Ashley gave birth to her second daughter in hospital, supported by her husband, doula (Gifted Birth Support) and hospital midwives. Ashley shares this experience in her own words along with some commentary from her doula.
A little background: My first birth was traumatic. 26 hours with contractions starting at five minutes apart and extremely intense. I had gas and two doses of pethidine which left me very out of it. I was confused, disorientated and terrified. I was coached to push for four hours (records say 2). When bubs was born all I could do was stare at her blankly. I was still very out of it and was for a couple of days afterwards. PTSD set in and the mother and baby psych unit in Melbourne was on call for me but I wouldn’t go without my husband. At four months I stopped breastfeeding due to my mental health and I slowly improved but at six months I felt like I ‘woke up’ with an infant I barely knew.
This time around I was determined to have a natural ecstatic birth. I read everything I could get my hands (or cursor) on. I was prepared, confident and very well informed. I hired a doula. I was ready.
“Doula: When I first met Ashley, it wasn’t long before I realised she was a survivor. For a young woman she had already overcome adversity, survived abuse and trauma as a child only to make it through a traumatic birth as well. A part of me was nervous about providing doula care; because I was worried I might say or do the wrong thing! But my nerves were short-lived once I learnt how self-aware and informed Ashley was about her upcoming birth and her choices.”
I had very light early labour contractions start on Sunday night/Monday morning and continue for two days. I’d had this on and off for a couple of weeks so had my fingers crossed and walked a lot of stairs while at school but just ignored it.
Monday night dtd (“did the deed”) with the hubby and they got stronger for two hours went to sleep and woke in the morning disappointed.
Tuesday night bounced on my ball and did a single leg release (spinning babies) and lots of forward leaning to try and get things going but tightening just keep continuing at the same pace.
10.00pm dtd again with the hubby not really expecting it to work. Again tightening got stronger and decided to sleep through them again.
Woke up at 2.00am needing the bathroom then I couldn’t get back to sleep. Started to think this may be it but I had already decided not to wake hubby as I thought it would be a long one. Breathing and meditating through tightening as they started to get stronger. Back and forth to the toilet constantly.
By 2.30am needed the shower which didn’t really help much just lots of squatting to get baby to move down. Hot water ran out so back to bed. At this point I jumped online to get some company as I was feeling a little lonely and worried. Instant support was amazing people from all over the world were actually cheering me on. No need for visualising imaginary women there.
“Doula: I woke at 1.00am remembering my conversation with Ashley on Monday, where we laughingly agreed a baby on Wednesday would suit us just fine! My doula bag was packed and ready to go, and as I began to drift back to sleep around 3.00am I thought I should quickly check Facebook on my phone. Lo and behold, Ashley had posted on the BWF support page and was in labour! No going back to sleep now…”
Shorty after contractions started to get hard. Around 3:15am I started to think this is going way faster than last time. 3:30 I wanted to wake hubby as labour was getting very hard and couldn’t really just breathe through them anymore, but once again I thought it was going to be ages yet (first labour was 26 hrs). So I told myself let him sleep till 4.00am. With each contraction I was willing the clock to go faster.
By 10 mins to 4 I couldn’t do it alone anymore. I woke hubby and he got up immediately. I went for the shower again. Again it wasn’t helpful really so I just knelt in the bottom and willed myself to relax and let the baby move down. Everything was starting to progress by then and I started to track of time.
Wasn’t long before i was leaning over the birth ball and moaning through contractions. At 4.20am I text my doula to let her know what was going on but didn’t think I’d need her yet. Not even five minutes later I changed my mind it was getting harder fast. Kate (my doula) said she’d get ready and come around. Somewhere around here John called our babysitter for our toddler to come.
I headed downstairs to be ready to go. Kneeling and leaning on the couch during contractions thought I was moaning very loudly but apparently was quite muffled. Kate arrived and started counter pressure on my back which helped a bit while we waited for babysitter to arrive so we could go to hospital. We realised there was no way I was going to be able to get my runners on so Kate gave me some thongs (flip flops) to wear. (Kind of giggled to myself in my mind when I saw the sparkles on the straps).
“Doula: My doula bag contains rubber thongs for when I provide support to birthing women in the showers and bath at the hospital. I hadn’t imagined they would come in handy like this, but a doula bag is meant to be full of tricks!”
Babysitter arrived and climbed in the backseat of the car kneeling and holding the headrest. Made me nervous without the seatbelt but the whole way there through contractions I was thinking why didn’t I do this last time?
Got out at the hospital and held onto John for the walk in. Had to stop for a few contractions and once to throw up. While I’m standing there puking I feel this gush. At first I wasn’t sure if my waters had broken or I’d wet myself but figured it didn’t matter as either way it was embarrassing and uncomfortable and just kept going.
Made it to the birth suite and had a contraction on the way to the room. Turns out I was allocated the same room I had my first daughter in. Found out no one was using the bath but had to wait for it to be cleaned and filled so immediately stripped and jumped in the shower for the meantime. Again the hot water offered little relief. Eventually the bath was filled and I was able to get in. They had it as hot as they could but it just wasn’t enough.
I found it difficult to fully relax as I was too buoyant and couldn’t float without my head slipping off the edge.
Started to realise around now that i wanted the epidural. I’d already given my code word well before this but Kate and John encouraged me to try different positions and to keep going as long as I could. I found it frustrating at the time but realised it was what I needed to do. I don’t remember a lot from here as there wasn’t really much activity. I switched to squatting against the edge of the bath and rocking through contractions keeping eye contact when I could to help me focus. Kate had hot water spraying on my back during contractions but it just wasn’t hot enough. I wanted scalding hot but I knew it wasn’t safe. After a while I felt myself start to lose focus like my first birth the contractions were manageable but the searing pain in my back and hips was just too much.
“Doula: During our prenatal discussions, Ashley and I had chatted about the hormones of labour and how to optimise her natural endorphins. However it did occur to me that as a trauma survivor Ashley may struggle to enter “labour land”, fearing dissociation and the inability to communicate as happened with her first birth. Sure enough, Ashley remained very aware and “in the moment” as her labour progressed and intensified. I witnessed Ashley and John lovingly connect with each other, with deep and meaningful gazes and touch. But I also suspected the pain of Ashley’s labour might be outstripping her endorphins and her wish to enjoy the birth as she had hoped.”
I could feel the anxiety creeping in and I realised if I kept going I was going to sacrifice my want of a joyful birth for a most likely fearful and traumatic natural birth. I made the decision for the epidural.
