If there is one question that first-time parents ask that makes me laugh a little bit on the inside, it’s this:

“What happens if the baby comes too quickly and I don’t make it to the hospital?”

The reason it’s funny is because the percentage of first time mothers who plan to have a hospital birth but don’t make it to the hospital, is extremely low (probably around the same percentage, or less, than babies born on their due date, ie. not very many). I can appreciate though, that it is a valid concern for some people who may have had very quick births previously or who have a very strong family history of quick births.

It’s also a funny question because the obvious answer to that question is – “You have a baby”. The truth is, if you are a full term, healthy pregnant woman without any pregnancy complications, and you are going to have your baby quickly, then it is very likely that the baby will be born healthily without complications (whether born at home, in the car or at hospital). This is a generalisation of course, as there can be emergency situations in any birth, but the MAJORITY of “born before arrival” babies and their mothers are happy and healthy when they arrive (usually by ambulance) to the hospital to be assessed.

But I thought I could highlight a few things for you, for peace of mind and so you are prepared “just in case”.

STAY CALM

No one benefits from panicking. Especially mums and babies. Encourage the mother to take deep slow breaths, focusing on really slowing down the “out” breath, as this helps relax muscles.

MOVE  SOMEWHERE SAFE AND COMFORTABLE

Women will often be in the bathroom when they realise they are too late to be transported to hospital. If this is the case, bring in some towels, pillows and blankets to make sure the woman doesn’t get cold and sore from the tiles and to make sure the baby isn’t born onto something hard and cold. If the woman is standing or kneeling, place a pillow covered by  towel in between her legs. If she is lying down, put a pillow behind her head and a few towels under her bottom.

RING FOR HELP

An ambulance is probably the quickest and safest method of transport if you think you are literally about to have a baby. The phone operator can also guide you through what to do over the phone. If you have time, ring the hospital to let them know what’s happening so they can be prepared and they too might be able to offer you assistance over the phone.

WHEN YOU CAN SEE THE HEAD

Encourage the woman to breathe the baby down and not to push. This will help the perineum to stretch slowly and not tear. If she can’t help but push, that’s ok – sometimes the feeling is involuntary and uncontrollable. When you can see a tennis ball sized amount of head, it is very near the crowning stage. Encourage her to blow out really big breaths. The contraction will do the rest of the work. You need to put the phone down and place your hands together in a cupped position next to the woman’s vagina, just in case the baby’s head and body come out quickly in one contraction.

AFTER THE HEAD IS BORN

The baby’s face will usually start to rotate to one side before or during the next contraction. This is the time to get your catcher’s mits on if you haven’t already. The baby will be born with the next contraction. Encourage the woman to push and the baby’s shoulders and body will be born. If the woman is lying down, it is ok to guide the baby gently onto a towel on the floor if you don’t feel confident to hold it all at once. Note – babies are VERY slippery when first born. If the woman is standing, hold a towel over your arms and let the baby gently fall into the towel then pull the baby close to your chest. When the mother is sitting in a comfortable position, you can then hand her the baby. Place the baby skin to skin on the mother’s chest and wipe over with a towel then cover with a blanket.

DO NOT TOUCH THE CORD

While the cord is still attached, the baby is still receiving oxygen and nutrients from the mother. This is especially important if the baby is not crying or moving normally. Do not tie the cord with ANYTHING. It is perfectly healthy to leave the cord attached until the placentas is birthed. Even after the placenta is birthed – LEAVE THE CORD ALONE. Just wrap the placenta in a towel and place in a plastic bag next to the baby. It is a huge infection risk to tie or cut the cord with anything that is not sterile, so leave it to the ambulance or hospital to deal with.

WHAT IF THE BABY’S NOT BREATHING

Turn the baby so that their head and body are facing the mother’s chest, in between her breasts, making sure their nose is free of course. Rub the baby all over, especially on the bottom of the feet. This will usually stimulate a response from a healthy baby who is just a little stunned from a quick birth. It is unlikely that you will need to do anything more than this, and if you do hopefully help will have arrived. If the baby is still very floppy and very blue or white, turn the baby back over onto it’s back but keep it on the mother’s chest. Clear it’s mouth and nose of mucous with a gentle wipe, then cover it’s mouth and nose with your whole mouth and give a gentle breath. Keep breathing into the baby’s mouth and nose at a rate of one every 2 seconds. Hopefully the baby will respond well and start breathing on it’s own. Remember – unexpected fast births usually have a very happy ending.

KEEP EVERYONE WARM

Wet blankets can cause a baby to lose heat very quickly as they have an immature thermo regulator, so keep mother and baby in dry warm blankets. Make sure baby stays skin to skin with the mother as this will keep them the warmest. Don’t wrap the baby up, just place blankets over the top of the two of them. Mother’s bodies can raise their temperature by 2 degrees to accommodate for a cold baby.

KEEP HYDRATED

Offer the mother water and juice. Keep the baby near the breast so they can learn how to self attach. Don’t be too stressed about initiating breastfeeding. Just let it happen naturally, and if it doesn’t, babies are usually fine to wait for an hour or two until someone can assist with feeding.

