Tag: midwife

My First Day

I started the new job yesterday and am pleased to say it was a great experience, and I left with a smile on my face.  I’m at one of the Netcare Stork’s Nest clinics.

It started off with some detective work.  I had never used the staff entrance or parking before – all I knew was they were somewhere at the back of the building.  So, on my arrival, I had to engage stealth mode and find people to follow in.  I eventually found my way into the building but then had no clue how to get to the clinic.  So I walked around (and got a little lost) but eventually found my way.

I was given my own set of keys at reception (fancy), and went to open up.  Everyone who works in the clinic is currently on leave (except for me of course), so I was sort of thrown in the deep end.  I discovered the light switches, and explored through cupboards to see where everything was and then started with the routine.  I joined the handover in our Labour Ward to find out which patients were there and what their stories were.  On entering the ward, the staff all greeted me with a hug to welcome me.  How sweet is that?!

After that, I compiled a list of all the babies that needed their first vaccinations (Oral Polio Virus or OPV and Bacillus Calmette–Guérin or BCG).  I did all the paperwork and then got ready to start the vaccinations.

Now, with vaccinating babies, there is a ton of health education and information to give to the moms and dads so that they know what you’re doing with their newborns, and know what to expect.  With my luck, thanks to flu and an over-zealous New Years Eve celebration, I have lost my voice.  So, for over an hour, I squeaked and squawked trying to explain everything.  Needless to say, a couple people had a good giggle and just called me a party animal, because clearly I must have lost my voice from celebrating.

After that, the girl who I am replacing at the clinic (she’s moving down to Durban) took me for lunch for us to get to know each other better.  It was so refreshing to have someone interested in me, and friendly, and talkative.  All along, I had thought there was a problem with ME!  Not so.

After lunch, I went to help out in the labour ward some more until 3PM came which meant HOME TIME!  Perfect hours.

There is A LOT to learn in this job, which I love.  The people are awesome, the work is interesting.  Needless to say, I’m very happy.

The Truth Behind Labour – Back Pain

Often, there is so much information to take in with regards to labour, that many people don’t know the facts from the falsehoods.  Here is the truth about: Back Labour.

Back Labour

Many women experience intense lower back pain when in labour.  Often it can be a constant ache, or it can come and go.  ‘Back Labour’ is usually due to your baby’s head pushing against the sacrum and lower back.  It is also thought to occasionally be caused by a baby in the ‘occipito-posterior position’, in other words, when baby is facing the stomach as opposed to the back.

A comparison of the most common head positions a baby may present with.
A comparison of the most common head positions a baby may present with.

Most women don’t describe back labour as being extremely painful; it is more often described as an intense ache.  However, if it is constant pain, it is more difficult to ignore.  Women can try prevent having back labour during their pregnancy by regularly performing pelvic tilt exercises, sitting on a birthing ball often, and keeping her knees lower than her hips when sitting during the day – these exercises are to try and prevent the baby from taking on an occipito-posterior position.

There are a few ways that are thought to help ease the pain of back labour.  Kneeling on all fours is found to be of big help, because gravity moves the baby’s head off the lower back and sacrum, therefore decreasing the discomfort.  Bouncing on a birthing ball and performing pelvic tilt exercises also helps minimize the pressure in your back.  Massage of the lower back helps many women, so make sure you have a loved one or doula present to help with this – counter-pressure on the lower back seems to help relieve the pain in a big way.  You could try massage with a tennis ball against the lower back during or between contractions.  Warmth also helps the pain, so try get into a warm bath or shower, or use a hot water bottle on your lower back.

My Tips for a Successful Birth

1.  Attend antenatal education classes.  The lessons learnt here are invaluable as you will learn everything you need to know about pregnancy, labour and childbirth.  It also provides an arena for you to ask questions and receive immediate feedback.  Most antenatal classes are ‘couples’ classes so that your partner can feel involved and learn about the process too.

2.  Follow a healthy diet, which is proven to lessen the incidence of high-risk pregnancies.  Eating well can also prevent pregnancy symptoms such as morning sickness.  Take pregnancy-appropriate supplements and vitamins to guarantee you are well nourished and to ensure your baby is developing appropriately too.

