My Baby Beginnings - Pregnancy & Postnatal Articles

How to Do Paced Bottle Feeding (and Why It’s So Important)

Thu, 11 Sep 2025 18:38:46 GMT

Paced Bottle Feeding: What Every Parent Needs to Know

Whether you plan to breastfeed with an occasional, exclusively bottle feed, or do a combination of both, one technique I recommend every parent who may use a bottle learn is paced bottle feeding . It’s a simple adjustment to how you give a bottle, but it can make a huge difference to your baby’s comfort and feeding rhythm.

Many parents are surprised when they first hear about it. After all, isn’t feeding a baby with a bottle just… tipping it up and letting them drink? Not quite! Babies fed with a bottle can easily end up drinking too quickly or taking more milk than they need. That’s because a bottle delivers milk much faster than the breast, and babies are born with a strong suck reflex.

Paced feeding helps slow things down and gives your baby more control — just as they would have at the breast.

What is paced bottle feeding?

Paced bottle feeding is a way of giving your baby a bottle that slows down the flow of milk. It mimics the natural rhythm of breastfeeding, giving your baby more control over how much and how quickly they drink.

Instead of milk pouring quickly into the baby’s mouth (as can happen when a bottle is tipped up), paced feeding lets your baby suck, pause, and breathe at their own pace.

Benefits of paced bottle feeding

Protects the breastfeeding relationship – if you’re combo-feeding or expressing, paced feeding makes it less likely baby will prefer the faster flow of a bottle.
Reduces wind and tummy discomfort – slower feeds mean less gulping and less air swallowed.
Supports baby’s natural hunger cues – they get the chance to pause, rest, and stop when they’re full.
Avoids overfeeding – babies have tiny tummies, and drinking too quickly can stretch them uncomfortably.
Promotes bonding – feeds feel slower, calmer, and more responsive.

Step-by-step guide to paced bottle feeding

Choose a slow-flow teat – ideally a narrow-based or gently sloping teat that encourages a deep latch.
Sit your baby upright – think barely semi-reclined, not tilted way back.
Hold the bottle horizontally – so milk just fills the teat, not the whole neck.
Let baby draw in the teat – don’t push it into their mouth, let them choose to take it in.
Pause often – tip the bottle down every few sucks if the baby is feeding too fast so they can get a natural break.
Watch their cues – stop if baby turns their head, pushes the teat out, or looks relaxed and full. A 'good baby' does not need to finish their bottle!

When should I introduce a bottle?

If you’re exclusively breastfeeding and you're happy continuing that you don't ever need to introduce a bottle. However if you are breastfeeding and would like to introduce a bottle, it’s usually recommended to wait until feeding is well established (around 4–6 weeks) before introducing it. Offering a small bottle a few times a week after that can help prevent bottle refusal later on.

If you’re combination feeding from the start, by choice or necessity, paced bottle feeding is especially helpful to protect your milk supply and avoid baby preferring the faster flow of a bottle.

FAQ: Paced bottle feeding

❓ How long should a paced bottle feed take?
Ideally, 15–20 minutes — roughly the same length as a breastfeed.

❓ How much milk should I put in the bottle?
Start with small amounts (1–2oz / 30–60ml). It’s better to top up if baby wants more than waste milk if they don’t.

❓ Can I do paced bottle feeding with formula?
Yes — paced feeding works with formula or expressed breast milk.

❓ Should I do paced bottle feeding if exclusively formula feeding?
Ideally yes - this helps support baby's natural feeding patterns and avoids overfeeding.

❓ Will my baby still get enough milk if I slow things down?
Yes. Your baby will still get plenty of milk, but at a pace that supports digestion and comfort.

Final thoughts

Feeding your baby should be a calm, connecting time — not a stressful one, or a race to the finish line. Paced bottle feeding is such a small change, but it can really support your baby’s digestion, help protect breastfeeding, and give you confidence that you’re following their lead.

If you’d like hands-on guidance, or if feeding feels stressful right now, I offer lactation and bottle feeding consultations where we can work through your baby’s unique needs together.

