1st January 2012
Happy New Year it is then – or certainly a very busy one. Christmas was quiet, and lovely, with a big kid well into the swing of things and a little kid who just loved the paper, boxes and the Christmas Tree decorations. A lot.
I have such mixed feeling about handling “Santa” and all the Christmas “stuff”. I hate trying to force Son #1 to write Christmas thank you cards. I know he appreciates the gifts but like most children he just doesn’t want to take the time to say so. I feel awkward about the whole “Santa” thing as we try (and often fail, to be fair) to be honest with him all the time, but to not go with it seems rather unfair too. I tell myself it’s all a bit of fun, make sure that there’s gifts from us too (don’t want him to get all the credit!!) and just go with it.
It was fun seeing Son #2, at 1 ½, just starting to realise that something special was going on. It was also the first time that we’ve been around a lot of family since he was tiny (the only seeing people at Wedding, Christenings, Funerals and the odd Christmas effect). I was surprised that I was slightly uncomfortable about breastfeeding an 18 month old in front of people who didn’t know that I was “still” breastfeeding and who weren’t strangers. It was fine but it wasn’t something I’d expected.
3rd January 2012
“Booking In” appointment at the hospital today. Following this experience we’ve decided that we are absolutely, without question going down the route of hiring an Independent Midwife.
Although the midwife that I saw was really lovely, I’ve come away with “high risk” highlighted on my notes. Why? Because:
a) Last time my waters broke at 36 weeks, and
b) I had a PPH after the birth of Son #2 which was marked on my notes as 500Mls (not technically a PPH) but was in fact a lot more of this (judged by my doula (mum), a retired midwife herself and the fact that I was nearly given a blood transfusion a few days after birth).
This means that if I transferred to hospital, or indeed planned a hospital birth, I’d automatically be pushed to have continuous foetal monitoring, no waterbirth, a managed third stage, probably augmentation of labour if I didn’t progress “fast” enough (which is unlikely as my labours are fast). I’m under “shared care” which means that I’m under a consultant as well as a midwife. Now this is all very well, and I appreciate that the NHS wants me and the baby to be healthy and well, but this just is not the way to go about it.
My waters breaking early before does not make me high risk per se. If they break early again then the risk is to be dealt with at the time.
The PPH was clearly caused by a combination of the following factors:
- I chose a physiological third stage. This means that I didn’t want the artificial hormone to release the placenta which is given by injection to most women just after birth. This then requires the uterus to continue to contract naturally which after a straightforward and non-augmented labour should be fine, but the Oxytocin levels need to be maintained after birth for this to work well. This means keeping mum warm (very important), comfortable, relaxed and secure. Not, as I was, pulled out of the birth pool, dripping wet, cold, naked and vulnerable which interfered with my body’s ability to contract and deliver the placenta.
- With a managed third stage the injection is given and then it is important to ensure the fast removal of the placenta to avoid it being trapped. Certain interventions can happen at this stage including various bits of messing around with the uterus externally and sometimes even pulling on the cord. It is very, very important to not do this as a matter of course with a physiological third stage but unfortunately in the hospital environment many midwives don’t understand this, and assume that a physiological third stage just means not having the injection, and getting on with everything else. It is likely that the messing around that was done to me triggered excessive bleeding.
None of this makes me high risk next time round as long as my birth attendants ensure that my third stage is treated with the respect it deserves.
I found the book by AIMS (Association for the Improvement in Maternity Services), “Birthing Your Placenta - The Third Stage” to be extremely helpful in my understanding of what is likely to have happened to me, and what I can do to avoid it in the future.
January 18th 2012
Trustees meeting for UKAMB (UK Association for Milk Banking) today which was, as always, very interesting. I’m a trustee of this brilliant charity and currently working with a wonderful volunteer web designer to create a new website. I donated milk with Son #2 and I’m so glad that I did. He had an undiagnosed tongue tie which was only found by Milk Matters when he was 6 months old. I’d had a really tough time breastfeeding him as it was always painful, never a nice experience, at least for me (he is a major boob monster so I’m assuming he likes it!). It was such a relief when Charlotte spotted his tongue and lip tie and the high arch palate which so often goes with it. Because of the tongue tie he had to work extra hard to get milk which explained his ultra-long nursing sessions, but unlike some mothers in my situation whose milk production can be affected by inefficient milk removal, I’ve always had a strong milk supply. It is likely that my daily expressing for the milk bank was enough additional stimulation to ensure a robust level of production. Kind of a karma thing, I like to think!
