Yoga or you-time? Looking after your mental health in pregnancy

Posted on 31/01/2018 by Antenatal Online | Leave a Comment

 

We all know the importance of staying physically healthy in pregnancy. We know for example that you donít need an additional donut for the baby, that sadly yes you can still go running and that resting for 9 months is for some reason frowned upon. In addition to looking after our physical wellbeing during pregnancy however, we are increasingly hearing that our mental health is just as important.

 

Most women will notice emotional changes during pregnancy - I for one threw a mug at my husbandís head in a pregnant rage and it is only because Iím an appalling shot that he lived to tell the tale. Some mums-to-be however donít just experience the normal hormonal highs and lows. Pregnancy is a time that prenatal anxiety or depression can develop.

 

There are however steps you can take to help you have a good emotional experience during pregnancy. Here Claire from Birth Story Listeners gives us her tips for protecting your mental health whilst growing your human:

 

Get connected: They used to say it takes a village to raise a child and while our notion of a village has changed, the sentiment remains the same. These days with many of us living away from our families our village may include our partner, friends, those we meet while pregnant at groups and on social media and medical professionals. It is important to gather your village around you before you give birth Ė we arenít designed to do this alone.

 

Be aware of your expectations: Itís great to have high expectations of your care givers and for your labour and birth and itís good to spend time thinking about your birth preferences. A birth plan can help you get informed about your birth choices and help you feel more in control. But birth can be unpredictable and there are times that things may not turn out exactly as you planned. That doesnít mean you canít still have a positive experience but it might help to think in advance how you would cope and what your wishes would be if your plans had to change e.g. if you plan a home birth but have to be transferred to hospital.

 

Work out whatís normal for you: If you understand what is normal for you in terms of your mental health and how you deal with stress then you are more likely to spot early signs of antenatal depression and to be able to get help. Seek advice and support early if you have a pre-existing mental health condition. Similarly seek advice if you are already taking anti-depressants and donít stop unless you are advised to by your GP.

 

Be kind to yourself: Some women experience symptoms of depression when they arenít able to live up to their own expectation about their pregnancy or birth, about feeding their baby or how they feel after said baby arrives. Having a baby is a life changing experience. Be kind to yourself and try to have realistic expectations of what your life as a mum will be like.

 

Talk to your partner: It really does help to spend some time talking to your partner about your worries and fears and to find out if they have any! How does your partner react to seeing you in pain ordinarily? How do they deal with stress? Do you like to be fussed over when you are in pain or left alone? Are you direct in asking for what you want or do you expect your partner to just know what you need? Will your partner feel comfortable speaking up for what you want in labour? How will they cope if they feel they canít solve a problem or find a role? All these things are worth discussing before you give birth.

 

Take positive steps: Eat well, sleep well, see friends, join antenatal groups, plan fun activities, sort out financial or relationship issues before the baby arrives instead of putting things off and learn to say no if necessary.

 

Most importantly of all, if you find you are anxious, fearful and down, donít suffer in silence, speak to your midwife.

 

Birth Story Listeners run a local peer support group in North Wales to support women who have had a difficult time in childbirth. Find out more at https://www.facebook.com/groups/birthstorylisteners/



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Mum-to-be? 5 things you need to know

Posted on 16/11/2017 by Antenatal Online | Leave a Comment

I have been a mum for almost 10 years which is scary because it feels like approximately 10 minutes. Far scarier however is the fact that I still have no clue what I am on with. When you have a baby you have a firm belief that it is the hardest thing in the world. Why wonít she sleep? Is she eating enough? For the love of God, how do I know I am doing this right? When you have a 9 year old you realise that unfortunately that was the easy bit and it is over. Contemplating a teenage version actually brings me out in hives.

 

The wiser among you probably have already worked out that there is no `rightí and are happy bumbling along and doing your best. You can stop reading and go and pointlessly shuffle some toys from one room to another in the name of tidying. For those who are a bit slower on the uptake, I give you some tips on the five things you should probably avoid lest you are driven insane:

 