WHAT IF THE MUM STARTS BLEEDING

This can be quite scary because most people are not used to seeing a lot of blood. Keep in mind that sometimes the blood is mixed with amniotic fluid and can look like a larger volume than it actually is. It is normal for there to be a small amount of blood loss at the time of birth and when the placenta is birthed. Anything under 500mls is acceptable. Think about what a 500ml bottle of water would look like if it’s spilled – huge right? So although it may look like a huge amount of blood, it may still be normal. It’s not normal when the blood keeps trickling or streaming after the placenta is out. In this case you need to rub the uterus very firmly. To do this, you place a hand horizontally across the woman’s belly button and press inwards about 10-20cm and rub downwards in a circular motion. What you should be feeling is a hard round ball about the size and shape of a cricket ball. If you do not feel this, keep rubbing HARD. EVEN IF IT HURTS. The woman may feel some gushes of blood and/or some clots pass, then the bleeding will hopefully settle. You can also put pressure on the woman’s perineum, as bleeding is sometimes caused by bad tearing. Assist the woman to breastfeed, as this can help to stop bleeding by releasing oxytocin, the hormone responsible for uterine contractions. If the bleeding does not settle down, then hopefully the ambulance you called earlier will arrive soon, if they haven’t already.

Remember remember remember – stay calm. It is highly likely that everything will be normal. Now sit back, relax, pop some bubbly and enjoy your beautiful new baby!

P.S. It’s a myth that you need boiling water – except to make yourself a cup of tea when it’s all over!

It was a Sunday and we had just finished church when my sister called and asked if we wanted to go out to yum cha for lunch. She said she had been having “period-like” pains since about 4am and she wanted to go out to keep herself occupied. She had also been having mild period pain for about a week and a half prior, so she wasn’t sure that this was the real thing. She was 39 weeks and 4 days pregnant. Her first daughter had been born at 39 weeks and 2 days, so she was already feeling “overdue”. She also thought that this baby might be a boy, and boys in our family tend to come late, so she wasn’t too concerned.

So the whole family, parentals included, went out for lunch. If she was having pains, she wasn’t giving anything away. She looked great, if not a bit tired. As we left to go home, I said “see you tonight?” and she said “yeah maybe, I’ll let you know”.

As night descended, I thought maybe the niggles had died down because I hadn’t heard any more from her. But of course, as soon as I hopped into bed at about 10:30pm my phone rang. It was Beth telling me the pains had started becoming stronger at about 8pm and she’d called mum to come and be around to look after soon-to-be big sister. She also called so I could defrost some breast milk I had expressed for my 7 month old. We had joked that I could just bring him along to the birth because he still feeds a lot at night.

So I defrosted some milk and tried to go to sleep, which was impossible as I was buzzing with excitement. I eventually fell asleep but woke every hour thinking, “is my phone working? Did I miss her call?”. But 3 am rolled around and still nothing. My midwife brain couldn’t turn off. I was thinking either the pains have switched off or the baby is posterior and taking it’s time. Then finally the phone rang and it was Ben telling me the pains were now every 2-3 minutes, lasting 20-30 seconds and getting more intense. I had slept in my clothes so I could just jump out the door but then I realised my toddler would be waking in 2 hours and my hubby had to leave for work early on Mondays. I gently woke him and asked him if it was ok to leave him with the kids (this had always been the plan, but we didn’t know the baby would come on a busy work day), and he said he didn’t think he’d be able to get the kids both ready in time to drop them with mum and go to work. So the joke of bringing my baby, became a reality. I bundled the sleeping beauty into the freezing car and scurried over to Beth’s house.

Luckily bub stayed asleep when we got there so I could focus on my sister. It often happens that when something in the birthing environment changes (like a new person coming in, or going to hospital), if the woman is not in rip roaring labour, the contractions slow down for a time before they pick up to what they were previously doing. As I was standing with my sister, her pains were coming every 2-3 minutes but they were barely lasting 10 seconds and she only had to breathe deeply twice and they were finished. I had a quick feel of her belly in the standing position, which is pretty impossible, but to me the baby did feel a little posterior. That’s when I started to worry.

Her first labour had been very straight forward – a few hours of prelabour, then gradually increasing contractions and baby born after about 7 hours. I was afraid that this was going to be a long, drawn out labour, which she would have trouble coping with after such a quick first birth. I didn’t say any of this to her of course, but I think she could read my mind. She kept saying “why are these pains so short? Why is it taking so long? Do you think it’s posterior?”. I tried to reassure her and give non committal answers. But she’s my sister. She could see through my vagueness. Nevertheless, she stayed calm and in the moment. Just focusing on breathing and swaying her baby down.

I tried my best to be her doula, supporting her and Ben and protecting her birth space. After a while I left her and Ben to labour together so I could make some tea and breastfeed. They are such a good team, Beth breathing and resting, Ben timing and making sure the heat pack was always hot and she stayed hydrated. Even though they were both calm and focused, my pesky midwife brain kept sprouting negative thoughts that I tried as hard as I could to ignore. I tried to remember to trust in my sister’s birthing ability. She is a fabulous birther.

At about 5:30am she said she felt like going to the hospital. I was thinking silently “oh no, not yet, you’re not established, we’ll be there for hours and the doctors do their rounds at 8 and they’ll want to intervene and it will start a cascade of events”. But as you know women know their own bodies and know when it’s time. So I trusted her, left mum with the kids and helped pack everything into the car. She told me later that she had known it was not as intense as last time yet, but she didn’t want to get to hospital in the day time and have to have contractions when everyone would be arriving for work and the foyer would be filled with people. Smart girl.

During the drive Beth had a few contractions. They weren’t too intense but they had started lasting 20-30 seconds again. Good, progress. I warned her that, depending on who was working, they might want to examine her to see how dilated she was, as her contractions were still quite mild. She was not very keen at all because she had not needed a vaginal examination fist time round as baby had been born an hour after arriving. Luckily, it was a very good experienced midwife who was working and I told her Beth wasn’t keen on an examination. She was happy to wait and see how things went.