January 19th 2012
I’m about 25 weeks pregnant now so certainly over halfway. I really have mixed feelings at this stage about that. I’m so determined to really enjoy this, my final pregnancy (or at least that’s the plan!). I want to remember every moment of feeling my little baby growing and wriggling. I’m getting bigger, just starting to feel a bit uncomfortable, and a bit fed up of peeing at night but on the whole it’s just lovely!
At the same time I just feel nervous about the idea of my waters breaking early again and want to get to term as soon as possible so that I know my baby’s ok. That was the trigger for a week of horrible stress and worry, with lots of pressure from the hospital to go in for induction but a real frustration that there was no information at all given about the risks of induction, or indeed the size of the risk of not being induced and the potential for infection.
We spent 5 days in front of the computer, going from no knowledge about PROM (prolonged rupture of membranes) to knowing an awful lot about it! We ended up with a great consultant who was very happy to talk through what we were learning but despite him being the senior consultant in the region it seemed that he had huge gaps in his knowledge!
For instance, he told us that being induced was the same as natural labour because the same muscles were being used, so it was no more painful. I pointed out that in spontaneous labour the body is also flooded with endorphins which counter the experience of pain, and it’s not the actual level of pain that is important, it’s the perception of that level of pain. He did concede this but I wonder how many other mums have been given this incorrect view of induction? We discussed the risks of induction such as an increased risk of C-Section, or instrumental delivery (which are very high), versus the risks of waiting for spontaneous labour in the absence of any sign of infection (which increases the risk of extremely serious, possibly deadly infection to the baby but the risk of this happening in any case is absolutely miniscule). None of these things were offered for discussion; everything was brought up by us.
He also had no knowledge of the risks to the baby’s gut of IV antibiotics in labour. He did not mention at any time the risk to the life of the mother from anaphylactic shock, and that the number of women who die from prophylactic and almost certainly unnecessary IV antibiotics in labour is not hugely different to the number of babies who die following delivery when an infection is present. He did not mention the diverse range of medical opinion over whether, indeed, the antibiotics significantly improve the outlook of babies statistically. He did not mention the babies who die from infection post birth not from the birth itself but from contracting something completely separate within the hospital but with an bacteria that cannot be treated because the antibiotics given to ward off an infection that may have not been there in the first place have caused resistance in the bacteria that is now making the baby sick. And he did not know about thrush, and how painful thrush in the milk ducts is, and that antibiotics can make the likelihood of contracting thrush much more likely.
There is no right or wrong choice when something happens such as premature and/or prolonged rupture of membranes, Group B Strep infection (although treated with IV antibiotics in labour) and other “higher” risk factors. All parents must make their own choice for themselves. What I find so upsetting is that the information to make these informed choices is just not given. Waters break and mothers are “on the clock”. They are told that induction is important “to avoid infection”. They are not told why, and this, to me, is a travesty.
24th January 2012
I decided to pop along to my NHS midwife to see if I could talk to her about borrowing one of the community birthing pools. Unfortunately the surgery messed up and while I’d asked for an appointment specifically with the midwife that I’d hoped would be able to be at my birth, it turned out that she was on holiday. So I saw her colleague – another community midwife who could just as easily be the one on call when my time comes.
I asked her about the birthing pools. Her reaction? “You have to speak to ‘M’ about that – she’s the one who is into that home birthing stuff!!”
Thank goodness we’ve signed on with the Independent Midwife. I knew I was with the right person when we both sat nursing our toddlers at the booking-in appointment!
30th January 2012
Peer support update training. Very useful but I was finding it hard to sit for the whole 2 hours in a low, “comfy” chair and had to switch to a more upright, firm one. I’m definitely getting bigger!
