Postnatal pelvic floor health and awareness.

Postnatal pelvic floor health and awareness.

Having a baby makes a woman three times more likely to leak urine than a woman who has not had one. In Australia alone, one in three women who have ever birthed will wet themselves. In the majority of cases, however, urinary incontinence as a result of pregnancy and childbirth is preventable and treatable.

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Pelvic floor physiotherapy classes by ABIB.

It is very important that health professionals who provide care for women during pregnancy and the postnatal period reach out to women about pelvic floor health. The importance of a strong and healthy pelvic floor cannot be underestimated. The pelvic floor muscles are tightly slung between the tailbone (coccyx) and the pubic bone, and support the bowel, bladder, uterus and vagina. Childbirth can weaken these muscles and cause problems, such as incontinence, later in life.

This is one of the main reasons why we have developed both pregnancy and postnatal pelvic floor physiotherapy classes with our physiotherapist colleague as we are passionate about making a difference to this often overlooked component of maternity care.

Returning to sport or exercise after birth

There are many misconceptions about when women can resume their sporting activities or other exercises after their baby is born and there is so much social pressure on women to lose ‘the baby weight’ due expectations conveyed via social media and the celebrity culture that surrounds us. Participating in sport, running or other high-impact activities early after childbirth may actually reduce pelvic floor muscle strength and cause long-term bladder and bowel problems or even prolapse of the pelvic organs. New mums can minimise the risk of these developing by following some careful precautions.

Postnatal exercise guidelines

It is very important that new mums check with their doctor, midwife, physiotherapist or continence nurse before returning to sport or exercise after birth. Remember, that joints and ligaments will still be quite loose in the first few months after birth as they have been stretched to accommodate a growing baby. Here is a general guideline which can be used to plan a return to postnatal fitness:

0-3 weeks postnatal

  • Walking
  • Postnatal abdominal muscle bracing
  • Pelvic floor exercises

 3-8 weeks postnatal

  • It is recommended that new mums wait until their 6-week postnatal review before starting back at the gym or joining a group exercise program.
  • Walking
  • Low impact aerobics or postnatal class
  • Low intensity water aerobics and swimming (once bleeding has stopped)
  • Gym program (maintain posture, light weights, no breath holding)
  • Postnatal abdominal muscle bracing
  • Pelvic floor exercises

 8-12 weeks postnatal

  • New mums can follow the guidelines for 3-8 weeks, gradually increasing their intensity and weights
  • Progression with postnatal abdominal muscle bracing

12-16 weeks postnatal

  • New mums should consider visiting a physiotherapist at this time for a postnatal abdominal muscle check and pelvic floor muscle testing before returning to high-impact exercise, running, sport or abdominal exercise programs.

After 16 weeks postnatal…

  • As a general rule, new mums can return to previous activity levels provided their pelvic floor muscles have returned to normal and they are not experiencing any back pain, vaginal heaviness, or urine loss during or after exercise.
  • Further advice from a health professional should be sought if these symptoms are present.
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The female pelvis & ligaments.

 

 Other factors to consider

New mums may feel more tired in the first few months after having a baby due to interrupted sleep, the extra demands of motherhood and feeding. Fatigue and over exertion during exercise can increase the risk of injury. It is always important that women listen to their body and how they are feeling. If new mums are feeling their muscles are aching; their bleeding changes colour from pink to red or it increases in amount (especially if it starts again after it has stopped) then they need to be reviewed by their caregivers. Continuing to exercise if these warning signs are apparent and ‘pushing through the pain’ is likely to end up causing severe damage.

Pelvic floor exercises can help speed the recovery for women who experienced a Caesarean birth or had to have some perineal stitches after the baby was born. Again, guidance from caregivers will assist with what specific exercises might assist with this type of recovery.

Other points to think about…

New mums should always be guided by their caregivers but should also consider the following:

  • Allow sufficient time to heal, particularly after a Caesarean birth.
  • Seek assistance if they are having trouble performing particular exercises.
  • Aim for slow, gradual weight loss.
  • Wear a supportive bra.
  • Avoid activities that place stress on an unstable pelvic floor and hip joints until strength and stability has improved.
  • Gradually increase the length of exercise sessions.
  • Drink plenty of water before, during and after exercise.
  • Don’t push themselves to the limit and always listen to what their body is telling them.

Regular exercise after childbirth offers a range of health benefits. Exercise helps new mums return to their pre-pregnancy shape and gives them increased energy to cope with the demands of new motherhood. It is important that new mums gently exercise their pelvic floor and abdominal muscles every day but that they ensure that their abdominal muscles have healed before undertaking any vigorous tummy exercises, such as crunches. New mums need to also be reminded that it may take months for them to return to their pre-pregnancy shape and weight and they should not be discouraged by what they might consider slow progress.

M.

References

Better Health Channel (2016) Postnatal exercises, Accessed 9/1/2016 via https://www.betterhealth.vic.gov.au/health/healthyliving/postnatal-exercise-sample-workout

Continence Foundation of Australia (2013), Pelvic floor awareness in pregnancy, childbirth and beyond, Accessed 9/1/2016 via http://www.continence.org.au/news.php/211/pelvic-floor-awareness-in-pregnancy-childbirth-and-beyond

Pelvic Floor First (2016) Returning to sport or exercise after birth, Accessed 9/1/2016 via http://www.pelvicfloorfirst.org.au/pages/returning-to-sport-or-exercise-after-the-birth.html

When will my period come back after my baby is born?