Experiences of Breastfeeding in Hospital

niamh@mybabybeginnings.ie (Niamh Cassidy) — Fri, 26 Jan 2024 19:15:49 GMT

Real mothers' experiences of Irish hospitals

Did you know that 62% of mothers initiate breastfeeding in hospital but only 37% leave hospital exclusively breastfeeding? In 2022, in an Instagram story I asked my followers to share their experiences of breastfeeding in hospital. In this post I'll share what came in through the story question box and also through my DMs. All stories are anonymized. It was really lovely to see some positive stories come in so lets start with those ones.

Luck and a bit of support can go a long way it seems and when people do get the support they need they really appreciate it! This DM is from a mother who accessed one of my Breastfeeding Support Packages :

"Re. the top up trap ...one of the midwives suggested a top up to me on the second day...had I not spoken to you for our intro chat, I wouldn't have been aware of it and I would have likely accepted. However because we had spoken and you had made me aware of some of these pitfalls, I felt confident to say I didn't want to do a top up and that I would plough on with exclusively breastfeeding. On one of my nights in the ward after giving birth I noticed that I was the only women (out of 7 in the ward) that wasn't putting in an order for a formula for the night."

Unfortunately, the positive experiences above in the image were in the minority of those sent to me, but we also have to remember that people are more likely to share challenging experiences than positive or easy ones. I'd also like to point out that this post isn't about demonising midwives, rather exploring the problems with the Irish Maternity system that means that women often do not get the support they need when it comes to breastfeeding.

Lets look at Sarah's experience :

"Offered formula in the delivery suite as baby wouldn't latch. It was clearly the end of her shift, she was tired and I don’t blame her in the slightest but why spend all the time and effort convincing us to breastfeed antenatally then be met with formula at the very first hurdle. I refused btw and spent the whole night hand expressing into a syringe"

When I initially wrote this blog in 2022 being offered formula in the delivery suite wasn't actually all that common but and was quite shocking as there is absolutely no need at this stage. But unfortunately since its original publication I am seeing this happen more and more. While it's beneficial if baby has their first breastfeed in the first hour after birth it is not a necessity so there was no need for supplementation and even if there was Sarah should of been encouraged to express colostrum instead, thankfully she knew to do this herself.

In this next story Michelle had three different challenging experiences , and not only in the postnatal ward. The positive outcome of this story is that due to her experiences she went on to train to be a volunteer breastfeeding counsellor and to support women in her community.

" Being told repeatedly that the latch looks fine even though I was crying with the pain for the whole duration of each feed. This was on my first and second babies.
Being told that I had got it wrong with the whole nose to nipple thing, and that my nipple should be at baby's bottom lip.
My third was a home birth but had feeding issues again. I remember going to the lactation clinic at the hospital and asking them to check my baby for tongue tie but being fobbed off and leaving in tears (she was my third baby and I was a trainee BFC and I knew she had a TT!). I got an IBCLC out to the house then who confirmed a very restrictive tie, which we got released.

Oh and being in the baby clinic with my 4 week old baby who roared in pain all day every day and wasn't doing enough dirty nappies. I asked to see an IBCLC but was told they were in meetings all day. I was given an Rx for omeprazole, which I knew wasn't necessary, and told that everything is fine."

I'm not sure what the above experiences say to you but to me it sounds like overstretched midwives and unsupported mothers. We have to ask how is this allowed to continue? It's not fair on the staff, many of the mothers expressed understanding about this but it should never be that a mother is afraid to ask for help because the people who are supposed to be there to help them are too busy.

Below is Jane's story, I did a private antenatal class with Jane & her husband while pregnant which included breastfeeding information. Jane's story gives us a myriad of different experiences and shows how individual midwives do count and how their support (or not) can leave a lasting impression.

" Hey Niamh hope you’re well!
I said I’d share my PP BF experience!
Initially in the delivery suit the midwife was so helpful, baby latched with some of my help but she was pretty good. The midwife returned and was so celebratory that as A FTM I had the knowledge to try it myself and she gave me extra tips. She was also super encouraging with skin to skin etc basically everything.
Then hospital was busy so I wasn't brought to a postnatal ward, I was brought to a gynae recovery ward. It was Friday night at 2am, one week before Christmas and covid was playing havoc.
Sadly, at this point I didn’t have a great experience. My husband was gone home and I was shattered after a 2 day induction and long labour!
The nurse, as I sussed very quickly didn’t have much knowledge of BF, she told me my baby was starving, I was being selfish, I wouldn’t be let home within 48 hours if the baby didn’t have food and lost weight.. it was not what I expected

