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Resources

Information sheets prepared as part of our Birth Education classes.

Prenatal

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    The qualities of a doula

    Some qualities you may, or may not, appreciate in a birth attendant/doula

    A helpful support person may be one who:

    • makes no emotional demands on you during labour, birth and bonding
    • will listen to, and not belittle, any fears or anxiety you may be experiencing
    • is easy to communicate with
    • is comfortable with physical contact with you
    • respects your right to make your own decisions
    • in no way expects you to perform for her
    • gives you her full attention and respect
    • is truly supportive and not simply a spectator
    • is enthusiastic about ‘active birth’ encouraging you to find positions comfortable for you during different stages of labour and birth
    • knows when to do NOTHING
    • can be invisible when necessary
    • is completely confident of your ability to give birth normally
    • is happy to do any practical jobs so that your partner can concentrate on you
    • is willing to stay with you in any eventuality
    • is un-inhibiting regarding nudity
    • is calm and centred throughout labour
    • has a sense of humour
    • has staying power and patience
    • is not easily offended
    • has a loving and heartfelt manner of being
    • recognises her own limits
    • has a talent for quiet observation
    • is compassionate and empathetic
    • can leave her ego at the door
    • is willing to cooperate with staff and equally willing to ‘fight’ them if necessary; is able to communicate your needs to medical personnel
    • knows when to give you some peace and privacy and can ensure others follow suit
    • is non-judgemental
    • is caring about your partner too. She will respect the ongoing interaction between you, your baby and family, and strive in every way not to interpose herself between those related family members
    • is available 24 hours per day
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    Role of a doula/birth attendant

    The following is a summary of our ideas on the role of a doula/birth attendant/ support person during pregnancy, throughout labour and birth and after the baby is born.

    Why consider a birth attendant/doula/support person?
    The benefits of support are considerable: It helps you feel more comfortable and confident in your ability to give birth. This can mean: a shorter birth, less intervention, that you view your birth experience more positively (even if there are real difficulties or if it is long and hard)

    Who to choose as a support person
    It’s important to choose people because you want them, not out of duty or others’ expectations of being invited. They need faith in birth process and willingness to support you in what you want. You may have relatives or friends who meet your needs or you might think about contracting a birth attendant/doula for your birth support.

    What we do as your doula
    We get to know women during pregnancy, which leads to a trusting relationship. This leads to the woman feeling greater confidence in her ability to give birth and increases her trust in birth process. We stay with a woman throughout her labour and birth – providing a continuity of care, which may not happen otherwise. We maintain contact in the following weeks and can talk over the birth experience, offer practical or emotional support.

    What we do as basic elements of birth support

    • Help create or protect a woman’s space to give birth.
      • Supporting a woman’s own emotional/psychological readiness and confidence to accept and go with birth experience ( before and during birth)
      • Eliminating or reducing environmental stresses. Creating a ‘safe’ environment.
      • Protecting the woman from negative influences eg other people’s anxieties or issues. Before labour: increasing awareness of people you are comfortable/not comfortable with. No duty to perform for anyone else. During labour: reducing sources of anxiety, being a calm presence, modelling support roles.
    • Provide practical, physical support.
      • Hot nappies, massage, drinks, toilet, food, face, ice, positions etc. All help a woman to be energised and focussed. Able to deal with letting go, with letting the baby out. Able to get through pain herself more effectively
    • Support woman to fully enter (go with) birth process
      • Before labour: exploration of fears, debunking myths, working out informed wishes, increasing faith in self and in birth process.
      • At labour: verbal encouragement, use of affirmations. Endorphine-stimulating massage
    • Advocate for woman.
      • Before labour: work together what woman wants/hopes for
      • At labour: ask Q’s / raise issues/ clarify recommendations/ seek info
      • At labour: Let caregivers know of woman’s ideas and wishes.