4th February 2012
That’s it, I’m off to buy some maternity clothes! I am alternating between a lovely, comfy pair of maternity trousers from last time and a seriously tatty pair of jogging bottoms. I’ve not got enough tops, although finding nursing maternity tops is tough anyway! We’re going to York to Paul Stride, a nursery shop which sells a really good range of rear facing toddler seats because I want to get ours checked for fit as we’ve bought a new car ready for the new arrival (it’s tough to find one with three proper seats at the back that isn’t an SUV!). There’s a water park there which we’ll take the boys to, and afterwards I’ll go across to the retail park and do some shopping. Wish me luck… I hate shopping!
Later…
Well hurrah, success. Toddler seat was fitted properly (phew), water park was loved by all (note to self, swim more, it feels great to take the weight off the bump) and I’ve bought 2 nursing tops which are really long and cover my bump really well, a nursing tank which can be worn under a normal top but covers my huge belly, and the most comfy pair of maternity trousers ever created. Nice one Mama and Papas.
Shame the rest of the store was filled with very, very pretty, very, very expensive and almost totally unnecessary “stuff” which shouts “buy me” very loudly. OK, so most people want a cot. Some babies never sleep in it, others use them from day one until well into toddlerhood. We have a cot. Son #1 slept in his cot from 2 weeks old, in his own room and Son #2 has never slept more than 5 minutes in it (once we managed to pop him in when he was deeply asleep but he almost immediately woke up and screamed blue murder). Baby number three will join us in our bed and we’ll play it by ear from there – although if they do prefer their own space it will be in the cot next to us, not in their own room.
But is it really necessary to have a cot, all the trimmings, a matching moses basket, matching mobile, soft toys, curtains, floor mat, nappy changing mat, nappy stacker…?
Don’t get me wrong, there’s nothing wrong at all with choosing to buy these things. It can be such a huge pleasure to go and buy beautiful nursery items and have everything waiting for your baby to come and complete the picture. But I just wish that it wasn’t seen as necessary.
9th February
I covered a breastfeeding group today as the peer supporter. I get so broody looking at the little babies. It’s a good job I’m pregnant! I do really enjoy it but I really do feel that sometimes it’s frustrating when I can’t “fix” everything. Fortunately we have a brilliant NCT breastfeeding counsellor/IBCLC in our region, and a small team of IBCLC qualified lactation consultants from the PCT as well as a large team of paid and volunteer peer supporters. It worries me, though, how few people know the differences between the different people who offer help – although not surprising. There is no legal protection for the term “breastfeeding counsellor”, few people know what the term “peer supporter” is so often they assume that a peer supporter is a breastfeeding counsellor and very few people know what IBCLC means. Fortunately, Milk Matters have a useful page on it all here:
http://milkmatters.org.uk/2010/11/12/whos-helping-you/
21st February
Midwife appointment again with my fabulous Independent Midwife, Debs from Wharfdale Independent Midwifery. As always she stayed for well over her 1 ½ hours and went through all sorts of questions with me. I was being called in for my 28 week blood tests and when I’d spoken to the NHS midwife about them, she just couldn’t give me any useful information about what was being tested. She did mention that it included rhesus antibody testing but I pointed out that I am rhesus positive and this is my last baby anyway, so, I asked, was there any need? Her only answer was, “it’s up to you” which wasn’t at all helpful in helping me to make an informed decision. Fortunately Debs was there to go through it all and help me to come to the right decision for us. It’s a non-intrusive test (if you can call a needle non-intrusive), meaning that it’s not going to affect the baby or me in any way, but it’s another thing to fit into the diary and that’s not easy right now!
22 February
UKAMB trustee meeting today. We’ve decided to get the new website live by the beginning of March – eek! Very exciting to actually get it up there though (to be seen at
http://www.ukamb.org). We are so lucky to have a fabulous volunteer who has done almost all the work on it for us (thanks Rebecca!). Hoping to make it a really useful resource for all potential and current donors of breastmilk, hospitals, milk banks and health care professionals.
28th February
Hypnobirthing session! Well this is new. I did something relaxing! And it was lovely. I’m really hopeful that it will be useful in labour but finding the time to actually practise it (and practise is key) is going to be really, really tricky. I definitely recommend it though! As much as anything to just have a break in the day!
10th March
Sheffield Home Birth Conference!