After about half an hour, when Beth had gotten settled in the room, she was rocking and swaying with the contractions and sitting on a fit ball in between. Still the contractions were about 30 seconds long and about 2 minutes apart. Then during a more intense pain, she felt a “pop” and her waters broke. There was only a little trickle, but as soon as I pulled her pants off I saw that the amniotic fluid was meconium stained (which means the baby had done a poo inside). Again immediately my midwife brain turned on and I couldn’t help thinking “oh no, the baby is distressed, something is wrong, she isn’t overdue so why would the baby poo other than being distressed?”. When will I learn to just be patient and trust birthing women and babies? I was also thinking “she’ll have to be continuously monitored and she’ll hate that cos she won’t be able to move around and then we’ll get a bad trace and the doctors will want to intervene some more, and the paeds will have to be present for the birth, and they will take the baby away and not let her have skin to skin and it’s all going to end badly”. All the while these stupid negative thoughts were rolling around my head, I outwardly stayed calm and reassured her by reminding her that my first born had had very thick meconium and he had been fine when he was born.

The CTG machine was put on and the baby’s trace was perfect, reactive and happy. I started to calm down and think more positive thoughts. It’s amazing how, when it’s a family member, you think all the worst case scenario things straight away. Normally a little bit of thin mec doesn’t cause me much concern because it’s so common and babies are usually fine. I was hoping my sister’s mind reading ability was being dampened by her inward focus to get through the pain.

After her water’s broke, it was game on. The contractions started doing what I had expected them to do the whole time. They were strong, lasting 45 seconds and coming every 2 minutes. This was more like it! She was having to breathe very deeply and occasionally let out a roar. I was getting excited. She was getting to the primal stage, where anything goes. She got tired of standing, so she jumped up kneeling on all fours on the bed. During the height of the contractions she was starting to use a high pitched scream. I really wanted to remind her to use low, growling sounds, as high pitched sounds can be restrictive and increase tension and pain. But I was too chicken. I didn’t want to annoy her during this immensely intense stage.

It turns out I didn’t have to worry, because within about 3 contractions she was groaning and grunting like she needed to push. I told her she was doing a great job and to follow her instincts and what her body was telling her to do. She became a bit agitated and was telling me I just had to tell her when she could push. I thought she was probably fully dilated by her behaviour and she also had the dark red line down her bottom crack which is a sign of full dilatation. I said she could try pushing and see if it felt better, just go with the flow.

Next contraction she was determined. She pushed like a champion birther and let out a huge scream at the end which caused the midwife to come running back into the room. I had put gloves on just in case the baby popped out before the midwife came in (I was secretly hoping it would). She was starting to show all the outward signs of immenent birth. I asked Ben if he’d like to help the midwife catch the baby. He was a bit apprehensive but excited. After about another 3-4 pushes the baby was crowning. When a midwife starts to be able to see the head of a baby, we usually make some remark about the amount of hair, to encourage the mum to push. This was no different, but this time the baby did really have a lot of hair!

One more gentle controlled push without a contraction and a gorgeous little face appeared, followed quickly by a teeny tiny body. The midwife and Ben caught the perfect little baby and tears of joy streamed from his face. Beth sat up so she could look through her legs to see the baby. “it’s a girl” she exclaimed, overwhelmed and relieved. I helped hold the beautiful little creature so Beth could roll over onto her bottom and meet and hold her new princess for the first time. She looked so tiny, cradled safely in the arms of her two loving parents. What better place to be? Absolute bliss!

As it turned out the paed only just made it to the birth and left about 2 minutes after, as the baby was crying and obviously thriving. The time was 7:10am. All my worry was unfounded, she had beaten the doctors by almost an hour! She had trusted her body and the process of normal birth. She had once again achieved the amazing miraculous feat of birthing her baby.

I am so proud of my big sister. She is an inspiration to me in so many ways. Especially through her birthing and mothering. She is a brilliant birther, a brilliant mother and a brilliant sister. I love her. And I love her babies.

This one’s for you Bee <3 xox

This is why we should really be discussing a range of time that we could reasonable expect a healthy fully developed baby to be born, instead of a specific “due date”. This range of time is between 37 and 42 weeks of pregnancy. Anything before this is considered premature, but anything after the single due date is considered post dates. I wonder if this use of the term “post dates” or “overdue” as soon as you pass the allusive “due date”, causes women to feel even more anxious, impatient and “over it” than they already are.

Now I hate to be the bearer of bad news but no methods of induction, either natural or medical, are foolproof. As i mentioned earlier, there are many contributing factors that decide when a baby will be born, so the things I suggest below will not always bring on labour. They may however, tip you over the edge, and get contractions started if you’re almost there. Some people will swear by one method or another because it worked for them, but as we are all individuals, so are our births and the things that work that spur labour on.

Below are some things that have worked for people over the years. Rest assured though, most babies will come when they’re ready. The minority that don’t can be helped along with medications that can be used to start contractions, in a hospital setting. And if every method and medication has been used and still labour has not ensued, we are blessed to have access to caesarean birth when necessary. Please don’t attempt any of these things until you are overdue.

The 3 Hot’s

Hot food – Very spicy food is thought to bring on labour by causing your digestive system and bowel to be irritated, which in turn rubs against and irritates your uterus, starting contractions. This may result in having diarrhoea in labour which is unpleasant.

