Archive for the 'Birthing articles' Category

Mar 19 2008

Labour TENS is essential for VBAC

Published by under Birthing articles

Experts agree that women wanting a vaginal birth after cesarean (VBAC) would be more successful if using a Labour TENS in the early stages of childbirth. Often women going for VBAC are fearful due to previous experiences of birth. Labour TENS expert Heather Greer explains that labour TENS helps stop the cycle of pain and fear by blocking out pain signals to the brain and releasing endorphins; the body’s own pain relief and feel good hormones. Heather adds “When pain control is literally in the hands of the women they feel empowered and more able to cope with labour.”

In Australia one in four births are born via caesarean section every year. This is higher than average according to the World Health Organisation (WHO) who recommend a caesarean section rate of 10-15%. The research suggests that women should have around an 80% chance of success of vaginal delivery even after more than one caesarean. Yet the figures for vaginal birth after caesarean (VBAC) in Australia are usually much lower than this, even in hospitals where VBAC is encouraged. Heather Greer suggests that this figure can be improved upon. In Australia labour TENS is still relatively new compared to Europe. Heather says “as more women use labour TENS successfully for VBAC the word is spreading and health care professionals are encouraging women to use labour TENS.”
Dr Chris Vose who has a PhD in midwifery and specialises in home-birthing agrees “I believe Labour TENS are essential to women who are having a VBAC”. Dr Vose explains that women wanting a VBAC are usually monitored continually which increases pain due to an inability to move freely. When using a labour TENS from the word go women are less frightened, more relaxed and more able to cope with discomfort. Dr Vose adds “I strongly believe a birth using Labour TENS is safer because, when women feel more comfortable, they are less fearful and this reduces the likelihood of adrenalin being released. When adrenalin is released in the first stage of labour it causes a preferential redistribution of blood supply away from the uterus and other visceral organs and this deprives the uterus and the foetus of oxygen’.

Lisa’s experience of a successful VBAC using labour TENS reflects this. The birth of her first child was long and difficult and ended in a caesarean. Second time around Lisa did lots of research, hired a labour TENS from www.labourtens.com.au and prepared her birth plan hoping for a vaginal delivery.

Labour started in the early hours, so she tried to sleep through the contractions. By 7am in the morning Lisa put on her labour TENS and timed each contraction which by now were only 3 minutes apart. After a quick call to arrange care for her toddler she informed the hospital of her progress. They told Lisa to come in whenever she felt ready or if she wasn’t coping. Lisa remembers coping well at home “as each surge came, I leant against a bench or wall, and pressed the ‘boost’ button on my labour TENS to relieve the pain. My husband held a cold flannel to my forehead and heat pack on my belly.

“After about 3 hours of this, the surges were closer to 2 minutes apart and lasting longer so we decided to make the 10min trip to the hospital. When we arrived at the hospital I was informed I’d have to be on the bed attached to the CTG monitor for at least 20min to get a good trace of the baby heart rate. I wasn’t too happy about this as I’d been coping well in upright positions but figured if it wasn’t for too long I’d be OK. I was also asked if I’d like to be internally examined at this point and was told I was 3cm dilated but my waters hadn’t broken yet. I was given the option of having them artificially ruptured but declined that since I felt there was no need to rush things only having been in labour for about 4 or so hours. About 1 hour after being strapped to the foetal monitor I was struggling to relax with the surges in this position. By this stage my husband was using the labour TENS boost button for me as I needed to solely focus within using the breathing techniques I’d learnt. During one surge he accidentally put it to ‘rest’ mode instead of ‘boost’ and I wasn’t too calm after that one ended, let me tell you.”

The seated position on the bed wasn’t helping things and I started to get cranky and demanded to know when I could get off this monitor and the bed. The midwife patiently explained that the baby’s position and movement was making it difficult to get a good trace and admitted I’d probably need to stay on the monitor for the entire labour. At this point I just about lost it and said “well if I’m forced to labour this way, I may as well have the caesarean!” She offered me an alternative of using a wireless monitor that needed to be inserted in the babies scalp and would allow me to walk around but this would mean breaking my waters to get it in. At this point I gladly agreed – anything to get off the bed. After breaking my waters, I felt a warm gush and then a strengthening of the surges as the babies head put pressure on my cervix. Having a surge while the midwife was inserting the monitor is something I’d never want to repeat but once it was in and I was given the all clear I just about cart wheeled off the bed with glee. I was told I was about 5cm dilated when she broke my waters.