I felt I was progressing too fast to cope as I was not getting enough time to adjust in between. I have no doubt that if I had stayed in the bath bubs would have come within the next hour. Someone got the midwife.
I had to get out of the bath and couldn’t even go in the shower while I waited for the anaesthesiologist to arrive. Kate kept reminding me I could change my mind but I was determined.
I was informed and had no doubts, although I did feel some disappointment. The midwife conducted the first internal examination (the first for my whole pregnancy) and it felt extremely painful. I began screaming and crying that it was painful, as she continued the exam to feel my dilatation throughout a contraction. I’d made it to 4-5cm’s dilation.
“Doula: Before birth, Ashley had explored her options for pain relief. She definitely didn’t want pethidine or the gas-and-air due to how these made her feel out-of-control and other side effects. Her plan was to try water and movement for natural relief or an epidural if the pain was distressing. Her birth plan did state to provide extra support to avoid an epidural if she was in transition. So to honour her birth plan, I gently reminded her she could change her mind when she found the exam upsetting and before the anaesthetist inserted the first needle. But Ashley was clear in her wishes and I was very keen to support her to achieve the empowered and non-traumatic birth she longed for – and in Ashley’s case, an epidural was a very effective tool for this purpose.”
The first attempt to insert the IV needle for fluids was a failure (I was still bruised three weeks later) but thankfully she got it in on the second go. I was lying on my side and returning to my hands and knees during contractions. My legs were so tired I couldn’t stay in that position. The monitor kept going off as my pulse went up and dropped fairly frequently. They eventually turned off the alarm as it was pretty normal for my pulse to do that. Baby was coping fine. I needed to pee but just couldn’t.
Eventually I got set up for my epidural I remember thinking while the anaesthetist reeled off the list of risks off the consent form that half of the risks and side effects were not even listed. Sitting on the edge of the bed I tried to stay still which was frightening. Kate kept reminding me I could change my mind. For an instant right before the needle went in I thought ‘I don’t need this’. Then the needle was in and I realised the position they had sat me in had made bubs rise and lessened the pressure so less pain…the minute I laid down again it the intensity would have returned.
The pain of the contractions started to wear off except for one spot on my left side which according to the midwife was “weird”. I was rolled onto my left side from there and after a while it went away.
I dozed on and off for a while I could still feel pressure but the pain was just gone. After they put in the catheter the pressure on my bladder was finally relieved.
All of a sudden my waters broke with force and I couldn’t believe it when they asked if was was sure. “Oooh yeah” I was sure. Had a second’s panic when I saw they were meconium stained but midwife said it looked old and baby was doing perfectly fine on the monitors so I relaxed.
After a while I started to feel the familiar pressure on the back passage. I told the midwife I was feeling pushy but she dismissed it. A couple of contractions later I told her again there was a LOT of pressure she took a quick look (between contractions) and again dismissed me. At this point I could feel myself opening slightly with each round of pressure. After roughly 4 more contractions the pressure started to tip me further onto my side. I again told the midwife.
Finally she checked internally her finger only went in about three centimetres. She got this surprised look on her face and said “Well that baby moved down fast.” I can’t remember if I actually said “I tried to tell you” out loud or not but i was definitely thinking it.
I saw them readying the synthetic oxytocin needle in preparation for the third stage and reminded them that I didn’t want it. They said I may need it for bleeding because of the epidural and while I wasn’t really happy about it I just let go.
“Doula: At approximately 5cm dilation with regular contractions, Ashley’s contractions continued to be strong and regular after the epidural took effect. She didn’t require augmentation for the rest of her labour, but the midwife did advise Ashley she strongly recommended active management for the third stage with an epidural. The second midwife was very direct with Ashley, insisting she accept the uterotonic for the placental birth. Ashley reiterated to the midwives she wanted delayed cord clamping for the third stage.” See this link for information about physiological placental birth vs active management.
At this point I was desperately trying to get John on the phone as he’d gone downstairs for food and I didn’t want him to miss the birth! He finally appeared and I was cleared to push. (I was already breathing the baby down anyway) I needed help getting my legs up as laying on my left side had made it extremely numb and heavy. Pushing was amazing; I could still feel my baby moving down perfectly but without the pain and fear from last time. I could control exactly how fast she was coming and knew exactly where she was. Crowning was definitely an interesting feeling. I remember saying “that does not feel good”. Within four contractions (record says twenty minutes) she was out.
“Doula: Ashley’s baby girl was born gently and steadily, while she continued to smile and stay in the moment. The midwives wiped her baby’s face clear of fluids and quickly lifted her up onto Ashley’s abdomen.”
Her breathing was a bit croaky so they gave her a good rub on my chest to clear her out (she was coughing up fluid for a good 24 hrs afterwards) and they cut and clamped the cord while I had a cuddle. I’ll admit I dropped the ball here as I was too ecstatic to notice what was going one but Kate said the midwives did wait a minute or two and and checked the cord for pulsations before they clamped.
Josalynn was a great colour so I figure she got most of the blood she needed. She latched on straight away and continued feeding for about 45 mins. She only got mad when the midwives touched her which I thought was funny. She did not want to be disturbed.
There was a little fuss at one stage where Josalynn was assessed to have a minor temp but I was convinced I’d just overheated her on my chest. Eventually they weighed her in and surprised us all with her being 9 pounds. I’d carried smaller then with my first child so we expected more around 8 pounds. They checked her blood sugar because of supposed LGA (large for gestational age) but it was fine. Other then extremely painful after pains (panadol, voltaren and endone as well as an anti-nausea shot later), I was fine.
I returned to school with bubby a week later to be the first student to breastfeed in class. By the end of the week she had gained past her birthweight and sleeping well.
For a little while I struggled with a feeling of failure for getting the epidural but eventually realised that this was due to peer exposure rather than actual disappointment. After my long and (mentally) traumatic birth with my first I had wanted a calm and ecstatic birth. It was only afterwards that I realised that I didn’t have to have a medication-free birth to achieve this.
I may have had an epidural, I may not have had the hospital water birth I had planned but when they handed my little girl to me I smiled, I held her, I looked in her eyes and I loved her. And at the end of the day that was all I truly wanted.
- Pregnancy within one year of sessions, – Client has a Medicare Number, – GP referral (non specific – letter stating for Pregnancy Counselling made out to Pieta Shakes),
- Provided at the GV Minds Office, – Bulk Billed, – 40 minute session.
The following information has been provided by Pieta Shakes, local mental health nurse, new mother, and provider of important pregnancy counselling (bulk billed with GP referral) for women within 12 months of their pregnancy.