  • Do not Google ANYTHING: For every expert who instructs you to lock your child in their bedroom as soon as the clock strikes 6.30pm and to not return even if they scream until they vomit, there will be another who says you should co-sleep until they are 10. Last night my youngest suggested he had a pain in his leg Ė 3 hours later I had diagnosed him with leukaemia. Everyone has an opinion and they are all conflicting. Save yourself a world of pain and step away from the search engine.
  • Keep your lies simple: In the early seventies I am absolutely convinced that Santa was responsible for all items delivered so why should 2009 be any different? That was an error. Raised eyebrows from child free disgruntled relatives who donít get a thank you because the kids firmly believe that Santa got them that overpriced scooter anyone? And how do we return the roller skates that the silly man sent 4 sizes too small? I urge you to keep it simple. He brings the stockings. That is all. And similarly with the tooth fairy. How cute I thought it was to craft a little note from said fairy. But bloody Amberís mother didnít write her a note. Damn her. Cue endless questions about why the tooth fairy doesnít like Amber.
  • Breastfeeding? Quick, give them a bottle: I loved breastfeeding but it is quite a responsibility being the one in charge of keeping them alive. Now truth be told, I am not big on going out - pyjamas and Doc Martin on Catch Up are more my scene but I did have tickets to see Tiffany off the telly in My Fair Lady. I was quite looking forward to it. I had expressed and given Evie a bottle early on but then, to be honest, I just didnít bother. I was pretty sure she had mastered that whole bottle thing and expressing made me feel like an unattractive cow. Imagine my horror when she turned her tiny nose up at the bottle I proffered and screamed her lungs out. Alas, I had missed `the windowí. I missed Tiff and then there was no escape. The bottle was permanently rejected. If you donít want to be in sole charge, donít make my mistake. Regularly offer your milk in a bottle.
  • Lower your sleep expectations: At the first meet up of our antenatal group post baby, we were alarmed by one of our number going round the table demanding, wild eyed, to know whether our babies were sleeping through the night. Sleep deprived she most certainly was but it was clear that she was feeling that either her or the baby were failing. Babies are supposed to sleep through the night right? Wrong. They are not. My eldest did at twelve weeks but my youngest didnít manage it until he was nearly five. No one would say that it isnít hard but you have not failed and your baby is not playing you up. He just needs you. It may feel like an age when you are a sleep deprived zombie but trust me, it will pass. 
  • Buy five identical soft toys: You havenít known heartbreak until your child has lost the mangled filthy piece of cloth formally recognisable as a monkey. Monkey had several lucky escapes. We once found him perched in the broccoli at Morrisons. Another time a member of staff took pity on us and posted him back from the Sea Life Centre. Alas like the proverbial cat he ran out of lives and is no more. Save yourself. Buy five monkeys.
I trust the 5 things I have learnt in ten years will be of use to you. Go with your gut, know there is no such thing as perfect and try and enjoy every precious minute. Ten years will go by in the blink of an eye.



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10 things your midwife wants you to know

Posted on 19/10/2017 by Antenatal Online | Leave a Comment

When I was pregnant with my first child I decided to have a home birth. To be honest I was taken aback at the level of hysteria this provoked among my nearest and dearest, ďAre you crazy? What is wrong with you? Get thee to a hospital where no harm can befall you!Ē As it turns out there was absolutely nothing wrong with me and my baby was born in our living room with no drama, an experience marred only by the fact that Bon Jovi was on the radio as she popped out. I had put my faith in my body but also letís face it, trusted that my midwife knew what she was on with. And she did. Turns out she had delivered quite a few babies and was a bit of an expert in all things child birth related Ė who knew? So who better to listen to in the run up to your birth than a midwife? Here, our midwife Nina tells you the top ten things she wants you to know about your pregnancy and birth:

 

1.   Always trust your instincts

If youíre anxious that your baby isnít moving as much as usual, make sure you get it checked out. If youíve been given advice that doesnít sit right with you, seek a second opinion. You donít have to say yes to things you donít agree with and similarly your care should be tailored to suit you and your needs.

 

2.   Focus on your own pregnancy

What is normal for others may not be normal for you. Try not to be negatively influenced by others experiences or be drawn into competitive comparisons. Be prepared for things to change in pregnancy and birth and try to stay open minded. Try not to set too many expectations as some women are left with a sense of failure when things donít go to their original plan. Instead, prepare your preferences and discuss with your midwife how you can achieve and apply these to different scenarios.

 

3.   Weíre not judging you

You will be offered lots of advice from your midwife in an effort to empower you with evidence to make an informed choice. We know that what is right for some, wonít suit others. We want to support you with the choices you make.

 

4.   No question is too trivial

If you are anxious or uncertain about anything relating to your pregnancy, birth or newborn no question is too silly. It is far more preferable to ask your midwife than Dr Google. We may not always have the answer but we have a wealth of evidence based resources and solid working relations with multidisciplinary colleagues to turn to for answers,

 

5.   Embrace non-pharmacological coping strategies

Labouring using Hypnobirthing, relaxation techniques and water helps you stay calm, relax and feel in control.