Hot bath – A warm bath can be relaxing and soothing, so even if it doesn’t start contractions, it is a lovely calming way of preparing yourself for the rigors of labour.

Hot sex – A woman I cared for once said “right now I think I could only manage tepid sex, do you think that’ll work?” Hilarious! The reason sex is suggested is because semen contains the largest amount of naturally occurring prostaglandins. Prostaglandins are a chemical that cause the cervix to become soft and ready for labour. The “gel” used to induce women in hospital is made from prostaglandin. Also, sex releases lots of endorphins – the love hormone – and oxytocin (also used in hospital induction) which can give contractions a kick start.

Walking

Going for long walks, especially on sand or with one foot up and one foot down on a gutter, can help babies move lower in the pelvis and the physical activity often stimulates Braxton hicks, which can sometimes flick over to real contractions during your due range.

Clary sage oil

Burn a few drops in an oil burner or add a few drops to your hot bath. Can bring on contractions.

Raspberry leaf tea or tincture

Start drinking the tea or get the tincture from a herbalist anytime after 32 weeks. The tincture is apparently stronger so you probably shouldn’t start taking it until 36 weeks (take the advice of the naturopath). Thought to reduce the duration of labour and increase the efficiency if contractions.

Evening primrose oil

Alternate 2-3 capsules orally one day and then vaginally the next (push the capsules as far up as they will go). Ripens the cervix and may help start cervical dilatation.

Reflexology

Works on Chinese medicine theories of activating the points on the foot that correlate to different body organs. The ankles are particularly connected to the uterus. Make sure you see someone qualified to do pregnancy massage. Can help contractions to start. If nothing else, it is nice and relaxing.

Acupuncture/Acupressure

Works in the same way as reflexology but uses different pressure points over the body to activate your uterus.

Naturopathy

A naturopath or traditional Chinese medicine practitioner can give you different herbal remedies to take orally. Black and blue cohosh can be used to help contractions start. CAUTION: there have been harmful effects to mother and baby found from these plant extracts when taken incorrectly, so only use as prescribed by a qualified health care practitioner.

Drive on a bumpy road

Self-explanatory. The jolts can cause contractions to start.

Watch the movie “Three men and a baby”

Apparently lots of women go into labour after watching this movie. It is thought to be because of all the baby crying stimulating the release of labour hormones.

Hold a newborn baby

Same reason as above – release hormones.

Never ever try to break your waters

It is very dangerous when not done by skilled professionals. If the baby is in the wrong position, you could cause a cord prolapse which cuts the baby’s oxygen supply and could lead to brain damage or death. Not to mention the possibility of injury to yourself or your baby from sticking foreign sharp objects up your vagina. Just don’t do it.

Last of all, wait and be patient. The baby will not be in there forever. One way or another it has to come out. Try and fill your time with rest, preparing the baby’s room, pre-cooking and freezing meals, spending quality time with partner, friends and family, and enjoying the time you have now. Your life is about to change forever, enjoy every minute of the journey!

This post is dedicated to Bec. You hung in there and now have a beautiful daughter. Now, wasn’t it worth the wait? God bless xx

It was our one year wedding anniversary when we decided to do a pregnancy test just on a whim and discovered that we were accidentally preggers. We had been discussing it, but were planning on starting a family after I had finished my teaching qualifications and had had a chance to work for a little bit. We calculated the due date to be roughly one month after I was due to finish my course. There were some jokes about planning it that way so I wouldn’t have to get a job.

My pregnancy was relatively standard. I had all day sickness for about 4 months, and bad sciatica and carpel tunnel syndrome in the second trimester. At 28 weeks, I developed gestational diabetes, which was really upsetting as I suddenly felt like my pregnancy was being taken out of my hands, and becoming very clinical. I had to see doctors all the time, and every decision made was because of the diabetes, as opposed to my wishes. There was the threat of having a big baby, increased chance of intervention and consequential caesarian, as well as health risks to me. I worked really hard and got it under control with diet, and as a third trimester scan showed, the baby was perfectly in the mid range for weight/measurements, so I was happy.

After I finished my last exam, I really focused on getting myself ready for labour. My husband and I started taking long walks, I read loads of books ( particularly helpful was “Birth Skills” by JuJu Sundin and Sarah Murdoch) and watched a few dvds of different types of births. I wrote a birth plan, and started taking raspberry leaf tea capsules to get my body and mind ready for the process of birth.

The plan was to try all the natural stuff first, until it didn’t work any more, and then progress to gas, and epidural as a last resort if needed. I had heard loads of stories about first babies taking ages to be born, so I had a labour bag packed that had EVERYTHING in it that’s suggested to help in labour – and ultimately, we didn’t use any of it!

2 weeks before my due date, after a long walk on the beach with a friend through soft sand, I woke at about 4.30am with what felt like bad period pain.. I started timing, but it was really irregular and eventually went away, so I went about my normal day – even planning a big dinner party for the next night. In the afternoon, the pains came back, but were an hour apart, so my husband and I went for a big walk, and made sure we were prepared to go to the hospital if we needed. We slept early that night, waking up every hour to walk through a contraction and time it. By 3am they were 15 mins apart, but increasing in intensity, so we decided to leave for the hospital.

I had hired a TENS machine, which had arrived in the post that morning, and by the time we put the electric pads on and got into the car, the contractions were 5 mins apart, but the TENS really helped me to take the edge off, so it wasn’t too bad.

