I am totally supportive of women writing, talking about and sharing their birth stories, in fact I encourage it. Telling stories helps us discover the meaning in our experiences and offers possible explanations for what we struggle to understand. Our hope, when we tell our stories is that we will feel less alone, more understood.
The telling of the story is as vital as the story itself but birth stories have a way of being as harmful as they could be healing when told to the wrong person.
Be mindful if the listener is still pregnant and desperately seeking validation for her fear of the unknown, her anxiety about giving birth and her need for reassurance. Not too long ago the teller was the listener and this knowledge should deepen her understanding to the absolute vulnerability that the listener feels. But the teller now has personal experience of all the things she feared deeply. Her questions about birth have been answered and she has joined the world of women who have a birth story to tell.
She openly shares her most intimate moments and thoughts. She resists holding anything back, and unapologetically shares details of her birth with no thought to sugar coating the things she most deeply worried about during pregnancy.
The listener sits wide eyed and wondrous. She takes everything she hears and adds it to her own personal fears and anxieties about her pending birth. Perhaps the teller experienced the exact thing that she most fears. This validates her fear. The details, the explanation, the reasons are irrelevant. All she is thinking is “It happened to her – it could happen to me.” The damage is done.
I recently saw a post on Facebook that stated most women spend an average of 11 hours per week planning and preparing for their wedding in the last 3 months leading up to the big day. That is a staggering 132 hours! For most women, no detail is left to chance. Everything is planned to within an inch of its life, including what to do if it rains unexpectedly at an outdoor venue.
The next most memorable day in your life will be the birth of your first child.
How much time will you spend planning and preparing for the next most memorable day of your life?
Surprisingly, what I am seeing more and more of these days is women finding out that they are pregnant and immediately handing their power over to a medical system who, although their top priority is safety, are erring on the side of caution. Decisions are made based on liability anxiety and not necessarily on what is best for you as an individual. Your choices as a woman will not necessarily be honored.
The bottom line of all of this is that we have to take responsibility for our pregnancy and birth – the same way that we took responsibility for ensuring that our wedding day was the way that we wanted it. Not the way that the wedding planner or your mother or mother in law wanted it, but the way that you wanted it. The way you dreamed of it as a little girl.
So how do you want your pregnancy and birth to be? Have you even thought about it?
It goes without saying that your health and the health of your baby are top priority but what will you do to ensure that is the priority of the care provider you choose?
Here are what I call the 5 C’s of effective birth preparation
It takes courage to step out of the mainstream and be vocal about what is important to you. It takes courage to decline or request procedures and recommendations when even after having done your own research you will be challenged with arguments that induce fear.
Recently, one of my clients was advised to go for a c/section at 38 weeks because at her last scan the estimated fetal weight was 3,7kg. This is only 200g more than the expected average but her Doctor told her of the danger of shoulder dystocia and how the weight would increase even more as time went by waiting for labour to start spontaneously. It took great courage (and listening to her inner voice that quietly reassured her) to decline the recommendation. 9 days later she went into labour on her own and gave birth to a healthy baby who weighed 3.4kg. The estimated weight was just that – estimated – and wrong! Another of my clients had the courage to decline the scan altogether and gave birth to a whopping 4kg baby. The same doctor said that if she had known, she would not have “allowed” her to give birth naturally! Both these women made courageous decisions that ultimately affected their birth outcome.
Smaller needle is used to inject medication directly into spinal fluid
Single injection of medication
Effect of medication is immediate
Single injection lasts up to 8 hours
Usually used for C/Section
Larger needle is used as catheter is inserted via needle into the epidural space
Continuous injection of medication
Takes up to 20 minutes for effect of medication
Continuous injection means the medication will be given until no longer required.
Usually used in labor and childbirth
If you have had a spinal for c/section you will be advised to lie flat for 12 hours after surgery. This sounds like a long time but is quite normal after major abdominal surgery.
How will I breastfeed if I have to lie flat on my back?
The first feed will be the most difficult as you will be completely flat and on your back. You will need to assistance of a staff member to latch and hold the baby, usually with the baby lying across your chest or tucked under your arm, depending on the size and shape of your breasts. By the next feed the staff should be able to help you to roll gently to one side and show you how to nurse effectively in a side lying position.
Below are step-by-step instructions on getting into the side-lying position (in a hospital bed) after a c-section:
· Begin with the bed in a flat position and side rails up.
· Use extra pillows behind the mother’s back for extra support.
· Carefully roll to one side while grasping the side rail and relaxing the abdominal muscles. Move slowly to avoid strain.
· To protect the incision from the baby’s kicking, cover the abdomen with a small pillow or towel.
· Place a pillow between the legs to minimize the strain on the stomach muscles.