I rang my husband and he was cool and reassured me. I sat holding my baby warm and close to my body, she fed a little and slept and fed and slept.. sometimes she cried!
The nurse returned and said I’d need to give her formula as my ‘milk hadn’t come in’ … I asked her how she knew that? She left.
Morning came and my husband was back, I felt braver with him supporting me as I was so tired.
That day was alright, nobody really said or did much, but def no support.
That night, a midwife was on. My baby was howling crying and I was wrecked. She said if I gave the baby formula we would both sleep.. now, here is where I get upset. She referenced my epilepsy, which is relevant when sleep deprived but there was no room to support and help me, it just scared the life out of me. She pushed the formula. I had harvested colostrum and I asked her to bring it from the fridge, she was a bit dismissive. You’ll never guess what..

I fed the baby and topped her up with colostrum of my own!
I was actually really proud ��
We both got some sleep and I felt better after that!

The final midwife I met was amazing. She was an IBCLC and was super helpful. I can never thank her enough because I checked out that day feeling so supported and confident!! Super experience!
I do think I was lucky as I had learned before had by doing classes with you and reading and just taking in information, but as you can see it’s a super mixed bag of positive and negative.
I also felt very strongly about giving myself, my baby and my body a chance to bf but I could see if a person wasn’t, they would have left with formula where maybe they would have been happier bf!

It’s when I look back I can see it clearer, at the time it’s all so much to take in!"

If all midwives had the knowledge, bandwidth and empathy of the first and last that Jane met I would meet a lot less distressed mothers when they get home and realise they don't know how to keep going with a mix of formula and breastfeeding and that they can't cope with the level of work that doing both at the same time brings. It's time that mothers were able to count on appropriate support for breastfeeding in hospital and not just lip service antenatally.

You can download my free handout for tips around breastfeeding in hospital here

Or if you'd like to check out my low cost Breastfeeding in Hospital Mini-Course which also includes my entire breastfeeding handout library you can find it here

The Stages of Labour

niamh@mybabybeginnings.ie (Niamh Cassidy) — Tue, 16 Jan 2024 12:05:21 GMT

What happens during the different stages of labour?

Let's take a stroll through the journey of labour – three exciting stages that bring you closer to meeting your little one!

First Stage - Ready, Set, GO!

So, here's the lowdown on the first stage, it has two cool phases - the early or 'latent' phase and the active or 'established' phase.

Early or 'latent' labour

In the early phase, your cervix is softening, and you might feel some irregular contractions. It's like the warm-up before the main event. It can last for many hours, even days sometimes! Most people are more comfortable at home during this stage, even as contractions start to become more regular. If you present to hospital in early labour you may be encouraged to return home or, if admitted, will be admitted to a ward, rather than a delivery room until you are in ‘active’ labour’.

Pro tip: Eat and drink to keep that energy up! You can try breathing exercises, move around, get a massage, or soak in a nice warm bath.

Active or 'established' labour

When things kick up a notch into the active phase, contractions become longer, stronger and more regular, usually about every 5 minutes or more frequently. When your contractions have been coming every 5 minutes, are about a minute long and this has been happening for at least an hour you may now be in active labour and chose to call your midwife or make your way to your maternity unit. Many maternity services diagnose 'active' labour when the cervix is dilated to 4cm or more. But don't worry you don't have to rush - in a 1st labour, the time from the start of 'active' labour to being fully dilated is usually 8 to 12 hours (This does not include the early/latent labour time, only from when those contractions are coming every 5 mins) so you should still have plenty of time to get to your maternity unit!

Transition

Now, let's talk about the grand finale of active labor – transition. It's like the climax of a blockbuster movie, intense and thrilling. Contractions are closer, lasting 60-90 seconds. Transition typically lasts 15 to 60 minutes. Many people who have laboured well without an epidural may at this stage feel the need for additional pain relief. Often reassurance and support is enough to help you through this stage. You have done all the hard work and you will be meeting your baby really soon! An epidural may or may not be an option depending on how close to the 2 ^nd stage your provider feels you may be. Some care providers may prefer not to administer an epidural at this stage as it may prolong labour unnecessarily and can't be more difficult to put in as you may find staying still hard.