The bed was raised so I could stand and lean over it. My husband continued to boost the labour TENS and reassure me that I was doing well, and that the baby was coming. After what seemed like only 3 or 4 surges in this position I started to get transition ‘shakes’ in my legs and feelings of wanting to push. At first the midwife didn’t believe me but after a quick check she said sure enough I had dilated remarkably quickly in this position with my waters broken.

I was told I’d have to get back on the bed to deliver which I wasn’t too keen about but managed to find a comfortable all fours position with my upper body resting on pillows. When the doctor arrived he wanted me in a side lying position. I wasn’t too keen to move but by this point I was feeling so positive that I could do this, I didn’t let it put me off. It only took a few surges to push the baby out and I don’t even remember at what point the head and shoulders came out, it just all seemed to happen in one surge. Before I knew it a baby was passed to my belly and my husband was telling me it was a little girl.

It was barely 6 hours since I had been breakfasting with my toddler and felt the first signs of labour. There was a bit of commotion at the other end as the doctor was worried about how short the cord was, but I was just happy she was out and I was looking into her big dark eyes. The placenta was delivered without problem and I required some stitches, which wasn’t too pleasant but at least I got to hold my little girl throughout. When all was said and done…and cleaned up we were left to feed and get to know our little girl. My husband opened the curtains to let in the warm sunlight and we were full of amazement and happiness at how alert and eagerly she fed. My husband and I joke this was a very ‘civilized’ birth. Given the choice I would definitely choose a VBAC over the repeat caesarean. I was so glad I’d hired the labour TENS -it was an amazing birth experience.”

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Jan 03 2008

Pre and post natal massage

Published by under Birthing articles

What is prenatal massage?

Prenatal Massage is specially designed to support and nurture pregnant women and their changing bodies. Prenatal Massage will ease aches and pains, relax muscles, improve circulation, reduce swelling in hands and feet, and relieve fatigue.

How do you lie on the table?

Women lie on their back or front supported with pillows if during the early stages of pregnancy. When this becomes uncomfortable women lie semi reclined for face up work and on their side supported by pillows for deep relaxing massage.

How can prenatal massage help me?

Pregnancy causes changes your posture and centre of gravity. This puts a lot of stress on your back, neck, abdominal muscles, and shoulders. Pregnancy also relaxes your ligaments, so that your pelvic joints are less stable, and your pelvis may shift and forward. The extra weight you’re carrying plus postural shifts often cause aching lower back, neck and shoulders. As trained prenatal massage therapist Heather knows where a pregnant woman’s sore spots are likely to be. Prenatal massage treatment is also deeply relaxing and calms the body and mind. Acupressure massage can also help to induce labour when women are full term .

Benefits of Pregnancy Massage include:

  • Relaxation and stress reduction.
  • Improve sleep (insomnia).
  • Relief from muscle cramps, spasms, and myofascial pain, especially in the lower back, neck, hips, and legs.
  • Increase in blood and lymph circulation, which can reduce swelling.
  • Reduces stress on weight-bearing joints.
  • Improve digestion.
  • Improves outcome of labour and eases labour pain.
  • Enhances the pliability of skin and underlying tissues to reduce stretch marks and scar tissue.
  • Stabilize hormones and providing support for the new mother with physical and emotional strains of pregnancy.

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Jan 03 2008

Natural Birth Education Classes

Published by under Birthing articles

If you are considering a Natural birth then natural birth education classes are essential for you and your birth partner. This class will help you feel more confident, more relaxed and in control of the labour and birth process. Natural birth education will empower you to make the right choices for you, and your baby. Heathers birth classes are packed full of practical information, exercises and tips for an active calm birth.