· Lean back into the pillows behind the back.
When using side-lying position, baby should be placed on his side, facing your body, chest to chest, so he doesn’t have to turn his head to nurse. Baby’s feet should be drawn in close to your body with his head either lying on the bed, or on your arm, whichever feels most comfortable to you. You can either roll your body forward to latch, or pull the baby toward you.
Remember that you will be encouraged to get up and move around 12- 18 hours after surgery (meaning that you will probably feed your baby about 3- 4 times in this position) before you will be able to sit and nurse your baby.
What causes a “spinal headache?”
Your brain and spinal cord are contained in a bag of fluid. The bag is called the dura and the fluid is called the cerebro-spinal fluid (CSF).
If too much fluid leaks out through the hole in the dura caused by the insertion of the spinal needle, the pressure in the rest of the fluid is reduced. If you sit up, the pressure around your brain is reduced even more. This decreased pressure can cause the symptoms typical of a post dural puncture headache.
What can be done about the headache?
Prevention is better than cure.
Lying flat for the first 12 hours is usually all it takes to prevent the headache from occurring.
How is the headache treated?
Treatment usually begins with lots of fluids. You may be given IV fluids while you are still in hospital. If this does not work then your doctor may suggest a blood patch.
The anesthetist takes blood from your arm and injects it into your back, near to the hole in the dura. The blood will clot and tend to plug the hole. This feels similar to having the original epidural or spinal injection. It takes about half an hour to do.
After a blood patch, many anaesthetists recommend that you lie flat in bed for 2 hours. It is also recommended that for the following two weeks you avoid excessive straining or carrying anything heavier than your baby. This is to help prevent the blood patch from becoming dislodged.
Perceived low milk supply
“Not enough milk” is one of the most common causes for stopping breastfeeding or choosing to supplement with formula. Unfortunately often it is a perceived
notion of not having enough milk which is loosely based on one or several of the following:
· feeling as if the breasts are not as full as they used to be
· baby feeding more frequently
· low maternal confidence
· misunderstanding/mismanagement of growth spurts
· lack of support from partner/family/society
· baby pulling away from the breast/restless at the breast/fussing between feeds
· Limited amounts of breast milk when pumping to assess the amount (never a good idea).
More often than not, the milk supply is adequate but is perceived as being low by the mother. With limited support available and a lot of misleading advice on available on the internet, a perceived low supply can easily become an actual low supply due to incorrect management.
Low milk supply, whether perceived or actual, is an issue that needs to addressed and managed if prolonged breastfeeding is to occur. Causes
It goes without saying that we all want a healthy pregnancy and healthy babies. As soon as we see the blue line, we change our diet, start exercising and clear the medicine cabinet.
Sometimes, however, we get symptoms that send us scurrying off to see the Doctor and depending on who you see, you may walk out with a prescription for antibiotics – the very things that you have been told NOT to take during pregnancy!
Let’s start by taking a look at a Short History of Medicine:
"Oh Doctor, I have this terrible pain!"
BC 2000 "Here, eat this root."
AD 1000 "That root is heathen. Say this prayer."
AD 1850 "That prayer is superstition. Drink this potion
AD 1940 "That potion is snake oil. Swallow this pill.
AD 1985 That pill is ineffective. Drink this antibiotic
AD 2000 That antibiotic is artificial. Here take this root.
Is it any wonder that we are confused? Our main concern is the possibility of adverse effects that these drugs may have on the fetus.
When might Antibiotics be used during pregnancy?
With Ramadan just days away, one of the questions I am often asked by pregnant and nursing women is whether or not they should fast in Ramadan. This post is not meant to encourage or discourage women from fasting, rather it is to provide information that can help mothers stay healthy if they decide to undertake even a few days of fasting.
Many women say that they would rather fast when everyone else is fasting instead of making their fasts up later. If you are one of those women, I hope this can help prepare you physically for the fast of Ramadan. Studies
conducted about pregnant women
fasting in Ramadan have found no adverse outcomes in the baby's birth weights, length, and head circumference. The fast of Ramadan also has not been found to adversely affect milk supply
in lactating women, although it can alter the content of breast milk, but without affecting infant growth
Pregnancy can be a challenging time to fast depending on when the fast falls in your gestation. Nina Planck, a real food expert and author, has written a wonderful book called Real Food for Mothers and Babies
that breaks up pregnancy's nutritional needs by trimester. Planck says that in the first trimester, when the organs of your baby are developing, your embryo needs minerals to become a strong fetus. The bones and muscles are doing most of the growing in the second trimester, so your baby needs calcium and protein rich foods. In the third trimester, the eyes, brain, and nervous system are rapidly developing; fats high in Omega 3's will aid this growth.