Feeling over the moon – and a little overwhelmed?!
Pregnancy and motherhood is such an amazingly, wonderful experience- from watching your belly grow, feeling your baby’s first kick, preparing the nursery, writing a birth plan right through to those expecting moments of heading to the hospital with the plan to bring home a baby! However, what those pregnancy, birth and baby books and phone app week by week’s may not let you know is that pregnancy and birth can be an emotional overload. The roller coaster of emotions and hormones required to grow and bring your baby into this world can easily send any expecting or new Mum into a world of anxieties and concerns.
As a new Mum I can recall reading many books and learning as much as possible about my baby’s development, only to end up with very unexpected twists and turns in my journey, finding myself often feeling overwhelmed, emotionally drained and isolated, not how I expected things to be. Just like other new Mum’s I often found myself blaming myself for twists and turns, for feeling inadequate and just not like the books suggest! However, with the right support I am able to reflect more realistically and enjoy each moment with my baby girl. My experience has only increased my interest in the field of perinatal mental health, and now that I am back to work I wish to support other Mums through this joyous and sometimes overwhelming time of pregnancy, childbirth and early motherhood.
I am a credentialed mental health nurse, which basically means a registered nurse with post graduate qualifications and experience within the mental health field. I hold both adult mental health and child and adolescent mental health post graduate qualifications and am currently completing my Master of Nursing (Mental Health). I have also completed education regarding perinatal mental health nursing. This past experience all comes together now by providing me the opportunity to assist other women through the journey of pregnancy, birth and early motherhood. As a registered Medicare provider I am able to provide Pregnancy Counselling to any woman who is currently pregnant or has had a pregnancy within the past 12 months of their sessions – this includes women who have delivered their baby, women who have experienced a loss or women who have had a termination of a pregnancy.
Pregnancy counselling is counselling offered around any concerns or issues the woman may have regarding her pregnancy, this may be non-directive counselling regarding decision making, providing information and support regarding pregnancy anxieties, birth anxieties, counselling following a traumatic birth (or unexpected change from the birthplan), assessing and assistance with baby blues/ post natal depression – basically anything to do with their pregnancy. Medicare entitles women up to 3 pregnancy counselling sessions with a mental health professional per pregnancy (again this could be up to 12 months after). In order to reduce barriers to accessing support I will be bulk billing all women (after all I know how money can be tight during this time!). That means NO cost for any woman referred by their GP. Of course, counselling can be provided at a cost if people so wish to skip the visit to the GP!
Appointments will be held at the GV Minds office – in The Shepparton Business Centre, 70 New Dookie Rd, Shepparton. I do plan to look into increasing options for home visits or appointments in other Goulburn Valley areas, such as Cobram, Echuca, Numurkah, however this will be a future venture, and there may be a cost associated with home visits (after all I have a baby to feed/clothe too!).
While 3 counselling sessions may not seem like enough it is a great start to feeling heard, clearing your head and walking away with information to arm yourself with steps to make your experience ever so more enjoyable and comfortable. If you do require further support I can guide you on the available local services and there may be other funded services under GV Minds of which you qualify for.
So, please don’t feel alone and certainly don’t feel inadequate if your experience isn’t matching up to the books and apps. Contact me today at GV Minds to arrange an appointment, or head to your GP for a referral letter made out to ‘Pieta Shakes’ for Pregnancy Counselling and feel supported. The first key to caring for your baby, is caring for yourself.
Happy and healthy 9 months and beautiful birth wishes for those expecting, and congratulations to those new Mums out there!
Director - GV Minds
Credentialed Mental Health Nurse
More importantly – New Mum of a special beautiful 5 month old girl!
Operating out of the Shepparton Business Centre,
Suit 3, 70 New Dookie Rd, Shepparton
If you believe women should have equal access to funding for home, centre and hospital birth, you can sign and share this petition.
Medicare funding and indemnity insurance are important aspects of providing women equitable access to independent midwifery care for their pregnancy and birth. For many women, a private midwife is their only option to obtain woman-centred, continuity of care.
Please sign, it only takes a minute!
Passionate about birth and a woman’s right to choose?
Come and see the powerful new documentary – The Face Of Birth
…And bring a friend who doesn’t know anything about birth ….. It’s everyone’s right to choose – even those who don’t know it yet.
WHEN: Thursday 29 March 2012
VENUE: Overlander Hotel Shepparton, Function Room
97 Benalla Road Shepparton
TICKETS: $18.00 per ticket, children free (cash only, ATM on site)
RSVP: 0438 298 388 or firstname.lastname@example.org
Finger food provided from 6.00pm, drinks available at bar, screening 6.30–8.00pm
Film is rated PG and running time is 90mins
Venue has space for prams plus an indoor children’s playground
AVAILABLE TO PURCHASE AT SCREENING
|The Face of Birth DVD set X 3 filmsThe Face of Birth, Meet the Experts and Birth Stories||$60.00 (RRP $75)|
|The Face of Birth DVDYour own DVD copy of the feature film||$23.00 (RRP $28)|
|Meet the Experts – Beyond The Face of Birth DVD Over 4 hours worth of talks on one DVD, a collection of advice, opinions and shared expertise from the world’s top birth experts||$23.00 (RRP $28)|
|Birth Stories – Beyond The Face of Birth DVDThis DVD captures the complete birth stories of mothers featured in film plus others. Moving and empowering, these stories are shared in their entirety, creating a beautiful new film that shares their diverse birth journeys||$23.00 (RRP $28)|
|Birth Journeys – book by Leonie MacDonaldThe Birth Journeys book is a collection of 29 positive and inspiring birth stories from women and men around Australia||$25.00 (RRP $29.95) Orders can be taken|
The Face of Birth – where to give birth in Australia, and with whom?
“The Face Of Birth. A film about pregnancy, childbirth and the power of choice.
Three years in the making, filmed across the globe from London to Alice Springs, The Face Of Birth is a moving documentary with vital information for anyone considering giving birth in Australia today.
In 2009 it nearly became illegal in Australia to have a homebirth. Three years later in 2012 the amount of women choosing a home birth has doubled! Who are these women and why are the government and medical establishment so against them?
Following the diverse heart warming and sometimes heart wrenching stories of a hand full of home birth mothers as they guide us through the plethora of information and opinions about where to give birth and with whom. The films helps sort out fact from fiction around the politics, risks, safety and fear in birth.