Natural birth education classes cover:

  • Planning your birth
  • Signs of labour – when to go into hospital
  • Natural pain management for every stage of labour, using yoga, breathing techniques, visualisation, active birthing, and relaxation for a calm birth.
  • Natural ways to induce labour
  • Positions for an active birth
  • Massage – teach your birth partner how to massage for labour
  • Maternity TENS – natural pain relief for labour
  • Using the mind to overcome, fear, pain and obstacles to a calm birth
  • Emotional freedom technique for pain relief and a calm birth

Group classes are conducted at Nature Care College St Leonards. To book a course at Nature Care College PH: 94383333 or visit www.naturecare.com.au

Private lessons are available in Balgowlah on the Northern Beaches, or at your chosen location (this may incur travel fee if more than 10km)

The benefits of private lessons are:

You can tailor make the teaching to your needs and condense the information into a shorter time
You do not waste time on things you already know
We choose a time and place to suit
A confidential supportive environment
The information is retained better
The class can be 1 hour or more depending on how much information you require. The price is $95 per couple for 1 hour, $145 for 90 mins. You will probably need between 1-2 hours. Please do not hesitate to contact me for further information on 02 94002709 or 0405 821880      

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Jan 03 2008

Birth Plans

Published by under Birthing articles

What is a birth plan?

It is a written communication tool which describes your wishes for labour, birth and afterwards. It lets your midwife and Doctors understand the kind of birth you desire if all goes smoothly. It is a good idea to keep an open mind in case things don’t go to plan. Remember to seek advice from your midwife or doctor when thinking about your options and ask them what choices are available. The medical team are there to ensure you and your baby are safe – it is important to listen to their advice and follow their instructions if complications occur.

Preparation

Before writing your plans go to antenatal classes, or read books about labour and birth to educate yourself on the process and find out your options. Talk to women who have had various kinds of births and ask them about their experiences, the pro’s and con’s. Discus the options with your care givers, partner or birth companion.

What to include in your plan

Place of birth / Home, hospital, birth centre.
Birth companion(s). Who you want with you, when and where. Consider a doula, or private midwife, or family and friends.
Consider whether or not to allow student midwives or doctors to be present. Whether you want photos or filming during labour.

Labour options

First stage:
Environment – Consider lights, music, furnishings, how long you will stay at home.
Options – Consider if you want to be able to move about freely, monitoring, vaginal examinations, enemas, shaving.
Pain management – Labour TENS, hypnobirthing, relaxation, mobility, breathing, bath /shower, birth pool, massage, homeopathics, heat packs, gas and air, pethidine, epidural.
Intervention – Consider hydration options if needed, monitoring options, types of induction and augmentation available, forceps or vauntuse, episiotomy, caesarean.

Delivery:
Consider environment and atmosphere. Choice of positions, squatting, kneeling, supporting legs or stirrups, where the baby is placed immediately afterwards.
After delivery:
Consider your choices about cutting the cord, bathing, placenta delivery – natural or oxytocin injection, vitamin K for baby.

Postpartum:
Consider separation – where you would like your baby during the day and at night, any medications, feeding options breast or bottle.
When you would like to go home.

Special needs for you and baby
Please inform your caregivers of any special considerations such as diet, medications, disabilities, ethical or religious considerations.