This is another one of those questions that I get asked daily. There are a few doctors in Muscat who have a very good reputation and although there is no doubt that they earned it through skill and expertise, the main reason they are so popular
is because of their excellent bedside manner
. Ten questions you need to ask YOURSELF about which doctor you should choose.
- What do you expect from you doctor in a consultation? (This is the most important question and ideally you should have at least 5 answers before proceeding with the next questions.)
- Does your doctor acknowledge you and address your concerns during a consultation?
- What, in your opinion, is the role of the doctor in YOUR pregnancy?
- What are YOUR beliefs about pregnancy and birth – does your doctor share your beliefs?
- If you have fears surrounding pregnancy and birth – what does your doctor do or say to alleviate those fears?
- Does your doctor say or do anything that exacerbates your fears?
- Does your doctor encourage you to take responsibility for your health and advise you on complimentary services to make your pregnancy healthy and enjoyable?
- Does your doctor address you by name and does he/she remember who you are at subsequent consultations. If he/she doesn’t – do you expect that they will remember your concerns when called to attend you in the middle of the night?
- Are you afraid to change doctors for fear of “hurting their feelings”
- What is your gut feeling?
In a modern world where everything is easy and disposable, why would you even consider using cloth diapers that need WASHING? Eeeuw! I get an image of dirty smelly diapers soaking in buckets next to the loo , not to mention the hassle of daily washing and drying. Why bother?
Well, there are several reasons to bother, but the health benefits rank top of my list.
Lets start with the chemicals that are used in disposable diapers – those lovely white throw away nappies don’t start off white. DIOXIN is a highly toxic by-product of the bleaching process and is the most toxic of all cancer-linked chemicals. Dioxin has been known to cause birth defects, skin disease and liver damage.
Without doubt this is one of the first questions that most newly pregnant expat couples ask me. Most of you want to book the first flight home to be near family and friends and close to a hospital or clinic that you are familiar; within a system that you understand. However, travelling home to have your baby brings a whole new set of restrictions. You will have to leave Oman no later than 34 -35 weeks into your pregnancy and if you husband travels later, there is the possibility that he would miss the birth.
If you give birth in Oman your only choice is to give birth in one of the private hospitals. There are no birth centers or active birth units and home delivery is not an option. Although there are several to choose from, the two main hospitals are Muscat Private and Star Care. For the purpose of this article I will focus on these two only. Read through the facts and then use them to prepare yourself according to what is available. Antenatal Care - facts about private hospitals in Oman
- Some people complain of "assembly line" prenatal care. Many doctor's offices are overcrowded and you do not get the personalized care and attention that you were expecting considering that this is the happiest most important time of your life.
- The visits with the doctor often last mere minutes. These types of appointments can leave you wondering what the point of the office visit was. Besides having standard tests done at each visit there doesn't seem to be much more to appointments.
This does not mean that they do not care. There is a very standard set of blood tests, scans and routine checks that are done at every appointment and at set times during your pregnancy (click here
for details) and the results of these will notify the Doctor of any risk factors or concerns.
Take time to read, know and understand the many aches and pains that are normal and expected throughout pregnancy (click here
for details) and use your discretion when finding information online.
Round Ligament Pain in Pregnancy
Your uterus is normally the size of a pear. Thick ligaments, one of which is called the round ligament, hold your uterus in suspension within your abdomen. As the uterus grows, these ligaments become very long and thin, stressing and tensing like rubber bands.
The ligaments pull and tug on nearby nerve fibers and sensitive structures, causing pain. The severity of pain can worry you. Although round ligament pain is uncomfortable, it is also very normal.
A ligament spasm, an involuntary contraction or cramp, usually triggers a sharp pain. These spasms are found more frequently on the right side than the left because of the normal tendency of the uterus to turn to the right.
You may feel round ligament pain as a short jabbing sensation or a sharp, stabbing pain if you suddenly change position, such as when you're getting out of bed or out of a chair or when you cough, roll over in bed, or get out of the bathtub. You might also feel it as a dull ache after a particularly active day – when you've been walking a lot or doing some other physical activity.
You may feel the pain starting from deep inside your groin, moving upward and outward on either side to the top of your hips. The pain is internal, but if you were to trace it on your skin, it would follow the bikini line on a very high-cut bathing suit.
Resting comfortably should help ease your symptoms.
You can also try flexing your knees toward your abdomen to get some relief or try lying on your side with a pillow under your belly for support and another one between your legs. A warm bath may help, too.
If you find that you're more prone to round ligament pain when you're particularly active, cut back to see if that helps. Then, when you feel fine, you can gradually increase your activity until you find the level of exertion that's comfortable for you. Yoga exercises help a lot as the postures work to strengthen the supporting muscles and ligaments thus relieving the tension on the round ligament.