Over 25 of the world top birth experts were interviewed, including the famed Sheila Kitzinger author of over 26 books on pregnancy and childbirth, and the founder of modern midwifery in the USA; Ina May Gaskin.
We hear from Australian pro home birth obstetricians Euan Wallace and Andrew Bisits, both doctors have started up hospital run home birth pilot programs. And on the other side of the birth pool debate, Dr Rupert Sherwood, who is the president of RANZCOG ( Royal Australian and New Zealand College of Obstetricians and Gynecology) the college to which they all belong that doesn’t support home birth.
Our diverse home birth mothers include AFI award winning actress Noni Hazlehurst. She’s known by one generation from Playschool and another from City Homicide, but do her fans know why she chose a home birth?
Mother and doctor Sarah Renwick Lau, chose a home birth for her second child after her first baby was delivered by C-section at maternity hospital in Darwin where she also worked. It seems her independent midwife gave much better care than her colleagues at the hospital.
And young Aboriginal mum Tanya Kunoth, from the remote community Utopia in central Australia, who had two babies in hospital and two babies on country, she shares why it’s so important for her to be able to birth on her land, and why for her home felt safer than in hospital.
Beautifully shot and openly revealing, The Face Of Birth tells about all the things we never knew about birth and the power of choice.”
Penny’s natural birth of Toby
This is a birth story of a first time mother that had a natural hospital birth, including natural ‘third stage’ of labour. Penny developed her birth plan with Gifted Birth Support.
My little baby is 5 weeks old on Saturday! How times flies. I wanted to FINALLY thank you for your help with my birth plan. Not only did you help me write a birth plan that made sense, you made it easy to read and the birth plan was followed exactly.
I couldn’t ask for more for my first birth!
Toby’s birth story
Friday 12/8 at about 9.30pm, I was lying in bed and felt something that resembled my waters breaking! I did not think much of it as I was 39+ 2 weeks and people had kept telling me first time mums go over! I had period-like cramps all night… so no sleep for me!
Saturday 13/8 at about 8.30am, I woke up and thought “yes, my waters have begun to leak.” Every time i stood up they definitely leaked some more!!!! I rang the hospital and they asked me to come in…but no rush they said!
So not wanting to be on ‘hospital time’ I didn’t go in until 1.30pm! Once there, I was hooked up to the ECG for nearly an hour (mum had to get them to come back, seems like they forgot we were there)… A midwife performed an internal to see if waters had broken. She said “no, you’re waters haven’t broken, it was just hind waters, but looks like you’re in early labour so you’ll probably give birth Monday”.
I was relieved to go home. Got home by 3.30pm and this is when things kicked in! My contractions started up straight away, so I wanted to rest and eat in case it was the real deal. Because I hadn’t really experienced Braxton Hicks contractions and the midwife estimated Monday, I was worried about getting run down.
By 5.40pm I was crying through contractions. My mum started timing and they were 40secs long and 3 mins apart! I COULD NOT do this till Monday!!! So i jumped in shower as nothing else was working! This took the pain right away, so at 6.30pm I decided to go to hospital so I could use their endless supply of hot water!!
We arrived at 7.10pm, and as I was wheeled to the ward the contractions were insane and intense! Another internal exam was done because I was told they “HAD to do it, and there is no other way to check your progress”. I had used a technique I found the xiphoid “fingerbreadth” method online for measuring dilation and progressand I estimated I was 7-8 cm using this method. The midwife told me I was 6cm, and said for a first timer I was looking at 4hrs more of dilating and 1 hr pushing.
At that point I didn’t think I would make it any longer. So they wheeled me into birth suite and straight into the shower. At this point the midwife that performed the internal check argued with me for 5 mins, telling me I was not allowed to put my undies back on because I was jumping in shower. Being in active labour and arguing, I found it very hard to explain to her that I didn’t want to be naked in front of everyone for the next 4 hours! She was rude so I decided to ignore her and got my mum to get me other undies!! OMG fighting with me in labour, not a good idea!
The midwife I was actually assigned to labour with arrived – ‘K’ she is a lovely midwife who is going independent next year! Having her take over my care was such a relief. She already had the bath running and said she had read my birth plan and wanted to get everything ready for me, so it could be followed. I was in heaven!!!
So moving from bath to shower, bath to shower, I worked through the contractions. Hours went by, or so I thought! I ended up on a birth stool in shower. Because I was told the waters hadn’t broken, when I felt something shaped like a ball coming out of me I presumed it was the waters (bulging membranes). This is when K said “oh my God, it’s your baby!” She caught him just before he hit the ground!
At 8.40pm, 1 ½ hrs after arriving at the hospital and only 15 mins of pushing/breathing my baby out, little Toby was born! The first boy in the family. I was shocked!
As planned, we waited until the cord had stopped pulsating before clamping. K asked if I wanted an injection (of artificial oxytocin) or to have natural third stage “as outlined in your birth plan.” I chose to move to the bed and wait for the placenta to come out by itself.
We had uninterrupted skin-to-skin contact from the moment he was born for 4 HOURS! Only then were the checks were done on baby and we moved to my room. But then I felt like we were forgotten again. The birth suites were busy and as I was first woman in there to give birth they took care of everyone else.
K’s shift ended at 9.30pm, and unfortunately at the shift change the midwives were rude and abusive! I am so fortunate I had K for the birth. I believe my birth would not have been so amazing without her being there!!! Mum told me later that she even ate her dinner in the room with mum while I was in bathroom as she just knew my labour would be quick.
I stayed in hospital from Saturday until the Tuesday. The whole time my mum and I were verbally abused and yelled at for silly little things. Like when I was getting checks done midwife1 told mum to take Toby out of room in his little plastic bassinet – but then midwife2 yelled at mum, accusing her of stealing him! Toby cried the whole time, mum couldn’t settle him and his tags had fallen off- they never fit in first place and he was only about 10 hrs old!
The hospital experience didn’t end there! I’ve made a complaint to hospital about this care so I will see if I get a reply! Oh and the midwife that checked my waters early on the Saturday asked me “did you get the birth you wanted or did you end up giving in to drugs like everyone else?
Mum and I proudly said, “yes I did have it the way I wanted!”
I felt like saying to her “unlike you, K believed me when I told her I thought my waters had broken!”
So in all, the birth was fantastic and just the best experience – thanks to K and my Mum.
The hospital stay, on the other hand, was the worst! I have never been more stressed, anxious in my life! As soon as we got home, baby and I were instantly relaxed and happy and we could finally sleep. I don’t recommend staying in the hospital so long – being a first time mum and with a 24:7 nurse button I had assumed the staff would be friendly and keen to help. My experience was the complete opposite, unfortunately.