When will my period come back after my baby is born?

In our last post, we discussed the lowdown on ‘that time of the month’. An understanding of the menstrual cycle is crucial for all women – especially for those who are planning to conceive. Another aspect that involves bleeding and having a baby and that is often misunderstood by some women after they birth is the bleeding that occurs after a baby is born and the return of their periods.

Every mother with a newborn experiences some level of bleeding after birth. Some bleeding is expected as it is nature’s way of getting rid of extra fluid and other tissue that may not have emptied from the uterus after the baby was born. After the placenta has birthed, the uterus starts to shrink back to its pre-pregnancy size and the extra litres of blood that were carried around during pregnancy need to get out of the body somehow! However, there are occasions when the bleeding is too heavy or excessive and if this happens women need to be reviewed by a doctor. We will discuss these symptoms shortly.

LOCHIA

Lochia is a Latin word traditionally used to describe vaginal bleeding following the birth of a baby. Lochia contains not only blood but other contents that were in the amniotic fluid. Immediately following birth, new mothers will find that their blood loss will be bright red and slightly heavier than the heaviest day/s of their period. However, women should not be having to change their pad more than every 4 hours or so. If this happens, a doctor or midwife needs to be informed. Over the next week, vaginal blood flow will decrease and the colour will change to a pink/red and then a brown/red colour. After 4-6 weeks, this discharge may then become yellow/white in colour before it ends entirely. It is expected that women might have some loss for up to 6 weeks after the birth of their baby, but this differs for each woman.

New mothers may notice that after breastfeeding or cuddling their baby that they experience a ‘gush’ of blood. The hormone called oxytocin is released during breastfeeding or when mothers are in close contact with their baby and one of its actions at this time is to contract the uterus again back down into the pelvis. Those hormones at work again! A ‘gush’ may also be experienced after sitting or lying down for long periods and this is purely because gravity is doing its job and the blood has been pooling in the vagina.

FEMALE ‘STICKS & SHEETS’ (aka pads & tampons)

It is a good idea to only use sanitary pads instead of tampons for at least the first 6 weeks after the birth. Tampons can harbour bacteria which can lead to an infection and it is also important that new mothers change their pad every 4-6 hours as bacteria can build up quickly on these too. Initially, new mums may like to wear maternity pads because they are more padded and offer more protection for a heavy flow when compared to normal sanitary pads but the switch can be made to thinner pads whenever it feels right to do so. It is a good idea for new mums to have a few packets of maternity pads at the ready for the first few days after the birth.

SEE A DOCTOR OR MIDWIFE IF…

New mums should expect their lochia to smell but it should not be offensive. It is very important that a doctor or midwife is consulted if new mums notice any of the following:

  • A soft, tender abdomen;
  • Sudden, bright bleeding especially if the bleeding has been pink/yellow/white for some time;
  • Discharge that has an offensive odour;
  • Persistent ‘fresh’ bleeding;
  • Passing large blood clots;
  • Having a temperature;
  • Feeling generally unwell.

These symptoms may indicate that an infection is present or that the uterus is struggling to get rid of something that is inside it. If any of these symptoms or a combination of them are present, new mums must speak to their doctor or midwife immediately.

WHEN WILL I GET MY PERIOD AGAIN?

There is no real set answer for this question – it happens at different times for each woman but how a new baby is fed can have a significant impact on this. If the baby is not being breastfed, generally the menstrual cycle will kick back into gear quicker when compared to if breastfeeding was occurring. This is because breastfeeding generally keeps levels of some hormones responsible for menstruation too low for ovulation and menstruation to occur. As a general guide, women who are not breastfeeding may have their period back within 6 weeks of birth and breastfeeding women may have it back within 10-12 weeks. Just remember that this differs for every woman.

Once the period returns it may take 6-18 months for it to become regular again (if it ever was). Again, how the baby is fed can impact upon this.

I’VE HEARD THAT YOU CANNOT GET PREGNANT IF YOU ARE BREASTFEEDING. IS THIS TRUE?

You may have heard that women who are breastfeeding cannot get pregnant? While this is a images7D20JL6Hmethod of contraception that is used by and works for some women, it is important to note that some ‘rules’ need to be followed to give this method its best chance at being successful. The main rule to follow is that EXCLUSIVE and regular breastfeeding (so, feeding every 4-6 hours) must be occurring. Given that many women do not know when they first ovulate again after their baby is born, if they have unprotected sex before their period returns, there is a chance that they will become pregnant again. So, women could become pregnant before they have their first period in this case.

Remember to ask questions of your doctor or midwife during your antenatal visits and after the birth of your baby about contraception and consider what method, if any, is right for you.

M.

REFERENCES

  • Coad, J. & Dunstall, M. (2004) Anatomy and physiology for midwives, London: Mosby
  • The Royal Women’s Hospital (2014) The women’s health book: A complete guide to health and wellbeing for women of all ages, Sydney: Heinemann

A quick guide to your menstrual cycle.