Labour

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    Ideas for birth helpers

    • Encourage woman to drink. – water, other drinks eg juice (orange not generally in favour) or milk or other energy drinks. Good to have bendy straws
    • Offer and prepare food in early stages of labour and with energy food/during as labour progresses
    • Assist with baths or showering by directing water spray onto ‘sore’ bits’ if needed
    • Wipe face and neck, shoulders with cool flannel as woman gets very hot in labour
    • Clean up vomit if it occurs quickly (nicer – for you- to have a bowl handy)
    • Remind woman to pee regularly
    • Go walking with her (night or day) This can often bring some energy and resolve to a woman’s labour
    • Organise cushions/pillows etc for comfortable positions
    • Massage, often lower back, shoulders, down thighs, feet (may not be appreciated during a contraction)
    • Stop chatting when contractions are on, and as labour intensifies become quieter, following woman’s own lead
    • Take photos if wanted
    • Keep self and others well fed and drinking regularly
    • Clean own teeth regularly (long labours) and shower too to be fresh and recharge energy
    • Look after other children if requested
    • Manage relatives if requested to do so prior to labour
    • Take phone calls if it rings during labour – be non-committal with labour info if you have not been asked by woman to provide it
    • Provide never ending hot nappies if used
    • Heat wheat packs or hot water bottles if wanted
    • Offer ice to suck (may need to pop it is woman’s mouth)
    • Hold hand
    • Eye contact/focus point
    • Create a birth story as time goes by (details get lost in a very quickly)
    • Tactfully encourage anyone who is radiating fear or anxiety away from the birth place for a while
    • Remain calm
    • Continual emotional support, affirmation and encouragement
    • Respect woman’s privacy (and couple’s at times)
    • Express woman’s wishes (or remind her/them about past stance if she is able to make own case)
    • Offer support to partner (reassuring word, touch/ hug etc)
    • Encourage partner to take a breather or sleep if labour is slow
    • Take time out yourself if labour is slow. You need to keep some energy up for the whole event
    • Remember not to crowd the woman (you can take a back seat at times: don’t need 3 support people in bathroom for example)
    • Keep alarm off your face (about birth noises or suggestions for labour management)
    • Offer calm problem solving approach if woman (and partner) need to make decision about labour management. Give them private time to make decisions. Respect her/their decision
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    ‘Natural’ ways of bringing on labour or increasing its intensity

    The topic of the Winter’ 02 issue of Birthings magazine from Homebirth Access Sydney was Natural induction.

    All the following ideas were found in this publication.

    • Reflexology
    • Walking
    • Walking up and down stairs
    • Sex
    • Aromatherapy ( clary sage)
    • Massage
    • Acupuncture
    • Evening primrose oil massaged onto cervix
    • Drinking small amount of castor oil
    • Drinking cummin seed tea ( 1tsp seeds steeped in boiling water. 1 cup per day)
    • Homeopathy
    • Herbs – blue cohosh and black cohosh, and others.
    • Acupressure -four fingers above inner ankle on shinbone, just to the side of the smallest toes’ nail, deep in webbing between thumbs and forefinger.
    • Curry
    • A good laugh and light mood
    • Glass of red wine ( contains prostaglandins) –
    • Nipple stimulation
    • Strong brew rasberry leaf tea
    • Blowing up balloons ( intrabdominal pressure increase)
    • Bumpy car ride/motor bike ride
    • Visualisation/meditation
    • Intense music
    • Swinging on a swing
    • Moxibustion on specific points
    • Drinking fresh pineapple juice/eating lots of pineapple

    Please note that I am passing on these suggestions only and do not vouch for their effectiveness nor their safety. It is strongly advisable to not self medicate, without good knowledge, with herbs as they can be very powerful and sometimes dangerous if used incorrectly.

    It’s probably also worth asking yourself

    • Is the baby ok although post dates? ( CTGS and fluid checks)
    • Is there a family history of longer gestation?
    • Do I really need to do anything?
    • Is there anything needs to be said/done before I can give birth?

    Although it’s a big ask – try not to angst about when the baby will come. Trust that it will when it’s ready.