I believe that if I didn’t have such a great birth plan, supportive mum and amazing midwife, my birth probably would not have gone as smoothly as it did!
And I also credit not using any drugs, my research on natural birth and trust in my body to give birth to having such a great experience and being able to remember every little detail about Saturday the 13th!
And I really believe Toby is more content and alert because I didn’t allow anyone to “inject” him or alter his natural journey into the world.
It was so fantastic and reassuring to have K quoting my birth plan and making sure I still wanted my wishes constantly through the night!
Thank you so much again for helping me with my birth planning!!
Toby – born 8.40pm | Sat 13 Aug 2011 | 3565g | 52cm
This informative article covers miscarriage, stillbirth and loss.
While written for clinical care givers, it contains valuable information for anyone who may encounter loss and grief.
Doula’s and other birth support may find the information valuable also.
Today I received an email asking me to choose between banking or storing my baby’s ‘cord blood’, after recently subscribing to an Australian parenting website.
This email plus my Facebook newsfeed has directed me to articles with advice about cord blood collection along with reassuring quotes from private blood bank employees.
So why aren’t these articles identified as advertising, given that private blood banks profit from this procedure? If they’re not advertising, why aren’t the claims about ‘cord blood’ collection backed up with evidence?
It looks to me like the advertising dollar and pre-prepared ‘advertorial’ is the reason why several Australian magazines and websites are promoting (simultaneously) ‘banking or storage’ as the only two options other than ‘waste’.
Unlike advertorial, an independently researched piece may have at least described the biological function of the umbilical cord and birth where the blood is not ‘wasted’.
Cosmopolitan Pregnancy Australia is featuring an article titled Should you store or donate your baby’s cord blood, where the author describes the umbilical cord as a “slimy, weird-looking thing” that contains a “small amount of blood”. I doubt you will be surprised the article quotes a manager from a private blood bank.
This subtle denigration of the umbilical cord is done to minimise the truth about the importance of the intact cord before, during and many minutes after birth.
An Australian parenting site, the Bub Hub, is promoting their new online ‘hub’ about cord blood to help inform parents. While the amazing properties of ‘cord blood’ are explained there is no mention of the purpose of the blood, stem cells, and immune cells to the baby. The blood is typically described as waste, then quickly followed up by the ‘reassuring’ comment that the waste can now ‘serve a purpose’ for research and medical treatment.
Quoting the articles from the Bub Hub:
“Collecting umbilical cord blood is not harmful to the baby or mother and if you don’t choose to store your baby’s cord blood, it would normally be discarded as medical waste after the birth.”
No mention is made of the true purpose of the blood that is prevented from reaching the baby by the clamp.
The Bub Hub provides content from the private blood banks about how cord blood ‘should be be collected’:
“Immediately after the birth of your baby, the umbilical cord is clamped and cut, separating your baby from the placenta and mother…The procedure is painless and risk-free to both mother and baby. It takes about three minutes and does not alter the birthing process in any way…Collection can only take place at the time of delivery and should be done as soon after the birth as possible. The longer you wait to collect the blood, the less blood you will be able to collect, which means fewer stem cells. To maximise the volume of cord blood collected the umbilical cord should be clamped and cut as soon as possible after the delivery of the baby. The cord should be clamped and cut as close to the baby as practical.”
This same article is also seeking to reassure parents there is no harm or risk:
“Are there any risks?
No. The cord blood is collected after your baby has been born and the umbilical cord has been clamped and cut. The cord blood that is being collected is blood that would routinely be thrown away. The procedure is painless and risk-free to both mother and baby. It takes about 3 minutes and does not alter the birthing process in any way.”
Both the Bub Hub and Cosmopolitan Pregnancy Australia are regurgitating content from the private blood bank Cell Care Australia’s website (and most probably receiving advertising dollars for doing so). There is an advertisement on the Bub Hub website by Cell Care that “celebrates the launch of the Bub Hub’s new cord blood info hub”.
So what are the truths about ‘cord blood’?
The truth and science surrounding physiological birth, placental transfusion and cord clamping still has some way to go before many clinicians cease clamping the umbilical cord at birth.
It is a no-brainer really, but ritual, commercial interests and false assumptions are still in the way of true understanding and change. So in the meantime, I offer to share my truths:
-Human beings are placental mammals, sharing in many millions of years of evolution that never required a surgical clamp for the umbilical cord.
The baby’s transition to ‘adult’ respiration and circulation at birth is complicated to explain, but the umbilical cord makes it simple – leave the baby attached to the mother until the cord ceases to pulse, until the placenta is delivered, until the mother and baby are ready.
-The umbilical cord is not weird or slimy – it is wondrous and the function of the umbilical cord is of vital importance to the baby before and after birth.
-The blood in the umbilical cord is not ‘cord blood’ or ‘waste product’ at all – it is the baby’s blood.
Studies have shown (for a long time) that up to 30-60% of the baby’s blood can be in the placenta at birth. This is because the placenta performs the exchange of oxygen/carbon dioxide until the baby transitions to breathing – the baby then needs this blood in their body to perfuse the lungs and meet the increased organ function of ‘adult’ respiration (compared to placental).
A higher amount of blood may be in the placenta at birth due to compression/ cord compression during the second stage, which can block venous return to the baby. The transfusion of blood back to the baby is especially important in this instance– a prior decision to immediately clamp can have grave outcomes for the baby with a very low blood volume at birth.
-Clamping of the cord is a surgical intervention that is ‘ritual’ and unfortunately upheld by those who will not cease interrupting a placental mammal birth in progress unless a random controlled trial tells them to.
-Despite what the advertising is claiming, there is clear evidence that “immediate cord clamping to collect as much blood as possible” is a harmful intervention – more harmful for some babies than others.
It absolutely does disrupt and interfere with the normal birth process and the baby’s transition (to breathing, to meet demand for increased organ function).
Associate Professor Judith Mercer explained in 2002 that “early clamping of the umbilical cord at birth, a practice developed without adequate evidence, causes neonatal blood volume to vary 25% to 40%. Such a massive change occurs at no other time in one’s life without serious consequences, even death. Early cord clamping may impede a successful transition and contribute to hypovolemic and hypoxic damage in vulnerable newborns.”
-Despite what the advertising is claiming, immediate cord clamping is not risk-free and does disrupt the birthing process, in many ways.
