Our Bumps and Babies Blog is a regular source of clear, understandable information based on the topics and discussions we have during Club BUMP, covering antenatal, labour & birth and postnatal. Please feel free to comment or ask questions (at the bottom of the page), like or share with others.
Written by Rebecca, one of our mums-to-be:
On the 18th March, following an energetic but fantastic pregnancy Zumba class, a third year midwifery student, Fiona, came to discuss the benefits of hand expressing colostrum from 37 weeks.
This was a session I was keen to attend as my mum had encountered problems when the colostrum she produced was just not enough to keep me satisfied.
The session began with Fiona talking through the benefits of hand expressing colostrum, these are detailed below:
– colostrum is the “liquid gold” that will help you to help your baby build resistance quickly and effectively against germs etc; by expressing extra before birth you can ensure that in any event your baby has access to this fantastic resource
– you have the ability to top up early breast feeds if the colostrum produced from the breast isn’t enough for your newborn
– once breast feeding has been established if you choose to move to combine feeding with expressed breastmilk and a bottle you won’t need to sterilise your bottles if you have avoided giving formula in the early days PLEASE NOTE: this is only if your baby has been exclusively breastfed and has had no formula at all within its diet.
All of these points were music to my ears and especially the last as we don’t have room for a steriliser in our kitchen!!
Fiona also went through the best way to hand express, and the hand positions to try. The group were also reminded that we need to express the breast and not the nipple; as Fiona rightly pointed out it is breast feeding not nipple feeding!!!
I was so excited to hear about all these benefits I promised myself that I would start hand expressing asap!! So that evening, after dinner, I sat down with a glass of water and began the process of hand expressing. At first it was a little slow going and I wasn’t sure I was using the correct hand position; however just as I began to think that it couldn’t be done a large drop of colostrum presented itself on my nipple and then more started to come through!! It was a fantastic experience and I felt so so proud of myself. Not only could I hand express my colostrum but also I knew then that my body was geared up to feed my baby on its arrival. It evoked an emotional response which I wasn’t prepared for and it also prompted my baby into a kicking frenzy which was amazing!!
I hand expressed for 4 days in a row and then popped my pot of expressed colostrum into the freezer ready to be placed in the cool bag on my way to hospital, (if you do hand express, the colostrum can be kept in any clean container in the fridge for 5 days, after the 5th day any collected colostrum needs to be placed in the freezer). I felt empowered and connected with my body and my baby and all in all felt that it was a fantastic experience.
At a recent Club Bump session we covered birth plans. A birth plan offers you a useful tool to get you thinking about what you would like for your labour. A good place to start is think where you would like to have your baby and what things you might like to have around you during labour to help you. For example a favourite picture to look at, music you would enjoy listening to, and comfortable familiar things from home such as pillows. Who you want with you during labour whether you would like to use a birthing pool during labour and whether you would consider giving birth in the pool. You could discuss your thoughts with your partner/birth companion.
All women can use a birth plan – it is not just for those of you with a straightforward pregnancy. If you have a pregnancy complication and know you will be giving birth in a hospital it provides a useful way of expressing your wishes, and forms the basis for discussions with midwives and doctors caring for you.
You can access a blank Birth Plan form on the NHS website: http://www.nhs.uk/Conditions/pregnancy-and-baby/Documents/Birth-Plan-blank-form-NHS-Choices-Pregnancy-Baby.pdf
It can either be completed and saved online (no one else can access it) or you can print it off to fill in and share with your midwife.
Talking about birth plans on Saturday stimulated a discussion about the latent phase of labour (pre-labour) or as we like to call it ‘limboland’.
This period can vary a lot between women but can present as:
- Random episodes of contractions
- Possible mucous pink/red show
- A few aches around the top of your legs and lower back
- A little mood change here and there!
There are strategies women can adopt to manage this period and one top tip is to keep the oxytocin (natural pain relieving hormone) flowing!
You can do this by keeping active – just follow your body – walk around, swing and rotate your hips, when sitting make sure you do not slouch backwards as baby will adopt the path of least resistance and may settle against your back. Relax on a birth ball, kneel on the floor and rock to and fro leaning over the birth ball, sit astride a chair leaning forwards with a pillow in front of your tummy for comfort.