3.  Perform appropriate exercises during pregnancy.  Pilates is a great example of beneficial exercise as it can help strengthen the pelvic floor muscles to help during childbirth.  Exercising in water provides gravity-free resistance with less risk of injury on joints and muscles, while increasing muscle tone, your strength and your flexibility.

4.  Go for regular check-ups with your gynae or midwife to identify any problems and to make sure baby is growing well.  This will help you feel reassured when it’s time for baby to arrive.

5.  Develop your own birth plan.  Your birth plan should outline everything you want and need out of birth and be sure to show this to your healthcare provider.  Your birth plan should cover all aspects, such as whether you want a medication-free birth, what type of birth you’d like, even what music you want playing when you give birth.  Remember, however, that not all births go according to plan – so be prepared to alter your birth plan if required.

6.  Bond with your baby and establish a relationship with your baby, before you have given birth.  Speak to baby, get your partner to give gentle massages, play music for your baby.

7.  Be prepared in advanced.  Have baby’s room ready, and be sure to have all the necessary equipment you’ll need for a newborn.  Pack your hospital bag in advance.  Being prepared will help you feel more calm as your labour nears, and not having a mad rush at the end of your pregnancy is essential to a calm and stress-free experience.

8.  Choose the birth option that suits you best, be it home birth, hospital birth, water birth, vaginal delivery or a caesarean section.  Research all the different types of birth and decide which one you are most comfortable with.  Be informed and make your own decision without being influenced by others.

9.  If you decide on a vaginal delivery, be sure to perform perineal massage to reduce the risk of episiotomy or tearing.  You should also practice Kegel exercises.  These activities will help increase elasticity as well as strengthen and tone the perineum for childbirth.

10.  Formulate your own positive expectations regarding birth.  Don’t expect pain, as you will then experience pain.  Dreading the idea of childbirth is sure to contribute to a negative experience.  Recognize birth as the welcoming of a beautiful and joyous addition into your life.

11.  Have a support person with you on the big day.  Whether your partner, a family member or even a doula, don’t labour alone.  Knowing you have someone to support you will help you relax and feel more confident.

12.  There are a variety of techniques to use during labour to make it easier and more manageable.  Consider massage, aromatherapy, and music therapy to help relax you.   A calm, quiet environment will help you feel more in control.  Water acts as a powerful pain management method.  Climbing into the bath once you’re in the active phase of labour (around 4-5cm dilated) will help greatly with your contractions.

13.  Consider different birthing techniques to help you during labour.  Hypnobirthing is a fairly new concept using active birthing, which alters the way in which you view birth.  For example, you view pain as ‘pressure’ and contractions as ‘waves’.  You allow your body to take over the process of birth.  Waterbirth is becoming more and more popular and provides a quiet, serene atmosphere for your baby to be born into.

14.  Don’t compare yourself to others.  Everyone is free to make their own choices, and everyone has different experiences of pregnancy, labour and birth.  Guilt is commonplace with pregnant women.  The important thing is to do what makes you happy and comfortable.  Try not to question your own decisions.

15.  Most importantly, believe in yourself.  Know that you can birth successfully.  Have a positive attitude.  You have essentially had nine months to prepare for the big day.  You can do it!

5 Things You May Not Know about C-Sections

Check out this great article by Sister Lilian on c-sections and a few things that you may not know about them.

What I found interesting is that the WHO (World Health Organization) recommends a maximum c-section rate of 15%.  In South Africa, the c-section rate is a whopping 70% – one of the highest c-section rates in the world.  This is due to a number of factors.

One of these factors is the avoidance of lawsuits.  Obstetricians are the most insured doctors, and often, they will perform caesarian sections at the slightest hint of something ‘abnormal’ in order to avoid being sued.

The ‘caesarian section versus natural birth’ debate is a very contentious issue, but I love the fact that Sister Lilian ultimately simplifies it all into this paragraph.

Of course, most importantly, at the end of the rite of passage that is birth, both woman and child should be safe and well. But, there’s more to birth than only a healthy baby and mother. A woman who feels good about her birth tends to find mothering easier, and there’s less chance of postnatal depression! From Baby’s perspective, it often means better health and less need of therapy to help with milestone development.

Just think before you decide! – Sister Lilian

What does it matter how we give birth – as long as we have a healthy mom and baby at the end of it?  Informed consent, and taking responsibility for your health is vital to ensure the best outcome suited to you as an individual, and as a mother.