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    Approaches to early labour

    You are at the beginning of an intense experience – possibly long, and most probably painful. Your body works really hard in labour. The uterine muscle has to pull itself open to approx 10 cm. The cervix may also have to soften and thin (efface) if it has not already done so. What you hope to see is a pattern of regular and intensifying contractions as indication of labour settling in for birth of baby. But some women don’t experience this in the short-term. Some impending/pre/early labours can go on for days. In either situation the following ideas may be helpful.

    Muscles don’t work when depleted of energy so it’s important to keep body tanked up with energy so need to eat and drink, especially long lasting type energy sources.

    • Big effort ahead – sleep through (if it’s night) it if you can to conserve energy or have a sleep/rest during day.
    • Avoid getting over excited or panicked as these burn up your energy. Try to go about ordinary business, just observing what’s happening. Be careful to avoid doing super strenuous activities which leave you exhausted.
    • Make sure you have your birth arrangements in order. Eg: get things ready for trip to hospital if you are planning on going there, go shopping for last minute supplies.
    • Avoid telling the whole world – it starts people (including you) watching the clock and counting labour time. And it may be a practice go rather than developing into full-on labour.
    • Have a shower or listen to music, sleep, meditate, go for a quiet walk What ever helps you relax physically and mentally.
    • Take note of your breathing – try to avoid over breathing, catching your breath. These keep tension in body.
    • Use comfort devices for crampy pain – hot water bottle, wheat pack– if necessary but try to be matter of fact – avoid high drama. You’ll need to concentrate on your labour later, while it’s not compelling: don’t.
    • Good sign of labour getting a bit more serious is inability to do other things while contraction occurring. Walking – have to stop. Talking – can’t continue.
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    Affirmations

    In Birth, Complete Preparation for your Mind and Body Rachael Broncher (Mandarine 1992) says “your mind is never idle. Thoughts always move through it, whether you are aware of them or not. The quality of your thoughts determines how you feel about life at that moment. Your thoughts influence and may alter whatever you are involved in…. The principle is quite simple – consciously establish clear objectives in your mind about how you want (to be)”

    Affirmations or resolutions are short, positive and inspiring statements about what you want to do or be like. Some people find them useful. If you are a person who typically lacks confidence then work on an affirmation which encourages you to believe in yourself. The message is…self-trust.” Affirmations need to be stated in the present “I am…” rather than “I will be. “ or “I’d like to be…”

    Example: I need a lot of sleep so I was pretty worried about night care of my first baby. My affirmations may be “I can make do with less sleep than I like” or “I can take naps when the baby sleeps” or when I was back at work and awake at night still. “I am relaxed ( breathe in breathe out) it’s as good as sleep, I can survive tomorrow”.

    The following affirmations were posted on a midwifery discussion list ( ozmidwifery). Thanks to all those who contributed. It’s great to have so many to choose from so that we can focus on the ones that really inspire us—or create our own.

    I believe in my ability to give birth easily.

    • I trust my body.
    • I have faith, courage and patience.
    • I completely co-operate with my body during labour and birth.
    • I keep my face arms and pelvic floor completely relaxed.
    • I focus on all going right.
    • My body will birth my baby safely and effectively.
    • My body will birth in its own time.
    • I am prepared and ready to welcome my baby.
    • I do not fight the birth, my body is relaxed – I am not afraid.
    • I believe in myself and I have nothing to fear.
    • My breathing is even, Inhale peace, Exhale tension.
    • My mind and muscles are relaxed.
    • My body opens like a flower greeting the morning sun.
    • My baby’s birth is joyful.
    • I love my body.
    • I love my baby.
    • We are beautiful.
    • I am a strong woman.
    • This is your mother, and this is your aunty. It’s a beautiful place out here, and we want you to come and see it.
    • My baby’s birth is a calm, joyous experience.
    • Each part of my body is completely relaxed, allowing the easy passage of my baby.
    • I relax through each stretching sensation, allowing my uterus to work effectively.
    • I am safe, and my baby is safe when the sensations are strong.
    • The stretching sensations appear to last only a short time, but are efficient, and quickly open the cervix…...opening…...so my baby can be born.
    • I focus my attention on breathing, bringing in oxygen which surrounds my muscles: bringing in nourishment, and washing out fatigue.
    • I am never alone…I have sisters throughout my city, province, my country and around the world who will be having their babies at the same time as me. I tune into them and send them my love and reassurance.
    • I trust my baby knows how to birth.
    • I trust my body will allow my baby to birth.
    • I direct my energy from my head, down through my body and out through my vagina…this energy assists my muscles to work efficiently, and helps my baby come out…easily…effortlessly…comfortably.
    • I now completely forgive the hospital staff and my parents for any mistakes they made at my own birth…It is now safe for me to let go completely.
    • My uterus is working well to bring my baby down and out of the pelvis…there is plenty of room for my baby to pass through… easily…effortlessly…comfortably.
    • It is safe for me to verbalise my feelings and desires…I am willing to allow others the pleasure of serving me.
    • My baby is being massaged and stimulated through the sensations of birth.
    • As I feel my vagina being pressed open by my baby’s head, I surrender completely, and open like a beautiful rose in full bloom
    • The power is mine
    • I am so good at this.
    • I have birthing wisdom.