A quick guide to your menstrual cycle.

Menstruation and the reproductive cycle has always fascinated me. We have all heard that a menstrual cycle is ‘normally’ 28 days long – but I don’t like the word ‘normal’. A ‘normal’ cycle can range anywhere from 21 to 36 days which can make it challenging for women who are trying to work out the best time to conceive – among other things. Many women have very little knowledge of exactly what might be happening on each day of their cycle. The more you know, the better you will be to prepare for each phase of the cycle. So, here is a quick breakdown of the amazing activities that are likely to be going on inside your reproductive organs each month!

Note that the following only counts if you are not taking the pill (otherwise, its the pill talking, not your ovaries) and it is based on a 28-day cycle.

Day 1: The first day of your period is also the first day of your cycle. Unless you are pregnant, hormone levels plummet and the blood and tissues lining the uterus break down and shed. The next 28 days are all about your ever-optimistic uterus prepping for the possibility of a nine-month house guest.

Day 2: The period continues. The second day of your cycle is generally a heavy one. While your PMS symptoms have probably left the building, you might have some cramps that accompany bleeding. This may be a day for super tampons that you will have to change regularly. If you find a small clot in your pad, don’t panic. That is perfectly normal at this point in the cycle. However, if you are going through a box of tampons in a day and passing plum-size clots, get checked out by a doctor.

Day 3: This is often the final ‘heavy’ day of bleeding. You will probably continue to see red blood. You may also experience some changes in your vaginal pH around now, which could lead to yeast infections and bad odours. If so, try a vaginal probiotic which you can by from the Pharmacy to balance things out.

Day 4: Your period usually starts to lighten up and may change in colour from bright red to brown.

Day 5: If you generally have a 5-day period, a panty liner will usually cover things here.

Day 6: For many, this is the first day you will be free from a period. Others have periods that last up to 7 days though which is normal for them.

Day 7: By now, your period should be completely or almost gone. This means that your body is gearing up for next month. Small follicles (little cysts on the ovaries that will release an egg or two) are starting to form. Oestrogen levels start to rise, testosterone stays low, and progesterone is absent.

Day 8: Those follicles are growing and preparing to release an egg. As the eggs start to develop, they produce oestrogen, so oestrogen levels will start to rise. Testosterone and progesterone levels will stay the same.

Day 9: Over the next few days, one follicle will continue to develop and mature. That extra oestrogen causes the lining of the uterus which is rich in blood and nutrients to thicken, so it’s ready if a fertilised egg implants.

Day 10: Oestrogen production should be off the charts today! The lining in the uterus continues its plans to house a potential pregnancy.

Day 11: If you are trying to conceive, now’s the time to kick your efforts into high gear since you are either ovulating or are about to.

Day 12: Even if you have not started ovulating yet, your fertility levels are high due to increased oestrogen production – and because sperm can survive in a woman’s body for a few days. Your cervical mucous is flowing and stretchy, and the main follicle should be fully ready to release an egg while the others shrivel up. You may notice an increased libido at this time because testosterone levels are surging! This is nature’s way of encouraging sex at peak baby-making time.

Day 13: Oestrogen levels are peaking and your body is almost ready for the egg to emerge from the ovarian follicle – this is ovulation.

Day 14: You are ovulating! The egg is released and you may feel some pain or have a little vaginal spotting which can be normal. This is your best baby-making day, so if you’re trying, get to it.

Day 15: Your egg is starting its journey down the tube in the hope of hooking up with a sperm. If you are trying to conceive, intercourse on the day after ovulation is a good ‘just in case’ practice. Now, oestrogen and testosterone levels are starting to drop and progesterone levels are increasing.

sperm in the fallopian tube

Sperm in the fallopian tube

Day 16: The egg is still hanging our waiting to meet a sperm.

Day 17: The lining of the uterus is thickening up. If the egg has united with a sperm, it will soon call this lining home. If conception hasn’t happened, the egg will die. Oestrogen levels are coming down and progesterone levels are sky high.

Day 18: Oestrogen will start to make a comeback. Progesterone levels are still very high.

Day 19: You might be wanting to know if you are pregnant if you have been trying to conceive. Don’t rush out to buy a pregnancy test yet – it is still a tad too early for this.

Day 20: The end of the cycle is nearing and its around this time that PMS might knock at the door. You may feel bloated , moody and consider buying shares in Cadbury to ensure a never-ending supply of chocolate is always in your pantry.

Day 21: Progesterone levels are still up there.

Day 22: Time to check your stash of pads and tampons so you won’t have to make an emergency trip at an awkward time to get supplies – you know that this almost always happens just when you don’t want it to!

the winning sperm

The winning sperm

 

Day 23: PMS is in full swing. Do whatever you have to in order to keep those emotions under control.

Day 24: About a week after ovulation, your progesterone levels will be at a high. Oestrogen will start to drop off.

 

Day 25: This will probably be the worst PMS day. Expect evil thoughts crossing your mind plus major bloat, tears and extreme impatience and frustration.

Day 26: DO NOT get on the scales. It’s not you; its all that extra fluid you are carting around.

Day 27: PMS symptoms should be packing up camp and making a departure.