Second Stage - Puuuussshhh!

Stage two kicks in when your cervix is fully dilated (about 10cm). Your baby is making moves down the birth canal, and you might feel the urge to push – kind of like you need to poop (but in a totally different context). You can follow your body's lead and push during contractions whenever you feel the urge. Mother-led pushing (where you follow your own body urges rather than directions) reduces the risk of tears, so don't feel shy in asking your midwife to ssshhhhhhh if she's shouting puuussshhhhh! If you have had an epidural, you may not feel an urge to push at all and may need to be directed by the midwife.

Pro tip for pushing: Try an all fours position – it's a game-changer, working with gravity and the pelvis. Short, panting breaths are your secret weapon when the baby is crowning. Once that head is out, the rest is a piece of cake – or maybe more like a birthday cake!

Third Stage - The Finale

After the baby's debut, it's time for the grand finale – the third stage where th eplacenta is born (you no longer need it!). Your uterus gets busy contracting, and the placenta makes its debut. Some find these contractions surprisingly strong, while others barely notice them. You will likely have your baby skin to skin during this phase and they may even have their first breastfeed.

There are 2 ways to manage this stage of labour:

active – when you have treatment to make it happen faster
physiological – when you have no treatment and this stage happens naturally

Active management is recommended if labour has been induced or augmented with sytocinon (synthetic oxytocin) as the body may not produce enough of its own oxytocin to facilitate the birth of the placenta. It is also sometimes recommended if there are risk factors for post-partum haemorrhage or it may be standard care in your maternity unit. If you would prefer a physiological third stage you should discuss this with your care provider.

In active management you are given an injection of syntocinon into your thigh as you give birth, or soon after. This makes your womb contract. Once the placenta has come away from the womb, the midwife pulls the cord – which is attached to the placenta – and pulls the placenta out through your vagina.

In physiological we wait for the body to do its thing!

Once the placenta is born, labour is over, woo hoo!

Now you're feeling more ready for birth, lets get you ready for breastfeeding! My Breastfeeding in Hospital Mini-Course can get you off to a great start and is only €25!!!

Christmas Inductions

niamh@mybabybeginnings.ie (Niamh Cassidy) — Thu, 07 Dec 2023 11:17:42 GMT

Is Christmas an appropriate reason to have an induction?

With Christmas coming up fast, there's the usual chatter in pregnancy worker circles about all the inductions that will be scheduled before the festivities kick in. Doctors seem to be booking inductions at 38, 39 or 40 weeks weeks, citing reasons like getting the best Christmas present, that staffing levels are lower so you won’t get as much support or even their own holiday plans if seeing someone privately. But really, are they good enough reasons to start a medical procedure that has many well documented risks?

The facts are that Ireland’s induction rate is climbing, even outside of the holidays with 35.1% of all labours induced in 2021. This was even higher for first time parents, 44% of them were induced. The national reports don’t give a month by month breakdown but the hospital ones do. Christmas and holidays might bring joy, but they aren’t solid reasons for induction. Yet, if we look at the busiest hospital in the country, the Rotunda. Their November 2022 inductions stats were

November 2022 Inductions

Overall: 38.1%

FTM: 48.7%

Shocking stats in themselves but now lets look at December 2022

December 2022 Inductions

Overall: 42%

FTM: 56%

Like WTAF!?

The World Health Organization says a normal pregnancy lasts between 37 and 42 weeks, emphasizing the differences between pregnancies. But these days, inductions, especially around Christmas, seem more about convenience than necessity, which raises concerns, especially for those pregnancies without any additional risk factors. What’s wrong with just letting babies come when they’re ready?

In it’s latest guidance the WHO recommends that “Routine induction of labour, for women with uncomplicated pregnancies, at less than 41 weeks is not recommended”.