    From the Birthrites website

    • Pregnancy is natural, normal, healthy and safe for me and my baby.
    • My baby feels my love.
    • Trust your body (not technology).
    • I love you little one, Mother will birth you gently.
    • Pregnancy is an emergence, not an emergency.
    • My body is designed to do the work of birth.
    • I trust my body.
    • I will allow the process to take place.
    • My body will stretch and open as my baby needs.
    • I believe in myself.
    • The process of birth is exciting.
    • I can go with my contractions.
    • My baby knows what it needs.

    from Carl Jone’s book “Mind over Labour”:

    • My changing body is radiantly beautiful.
    • I am able and willing to give my unborn child everything he or she needs to grow and be perfect.
    • I eat nourishing foods for my unborn baby.
    • I am able to make the best possible choices for a healthy, joyful birth.
    • Childbirth is a normal, healthy event.
    • My body is my friend.
    • I trust my body to labour smoothly and efficiently. I am able to birth safely and naturally.
    • I am able to birth in the best possible way for myself and my baby.
    • I fully feel the force of my new life within me.
    • The power of birth strengthens me, my child and my partner.
    • For Fathers:
    • I am able to make the best possible choices for a healthy, joyful birth.
    • I see my partner as a strong and capable woman.
    • I am able to support my partner during pregnancy and birth.
    • We are working harmoniously together. We are grateful for this powerful experience.
    • The power of birth strengthens me, my child, and my partner.

Postnatal

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    Baby-led attachment to the breast

    The following is the Australian Breastfeeding Association’s description of baby-led attachment: how your baby can attach him or herself. This can be an answer to many attachment problems.

    Baby-led attachment is the term given to the process where your baby follows a pattern of instinctive behaviours to get to the breast. This can be for the first breastfeed or at any time when the attachment is not correct and your nipples are damaged. The process is most often described as follows:

    1. Sit comfortably, whether in bed with pillows behind you and one under your knees, or on a chair with your feet on a low stool or cushion. It is helpful to be well-supported and comfortable, as you may be sitting in that position for a while. Speak to your medical adviser if pain is making it difficult for you to relax.

    2. Start with a calm baby and a calm mother. Humans learn best when they are in a calm, receptive state. Your baby’s instincts in response to hunger will lead her to the breast and to suckle, however it is the flow of milk she then receives that teaches her this is where milk comes from. If your baby is stressed, crying or upset, she will not be in a receptive state to be able to follow her instincts. Calm your baby by gentle rocking and cuddling, talking to your baby, making eye contact and being skin-to-skin.

    3. Skin-to-skin contact is a very important part of this instinctive process, so while you are both learning, you may find it useful to remove your shirt and bra, and to remove your baby’s clothes, leaving her in just a nappy. Make sure the room is warm enough to be comfortable for you both.

    4. Hold your baby in a way you both find comfortable. Many mothers find that holding their baby upright on their chest, between their breasts, works best for them.