Day 28: This is about the time that your cycle comes to an end. If you are not pregnancy, your period is on its way. The lining of the uterus is very thick and getting ready to shed. Tomorrow, the cycle starts all over again.

M.

REFERENCES.

Streicher, L. (April 2015) ‘A 28 day guide to your reproductive cycle’. Dr Lauren Streicher is an obstetrician and gynaecologist at The Feinburg School of Medicine at Northwestern University  in the United States. Dr Streicher has a blog @ www.everydayhealth.com

 

 

 

 

 

 

 

Severe nausea and vomiting in pregnancy.

Severe nausea and vomiting in pregnancy.

Our blog is back! We wanted to get back into the swing of things by talking about a condition called hyperemesis gravidarum (HG). Many people had never heard of this pregnancy complication until it was highlighted in the media that Catherine, Duchess of Cambridge suffered from this condition when pregnant with Prince George and Princess Charlotte. Unfortunately, much of the media misrepresented the Duchess’ condition as “morning sickness.”

kate and william

Mothers who have suffered through HG will confirm that referring to it as ‘morning sickness’ is like calling a cyclone a drizzle of rain. HG does share some symptoms of ‘morning sickness’ which is experienced during 70% of healthy pregnancies, but the comparison is way off the mark. Remember too that ‘morning sickness’ can be experienced at any time of day.

HG is the recognised diagnosis of a debilitating and potentially life-threatening pregnancy disease marked by rapid weight loss, malnutrition and dehydration due to unrelenting nausea and/or vomiting. The severity and duration of HG varies, but it prevents women from performing their regular daily routines, creates persistent physical and emotional distress, and is linked to significant costs for fetal health, maternal health and the economic wellbeing of families and communities.

WHAT CAUSES IT?

The jury is out regarding the cause of HG; it is thought to result from a combination of factors including genetics, body chemistry and overall health status. One theory suggests that excessive levels of beta human chorionic gonadotropin (hCG) is the major cause. This theory would explain why HG is most frequently experienced in the first trimester of pregnancy as hCG levels are highest at that time and decline afterwards. Elevated levels of maternal oestrogen have also been proposed as a cause.

Many women that suffer from HG feel unsupported and trivialised and some lack consistent, proactive treatment for their condition, while symptoms worsen and health complications escalate. It is important that women have access to health care professionals who are aware of the latest HG research and treatments and who show compassion for their patients. Access to this this can be an issue though; especially in rural areas. It is heartbreaking when women seek assistance to terminate their wanted, planned pregnancies because they and their families are desperate for physical and emotional relief from this condition.

Women who have suffered from hyperemesis are begging for answers as they recover from very difficult pregnancies and with the knowledge that they face an 80% risk of experiencing HG again in future pregnancies (King, 2014). More than 75% of HG women decide to reduce their family size because of the condition’s debilitating impact and the lack of effective treatments available.

Advancing research on this little-understood condition is critical. Currently, there are studies being conducted throughout the world to learn more about HG but here are some reasons why HG awareness, education and research is urgently needed:

FETAL HEALTH COST

  1. HG babies are at increased risk for low birth weight, to be small for their age and born prematurely.
  2. Prolonged nausea is linked to behavioural, emotional and learning problems in children.
  3. 15-20% of HG pregnancies are lost to therapeutic terminations and current treatments are not adequate to prevent termination of these planned, wanted pregnancies.

MATERNAL HEALTH COST

  1. Complications including damage to eyesight, hearing, tears within the oesophagus, loss of fingernails, rib fractures and even death have been reported in cases of HG.
  2. Risk of Wernicke’s encephalopathy, a neurological syndrome caused by thiamine deficiency in HG pregnancies.
  3. Complications such as dehydration pose a serious threat to women without access to immediate medical care.
  4. 18% of women report full criteria of post-traumatic stress disorder (PTSD) following a HG pregnancy.

There are lots of economic and social costs too including medical visits, prescription medications and time away from work, family and friends.

Here is a quick comparison of how to work out the difference between ‘morning sickness’ and HG:

Morning Sickness Hyperemesis Gravidarum (HG)
You lose little if any weight. You lose 2-10kg or more. (> 5% of pre-pregnancy weight)
Nausea and vomiting do not interfere with your ability to eat or drink enough each day. Nausea and vomiting cause you to eat very little and get dehydrated if not treated.
You vomit infrequently and the nausea is episodic but not severe. You have significant discomfort and misery. You vomit, or feel the need to, often and may vomit bile or blood if not treated. Nausea is usually moderate to severe and constant.
Traditional remedies like diet or lifestyle changes are enough to help you feel better most of the time. You will probably require fluid hydration through an IV and/or medications to ease your symptoms.
You typically improve after the first trimester, but may be queasy at times throughout pregnancy. You usually feel some relief by mid-pregnancy, but may be nauseous and/or vomit until late pregnancy.
You will be able to work most days and care for your family, though less than usual at times. You will likely be unable to work for weeks or months, and may need help just caring for yourself.
You may feel a bit depressed at times, especially if you have more severe nausea, but are able to be your usual self-most of the time. You will likely forget most of the unpleasantness after delivery. You may feel anxious about what lies ahead if you had HG before. You will likely become depressed due to misery and physical depletion. More severe HG often is traumatic and may impact you for years to come.
©HER Foundation

 

There are a few great resources that you can access to get more information about HG. One is the HER (Hyperemesis Education & Research) Foundation which contains links to some amazing resources and has an online support forum. See their website at www.helpher.org. You can also access your doctor or midwife for more information. Some other therapies such as massage, homeopathy and traditional Chinese medicine can offer treatments to alleviate nausea at different stages of pregnancy and often work successfully in conjunction with prescription anti-nausea medications.