 

6.   Always carry your pregnancy notes with you

Accidents are accidental and you never know when youíll need to see a midwife or Doctor urgently.

 

7.   Learn about the changes that will happen to your body at different phases of pregnancy and labour

It will help you to understand and interpret the different feelings and sensations you will experience. It will also reduce stress and anxiety relating to these feelings and sensations. For example, stress and anxiety inhibits the natural flow of oxytocin which enables your uterus to contract and labour effectively.

 

8.   Ensure you have a supportive birth partner(s)

Choose someone who you can Ďlet goí with. Someone who will help you stay hydrated, energised and focused. Someone who may be able to offer words of encouragement, massage or even just maintain a quiet presence. Someone who just knowing they are there makes you feel safe.

 

9.   Donít be rushed into making decisions

Ensure you have all the information you need to give consent or agree to a procedure. If youíre not sure whatís happening, ask the midwife to stop and explain:  What will it achieve? Why is it important? How will it happen? What are the risks? Some aspects of birth can feel like a blur, it is important to feel empowered and informed about your experience.

 

10. Take time to get to know your baby

Skin to skin is a fantastic way to bond with your baby, keeping them warm whilst Ďdrinking iní every detail of your newborn.



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Planning a VBAC after a Caesarean

Posted on 14/09/2017 by Antenatal Online | Leave a Comment

Vaginal birth benefits mum and baby both physically and psychologically and having a one C-section doesnít necessarily mean that will be your only option for subsequent babies. How you feel about VBAC however will depend a lot on the circumstances leading up to your caesarean birth, such as:-

  • Whether the baby was breech or in an unstable position
  • Was there presumed slow progress/ failure to progress in labour?
  • Fetal distress
  • Whether you had twin or multiple birth
  • Placenta malposition

Only you can decide whether you want to try for a VBAC but it is well worth talking to your midwife or obstetrician as they will be able to advise and support you.

Many hospitals will offer a birth choice clinic where they can talk you through the statistics and give advice based on local and national guidelines (National Institute of Clinical Excellence (NICE)). There are also several other organisations that can support you and help you make an informed choice. These include the National Childbirth Trust (NCT), The Positive Birth Movement or AIMS.

Itís important to remember that whilst guidelines and protocols are in place, you are under no obligation to comply. You will still be supported in your choices and will be eligible to be cared for by the hospital and midwifery team of your choice in the setting you choose.

Most hospitals will recommend that your VBAC takes place on an Obstetrician- led Labour ward with continuous electronic fetal monitoring and will recommend Intravenous (IV) access which involves a cannula in the back of the hand that can be readily attached to a drip in the event of an emergency. This may not be how you envisaged your birth to happen. Most units will have a birth centre lead midwife and/ or a consultant midwife who can design a birth plan with you to suit your needs and wishes. You can opt to be supported by your midwife in a home birth setting or on the birth centre if you wish. You can also opt to not have IV access - the risk of a sudden emergency in VBAC labour isnít much difference to any other labour and IV access can easily and quickly be sited by the medical team if necessary.

What are the risks of a VBAC?

VBAC can be safer due to increased risks of infection with Caesarean section. With repetitive Lower Segment Caesarean Sections (LSCS) there is an increased risk of placenta praevia in future pregnancies and therefore an increased chance of an emergency hysterectomy.

The risk associated with VBAC and scar rupture (when the previous scar opens and causes bleeding) is 0.35% and the risk of scar dehiscence (when the previous scar becomes thinner and begins to separate) is 0.5%.

These risks are slightly lower if there is a longer time frame between pregnancies. These risks can be monitored closely in labour through careful observation of your pulse rate, babyís heart rate and observing for scar pain or bleeding. It is important to be cared for on a 1:1 basis by your midwife.

How can I improve my chances of a VBAC?

Approximately 70% of women who opt for VBAC are successful. You can optimise your chances of a successful VBAC by:-

  • Discussing and formulating a birth plan with your midwife
  • Waiting for spontaneous onset of labour (Induction of labour increases the chance of scar dehiscence)
  • Opt for intermittent monitoring of your babyís heartbeat- NICE guidance recommends continuous electronic fetal monitoring however the Cochrane review found that continuous electronic fetal monitoring is not more effective and does not reduce mortality or morbidity.
  • Stay upright, mobile and ensure you have a supportive birth partner.