At the hospital, I was 3 cm dilated, but the heart rate monitor showed that the baby was asleep, so I got to guzzle some apple juice to wake it up (and it was divine because I hadn’t had juice in 3 months because of the diabetes!!). Once we moved into a birthing room, I spent an hour or so sitting in a chair, breathing slowly and concentrating on relaxing through each contraction using the TENS machine, and as it got more intense, my husband and I stomped around the room, using the TENS machine. What I loved about the TENS was that I got to control when and how it was used.

We had some spectacular midwives, who were super supportive, especially when the doctors came in wanting to speed things up with drugs. The midwives were in my corner and managed to get the doctors to agree to just manually breaking my waters, without giving me drugs to speed up contractions. When I got up to use the bathroom, my mucus plug dislodged (which was pretty gross – I had forgotten about that happening too so it was a surprise), and when they checked, I had dilated to 7 cms in 3 hrs, which was great. My amniotic sac was broken with the crochet hook, which didn’t hurt at all.

Contractions were steady and consistent, and the TENS machine paired with stomping around the room and swaying hips, was still effective, so we didn’t see the need to try anything else. Slowly, my blood pressure was increasing, which was causing concern for the doctors, and a cannula was put in my hand, just in case they needed to give me drugs.

I was starting to get very uncomfortable, and felt like there was a lot of pressure on my sacrum. I felt like my hips were really loose and were going to fall apart. By this time, my husband was in charge of pressing the button on the TENS machine, and putting pressure on my hips from each side, because I was concentrating on breathing and relaxing my body. The midwives suggested I use the bathroom to make space for the baby’s head to descend, but when I stood up, all I could think about was pushing. This was probably the worst part of the whole labour, because I really really wanted to push, but I knew I couldn’t until I was completely dilated, and I was starting to have contractions back to back. I needed to lay on the bed to have my cervix checked, and it took me about 10 mins to get up on the bed, because I knew sitting was going to be very uncomfortable and I didn’t want to do it. Eventually I made it up there, and was announced to be fully dilated. I was allowed to push!

I think it took me about 5 contractions to fully understand what I was supposed to do, despite the midwives telling me I could push and push hard, multiple times. I was still trying to relax through each contraction. By this time, I was sitting up on the bed, with my eyes closed. It probably wasn’t the best position to birth in, but I was comfortable and didn’t want to move again. Three doctors and three midwives were in the room, all commenting on what a great job I was doing, which was encouraging. After wards, I was told the doctors were there to intervene (they wanted to use the vacuum forceps) but the midwives stuck up for me and said I was going to do it on my own. The next push, I was crowning.

I knew this bit would sting, and it did, but I was so determined to finish it, that it didn’t really bother me. Next thing I knew, the head was out, and on the next contraction, the rest came out, and then she was up on my chest, looking me in the eyes. She didn’t really cry, and was so alert, it was amazing. Within 10 mins, my husband and I had taken photos and texted family and friends to share our excitement.

Out of everything to worry about in labour, tearing was high on my list, only because I have had some close friends who had really terrible tears. I had a second degree vaginal tear, and a small perineal tear, but it wasn’t as bad as I thought it would be. I was stitched up, and hardly even noticed it after wards. It wasn’t worth the worry.

And, all in all, I thought the whole process was relatively easy (I know every other mother out there is annoyed by that sentence!). I had such a positive experience, ultimately because I was in control of every aspect of my birth, and was encouraged and supported to have faith and trust that my body could do it on my own. After wards, I felt so empowered and strong – I had had a baby!!

The only thing disappointing about the whole process was that I didn’t get to have my dinner party…

The basic concept is that spending a chunk of one-on-one time with your child can drastically change their emotional and behavioural issues. Well duh! Didn’t we all already know that? But there is a slight difference to this new method. The mysteriously lost article on EB talked about having a 24 hour period of one-on-one time with your child, where they are the boss. They get to decide what you do, where you go, what they eat, when to go to bed… Basically every decision is up to them. The only thing the parent has to do is say yes and shower the child with affection whilst telling them you love them, constantly. You also share a bed with them if that’s what they want. It’s all about them. This “love bombing” supposedly rewires the brain’s pathways to help kids feel more confident and secure, especially following a trauma. I should also mention that it was only recommended for children between the ages of three to adolescence.

The author of the EB article experimented with love bombing with her two kids because they were showing differing levels of PTSD (post traumatic stress disorder) following their father’s suicide. Her son is very active and crammed lots of energetic activities into their 24 hours together and ate tons of ice-cream and soft drink. Her daughter is more quiet and they enjoyed doing craft together and having lunch at her favorite restaurant. The mother now swears by love bombing. The kids loved spending “special” time alone with their mum. She says the changes in her kids’ behaviour was almost tangible. She has implemented love bombing her children every once in a while, to help boost their confidence and self assurance. They call it “mummy day”.

I am really interested by this. I would love to try it out. Not only for my kids, but for me. I often feel sad that I don’t get to enjoy each of my beautiful children by themselves without any other distractions. When his brother was born, my first child had to learn that he no longer got my undivided attention. My second baby has never even really had my undivided attention like an “only child” would. How precious it would be to give that gift of time and love to each of them separately.