What a brilliant day. I was on the UKAMB stand with Gillian Weaver (one of UKAMB’s founders) and also had the opportunity to listen to all the talks as well. The visitors were mostly either midwives or student midwives and they all got to hear about the effects on the critical hormonal components of a natural birth of standard “interventions” such as just going into hospital, pain-relief drugs, artificial rupture of membranes and just being around people that the mum doesn’t know.
It was a wonderful day with everyone learning so much about the way that birth is a hormonal event, using the analogy of sex. If we had to “perform” under bright lights, in hospital, with random people coming in and out to check on progress and threatening us with drugs if we didn’t get on with it I’m not sure that many babies would be being born at the other end of it all!
11th March
Eeek, lugging those boxes around and standing around all day has done nothing for my pelvis. Ouch!
15th March
Great. I’m supposed to be giving a presentation today, together with one of our regional Lactation Consultants, for people who have passed the council’s “Eatwell” award – a way of encouraging catering outlets to offer healthy options on their menu. The award includes asking the outlet to be breastfeeding friendly, but with the Wakefield Breastfeeding Welcome Scheme now launched we wanted to make it a bit more in depth, and also bring companies onto the scheme where possible. However, I’ve pretty much lost my voice and I feel really rubbish. Just a cold but still, it’s a nuisance. Well, here goes, I’ll do my best.
Later… well other than sounding pretty odd the whole day went really well. We got several companies signing up and lots of interest which is fantastic. All we need now is some funding! Off to bed – I’m shattered.
16th March
Had to cancel my hypno session today as I just feel rubbish. Lots of Braxton Hicks going on and I’ve been finding it quite hard to sleep at night as well. This cold I started with last week is really taking hold and I think I’m heading towards chest infection territory. I usually shake things off quickly but being pregnant lowers your immunity to help to stop the body from rejecting the foreign genes in the baby. Really feeling rotten and just exhausted. Is it being ill or is it being very pregnant?
19th March
Went to docs this morning as I’m convinced I now have a chest infection, ear infection and probably a sinus infection. I am exhausted and am sleeping 2-3 hours a day, and just can’t do anything without it wearing me out. I’m in awful pain across my ear, around my eyes and a horrible headache and I’m coughing badly, too. Doctor says it’s just a viral infection so I suppose I’ll have to wait it out. I’m not the world’s best patient though!
Midwife back again this afternoon. Slight concern that the baby, at just 34 weeks, is now definitely engaged which I’d thought was the case as my bump has dropped significantly and pressure has lessened on my lungs (good timing with my cough) but I can really feel it in the pelvic area. Not good when I’m coughing a lot, having that lump on my bladder!
So all out now for getting the last few things sorted out. Pool arriving in a couple of weeks and my friend is sorting some girls and boys newborn clothes out for me. I’d always expected an earlier arrival but I really do hope it’s not just yet. 34 weeks is too soon L
22nd March
Feeling utterly terrible so my lovely hubby took some time off work and drove me to the health centre. We were lucky to see a fabulous prescribing nurse, who knew about the Breastfeeding Network’s drugs in breastmilk line (http://www.breastfeedingnetwork.org.uk/drugs-in-breastmilk.html) and was able to ensure that what I was given was safe for both breastfeeding and in pregnancy! She said that I was in fact right, I had a serious ear infection (no wonder I was so ouch), sinus infection and a chest infection. Given me some antibugs and hopefully they’ll start to work soon. Maybe I feel so rough because I really am ill, not just pregnant!
25th March
Finally, the antibugs are working and I’m starting to really, really feel so much better! I can actually do things with my todder without feeling horrendous and we can turn Cbeebies off! Definitely it was being ill, not being pregnant, although at nearly 35 weeks I’m starting to really feel the weight, not to mention that bowling ball in the pelvis sensation. I’m getting nervous about tandem feeding again after a friend has had a gorgeous little girl and her toddler, a few months older than mine, has gone milk mad! My son’s latch is pretty poor so I hope I can cope with it.
28th March
Birth pool arriving by the end of the week and my friend has given me my birth ball back and lent me her TENS machine. Just need to get practising with the hypnobirthing now and hope that the little one hangs in there a bit longer…