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…
The mantra of three year olds everywhere, "but wwwwwwhhhhhhhhyyyyyyyyy?", "why is the sky blue", "why do I have to put shoes one", "why can't I eat my sandwich doing a headstand next to the dog?". Their pursuit of "why" is relentless as anyone who has been in that position will tell you - even when you think you have the best answer ever, they toss back a "why?" to that too!