 

Nina, Antenatal Online Midwife

 



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Three Things You Need to Know About Weaning in a Low Sugar Family

Posted on 15/06/2017 by Antenatal Online | Leave a Comment

 

At the start of 2015, my husband and I decided to give the I Quit Sugar 8-Week Program a try. After reading Sarah Wilsonís book, I felt that it couldnít hurt to attempt the detox, and experiment with the idea of giving up sugar. 8 weeks later, I felt amazing. After weeks of nasty withdrawal symptoms, I had to admit that my supposedly uber-healthy diet was anything but, and the amount of sugar I was consuming in the form of fruit juice, dried fruit, dates, honey, agave, raw sugar and maple syrup was excessive.

 

2 and a half years on, I havenít looked back. The longer Iíve been off sugar, the easier it has become. Shop-bought and even most home-baked sugary bakes are far far too sweet to me now and are often accompanied with stomach pains and nausea that simply are not worth it. Eating low sugar has lifted my mood, energised me, and cleared up my skin.

 

The number 1 motivation for me in giving up sugar was my daughter. I was just starting to wean her when we did the program, and I realised I needed (and wanted) to model better food choices for her. And I wanted to start her off on the right foot. When my son was born at the end of that year, I felt much better equipped to deal with weaning as a low sugar family, and the difference was palpable: while initially my daughterís favourite foods had all been fruits, my sonís was broccoli. Why? Well, I put it down to three main reasons:

 

1.    I ate better in pregnancy

 

I used pregnancy as an excuse with my first. In morning sickness, I lived off Cheerios and fruit juice, and I figured pregnancy meant I could eat pretty much anything I wanted. But the old adage of ďeating for twoĒ has long been put to bed (we only need about an extra 300 calories in the 3rd trimester and while breastfeeding), and in truth, pregnancy is a time in our lives where eating healthily is even more important than ever before, because what we eat, our baby eats. Now, donít get me wrong, thereís nothing wrong (in life in general), with an occasional sweet treat (I include all free sugars - fruit juice, honey, syrups, etc - in this). But I was eating these things almost daily, so they werenít treats, they were habits. With my son, I made far better choices, which I found surprisingly easy. Morning sickness struck, but I reached for homemade bread, bananas and ginger tea (and felt better for it!). And once I reached the 2nd trimester, I made sure to include lots of vegetables, particularly leafy greens, in my daily diet. I made a big batch of low sugar snacks to keep in my fridge and freezer for when hunger struck, and my extra 300 calories came from eggs, vegetables, a piece of fruit or organic full-fat milk.

 

2. I ate better while breastfeeding

 

Initially I wasnít amazing at this. We moved to a new house in a new city and had a newborn all around the sugary Christmas season, and although it wasnít as bad as it used to be, my diet had slipped into some bad habits. But after a mini-detox got me back on track, I ate as well as I could while breastfeeding to encourage my sonís tastebuds to form according to what I ate.

 

3. We weaned with vegetables first.

 

My daughterís first food was banana. She moved on to fruit purees and rice cereal as recommended. My sonís first food was spinach. He loved it. And we moved him on to asparagus, broccoli, beetroot and sweet potato (all steamed and pureed at home, served with a tiny bit of oil or butter to help absorb the vitamins) before bringing in any fruit at all. We skipped the rice cereal entirely with him and gave him wholegrains and good-quality protein when he was able to stomach them. Before he was one he had enjoyed chomping through mostly vegetables, a selection of whole fresh (unsweetened) fruits, oily fish and organic meat, organic full-fat dairy and eggs, and a selection of wholegrains. He still eats like this to this day, as we all do.

 

My children occasionally have a small amount of sugar, but on the whole, we are a very low sugar family and they do not feel at all deprived. They eat well, enjoy their food (particularly their vegetables!), and have been known to choose fruit over cake on occasion. Parties and holidays can be tough (for me, not so much for them), but we have really learned from our experiences, which is why I put together a 7-day e-course on Party Survival for low sugar families based on what we have learned from our own experience and other low sugar familiesí.

 

But the truth is, although it is never too late to come off sugar, I do believe that the work we put in in the earliest days of pregnancy, breastfeeding and weaning really made a difference, and laid a solid foundation that made it far easier for us later on!

 

If you are interested in finding out more about cutting back on or quitting sugar as a family, head over to www.raisingsugarfreekids.com for information, tips & tricks and recipes.



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