There are a few things I’d probably do differently though. I think I’d still have to have rules. Things like “no hurting other people” and “no swearing” etc. would still be in place. I’ve heard a few people do different versions of the same kind of idea. I read about one woman who has a pyjama day every school holidays with her kids, where they stay in bed and watch movies or tv all day. Another has a day of unlimited xbox use once every school holidays. What a great idea! I love that parents are making conscious decisions to shower their kids with the desires of the kid’s hearts. It’s all too easy to stay in the pattern of “cruel to be kind” or “doing it for their own good”, which of course is necessary the majority of the time, after all we parents only want the best for our kids. I like, however, that love bombing allows kids to have a say and get to do harmless fun things with their devoted mum or dad’s undivided attention, every now and then.

Even if it doesn’t “reprogram” a child’s behaviour and self esteem, I can’t see that it would cause too much damage (besides maybe a trip to the dentist). It’s not the same as over-indulging a child all the time. The child knows the game, the parameters. It’s an occasional foray into being solely responsible for one 24hour period’s activities.

I’m going to try it when my kid’s are at an appropriate age and can reason more sensibly. Can’t wait!

What are your thoughts?

When does sharing go too far? Is it really that bad to befriend patients or ex-patients on facebook? When does online activity cross the personal-professional boundary? Do you agree with the nursing board – that nurses and midwives should keep their personal and professional social networking identities separate?

I’m not going to share too much about my personal opinion for fear of getting in trouble, but suffice it to say that I do not have two separate identities in my real life, so why would my online life be any different? If I share stories of my experience of people’s births, I keep them general and would never mention names or identifying data. When I have shared other people’s whole birth stories, it is with their permission, and they are the author!

I share online, in the forum of this blog, in the hope of helping people. Becoming a parent is a monumental time in a person’s life and many look for support and answers online. I hope to provide unbiased, research and experience based information to help people on their journey. I would never want to jeopardise my professional practice by acting inappropriately online.

In saying this though, I can not believe (as written in the article) that a US nursing student was expelled for posting a picture of a human placenta. Is that really such a horrendous act? I can understand that facebook might remove the image as being offensive, but is expulsion from university really necessary? Maybe she didn’t have consent, maybe she had a disgusted face in the photo, who knows? But placenta’s are not generally identifiable as coming from any particular person, so a breech of privacy seems unlikely.

Anyway, there is my little rant. It upsets and scares me that the fear of litigation could hinder attempts to help people in the online form. Yes, we need to be careful what we share, but surely our careers should not be threatened because we have an online presence.

So, rule number one: Pack light (trust me, you will not need 17 pairs of pants). Rule number two: Pack light (you are not going to a third world country, so if you forget anything or run out of something, send a friend or family member out to get it for you). Rule number three: Pack light (even an entire support team with big appetites will not need a whole esky of food to “get through” the labour).

The average length of stay for a normal vaginal birth is around 2-3 days at most hospitals (add another 2-3 days for caesareans). Every hospital differs with what they provide for your stay, ask your midwife what your hospital provides. Every hospital will provide linen (including sheets, blankets, towels, baby singlets, baby gowns and baby bed linen). With all that said, below is a list of things that you will require.

For you

Comfortable clothes to wear in labour.

There will be hospitals gowns that you can wear, which some people find great because they are made of breathable cotton, with easy access to go to the toilet, it doesn’t matter if it gets dirty and you don’t have to wash it. If you would prefer to wear your own clothes, an oversized tshirt or nightie is perfect.

Handy Hint: Pack separately in a plastic bag – your toiletries, one pair of undies, a singlet top (the tightness of a bra may hinder milk production in the first few days), loose track pants, a tshirt and slippers. Put this bag at the top of your suitcase, so your partner or the midwife can find it easily when you’re having a shower after the baby is born, without having to dig through your whole bag.

Other clothing.

3 long loose pants, 3 baggy tops, 2 pairs of winter pj’s, 8-10 dark coloured undies in a size bigger than normal, 2-3 maternity crop tops or singlets (“target” and “bras n things” sell them and they are less restrictive than bras), thongs (flip flops), 4 pairs of socks, slippers and a warm jumper (the air-conditioning in hospitals is notoriously freezing).

Toiletries.

Toothbrush, toothpaste, moisturiser and lip gloss (air-conditioning is extremely drying) hairbrush, shampoo and deodorant are all essential. You don’t have to look glam in hospital, it’s not a competition, remember you will have a newborn to look after and less time to beautify. But if you would feel more yourself with makeup on, then go for it. Try not to use shampoo or deodorant for at least 24hrs after birth and then only use no or low-scented products, as babies need to learn your natural smell, which helps them to identify and bond with you. That may sound repulsive to you, after giving birth and all, but it is really important and a good warm shower will wash off any “grossness” and still leave your natural scent intact.

Pads.

I found the most comfortable to be the “Stayfree” brand, currently in blue and pink packaging. This is because they are very thick, so they support and give extra padding to your sore perineum after birth. Warning though – it does feel like you’re wearing a surf board! I found “Big W” to be the cheapest place to buy them. The “Libra” brand aren’t bad either. You should change pads every 2-3 hours or more frequently when full, so you will need roughly one packet of pads per day for the first week. You may also need breast pads, in case your milk comes in super fast, but you won’t need heaps, 4-6 should do the trick.

Food.

For labour, you might like to pack a SMALL goodie bag for you and your support people. Apple juice or sports drink, a few muesli bars, a packet of lollies and a few cuppa soups should be fine. Hospitals generally have a cafeteria open during the day, and vending machines all hours, which can be a nice five minutes of relief from the intensity of the labour room, for support people. Pack some gold coins for the vending machine in a separate purse so you won’t spend them. For the rest of your stay, the hospital will provide main meals and light snacks and water, but when you are breastfeeding you are usually ravenously hungry, so pack some extra muesli bars, fruit or biscuits to nibble. You can also give visitors the job of bringing you these snacks, so your bag isn’t so big.