Try to eat and relax as best you can – rest on your side not your back when you catch a breather. A warm shower can be very comforting and refreshing.
In the absence of a problem, stay at home until the pattern and strength of your contractions evolve into a distinct pattern. Then call the midwife!
It’s a mixed blessing now the hot summer days are here; while it’s lovely to finally have some sun when you’re pregnant or looking after a little one, it can be a challenge staying cool and comfortable.
One great solution is swimming and the benefits of swimming while pregnant are well known – it improves your stamina, muscle tone and circulation as well as supporting your increasing weight, and in the hotter months it’s an ideal way to keep cool while exercising. Just floating in water and enjoying the freedom and relaxation that being buoyant provides is a tonic in itself! Even more enjoyable if you can get along to an outdoor pool. We’re lucky to have four right here on our doorstep in Oxfordshire at Woodstock, Hinksey in Oxford, The Lido in Chipping Norton and Abbey Meadows in Abingdon.
If you’ve got a baby or toddler and don’t fancy taking them swimming just yet, then a splash park is a fun way to enjoy the warm days and still cool off. The Leys in Witney, Memorial Park in Wantage or Riverside Jubilee Park in Wallingford have great amenities including cafes and toilets with baby change facilities and best of all they’re very reasonably priced or free!
Swimming is a great way to minimise the amount of time you spend sitting and counts towards the 150 minutes a week of moderate intensity exercise recommended for health benefits.
Water birth was the hot discussion topic during Club BUMP recently. On hand to answer the group of mums-to-be questions was Ethel Burns, a midwife for over 30 years and lecturer at Oxford Brookes University. Ethel introduced the first custom made birthing pool in an NHS maternity unit in the UK, in Oxford in 1990.
Club BUMP offers women an enjoyable half hour chat after a fun dance-based hour long workout. It covers a wide range of pregnancy-related topics: from soothing massage techniques and helpful birth tips, to pain relief options and breastfeeding advice. Uniquely, the classes also encourage Mums to return with their babies, and to dance with them, safely supported of course!
Here’s a selection of the water birth discussion questions and answers.
Does water help with pain of labour?
Birthing in water helps you zone out and creates a relaxing environment to optimise the release of the body’s natural pain-killers. The buoyancy of being in a birthing pool helps you to move into different positions. Women who choose to labour in water are less likely to have an epidural or sedation, or require labour to be augmented with an infusion of synthetic oxytocin, and are more likely to give birth spontaneously compared with women who labour on land1, 2.
Does the pool stay warm?
Babies don’t like water that’s too hot or cold. Your midwife will ensure that the pool is kept around body temperature using a thermometer, whether at hospital, in a midwifery led unit, or at home.
What happens with all the ‘stuff’ that’s released during birth in a pool!?
It’s true that some women open their bowels during labour, but this is a great sign your baby’s nearly ready to be born! Your midwife is very used to this and can help you out of the pool to the toilet, or they will discretely keep the pool tidy for you. Blood is heavier than water and so usually sinks to the bottom of the pool. Your midwife will be monitoring your blood loss during a waterbirth the same as during land birth.
When will I be advised to get in the pool?
In hospital you might be advised you can only use the pool once you’re in ‘established’ labour (midwives class this as 2-3 strong, regular contractions in 10 minutes, and when your cervix is around 4 cm dilatation). However, immersion in water can be very beneficial at any point during labour. There is sometimes a concern that getting in the pool ‘too early’ will slow down labour, and it is true that sometimes contractions can slow down for a short period after you have been in the pool for around 30-40 minutes. However, the frequency and strength of the contractions usually then return and labour proceeds normally3. If labour does slow in the pool, your midwife can support you to stand up out of the water, or have a walk around to get things going again. It is important to remember that the duration of labour is always at best an educated guess!
Is it true that babies are calmer when born into water?
Yes water birth babies are often calmer. Your midwife will keep a close eye on you both.
Does water birth help prevent tears down below?