    5. Your baby will start to move her head. As your baby starts to follow her instincts, she may start to ‘bob’ her head around on your chest. As you support her in a way that feels right to you, she will start to slide, crawl, fall or even throw herself towards one of your breasts.

    6. Support your baby. As she moves towards one breast, you may find it helpful to move your baby’s bottom across your body towards the other breast. You may also need to move your hand and wrist to support your baby’s back and shoulders. This support to your baby’s upper body gives her the stability to be able to control her head movements as she attaches.

    7. Attaching to your breast. Now that your baby’s head is near your nipple, she may nuzzle your breast for a little while. That is fine. As long as she is still calm, she will eventually dig her chin into your breast, reach up with an open mouth, and attach to the breast. You may find it helpful to pull baby’s bottom closer to your body, or to give even more firm support to her back and shoulders at this time. This will help her to dig her chin in, keep her nose free of the breast, and get a good mouthful of breast. If she loses contact with your breast, this may interrupt the instinctive process. She may continue once in contact again, or if she does not, you may need to move her back to a more upright position between your breasts and start again.

    8. When your baby is well attached to the breast, her mouth will be right over the nipple and well onto the surrounding darker area (areola), with her tongue underneath the nipple. She should have more of the ‘chin-side’ of areola in her mouth than the side adjacent to her nose. Her top and bottom lips will open out over the breast, with her chin pressed against the breast and her nose clear. A correctly attached baby will be able to breathe while feeding – most mothers find they do not need to hold the breast away from the baby’s nose. Doing so may pull the nipple from her mouth or even block the milk ducts below. If her nose is pushing into the breast, try moving her body and legs closer to you. This will bring her chin further in towards the breast and free her nose naturally.

    ‘Chest to chest, chin to breast’ is a quick way to describe good positioning.
    Your baby’s body will be positioned such that her head, neck and spine are in a straight line, with her head tipped back over your hand or arm. Her body should be facing yours. She may end up being held almost horizontally under your breasts, or she may be lying more diagonally across your body, or even into your lap. As long as her back is straight, her body close to yours, and you are both comfortable, that is all that matters. Take the time to try different positions to find what best suits you both.

    If you feel pain beyond the initial stretching of your nipple, your baby may not have taken a big enough mouthful of breast. You can break the suction by inserting a clean finger in the corner of her mouth, between her gums, and try again. Baby may be happy to re-attach without changing position, or you may need to bring her more upright and start the process again. Similarly if your baby becomes upset or distressed during the ‘baby-led attachment’ process, calm her first, and start again. This is a learning process for both of you, it is okay to take your time.

    As you and your baby start to feel comfortable with breastfeeding, you will quickly learn to put your baby straight into the feeding position you have both come to enjoy.

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    Babies and sleep

    Tired Signs

    • Fussing/whingeing
    • Increase in jerky movements
    • Flicking ear
    • Eyes drooping/shutting
    • Baby averting gaze or face

    Soothing ideas

    • Rhythmic music – pacing, dancing, walking, rocking
    • Being upright over a shoulder
    • Burping (over shoulder with gentle back rub to pat)
    • Feeding
    • Dummy/little finger/own fingers or fist
    • Singing
    • Patting
    • Music
    • Swaddling
    • ‘on you’ in a sling/pouch
    • slightly raised head in bassinet
    • hot water bottle in bassinet
    • swaddling
    • gentle and calm movements

    Information about babies’ sleep

    • A new baby’s sleep cycle is about 45 minutes long, and the baby may sleep for several cycles. However the first half of a cycle is REM (dreaming/active) sleep. During this REM sleep babies can wake easily with external or internal stimuli. If they stir or cry in this period, patting or rocking and ‘shh’ –ing may help the baby to settle back down into deep sleep.
    • Babies learn about night and day. Try to keep night care quiet and calm and gentle so as not to excite the baby into full wakefulness.
    • Many babies can tolerate not having a nappy change at night, ie no skin problems and not upset (especially if you use disposables). This minimises the amount of disturbance for you all.