Breastfeeding aids.

You might like to take a breastfeeding pillow to help you support baby in a more comfortable way (though I never used one). Note: always attach baby to breast without pillow first, once baby has attached properly, then position the pillow. Using pillows before attachment may cause incorrect attachment, which can lead to nipple damage. If your nipples do receive damage, then you might like to have a small tube of “Lansinoh” cream to help soothe, heal and keep cracked nipple soft and not form scabs. Lansinoh is the only approved topical nipple cream for breastfeeding (don’t use paw paw ointment) and you only need a teeny tiny bit on the damaged section of nipple. You might also like to take a watch/clock, notepad and pen to write down when, what side and how long each feed is, because the midwives will ask you. Some people find it hard to remember what breast to feed from, so take a bracelet to wear on your wrist on the same side you need to feed from next.

WARNING: Never self-administer ANY medication whilst in hospital. This includes panadol, nurofen, cold and flu tablets and ural sachets. The hospital has all of these medication on site and all you need to do is ask the midwives if you require it. The midwives need to know everything you take, so they can ensure there are no harmful drug interactions and that the medication is safe for breastfeeding.

For Baby

Babies don’t need much in hospital. One small packet of nappies, wipes, 4 pairs of socks, 2 scratch mittens, one going home outfit and one beanie is enough. You don’t need any other clothes as it is much easier dressing/undressing baby for various hospital tests when they wear the baby hospital gowns. Besides the fact that they will get wee, poo and vomit all over them and you don’t have to wash them! Babies regulate their body temperature through their heads so make sure you never put a baby to sleep with a beanie on unless you are watching them the whole time. This is to avoid overheating and suffocation hazards.

I recommend using disposable nappies and wipes in hospital even if you are planning on cloth nappying at home. This is because cloth nappies are usually too big for newborns for a couple of weeks, the first poo (meconium) is next to impossible to remove from cloth, and you would have to take soiled nappies home to launder them. Breastfeeding is the preferred form of infant feeding but if you are planning to artificially feed, then bring bottles, formula and sterilising equipment. Dummies are not recommended for breastfeeding babies. If you do want to use dummies, then try to wait at least until your milk has come in, which will most likely be when you are home already. Remember, the more you feed the quicker your milk comes in, so using a dummy will cause a delay, possible nipple confusion and incorrect sucking and attachment onto your breast.

So now you’re armed with knowledge of the essentials. My only other advise to you is to enjoy yourself. Read all the hospital pamphlets about breastfeeding and baby behaviour, take a good book and go to the in-house classes on bathing, sleep and settling, physiotherapy etc. This will be a time in your life that you will never forget and in the end, who cares what was in your bag?!

This is why I was so excited when last year in November the Labour government’s Maternity Services Review included provisions for midwives to become Medicare eligible. This means that eligible midwives are now able to provide maternity care with medicare rebates to women seeking to be treated as private patients. Previously women seeking private midwives had no option of Medicare rebate and instead had to lump the entire cost.

The Nursing and Midwife Board of Australia highlights the criteria to become an eligible midwife.
An eligible midwife will have:

• 3 years postgraduate experience,
• currency across all areas of midwifery,
• completion of a professional review program
• completion of a prescribing course (or within 18 months under transitional arrangements).

I can understand the need for these criteria, but I am irritated by a few things. I agree with the first three points. I don’t mind the fourth point if it were at all possible. There are currently no educational facilities that provide prescribing courses for registered midwives. How is any midwife meant to complete a course that doesn’t exist? AND 7 months into the reforms, with still no prescribing courses for midwives, how would anyone under the so called 18 month transitional arrangements, actually transition?

My next issue is related to the stipulations put on the care eligible midwives can give to women to allow them the obtain the Medicare rebate. Women can only get the rebate for private care for antenatal services, delivery in a hospital (or hospital birth centre) and postnatal services. What about women desiring a home birth with a private midwife? If public hospitals can offer midwifery home birth programs, why can’t private midwives offer home birth as an option?

Also, how is a private midwife supposed to provide delivery care in a hospital? I don’t know if many public hospitals would allow private midwives to have visiting rights to provide delivery care to their private patients. Who’s resources would the midwife use? Would she have to bring all her own equipment? If not, how much would the hospital charge her to use their equipment? Do the hospital’s own women or the private midwife’s women get priority for rooms, medical review, available equipment etc.? The midwife would almost certainly receive backlash or at the very least a begrudging attitude to her taking up “their” rooms and resources. How would we overcome this problem?

The other statement in the maternity reforms outline which is good in theory but impossible in practice, is that eligible midwives must have collaborative arrangements with medical practitioners. This article came up on my google alerts emails. It talks about how in the seven months since the reforms became active, only 7 midwives out of Australia’s 42000 midwives have become medicare eligible. SEVEN!!! Ridiculous!

Apparently doctors willing to sign a collaborative arrangement are more than scarce. Surprise surprise. Why would a doctor sign a document that could mean they have less women seeking their care and no financial benefit? Besides the fact that a doctor would most likely want to KNOW the midwife and her skills and abilities before agreeing to take on any of her women who develop a problem outside of her scope of practice requiring transfer to obstetric care. This eliminates the possibility of any midwives who are already practicing as a private midwife to obtain a collaborative agreement, because for one they don’t work in the hospital, and are therefore unlikely to know any obstetricians personally. What obstetrician would sign an agreement with someone they don’t know from a bar of soap?