If you think you have HG or know of someone who has there are 3 things that the HER Foundation recommend you do quickly:

  1. Find a health care professional who offers compassionate and expert treatment of HG.
  2. Find an advocate to speak on your behalf so they know what you need and how you are responding to treatment if you are feeling too unwell to do this yourself.
  3. Find support from other women who have suffered from HG and ensure that you have support to combat insensitive or incorrect information about this condition.

 

REFERENCES

Complementary & Alternative Medicine, Hyperemesis Education and Research Foundation, Accessed 20/11/2015 via http://www.helpher.org/hyperemesis-gravidarum/treatments/complementary-alternative/

King, A. (2014) ‘When pregnancy makes you violently ill’, The Natural Parent Magazine, (17), pp.40-42

 

 

A little ‘escape’ for mums-to-be.

Massage in pregnancy: A little ‘escape’ for mums-to-be.

I am often asked whether pregnant women can undergo a massage and the answer is ‘yes’! There are many benefits to massage during pregnancy. Pregnancy is such a special time in a woman’s life when she is experiencing significant physiological, structural and psychological changes, and massage can assist with these ….

What are the benefits of pregnancy massage?

Massage therapy has been demonstrated to be effective during pregnancy (Field, 2010). Countless studies report that women who receive massage when they are pregnant have decreased rates of depression, anxiety, and leg and back pain. The level of cortisol, which is a hormone that is related to stress often decreases in amount and this, in turn, can have a positive benefit on the unborn baby making it less stressed also.  Many women that undergo massage when they are pregnant report they experience less pain in labour and an improved emotional experience at this time. It is well documented that more relaxed mothers tend to have a lower risk of intervention during labour and birth.

It is important to highlight here, that the results I just mentioned are based on studies where women underwent massage therapy for at least 20 minutes per week in the second and third trimesters of pregnancy.

Some other benefits of pregnancy massage include:

  • Reduced anxiety – again positive effects influencing all of those hormones!
  • An energy boost given this is an opportunity to rest and relax
  • For some women, nausea and heartburn can be relieved but in some women, massage can make these discomforts worse
  • Relief of a sore neck, back and heaviness in the pelvic bones, leg cramps, and fluid retention in the ankles and feet
  • Muscle relaxation and relief of joint pain… and sciatic pain which is common in pregnancy
  • It builds a sense of connectedness with another person
  • The opportunity to kick back and be pampered!
  • Improved sleep due to relief of discomforts and release of muscle tension.

Is pregnancy massage safe?

It is important that pregnant women discuss their general wellbeing and inform their massage therapist of what trimester they are in so that the best outcome for the treatment can be determined.

Many women complain about how uncomfortable they can be when they have a pregnancy massage in a venue that is not properly equipped for this. Many places require pregnant women to lie on their stomach when they are being massaged and while there might be a hole for their pregnant tummy to fit into, it often leaves them in a position where their enlarged breasts are squished and squashed and that hurts! It is not safe for women to lie flat on their back when they are pregnant anyway as this position can constrict major nerves and blood vessels which supply oxygen and nutrition to the baby. So, this position is also ruled out when receiving a massage treatment.

Who performs pregnancy massage in the Wimmera?

Did you know that the girls at Sassi Beauty Bar in Horsham have a special pregnancy bed that is used on their tables for pregnancy massage which ensures comfort for the pregnant belly and breasts? Pregnancy massage at Sassi uses a combination of Swedish and lymphatic drainage techniques to assist in alleviating the tensions and discomforts that can be experienced during pregnancy. Pregnancy massage differs from ‘general’ massage because there can be some risks when particular pressure points are stimulated. These are located within the wrists and ankles and when massaged, can stimulate contractions. This specialized body massage at Sassi can help relieve muscle tension, increase circulation and reduce water retention.

pregnancy table 1

I highly recommend that girls who are expecting a baby and need to take some time to relax pay the girls at Sassi a visit. The girls can either perform a 30 or 60 minute massage. Sassi also offer a fantastic ‘Baby Moon’ package which is the perfect way to spoil an expectant mother as she is treated to a massage, facial and spa pedicure. Divine! Remember that massages at Sassi will not be performed when women are still in their first trimester.

For the girls reading this who are not in the Wimmera, it is important that you find a qualified therapist who specializes in the field of pregnancy massage. Ask your midwife or doctor who they might recommend in your area. ALWAYS ask the therapist what qualifications they have. I cannot stress this enough! It is also recommended that you phone your therapist prior to your appointment to ask what position/s you may be placed in during your treatment.

