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Posts Tagged ‘caring for yourself’

How to catch an unplanned homebirth

Monday, January 23rd, 2012

Ok, so it has been a shamefully long time since I posted anything at all. This is due to life becoming crazy, two beautiful boys becoming even more active and needing a lot of attention, returning to work earlier than planned and our little family moving back in with my parents (arrrrgh). Needless to say, the spirit has been willing but the flesh has been weak (and tired and very time poor). So I thought I’d ease myself back into it with a fun topic. Thank you to my loyal friends and readers for waiting so patiently and urging and encouraging me to continue. I hope you enjoy this one.

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!

Sex after babies

Monday, May 16th, 2011

What a taboo subject! No-one ever talks about this before you have babies. Maybe you might tentatively ask a close friend what she thinks, but do we really want to know or is denial preferable? I also suspect most women will almost certainly not discuss post natal sex with their partners. In my experience people just expect it to be horrible. But what is it actually like? How long should you wait? What about body image issues? How will I find the time for sex, especially with a newborn to look after? Will I even feel like it?

If you had a vaginal birth, there are obviously some physical changes that your anatomy has gone through. If you sustained any perineal trauma that required suturing, you probably would’ve been advised by your midwife or doctor to wait 6 weeks until resuming sexual intercourse. This is to reduce the risk of infection or reopening the wound. It is also sensible to wait until your post-birth vaginal bleeding has stopped, which is usually around 6-8 weeks. Of course your vagina may still feel too tender or even painful to consider sex for even longer than the suggested waiting time. Even if you didn’t have stitches, you will most likely still feel uncomfortable for some length of time. After all you did just miraculously birth a baby! Follow your body, take time, you are the best guide as to when is the right time.

If you had a caesarean, you may be surprised to learn that it is probably best to wait the same amount of time as for a vaginal birth. A caesarean is major abdominal surgery, which requires time to heal the many muscle and skin layers that are cut during surgery. 6 weeks is a good guide to wait for healing and for post-birth bleeding to cease. Again follow your body and stop if you have any signs of discomfort.

One of the most sad and misguided jokes I have ever heard regarding post natal sex, was out of the mouth of a man who had just watched his wife give birth vaginally – “It’s like watching your favorite pub burn down – you think, ‘I used to go in there and have fun’”. Although I really don’t like this horribly crass joke, I think the core of the matter is that the man obviously had concerns about sex in the future, concerns which needed to be discussed and addressed. Talking with our partners is so important, not just with regards to sex after babies, but for all aspects of life. If a couple has a reasonable expectation of the how’s, what’s and when’s of post natal sex, then it shouldn’t be such a scary or unknown event.

I have had intimate conversations with many of my friends regarding their experiences of post natal sex. One friend said she did not have sex for 9 months after her child’s birth, as she had very bad perineal tearing and was in too much pain until then. But she still went on to enjoy sex and have more children. I also had another friend who, after having four children, said her sex life had never been better. It can take a while for you and your partner to relearn the new form your body has taken and what positions might be the most comfortable, but it is definitely possible to have a very fulfilling sex life after babies.

There are a few things you can do to help make the first time more enjoyable. Firstly, foreplay. Do not overlook this. It will help you to relax and get your mind off stressing about what it’s going to be like. It will also help release vaginal secretions to reduce friction. Secondly, lubrication. It can be helpful to use water based lubrication to also aid in reducing friction and pain. Thirdly, position. Usually, the most comfortable position is with the woman on top as she is able to control the speed and depth of penetration. Fourthly, go slow. Take it easy, go very slowly. Make the aim of the experience be to see what everything feels like. Don’t expect or plan for either of you to climax, but instead think of orgasms as a bonus (this will of course be different for everyone and will come back with a bit of time and practice). During the waiting and healing time, keep in mind, there are other ways to achieve sexual satisfaction that don’t include penetration. Fifthly, plan the timing. Your first post natal sexual experience is not the time to be spontaneous. Planning ensures that the baby is fed, sleeping and in another room so you are not distracted and worrying about the baby’s every noise. It also ensures that you have adequate contraception.

We need to get talking. Talk to your close friends. Talk to your mum. Talk to your partner. One of the best things you can do is be prepared. Loving partners WILL understand and want to do only what your feel comfortable doing. Sex after babies can be fun and exciting and sometimes even better than pre-baby sex. Take your time and if you have continuing concerns make sure you see a GP or sexual health professional.