All of these factors seems to make Medicare eligibility insurmountable. And I haven’t even touched on the problem of inaccessibility of insurance for private midwives. If the government really wants more midwives to take up the challenge and run the gauntlet of becoming a Medicare eligible midwife, they need to do more, make it easier and help midwives make the transition.

Before sharing some relevant articles, it is important to make note that the most reliable form of research is called “randomised controlled trials” (RCT). This type of research ensures that people participating in the study are randomly assigned to one treatment or another (in this case elective caesarean vs vaginal birth), which eradicates any possible bias. Another important aspect to the RCT studies, to ensure there is no bias, is called “double blind”. This means that neither the participant nor the person collecting outcome data, knows which treatment has been assigned to which patient. Due to the nature of birth itself, neither of these methods to ensure an unbiased result are possible. Every woman is going to want to know, and moreover, choose, whether she is having a vaginal birth or caesarean. There are probably no women who would allow “the system” to allocate her to one mode of birth or another. Obviously, the people collecting outcome data would also know which type of birth each woman has had.

Does this matter? The short answer is yes. It does matter whether a study has bias either towards or against a certain treatment because the participant, or data collector’s desire for a particular outcome, can skew the results. So, each study must be scrutinised carefully to determine the extent of the bias and the accuracy of the information.

In this particular instance though, bias may actually be helpful. If a woman is biased towards having a VBAC rather than elective caesarean, this will increase her rate of success. Her passion and determination to have a VBAC will help to prepare her for the marathon of labour and birth. If a woman is biased towards elective caesarean, then obviously she will not WANT to labour, which would greatly hinder her success at giving birth vaginally.

Having said all of that, the general success of women attempting a VBAC is roughly 70% in most cases. Considering that the caesarean section rate for ALL births (including elective caesareans) is between 15-30% at most hospitals, if you are passionate about vaginal birth and have weighed up the risks, then the odds for successful VBAC are worth it.

If a woman has had a previous successful vaginal birth, either before or after the caesarean, the chance of another successful vaginal birth are increased. If the successful vaginal birth was after the caesarean, her chances are increased even further.

This study by Hoskins and Gomez (1997) discusses the success of VBAC in relation to cervical dilatation at the time the previous caesareans were performed. The study showed that the VBAC success rate was around 70% for all of the causes for previous caesareans, such as malpresentation (baby facing the wrong way eg. breech), fetal distress (baby’s heart rate too high or too low) and arrest disorders (baby getting “stuck” in the birth canal, or labour slowing or stopping) up to 9cm dilatation. The only difference was found among the previous caesareans done for arrest disorders at full dilatation, in which case the success rate was 13%. This low percentage is because if the previous caesarean was performed at full dilatation because the baby would not descend and could therefore not be pushed out, then it is reasonable to assume that subsequent babies might have the same problem, especially if the babies have the same genetic material (eg. mother and father). If the previous caesarean was done because the labour stalled or stopped, it is possible the same thing may happen is subsequent labours.

There are risks associated with VBAC that need to be considered. Uterine rupture is by far the biggest concern when considering VBAC. As you can imagine, uterine rupture is life threatening for both mum and baby. If an emergency caesarean is not performed immediately, the baby could be severely disabled or die from lack of oxygen and mum could suffer huge blood loss, require hysterectomy or die. The risk of uterine rupture however, is thankfully very low. It has been found in numerous studies to be between 0.4 – 1.5%. There is also a risk of needing to be induced for one reason or another, which among VBACs has been shown to further increase the risk of uterine rupture.

There is so much that can be written about this topic and there is an abundance of literature available to aid in informed decision making. Vaginal Birth After Caesaean section is a safe and sensible option to choose for most women desiring a normal birth following a caesarean.

Here are some useful websites…

http://www.vbac.com/

http://www.birthrites.org/vbac.html

1. What is your name, age and favourite colour?

I’m 27, favourite colour turquoise.

2. When did you know you wanted to become a midwife?

I knew I wanted to be a midwife when i was 19.

3. Where did you do your midwifery training? Why did you choose that particular uni/hospital?

I did my training at UTS. I chose UTS as it was the partner uni with Sutherland/St George hospitals, the closest hospitals to home.

4. How long have you been a midwife? And what area of midwifery do you work in?

I’ve been registered going on 2 years and I rotate everywhere.

5. Are you a mum? Whether you answered yes or no, do you think that has any affect on your practice as a midwife?

Yes, I’m a mum of 2 and yes I think it hugely effects my practice.

6. What is your favorite birthing memory?

Fav birthing memory??? Too many to decide on 1, but honestly probably my own labour and birth, does that count?

7. Can you recall a time when you were most scared as a midwife?

I was most scared with the 1st shoulder dystocia I witnessed as a student. It was a bad one, head was out for nearly 3 mins then she had a 3L pph [post partum haemorrhage] really scary, I cried at home for ages!

8. What’s your birthing or midwifery philosophy?

My birthing philosophy is –  its “womens choice”, as long as they make an informed decision, I’ll back them 100% with whatever they want!

9. Do you think you’ll still be a midwife in 20 years?

Yes I think I’ll be a midwife in 20years.

10. What’s one thing you want every expectant mother to know?

Every mother should know there is no such thing as a birth plan! You need to be open the possibility that anything could happen & you’ll probably poo yourself.