Some massage therapists uses aromatherapy oils and burn incense to heighten the sensory experience. It is important to note however that there are many oils that need to be avoided in pregnancy as they can prompt uterine contractions. These include and are not limited to oregano, peppermint, thyme, basil, sage and rosemary. You may prefer that the massage therapist uses non-scented oils.

Some women are concerned about how exposed they might be during a pregnancy massage when it comes to removing clothing. How much skin you expose during your massage is entirely up to you but it is worth keeping in mind that the more access the therapist has to your skin the better; because touching as much as the skin surface as possible will heighten the sensory experience of the massage so you will get the most out of it!

Prices for pregnancy massage treatments vary between providers and a rebate for this treatment is available through some private health insurance funds. This is dependent on the level of cover that you have and it is your responsibility to contact your health insurer if this might apply to you.

When should I avoid massage in pregnancy?

I have listed here some circumstances where pregnancy massage should be avoided:

  • If your midwife or doctor have advised you against it
  • If you are in a high-risk pregnancy category or have previously had a premature labour
  • If you have high blood pressure in pregnancy
  • If you have pre-eclampsia or sudden swelling of your hands, legs or feet or if you experience severe headaches
  • If having a pregnancy massage makes you feel sick or faint, gives you a headache or you just don’t enjoy it – then STOP! Don’t persist with it if it makes you feel unwell or uncomfortable.

Ask the therapist to stop if you feel they are being too vigorous – you must say so! It needs to be a pressure you can tolerate so you can gain the maximum benefit of the massage.

Just one final comment… as I have already mentioned, some massage therapists will have a policy of not performing massage within the first trimester, or 12 weeks or pregnancy. This is because of the increased risk of miscarriage at this time. Also, ALWAYS, do your research and check that the massage therapist is qualified and accredited to perform pregnancy massage.

So now, kick back, relax and enjoy!

M.

References

Association of Massage Therapists (2014) Classified Massage Therapy Research, New South Wales, Association of Massage Therapists, Accessed via internet, 28/5/2015 http://www.amt.org.au/downloads/practice-resources/AMT-Classified-Research-January-2014.pdf

Field, T. (2010) ‘Pregnancy and labour massage’ Expert Review in Obstetrics & Gynaecology (March), 5:2, pp.177-181, doi: 10.1586/eog.10.12.

 

Empowering Calmbirth

 

Empowering Calmbirth®

Childbirth can be one of life’s most empowering experiences. Couples simply need the practical skills and confidence to do it their way. However, somewhere along the way many women have learnt to connect childbirth with fear, anxiety and trauma.

It doesn’t have to be like that.

From years of clinical experience, I know that expectant mothers who learn skills to relax and trust the process of childbirth are more likely to feel calm and confident and less likely to need intervention.

In my years as a midwife, I have heard many new mothers say “never again” after their baby is born, and have seen first-hand the fear that many women endure during childbirth. This is one of the reasons why I became a Calmbirth® educator. I want to assist mothers to feel centred, calm and in control; to trust their bodies and the process of childbirth. Calmbirth® aims to give couples the knowledge and confidence to work with their birth experience as it unfolds and to avoid unnecessary interventions.

The results Calmbirth® has achieved with thousands of birthing couples speak for themselves. In 2013, a report was published after 3,800 couples across Australia who undertook the Calmbirth® course were surveyed. These couples birthed in both public and private hospitals. One of the primary findings of this survey was that while more than half of expectant mothers felt anxious, frightened or very frightened about birth BEFORE attending their Calmbirth® course, these feelings reduced significantly after undertaking the program as only 2.6% of women who were surveyed said that they still felt this way AFTER completing the course.

Between 2008 and 2013, the antenatal program coordinator at The Royal Hospital for Women in New South Wales conducted a study on the benefits of Calmbirth® and found that AFTER attending a course:

  • 45.4% of women used no pain relief in labour,
  • 29.4% used nitrous oxide gas in labour,
  • 8% of women used Pethidine in labour, and;
  • 24% of women used an epidural.

When compared to statistics about the use of pharmacological pain relief in ALL public and private hospitals in New South Wales where women birthed and who DID NOT attend a Calmbirth® course:

  • 10% of women laboured and birthed with NO pain relief,
  • 43% used the nitrous oxide gas,
  • 16% used Pethidine, and;
  • 46% of women used an epidural.

Women who attend Calmbirth® classes routinely tell us that they learnt to transition from feeling fearful and experiencing a lack of control before and during birth to gaining confidence in themselves and their ability to give birth. We teach women the skills they need to remain calm, even when their birth deviates from the experience that they imagined it would be.

As one mother said: “this was certainly not the birth I had planned but I was calm as things moved further and further into the territory I had so wanted to avoid. I think if it wasn’t for Calmbirth®, I would have been frightened, panicked, angry and overwhelmed by having to go to hospital and by the various interventions that followed. Instead, looking back now, I realise I was very centred and clear and my baby was never in distress – and was born wide-eyed, calm and very present.”

See our ‘Classes’ page on the website for more information about Calmbirth®. If you would like a copy of the survey mentioned in this post please email me!

M.

REFERENCES

Svensson, J. (2013) Calmbirth® and The Royal Hospital for Women, Randwick Pilot Study, January 2008-June 2013, Sydney: New South Wales, Australia.