This is because of the risks associated with induction including:

“Failed induction ” - An induction might be considered failed if the methods used don't result in a vaginal birth after 24 or more hours. In such cases, a C-section might be recommended.
Fetal Distress - The medications used to induce labor — synthetic oxytocin and/or prostaglandins — can cause the uterus to contract too much, and too strongly, which can lessen the baby's oxygen supply and lower the baby's heart rate sending them into distress which can mean s caesarean birth might be necessary to save them.
Infection - some methods of labour induction, such as rupturing the membranes (breaking the waters), might increase the risk of infection for both mother and baby. The longer the time between membrane rupture and birth, the higher the risk of an infection.
Uterine rupture - This is a rare but serious complication in which the uterus tears due to the extreme contractions caused by induction.

It can be tempting to want to meet your baby sooner rather than later and the last weeks of pregnancy can be demanding, but they're also a time to relax and enjoy. Managing stress, staying emotionally balanced, and looking forward to the birth can have a big impact on having a positive birth experience and on your postpartum health.

Healthcare providers, despite being human and wanting holiday celebrations, have a responsibility to ensure medical decisions are based on evidence, not convenience. The flaws in our maternity system and potential biases mean it’s necessary for parents to be able to advocate for themselves and have informed discussions before making any decisions.

When researching for this blog I asked some parents to share their stories with me and I want to say thank you to everyone who did. You can read them now below.

“I was offered an induction at 42 weeks, my doctor always said let’s wait and see, hopefully a spontaneous labour will result. In the end I opted for induction as I became so uncomfortable! The doctor did suggest that maybe after 42 weeks it would be time to consider. What really made the experience less than ideal was that the hospital was sooooo busy because of the amount of inductions booked; it was the 17th of December. From talking to many mothers to be there, they were all around 39 weeks or so and wanted to have an induction so to avoid being away from their other children over Christmas.. the labour wards were FULL. The midwives stretched beyond limits, and post natal wards were full. I end up on a gynae ward with women who had just had hysterectomies; I felt awful. I have since had a spontaneous labour, and I can honestly say the experience in incomparable. This time round felt so much easier, my baby and body decided when ready and recovery had been more gentle. I knew the information on induction; informed of risks etc. however, I would urge anyone to deeply consider opting for an induction (unless medically indicted), it’s a huge decision. I wasn’t pushed into it, but I’ve heard it is so, so common to be pushed for it, which is so wrong and makes me mad. Especially now that I have the two experiences to compare!” - R

“My due date was 15th December 2021 with my first little girl, (due my second next feb), also an IVF pregnancy. A few days after my due date I had an anxious night and felt like baby wasn't moving as much. I went in for CTG trace and my consultant did a sweep with my permission, all was fine with baby and movements were fine. she then talked about placenta failing post due date etc. At 7 days post due date, she booked me in for induction, pessary, at this point I was so nervous that something would happen to my baby despite all my reading about dates and placenta etc. I know if it hadn't been Christmas week that she would have allowed me more time. My 10 days over would have been Christmas day and my consultant wasn't on duty over Christmas weekend. I went ahead with induction at 7 days post dates and baby was born the night of 8 days over. All was fine and I managed a natural delivery with some vacuum. It was not the labour I wanted or planned for and Christmas definitely had an impact. ” - C

“My first was 12 days over...from 37 weeks on a weekly basis I was being told he was huge and wouldn't lend well to a vaginal birth. He was grand and 8 lbs. Second...same story. Absolutely massive baby...9lbs. 3rd...same story...another massive baby. I told them I had heard that story twice. Absolutely no pain relief on her, not even gas and air and she flew into the world. 8lbs. I get really angry when I think about how someone with less education and less support might feel pressure to comply. My husband is a doctor and while not in the area of obstetrics he was a great help and his support was huge. He never understood the push to get them out and used say they'll come when they're cooked” - M

If you're interested in learning more about evidenced based care and informed decision making - putting you at the centre of the decision making check out my Private Antenatal Classes delivered in the comfort of your own home.

Getting Breastfeeding Started

niamh@mybabybeginnings.ie (Niamh Cassidy) — Thu, 02 Nov 2023 12:31:53 GMT

When you’re planning on breastfeeding or just started you probably have many questions. Hi, I'm Niamh Cassidy, a lactation consultant in Dublin, and in this article I am going to answer some of the ones I hear most often to help you get breastfeeding off to a great start.

When Breastfeeding Starts

Your preparation for breastfeeding started before you were born, continued during puberty and ramped up in pregnancy. If you are more than 18 weeks pregnant your body is already making colostrum , the first milk, for your baby for when they are born. You may not see it yet but that’s ok, rest assured, it’s there, ready and waiting.