All disruptions to the physiological birth process pose risks to mother and baby. We know that immediate cord clamping causes and risks hypoxia, hypovolemia, hypoglycaemia, respiratory distress, and reduced red blood cells in the newborn. Infant anaemia from reduced red blood cells may not sound that serious but it is linked to cognitive deficits – low IQ and developmental delay.
Given the known side effects of cord clamping, we can refute the claim by private blood banks that collecting the baby’s blood will not disturb the birthing process in anyway (like the Bub Hub/Cell Care are claiming). If the early clamping does produce the results Judith Mercer describes (impeding the baby’s transition to breathing and creating pathologies) the baby may require resuscitation, artificial warming, monitoring for respiratory distress, treatment and observation for low blood sugar levels etc…all of these procedures separate the mother and baby at birth and subject them to untold stress and anxiety.
Something else for women to consider is that immediate cord clamping leaves the placenta unnaturally engorged, which can complicate or risk the safety of the ‘third stage’ of labour. This is yet another way the collection of ‘cord blood’ can interfere with the natural birth process.
-Despite the excitement about stem cells and their application in research and healing, we don’t yet fully understand the impact of depriving newborns of their own blood and stem cell/immune cell transplant at birth. Many aspects of human childbirth are not yet understood which makes it impossible to measure the true impact of intervening and altering its processes.
-The truth for some families is the decision to disrupt the physiology of placental transfusion and collect the baby’s blood in the cord may be made on compassionate grounds for a gravely ill family member. But for all of these families and anyone else contemplating banking/storing, it is vitally important they have all the information about the natural purpose and function of this blood.
Informed decision-making cannot be made based on false claims that collecting the blood is risk-free and an altruistic act using medical waste only. This surgical intervention/procedure deserves the same careful consideration and disclosure of other bodily donations (like bone marrow and organs).
-Ask your friendly equine veterinarian about placental transfusion!
Care providers that work with other placental mammals know the life or death importance of not disturbing placental transfusion at time of birth. Observing animals giving birth, if done properly, is designed to not disrupt the mother to ensure the baby receives their full volume of blood in the minutes after birth. Homebirth midwives and other progressive care providers know this is just as important for human beings too.
To expand further on my own ‘truths’, I can provide a clear example where the medical community concurs that immediate cord clamping alters the birth process and is not risk-free.
In 2009 the Royal College of Obstetricians and Gynaecologists released an Opinion Paper about Clamping of the umbilical cord and placental transfusion.
The Opinion Paper states:
“Immediate cord clamping became routine practice without rigorous evaluation. There is now a body of evidence suggesting that immediate, rather than deferred, clamping may be harmful for both term and preterm births.”
“Infants who have immediate cord clamping have lower iron stores for up to 6 months after birth. The potential implications of the reduced iron status in early childhood have not been adequately investigated. Iron deficiency in the first few months of life is associated with neurodevelopmental delay, which may be irreversible.”
“The suggestion that, for preterm babies, immediate clamping may increase the risk of intraventricular haemorrhage is of particular concern and merits rigorous and prompt evaluation in randomised trials. Possible mechanisms for this increase are hypovolaemia or increased fluctuation in blood pressure during the abrupt transition from fetal to neonatal circulation.”
“Current guidance on the collection of umbilical cord blood for stem cell banks does not state when the cord should be clamped. It would be reasonable to advise parents of the advantages and disadvantages of placental transfusion when they are considering cord blood banking. (emphasis mine)
In summary, while researchers and advocates for safe birth are trying to educate parents about cord clamping, wealthy blood banks are targeting parents via magazines and websites.
The content that trusted parenting websites are hosting should be clearly labelled as advertising, otherwise it should disclose ALL the information about placental transfusion, neonatal transition and the risks of immediate cord clamping for the baby and mother.
Gifted Birth Support 2011
References are hyperlinked within this article.
This article contains opinion and does not constitute medical advice. Please research your own medical decisions thoroughly and in consultation with a clinical care provider.
This is a local mother’s story of reproductive difficulties, a threatened pregnancy and premature birth.
Supported by her own mother, this woman experienced many scares and stressful events in her journey to become a mother to her beautiful little girl. Mother and baby received medical care locally and in Melbourne for part of the pregnancy, the birth at 33 weeks and her daughter’s intensive care.
Back when I was 13 years old I was diagnosed with PCOS and endometriosis, and was told that the chances of me ever naturally conceiving were extremely low. I have always loved kids and had always wanted my own so even at 13 I was really devastated to hear this from my Gynaecologist. By the time I was 17 I had been through several laparoscopies and curettes. I had also required several blood transfusions due to blood loss through my period. Since I was 15 I have needed iron injections at least twice a year as I become anaemic due to blood loss from my periods.
At 18 I decided that I wanted a baby no matter what so I did everything in my power short of IVF to fall pregnant, I had a lot of different medications and cysts lasered and D&C twice in 18 months to try and help me conceive. Nothing worked; I fell into a spiral of depression as all I could think of was the baby I was never going to have – because that’s how it felt at the time.
After trying for 3 years to conceive and having ridiculous amounts of medication and injections to try and control my bleeding and regulate my period it was all getting too much. So at age 21 I gave up on the idea of being a Mum, which in turn caused me to become even more depressed. In January 2010 it was discussed and decided the best thing for me was a hysterectomy because my bleeding and other medical issues were making it impossible for me to work or anything like that.
In March 2010, I presented for my pre-op check, urine was tested and to my surprise and the doctors it said I was pregnant! Not believing this I was sent for bloods and ultrasounds but the ultrasound wasn’t going to be for another week. Bloods soon came back saying that I was indeed pregnant. My doctor then rang the radiology department and told them I needed an ultrasound sooner. By that afternoon I got to see this tiny little baby growing inside my belly. I cried for days because I just couldn’t believe what was happening.
I was told to make sure I took things really easy as with some of the medical problems I have put me at high risk of losing the baby. When I went back to the doctors the next day about my ultrasound results I was told I was 9 weeks and 5 days pregnant approximately. I couldn’t believe what I was hearing or what I had seen the day before on the ultrasound screen. I was 22 years old when I discovered I was pregnant after many years of reproductive difficulties.
At 12+2 weeks pregnant I had my first major bleed. Upon arrival to the A&E I was told after an internal that thing were looking pretty bad and if I hadn’t already lost the baby I soon would. They said there was nothing that could be done and we would just let nature take its course. So yet again I lay in another hospital bed, devastated that I was about to lose my baby (if I hadn’t already). Thankfully though we made it through and an ultrasound showed that bub was still there and doing okay. I was sent home and told to stick to bed rest for a few days and wait to see what happened. After a week all was well, bub was still there and the bleeding had stopped.