My 5 top tips to help create a positive birth experience.

 

 

My 5 top tips to help create a positive birth experience.

So, you are pregnant and you are super keen to do everything you can to achieve the birth of your dreams. You want your pregnancy to be super smooth and of course, your top priority is the health of your unborn baby. Undertaking independent childbirth education is one of the best things you can do to prepare yourself as you work towards achieving the positive birthing experience that you desire.

Are you unsure as to what ‘independent childbirth education’ means? Put simply, it is a series of education sessions about the processes of pregnancy and birth. It involves empowering expectant parents to become more confident to cope with having a baby and allay any fears or anxieties they may have about the miracle of birth. It involves teaching strategies about how you can achieve the birth experience that you want via a very personalised approach which enables you to become more informed about it. It also considers and educates about the unexpected challenges that can and do arise in labour and birth and helps to prepare you for these possibilities. You will always have the same person teaching you in our Calmbirth® classes at A Baby Is Born because this is how we develop a therapeutic relationship and because I am so passionate and positive about what I do!

I have heard women say on countless occasions that they want to have a “natural birth”. I think this is fantastic! However, after I ask some women how they are preparing for their labour and birth, I sometimes receive the reply that they are just going to “go with the flow” when it all happens and that they will learn what they have to when they start contracting. When I hear this, I worry and feel just a bit heart-broken because although many women will achieve the labour and birth that they desire, some will not if they have not prepared themselves as well as they possibly could of.

I can hear some people saying that labour and birth is only for “one day” – meaning that it only takes one day for a baby to be born so it can’t involve too much preparation when compared to the time involved raising a child which lasts for years! I believe that this cannot be further from the truth. Women and babies do have the instinctual knowledge necessary to work together during this amazing journey but the issue has become that over time, we have moved away more and more from just letting this highly intricate, yet incredible process ‘happen’ and have substituted this trust and faith in the way the female body is designed in medical technology and all the machines that go “ping” instead. For the most part, birth was regarded as ‘normal’ in years gone by but today, for countless reasons, many women are almost shielded from normal birth and its processes. Societal norms and the media, in addition to some other groups have a lot to answer for in regards to this.

If you want a particular type of birth in the current birth culture, preparation and practice is essential.

Here are my top 5 reasons why independent childbirth education is so beneficial:

1. It is not called INDEPENDENT for nothing.

Independent childbirth education is not directly associated with any single health care organization so it is highly likely that the content delivered is specialized, comprehensive and covers a broad range of topics. It does not focus on ‘one way’ of doing things – it looks at every option that is on the table and considers a balanced view of possibilities. It focuses on what is best and possible for YOU because it concentrates on individuals. The classes are designed to empower and inspire. We focus on how your body can activate its own pain relief but we do talk about medications that can be involved in labour and birth too.

2. We get ‘hands on’.

We have a strong focus on getting your birthing partners/support people INVOLVED! We spend a lot of time talking about techniques and strategies that can be used in labour and birth and we create an environment where partners’ especially learn much more and feel more comfortable about getting involved. The people that support you in labour and the birthing experience need to be as informed as you are as they will be your ‘go to’ person and ‘rock’ throughout this amazing journey. It is so important that your partner learns and understands exactly what is going on during labour as they are usually going to want to help ‘fix’ something that you don’t want to have happening. Their ability to provide support when you might be anxious or scared is paramount to helping you stay on your path and find relief and reassurance.

3. Remember, it is about YOUR body, baby and birth.

Independent childbirth education is highly individualized. There is a focus on concentrating on YOUR goals, dreams, aims and desires when it comes to pregnancy and birth and learning more about things that you want to learn about to address your particular needs. You will become more empowered to pre-empt and avoid situations that you want to steer clear of. It assists you to build up your resources so that even if your labour and birth does not follow the path that you wanted it to, you can still look back on it and say that you enjoyed a really positive experience.

4. Let’s work together!

I am sure that you have heard doctors, midwives and many parents say that the only thing that matters in labour and birth is that a healthy baby is born? You may have things recommended to you during your pregnancy and labour that may actually make the birth harder when the intention of this recommendation is that it will make things easier for you. You may be confronted with having to make a decision or choices when you are actually in labour about something that you are not sure of or that you have never even heard of! You need to know what you want under challenging circumstances so that you can safely achieve your goals. Independent childbirth education helps you learn the facts and stand up for yourself to achieve YOUR labour and birth goals.

The MOST IMPORTANT thing here is that birthing women and their caregivers always listen, respect and appreciate each other and are totally and accurately informed about the suggestions and decisions we are making.

5. Find out about ALL your options for birth.

As women, we have so much to thank our mothers and grandmothers for. However, as we know, today’s world and culture is quite different to the one that they knew when they were giving birth and raising families. The mindset of many of the women birthing in the world today has shifted – we expect more and something different when it comes to making choices in our lives. We expect more of ourselves, our work, our families and friends and in our lives in general.

What about what we expect when it comes to birth? Some women accept the ‘process’, if you like, of having a baby that we see on television and social media. Often, we see so many, (too many actually) disempowering, mostly inaccurate and angry images and hang on to the ‘bad’ conversations about birth that we hear when we are out and about. Some women pass on the, “don’t expect too much” baton to other women – so basically they are saying that you will be disappointed if you set your hopes too high.

