrition and health for your baby.

IF YOU NURSE YOUR BABY FOR 18 MONTHS

You will have continued to provide your baby's normal nutrition and protection against illness at a time when illness is common in other babies. Your baby is probably well started on table foods, too. He has had time to form a solid bond with you - a healthy starting point for his growing independence. And he is old enough that you and he can work together on the weaning process, at a pace that he can handle. A former U.S. Surgeon General said, "it is the lucky baby... that nurses to age two."

IF YOUR CHILD WEANS WHEN SHE IS READY

You can feel confident that you have met your baby's physical and emotional needs in a very normal, healthy way. In cultures where there is no pressure to wean, children tend to nurse for at least two years. The World Health Organization and UNICEF strongly encourage breastfeeding through toddlerhood: "Breastmilk is an important source of energy and protein, and helps to protect against disease during the child's second year of life."* Our biology seems geared to a weaning age of between 2 1/2 and 7 years**, and it just makes sense to build our children's bones from the milk that was designed to build them. Your milk provides antibodies and other protective substances as long as you continue nursing, and families of nursing toddlers often find that their medical bills are lower than their neighbors' for years to come. Mothers who have nursed longterm have a still lower risk of developing breast cancer. Children who were nursed longterm tend to be very secure, and are less likely to suck their thumbs or carry a blanket. Nursing can help ease both of you through the tears, tantrums, and tumbles that come with early childhood, and helps ensure that any illnesses are milder and easier to deal with. It's an all-purpose mothering tool you won't want to be without! Don't worry that your child will nurse forever. All children stop eventually, no matter what you do, and there are more nursing toddlers around than you might guess.

WHETHER YOU NURSE FOR A DAY OR FOR SEVERAL YEARS

The decision to nurse your child is one you need never regret. And whenever weaning takes place, remember that it is a big step for both of you. If you choose to wean before your child is ready, be sure to do it gradually, and with love.

*Facts for Life: A Communication Challenge, published by UNICEF, WHO, and UNESCO, 1989**K Dettwyler. A Time to Wean. Breastfeeding Abstracts vol 14 no 1 1994 ©1997 Diane Wiessinger, MS, IBCLC 136 Ellis Hollow Creek Road Ithaca, NY 14850

Open Day !

Come and visit us on our Open Day on  

Saturday, the 1^st of September from 10am to 2pm.

Open day at Genesis Clinic is a great opportunity to have guided tours of the clinic, meet some of the private midwives that work at Genesis Clinic and receive all the information you need. 

Not only that, there are prizes up for grabs and the first 100 mums (and dads) receive a goodie bag!

We will also have exhibitors at the Open day, with pregnancy and birth related products and services that we endorse.

We will also have water-birth DVD screenings – as well as talks about birth, doula’s and midwives in the training room!

We would love to see you there !

*Beverages will be on sale at the coffee shop