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Jan 03 2008

Prenatal yoga for backs

Published by under Birthing articles

  • Pelvic Tilts (for abdominal muscles): The pelvic tilt can be performed while lying on your back (if under 20 weeks), or standing against the wall (if over 20 weeks). Ensure your back is against the floor or wall with knees bent, feet resting on the floor. Place your hand in the small of your back, to find a space between your back and the floor or wall. Inhale and try to flatten the lower part of the spine against the floor, or wall. The buttocks should be relaxed in order to isolate the abdominal’s. Exhale to release back to neutral spine.
  • Cat pose (for spinal flexibility): Start on hands and knees with a neutral spine. As you breathe in tilt the tail bone towards the ceiling and open the front of your chest as you look up. On the exhale reverse this curve. Push the hands into the floor to arch your back upwards, tucking tailbone under. Keep moving the whole spine a fully as possible in both directions in time with your breath.
  • Hamstring stretches: Stay on hands and knees. Inhale to extend your leg backwards so the toes touch the floor. Gently press your heel towards the ground and hold for a count of ten.
  • Hip circles (for pelvis and lower back): Stay on hands and knees, or stand up to perform pelvic rotations. Circle your pelvis in all directions.
  • Arm and Leg Raises (for back muscles and buttock): Kneel on your hands and knees with a straight spine. Lift your right arm forwards and left leg backwards to form a straight line with your spine. Pause in this position and breath. Ensure your pelvis is tucked under to stabilise the spine. Slowly release and lower your arm and leg. Alternate lifting the opposite arm and leg. If you have difficulty keeping your balance in this position, modify the exercise by performing only the leg or arm raises separately.
  • Kegels (for pelvic floor muscles): To exercise the pelvic floor muscles, try to imagine you are stopping urinating mid flow. Pulling the muscles of the vaginal area up and inwards. You should not feel your buttocks, thighs, or abdominal’s tightening as you do this.
  • Frog pose (for back stretch) : Start on your hands and knees, with your knees wide apart and toes touching. Place your hands forward just a little in front of your head. Place a firm pillow under your buttocks to give support if needed. Sit back on your legs, buttocks to heels and stretch your arms forward to feel a stretch along the spine. Breathe and hold for a count of ten.
  • Wall Squats I (for abdominal muscles, buttock muscles and thigh muscles): Stand with your head, shoulders, and back against a wall with your feet about 1 to 2 feet away from the wall. Press your lower back into the wall and squat as if you were going to sit down, with the knees approaching a 90-degree angle. Come back up slowly, keeping your back and buttocks in contact with the wall.
  • Wall Squats II (for pelvic stability: stand against the wall as for previous pose. Take a firm pillow or block between your knees and squeeze. Do not hold your breath or clench your teeth. Hold for a count of ten. Take a strap or soft belt around your thighs, and secure it at hip width. Pull your knees apart so your thighs are bracing against the belt to prevent your legs moving wider than the hips. Breathe and hold for a count of ten.
  • Seated twists (for lower back): Sit on a chair sideways. Inhale as you lengthen your spine. Exhale and turn to the side taking hold of the back of the chair. Breathe and hold for a count of ten. Repeat on other side.

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Jan 03 2008

Back pain in pregnancy

Published by under Birthing articles

Back pain seems to be an inevitable part of pregnancy. Is it something to be endured along with tiredness or are there ways to manage or prevent back pain?

Research has suggested that 50 to 80% of all pregnant women are reported to suffer back pain at some time during their pregnancy. This may not be surprising considering the huge changes which occur in a woman’s body. Weight gain, increase in fluid, postural shifts and hormones have all been blamed.

If you’ve had a previous injury, back problem or suffered back pain before you became pregnant you are more at risk of back problems when pregnant. If you do a lot of repetitive lifting or bending, either in your work or when caring for a toddler – this also puts you at a greater risk. Stress caused by physical or emotional problems can also exacerbate pain.

The two most common types of pregnancy related pain are lower back or posterior (back of) pelvis. Activities such as walking and running, rolling over in bed, bending forward, twisting, lifting and climbing stairs can all aggravate pain.

Remember preventing back problems is easier than trying to cure backache once it’s started. Pregnant women’s posture alters significantly as the weight of the baby increases, the mothers centre of gravity alters. Weight at the front tends to make women lean backwards, thrusting their shoulders back and stomach out thus creating an excessive curve in the lower back. This causes significant strain in the lumber spine which can lead to back pain.

Help yourself by:

  • Taking short periods of rest combined with activity
  • Strengthening your back and muscles with pre natal yoga, or swimming
  • Correcting your posture
  • Make your environment or workspace posture friendly
  • Wear comfortable soft-soled shoes or insoles
  • Sit with small cushion placed at the lower back
  • Lie on your side with a cushion between the knees and ankles and the abdomen supported by a banana or pregnancy pillow
  • Use ice or heat on the painful area
  • Have a prenatal remedial massage
  • Use a TENS (transcutaneous electrical nerve stimulation) machine if 37 weeks plus or under medical supervision only
  • Try a pregnancy support belt or sacroiliac belt

Hormonal changes during pregnancy cause the ligaments to soften and increase mobility in the joints. The pelvis naturally widens to enable the foetus to pass through the birth canal more easily. This can cause problems as the pelvis is particularly vulnerable to miss-alignment due to the increase in load, and softened ligaments. In conjunction with lengthening of the abdominal muscles, this results in increased joint mobility, pain and decreased stability. There are pregnancy back supports available which may provide an increase in joint stability and alleviate low back and posterior pelvic pain.