What if you could learn more about how pregnancy and birth does not need to be like this? Independent childbirth education focuses on helping you find your own path, regardless of what type of birth you would like to have, to become fully informed about the journey and your rights and choices… it helps you appreciate that birth is not simply a means to an end and something that you just have to ‘get through’.

I realise that there are sceptics out there who believe that childbirth education classes are a ‘waste of time’ and that they ‘don’t work’ based on anecdotes or stories that they have heard or read. These beliefs could also be the result of a negative experience that occurred to them or somebody close to them and as I have already said, these unexpected challenges can and do occur. Or, it could have been that the people making such comments did not really ‘put in’, understand or embrace what they had been taught. The human body and mind are very powerful – there is an enormous amount of scientific evidence to support how our inner resources do work when required.

After reading this you might be thinking that you have to sit an exam before you go into labour to test your knowledge?! The point I am trying to make is that the exam could in fact be your labour and birth experience so it is worth spending the time to prepare for it as much as you can.

It is SO important that you have control over what you want so that you can achieve the birth experience that you hope for. You don’t have to be a birth expert to achieve this – you need to be as informed as you possibly can be. ALL the choices that you make about your pregnancy and labour will affect the birth of your baby.

So, unless you already know a great deal about labour, birth and all the options that go along with this experience, it’s a good idea to consider independent childbirth education so that you can learn all your options, practice techniques to assist you during labour and overcome any fears you may have. Through careful preparation, you will put yourself on to the path to reaching a wonderful birth experience.

M.

Your Body. Your Baby. Your Birth.

An author named Diana Korte once said: “If I don’t know my options, I don’t have any.” Some of you may have heard this phrase? I cannot emphasise enough just how relevant these words are when preparing for pregnancy and the birth of a baby.

When you commence the journey that is preparing to birth a baby and become a parent, you begin to construct your pregnancy and birth reality with the choices that you make about your focus, preparation, care options and above all, the mindset that you will adopt as the time of the birth approaches. Having said that, you will also construct your own reality if you do not make any choices or do not do the best that you can when it comes to getting informed about to achieve the best outcomes that you possibly can within your pregnancy and birth and how to best benefit your baby as they continue to grow and are born into the world. If you really want to achieve the goals of the healthy pregnancy and joyful birth that you dream of then you need to realise that the power to achieve this lies within only one person – YOU!

The birth of your baby concerns YOUR body. It is so important that it is in the best shape possible for childbirth and that you nourish it and respect it as your baby continues to grow. Ultimately, all your preparation in pregnancy will result in YOUR birth experience and of course, that of your baby as it journeys into the outside world. This preparation will also significantly impact on your support people at this time… so these are just some of the reasons why you always need to consider what you have or have not done to best create the pregnancy and birth outcomes that you desire and that suit your circumstances.

I have met many women across Australia who felt, that for a multitude of reasons that they had no options when it came to experiencing a particular pregnancy and birth pathway.  In addition to many other reasons, fear, past experiences, location, anxiety and “because I was told to do…” were responsible for the pangs of guilt that some of these women continue to feel because of things they missed out on or wished that they had of known to be able to improve outcomes after their babies were born or even when they were still pregnant.

Not one of us knows ‘everything’, but knowing what you need to know or what questions to ask is a major reason for this conundrum that many pregnant women and couples face. I firmly believe that women need to be given the opportunity to challenge their fears about pregnancy and birth and be supported to process and work through these. Not only will this positively change each woman but it will also have a constructive impact on our current birth culture.

It does not matter HOW you intend to give birth – these comments are as relevant to every birthing woman regardless of whether she births via a Caesarean, induction or a spontaneous vaginal birth. These comments are also just as relevant to a first-time mother as they are to a mother with many children. It is just so vital that women understand their options and everything that is said to them during their pregnancy and birth experience because how women intend to birth and the experience that they have will impact on their emotions, mind, spirit and body for the rest of their life.

M.

Welcome!

Welcome!

I will keep this introduction short and sweet because there is some information about me on our website. I am a country girl (who has the occasional penchant for the city too!) and I am a nurse and a midwife. This blog has been born because I have always been incredibly passionate about midwifery and women’s health and it is wonderful to now be able to put my extensive knowledge about these fields in a place where I can share it with you.

Part of the inspiration for the name of this service comes from the book by Lennart Nilsson titled ‘A Child Is Born’. You may have heard of it or read it? It has long been one of my favourite books and has a pride of place on my coffee table. It contains spectacular images which explore the miracle of human reproduction and birth … the photographs are so amazingly detailed and some still just take my breath away even though I have looked at them hundreds of times!

Through this blog, my intention is to provide resources and discuss topics using contemporary and evidence-based information related to the world of pregnancy, birth and breastfeeding in addition to other aspects of women’s health.

I have had a ball compiling these posts! My aim is to inspire, enlighten and empower you with thoughts and knowledge so that you can maintain your health to the best of your ability and achieve the pregnancy, birth and early parenting experience that you desire. I hope you enjoy reading them!