Some people choose to hand express some colostrum in the last few weeks before their estimated birth date. This is often called antenatal expression of colostrum . This can help you get to know your breasts better and to have some extra colostrum available should your baby need it but it is not something that you have to do. If you choose to give it a try do not feel discouraged if you don’t get much, or anything at all, sometimes your body just wants to wait for the baby.

Breastfeeding itself obviously starts once the baby arrives.

Breastfeeding, How to Start

The first hour after the baby is born is often called the Golden Hour and this is when we hope to see the first breastfeed. In Irish hospitals, mums and babies are typically kept in the birthing suite (often referred to as the delivery room) for at least this first hour to protect this amazing time. Baby will be skin to skin (not dressed) on your chest to help facilitated this. As a lactation consultant I encourage as much skin to skin as possible over the first few hours, days and weeks so no need to dress baby for that move to the postnatal ward.

In that first day we hope baby askes to feed at least every three hours, but some babies are tired after a long labour or if there were any birth interventions and may not feed as much. We can facilitate feeding by keeping the baby with you skin to skin as mentioned. If baby isn’t feeding as frequently as we might like we can keep an eye on the nappies to see if everything is ok. We would like to see one wet and one poopy nappy in that first 24 hours.

Why is Breastfeeding Painful

I am often asked this or if it is supposed to be painful. Here’s the thing, it shouldn’t be painful. Initial latching in the first few days might be slightly uncomfortable or feel a bit odd but it shouldn’t hurt . You should not be holding you breath because of the sensation. If you are, or it hurts, we need to see what’s going on. Typically, it’s a simple as changing the position you are feeding your baby in.

Which Breastfeeding Position Is Best

The best position is the one where baby is getting milk and you have no pain. For many mothers this means you are in a reclined position with your whole body supported and baby is belly down on your chest. Baby may be straight down the mother’s body or at an angle. The most important part is that the baby’s body is fully against yours, that they are not turned away or sitting on a breastfeeding pillow on their back. When the baby’s body is not in close to the mother’s body it’s hard for them to get a deep latch and that’s when breastfeeding hurts.

How do I know my baby is getting enough breastmilk?

This is usually parents main concern around breastfeeding and it can often become highlighted on day 2 when baby starts feeding round the clock. You see, on day two, your baby starts to ‘wake up’ and become more aware that they are no longer in the womb. They miss being part of your body and they are experiencing so many things for the first time, including hunger, cold, lights etc. Your body is their safe place and feeding helps them relax and cope with all of these new experiences. They are also very clever and are doing to work to tell your body to up the milk supply and start that transition to mature milk, what many people refer to as ‘the milk coming in’ .

If your baby just wants to feed and be held on day two this does not mean you do not have enough milk. Its just a normal behaviour for new babies. Again, we want to look at the nappies, two wets and two poopy nappies? We’re all good.

What if they are not doing enough nappies or are jaundice or their blood sugars are low?

The first port of call is to breastfeed them more . If this isn’t sufficient you can hand express colostrum and give them that. WHO protocols would state that donor milk is the next option but this is only available for premature and sick babies in Ireland. The last option is supposed to be formula as we know that early introduction of formula to breastfed babies can cause them harm through increasing risk of allergies, sickness and interfering with the establishment of a full breastmilk supply.

Where to Find Breastfeeding Support in Ireland

There are lactation consultants in most of the maternity units during ‘office hours’. The midwives on shift can also provide support. Unfortunately, due to understaffing how much support either can give can be limited. Many parents with health insurance choose to engage a private lactation consultant for support before and after their baby is born. There are also voluntary groups with trained breastfeeding peer supporters that you can visit before and after you baby is born such as Cuidiu , La Leche League and Friends of Breastfeeding . These are typically free or donation based.

Which Breast Pump Is Best

If you want to breastfed you don’t typically need a pump. But for some, a breast pump can be a valuable (or needed) addition to your breastfeeding journey. There are many options out there but not all of them are suited for all scenarios. It’s usually better to wait until after your baby arrives and then get advice from a breastfeeding professional as to what pump may suit your needs.