Then at 16 weeks exactly I had another bleed so it was back to A&E. Upon arrival I had my jumper around my waist as the blood loss had flooded my pad and my jeans were now also covered in blood. Embarrassed, upset and very stressed they took me back out and put me in a cubicle, where again hours of laying and having blood tests and ultrasounds seemed more like forever than just a couple of hours. I was told there was nothing they could do this time as well and just wait and see what happens as nature would take its course, but again bub was still doing alright despite the bleeding.
I then had bleeds at 19 weeks, 22 weeks and 24 weeks. Being almost at, and over, the halfway mark I cried so much as it had been such a struggle to fall pregnant in the first place and then to almost lose my baby so many times I was struggling to cope emotionally.
When I had my 24 week bleed I spent two nights in hospital so they could monitor me and bub. After all being okay for two nights and the bleeding stopping I was off home again.
At 27 weeks+3 I woke up in the morning and had a shower. I then went back to my room to get dressed and there was a sudden gush of fluid that ended up all over my floor. But as it wasn’t blood I wasn’t to panicked. I rang my mum who was at work to ask her how I would know if my waters broke but she was unable to answer the phone, so I left her a voice message. She soon rang me back and tried to calmly tell me to go to the hospital and she would meet me there. I could tell by her voice something was wrong and maybe it had been my waters breaking. I rang the birth suite at GV Health and told them I was coming. They took me straight in and had me lay down.
They performed an internal exam and a swab to test if was my waters (amniotic fluid) and before the tests had come back I was having contractions. Everyone seemed a little worried so I in turn started to panic. It went quiet for around 10 minutes and then I was told an ambulance would be there in 15 to 20 minutes to take me straight up to the Royal Women’s Hospital (RWH) in Melbourne. The whole time I’d been there I was crying but this made me become hysterical as it looked as though my little girl was going to be born.
I was given medication to try and stop my labour. I had the IV drip to try and keep me hydrated as due to severe morning sickness right through my pregnancy I was often unable to keep food or water down. Being in the emotional state I was in just the thought of food was enough to make me vomit. The ambulance arrived and we were soon on our way to Melbourne, my mum accompanied me there in the ambulance.
Upon arrival at the RWH on the 21st July 2010, I was taken straight to birth suite which scared me a little as I was no longer having contractions and didn’t think I was still in labour. I soon found out the labour had stopped and we just needed to monitor baby and myself for a while to make sure I didn’t go back into labour.
I was taken to a hospital ward room a few hours later. My mum was then told it was time for her to leave the hospital and panic set in again – but not for me this time but for mum! We had not even thought about somewhere for her to stay. Her first idea was to go and sleep down at the train station I was really upset by this idea as I couldn’t handle the thought of something happening to her while I was in here. I soon called the nurse who brought us a list of motels in Melbourne. She suggested mum ring the “Local” ones. Neither mum nor I had any clue what was local or close.
Mum went downstairs and sat for a little while and another nurse asked her what she was doing. Mum explained she had nowhere to stay and didn’t know what was close and what wasn’t. The nurse soon helped mum find somewhere within two blocks to stay. Mum came back to the ward to let me know and I was no longer panicked or in tears over that, I was relieved. The day had been bad and good all in one. Bad things: 1. My waters had broken and I was in labour, 2. We were such a long way from home. 3. Mum originally had nowhere to stay. But had gotten better: 1. I was no longer in labour and 2. Mum had somewhere safe to stay, so I could try and get some sleep knowing bub was okay and so was my mum.
The next day it was organised for mum to go into the Royal Women’s Hospital Crisis Care Accommodation. The first week was just so full of ups and downs. To start each day it was an internal examination, A CTG and a heap of medication (some to try and stop me going back into labour, some to boost my iron levels back up, and some to try and prevent infection, as well as steroid injections for baby). I was in a room with another lady which didn’t bother me – what bothered me was I felt trapped and in the dark and extremely shut in. I couldn’t see the sky outside, I was unable to walk anywhere and relied solely on my mum to take me anywhere even for a cup of tea in a wheelchair as I wasn’t allowed to stand. It became unbearable as I live for the outdoors and I am always outside and suddenly I was stuck in this room, I couldn’t see the sky, smell fresh air or even watch the people in the street below out the window.
I spoke to one of the social workers and was soon moved to another shared room where the lady was fine with the curtain being pulled back so I could at least see outside! It made the world of difference to my emotional and mental state.
The next 6 weeks before my daughter was born were really scary. Doctors came in daily to do tests and monitoring, I had so many trips to birth suite as they would decide baby wasn’t doing well and I was going to be induced but after some more monitoring things would settle down a little again and her heart rate would pick up.
On the 23rd of August I went into labour again but thought I was just having Braxton Hicks contractions so I didn’t worry about it. Monitoring was done and I was allowed to go downstairs and get a drink. While downstairs the doctor had checked the CTG results and wanted me back to birth suite immediately. So in a panic I rushed back up to be informed that he thought I was in labour again, so back on the machine it was. I was in labour again but only 1cm dilated.
That was all before 9.00am. By 7.00pm I was still only 2cms dilated and it was decided they would give me the drip which is used to induce labour to try and speed things up a little as I desperately wanted to give birth and avoid a C section. By 10.00pm my cervix was closing although I was having constant contractions without a break. I was given an epidural, which I had previously had when I was younger for surgery due to being asthmatic. Nothing seemed to be happening and I wasn’t allowed to hop off the bed I had to just lay there even before the epidural. I started to become very stressed and exhausted due to the fact I was so far from home and so many things had and were not going the way they should. My baby’s heart rate dropped majorly and the doctors came in and watched the monitor as if something was really wrong. Bubs heart rate sat at between 20 and 40bpm for 10 minutes and it was decided there was no choice left I had to go for an emergency c-section as bub couldn’t handle labour any longer.
My epidural was topped up and I was rushed to theatre when I would soon become a mum. Upon being delivered my daughter wasn’t breathing at 5 minutes resus was begun. I lay on the theatre bed crying at the sight of my baby being grey and not moving or making any noise. Fear had set in and I was becoming hysterical again but I was so exhausted I couldn’t even make a sound but the tears ran down my face. My mum was standing at the top of my head holding my hand telling me it was going to be alright.