Most common pain relieving drugs are unsuitable during pregnancy, or have unwanted side effects.
Try some drug free methods of pain relief such as a acupuncture or massage. A maternity TENS (Transcutaneous Electrical Nerve Stimulation) is safe to use when 37 weeks plus pregnant. TENS is user friendly and up to 90% effective instantly. Just apply the self adhesive electrodes to your back and turn the machine on until you feel a pleasant buzzing sensation. labour TENS is easy to use at home and safe for mum and baby. Heather Greer a Registered Nurse and maternity TENS expert says “Women often use a labour TENS machine for pain relief in childbirth, yet forget that it the ideal method to treat aches and pains whilst pregnant. The neurotrac NT3 or labour TENS machine are the best all round TENS for back pain and labour pain.” Heather combines massage and TENS therapy for a highly effective unique treatment. Heather adds “a combination of treatments such as massage, TENS, acupressure points and yoga give a holistic approach to a complex problem”. A variety of TENS machines are available to hire or buy from labourtens.com.au. Up to 100% health fund rebates are available for labour TENS purchases depending on your level of cover.

If back pain persists or you experience sciatica consult your Doctor. You may also like to consult a physiotherapist, chiropractor, Osteopath or acupuncturist for treatment if symptoms persist.

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Jan 03 2008

Natural ways to induce labour

Published by under Birthing articles

If you are full term and in danger of being medically induced you may like to try some natural methods to trigger an overdue labour.

Home treatments

  1. Nipple stimulation – twiddling the nipples for 15 minutes or more stimulates the release of oxytocin, the hormone responsible for uterine contractions. 
  2. Sex – followed by lying on your back with a pillow under your bottom for at least 30 minutes. Semen is rich in prostaglandin which ripens the cervix. Midwives often use a prostin pessery containing prostaglandin to medically induce labour. Also if you’re lucky enough to have an orgasm as well, this will often start labour spontaneously. 
  3. Spicy curry – This is a purgative and will stimulate the digestive system. Have as hot a curry as you can stand. 
  4. Massage cervix – Midwives will often use a membrane sweep. You can try massaging the cervix yourself but be gentle. Method – 2 o’clock spot on cervix, rub for as long as 30 min, slowly and gently. 
  5. Homeopathy – take Caulophyllum 30c every 30 minutes until contractions start. Then every hour until established in labour. 
  6. Evening primrose oil – use gel capsules, take 3 x daily orally. Or 2-3 capsules high in the vagina and rest. Repeat 2-3 x 24hr intervals to ripen the cervix. 
  7. TENS – try a labour TENS unit. Attach electrode pads to the back as described in instructions and leave on rest mode. Use for 30 – 60 minutes twice daily. Once in labour use the labour TENS unit to relieve pain as instructed. Use 30mA current to acupressure points “spleen 6” (lower leg) and “liver 3” (foot). 
  8. Blowing up balloons – builds up intra-abdominal pressure and can put more pressure on the cervix to move things along. 
  9. Eat pineapple – There seems to be general agreement that pineapple and its bromelain components do have a fibrolytic action, perhaps helping to soften the connective tissue of the cervix. 
  10. Exercise – walking, running, bouncing on a birthing ball, yoga, swimming and climbing stairs. Also curb walking, I know it sounds funny, but I’ve women who swear by it! Walk along a curb, one leg up on the curb and one in the gutter, then turn around and go the other way.

 Professional treatments

  1. Acupuncture 
  2. Acupressure massage 
  3. Homeopathy 
  4. Herbalist 
  5. Cranio sacral therapy

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