Most women have some perineal tearing during childbirth, and this can range from minor grazes to your labia and shallow tear to your vagina to deeper tears into muscles. Evidence shows that women giving birth in water are less likely to have an episiotomy (a small cut) and more likely to not tear at all1, 4, 5. All pregnant women planning a vaginal birth can help reduce these chances further by doing perineal massage in pregnancy – this is gentle massage of the perineum, or skin between the vagina and anus 6.
- Burns EE, Boulton MG, Cluett E, Cornelius VR, Smith LA. Characteristics, Interventions, and Outcomes of Women Who Used a Birthing Pool: A Prospective Observational Study Birth. 2012; 39(3,): 192-202.
- Cluett E, Burns E. Immersion in water in labour and birth. Cochrane Database Syst Rev 2009 22nd October 2009 [cited 2016 14th January ]; CD000111.pub3.]. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000111.pub3/pdf
- Benfield RD, Hortobagyi T, Tanner CJ, Swanson M, Heitkemper MM, Newton ER. The effects of hydrotherapy on anxiety, pain, neuroendocrine responses, and contraction dynamics during labor. Biol Res Nurs. 2010; 12(1): 28-36.
- Geissbuehler V, Stein S, Eberhard J. Waterbirths compared with landbirths: an observational study of nine years. Journal of Perinatal Medicine. 2004; 32(4): 308-14.
- Henderson J, Burns EE, Regalia AL, Casarico G, Boulton MG, Smith LA. Labouring women who used a birthing pool in obsteric units in Italy: prospective observational study. BMC Pregnancy Childbirth. 2014; 14(1): 17.
- Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic reviews. 2013 [cited 2016 4th February]; Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005123.pub3/epdf
Authors: midwifery student Emma Thompson and midwife Ethel Burns.
Written by Julia, mum to Ella & Jack:
Pregnant – to exercise or to not exercise?
Whilst attending a birthday party for a 2 year old the other weekend I overheard a newly pregnant mum talking about exercise and a local exercise class. She wasn’t going to go because, in her words “I didn’t exercise before I was pregnant so it’s not the right time to start now.”
With my Club BUMP hat on, her comment prompted me to go online and see what exercise advice is out there for newly pregnant mums. Can’t say I was surprised by the varied opinions and advice to be found on networking sites, forums and the plethora of pregnancy and baby related websites. Never mind the advice friends and family, or sometimes complete strangers, feel obliged to pass on.
Here are some basic facts:
If you haven’t been exercising regularly – it is never too late to get ‘active’ – you can start with activity that is of moderate intensity, 15 minutes three times a week and then build up gradually. You should aim for 30 minutes a day of moderate activity on most days of the week. By moderate activity we mean activity that makes your heart beat faster, but you still have enough puff to talk but not sing! This is completely individual and varies from person to person. Activities you might consider include brisk walking, cycling, swimming or dancing.
If you regularly exercise already, you can carry on as before until it gets uncomfortable. You do need to avoid things that might bump your bump! Also avoid extreme sports like scuba diving, or sports at a high altitude.
Use a calendar or diary and make a plan – set your own goals or just reminders!
Incorporating light to moderate intensity exercise will help you build your stamina which you need for labour and childbirth. It also helps keep you feeling energetic and feeling good – kills those mood dips!
Antenatal classes are specially tailored for pregnant women, can be fun and sociable, offering the opportunity to meet other mums-to-be. Why not come along to Zumba 4 Bump and get your body moving and the endorphins flowing?
Classes like aquanatal swimming, pregnancy yoga and Pilates are good for your muscles and flexibility. Yoga and Pilates classes often finish with a few minutes of wonderful relaxation.
Need some personal advice? If in doubt, check with your GP or midwife for individual advice before returning to or starting a new class.
And me? Before you get the impression I have a wardrobe of Lycra, I’m not really into exercise classes or the gym, I’d rather go for a good walk in the great outdoors. On a dark, winter evening after a busy day at work the temptation to curl up on the sofa was enormous BUT going to my exercise class was worth it, I came home mentally and physically happier. Plus I made some super friends who I still see regularly.