Finally she moved and coughed and slowly started to get colour to her. I was finally able to stop holding my breath! I was allowed to see my daughter H very briefly before she was taken away to NICU (Neonatal Intensive Care Unit). I longed to see my little baby girl all night but no one would take me. I was put in a room with another lady on the ward who had just had twins that were beside her bed all night long. Every time I heard them cry I cried – I wanted to see my baby. No one had even told me if she was still okay and the nurses wouldn’t let my mum (who I had sent with H to special care) into the ward to even tell me about H or check I was okay. I felt a serious sense of hate towards the other lady as she laid there and goo’d and gah’d at her babies while I sat there in tears longing to see my baby.
8.00am the next morning mum snuck through the doors with one of the doctors, grabbed a wheelchair and took me to see my beautiful little girl. She was just so precious but I didn’t want to touch her at first because she was connected to machines and drips.
After 3 days in NICU in Melbourne we were transferred back to Shepparton – owing a big thanks to all the doctors and nurses at G.V Health and the RWH, and a very special thank you to NETS (Newborn Emergency Transport Service). There was six more weeks of hospital care needed for my daughter, she was suffering apneas and braddys, and a few other things but then I finally got to take home my baby.
I’d like to add that during this very stressful and momentous time I did get to meet some other wonderful mums in hospital who were there when their babies and mine were born. I am happy to say I am really good friends with them to this day.
So all in all on the 24th August 2010 at 12.03am my 33 weeker H was born, weighing 1700g (3.75lbs)
There is a world of people I owe thanks to for having my daughter here with me today. For their support and expertise, words can never convey my full appreciation.
The following is a collection of links and resources for women expecting twins and more!
Please feel free to suggest additions
This birth plan was shared by Olga who lives in the UK.
Olga and her partner planned for their second baby to be born at home assisted by midwives, after a traumatic induction with their first baby. You can read the story about Olga’s positive and empowering second birth here.
OLGA’S BIRTH PLAN
My husband, Christian.
I agree to student midwives being present during my labour.
Positions for labour and birth
I would like to remain active and use whatever position I find comfortable. Please encourage me to stay off my back! I may wish to move throughout the house and to use the bath or shower from time to time. I would like to minimise internal examinations. Please do not offer to break my waters, and please be very careful to avoid doing so during any internal examinations. If the baby appears to be poorly positioned or labour is not progressing well for some reason, I would appreciate it if you could suggest changes of position or movements which might help. I will use aromatherapy and homeopathy during the labour.
Please do not offer pain relieving drugs unless I ask for them. I do not wish to use Pethidine under any circumstances so please do not offer it. I would like to use a birth pool and natal hypnotherapy techniques. Please leave Entonox in the car but I would like it to be available in case I ask for it.
I have bought a birth pool in a box and intend to give birth in it. It is important that the pool temperature is comfortable for me so, unless it is outside normal safety limits, I will choose the temperature myself. I understand that I would probably want a cooler temperature during the first stage of labour, and warmer – nearer blood temperature perhaps – for the second stage. I would like to have a water birth if possible and would appreciate your support in encouraging me to give birth underwater.
I am happy for you to examine me to let me know when I am ready to begin pushing my baby out. Please keep the room as quiet as possible during the second stage and adopt hands-off approach. I would like to minimise distractions at this time. I would like to give birth in an upright, kneeling, supported squatting or all-fours position to give the baby maximum space to descend through my pelvis. I do not want to be on my back or semi-reclining unless that position seems right for me on the day, having tried alternatives. If I am too tired to maintain an upright position then please encourage me to lie on my side instead of my back, to allow maximum mobility in my pelvis. When my baby is born, I would like my husband to catch him and he will pass baby straight to me. I would like to avoid perineal damage if possible and would appreciate your guidance in giving birth gently to accomplish this. However, I would rather tear naturally than have an episiotomy. I would like the lights dimmed when my baby is born, and for the minimum amount of noise to be made. I hope that it will be a gentle entry into the world. Please do not suction mucus from the baby’s nose and mouth ‘just in case’ – only suction if necessary.
Monitoring your baby’s heart rate
I do not agree for continuous monitoring, but I am happy with hand held Doppler or waterproof Doppler for when I am in the pool if you feel that’s necessary. I would like Doppler monitoring to be kept to absolute minimum. Please do not ask me to come out from the pool for monitoring.
Do not perform routine episiotomy. I do not agree for forceps/ ventouse delivery unless absolutely no other options, especially not because ‘lack of progress’.
I would like a physiological third stage with the cord clamped and cut when it stops pulsating. I wish no drugs to be used unless specifically indicated. It is important to me that you do not clamp the cord until it has stopped pulsating, if baby needs to be resuscitated, please do it with cord still attached. Please do not pull on the cord or use fundal pressure unless there is a specific indication to do so, as I have read that this is contra-indicated in drug-free third stages. If I give birth in the pool, I may like to get out of the water for the third stage.
Care of the baby
I would like to breastfeed my baby as soon as possible after the birth. I would like to keep the baby unclothed and close to my skin immediately after birth, to maximise skin-to-skin contact. Please do not administer prophylactic Vitamin K after the birth.
In case of transfer to hospital
If transfer by ambulance becomes necessary, please do not strap me in on my back – I would prefer to be on my side, to make contractions easier to deal with.
Please do not offer Pethidine/Demerolas I am concerned about its possible effect on my state of mind in labour, and on my baby’s health. I would prefer to have an epidural. I do not agree to student doctors being present during my treatment.
I am very keen to avoid a caesarean section if it is at all possible, as I do not want to enter future labours with a scarred uterus. I particularly would like to avoid a caesarean just for slow progress. If labour is simply taking a long time but my baby is not in immediate danger, please would you encourage me to keep going and perhaps to try changes of position or movements which might help. Please do not offer a caesarean unless my baby is in danger.
If a caesarean section becomes necessary, I would prefer to remain awake with epidural or spinal block anaesthesia. I would like my husband to stay with me at all times, and would like to breastfeed the baby as soon after birth as possible.
If I suffer a severe post-partum haemorrhage, please do not perform a hysterectomy unless it is the only available course of action.
Please do not give my baby supplements of glucose water or formula milkwithout my permission. I would expressly like to avoid having any formula supplements unless it is unavoidable, and certainly not in the first two days in any event.
Under no circumstances is my baby to be bottle-fedas this could lead to nipple confusion and hinder breastfeeding. If supplements are necessary, please give them by spoon or other method, not by bottle.
If I have trouble breastfeeding, I would greatly appreciate the help of a midwife who is fully supportive of breastfeeding, and would also like to be given contact details for local breastfeeding counsellors.