Breastfeeding is the normal, natural way to feed you baby but it is still something that you both need to learn how to do . This can take a few days or a few weeks and your body and your baby are set up to allow for this learning time as babies need so little milk at first and it slowly ramps up over the first few weeks. If you would like more support in relation to preparing for your breastfeeding journey check out my Breastfeeding Support Packages . Or if time or budget are a concern check out my Breastfeeding in Hospital Mini Course .

How to Make Choices during Pregnancy and Birth

niamh@mybabybeginnings.ie (Niamh Cassidy) — Thu, 26 Oct 2023 11:39:27 GMT

The Importance of Informed Decision Making in Maternity Care

When you are pregnant you will be faced with many choices

What kind of antenatal care is best?
Where should I have my baby?
What tests to get?
Should I have an induction if I go past my due date?
What pain relief will I use in labour?
And many more….

Maybe you have considered some of these, or maybe you haven’t. That might be because you believe you will be told what is ‘best’ to do so you don’t need to make decisions or because you’re afraid to make the ‘wrong’ decisions. Or it might be that even though we DO have choices in all elements of our maternity care, it may not always seem that way.

Ever hear a parent say “they won’t allow me to go past my due date” or “they said I have to be induced”? If you’ve had a conversation with even a handful of people who have been pregnant you’ve probably heard this but the truth of the matter is you have the human right to make decisions about what happens to your body and you are the only person who can ‘allow’ something or not.*

Informed Decision Making (IDM) may be a term you’ve heard of before, or perhaps informed consent or shared decision making? They are all similar and are often used interchangeably but for me the gold standard is Informed Decision Making (which includes informed consent & informed refusal). Shared Decision Making, in my humble opinion can fall short as an ideology.

I define informed decision making as having the information required to understand risks, benefits, limitations, alternatives and uncertainties of any treatment, test or intervention offered and the understanding that you can consent to, or refuse, any of the options, and that you can withdraw consent at any time.

Let me give you a non-maternity example of this in practice that I experienced a few years ago. During a dental appointment for my son who had an abscess on a tooth I was informed that he had a number of cavities that the dentist recommended the best course of action would be to remove some teeth under general anaesthetic (GA). I was hesitant and she then suggested that we could treat the abscess with an antibiotic and see if the pain resolved. She also mentioned that due to his age the most problematic tooth might fall out itself soon so I decided to go with the treat and see approach. A few months on and the abscess came back and the tooth hadn’t fallen out so we went back to the dentist who again offered to remove some teeth under general anaesthetic. She suggested that four teeth should be removed. I asked her could the three without the abscess be filled instead of extracted and she explained the rationale for removing them. I also asked could they be removed under local anaesthetic and she discussed how that would work and the risks and benefits of that approach and why they would not generally recommend that for four baby teeth as it would be four separate extractions and that we could choose to have the one with the abscess removed under local and leave the rest or choose the original option offered. I considered our specific circumstances and agreed a GA would be best for extractions. She then explained the risks of GA and gave me a leaflet to read. I asked about aftercare and pain and she talked me through that. I then consented to the procedure and filled in the paperwork. Then, and very importantly, the dentist informed me that if at any time before the scheduled treatment we changed our mind we can do so and we can do it without consequence. This was vital because many people feel that once something is ‘booked in’ they must go forward with it so it was really reassuring for me to know that we could change our minds and decline the treatment at any time.

AS someone with a clear understanding of Informed Decision Making I was in a position to ask the questions I needed to get the information necessary to make a decision even though all the options were not originally highlighted to me by the dentist. In the birth community we often use the acronym BRAIN to describe this.

B – what are the Benefits?

R - what are the Risks?

A – what are the Alternatives?

I – what is my Intuition telling me?

N – what happens if I do Nothing or wait?

Can you pick out each of these questions from my story? They are not always done in order.

In my example it started with my Intuition, I wasn’t keen on my child having a GA for a tooth, as I was already aware of some of the risks, so I was then told what would happen if I declined/waited and that is the option I chose. Had the abscess not reoccurred that may have been the end of the story. Due to the reoccurrence, we went back to the dentist and went through the benefits and risks of the treatment offered and the alternatives that I asked about. I was then able to feel comfortable that this was now the best course of action (my intuition told me) and I also knew I had the opportunity to change my mind (do nothing or wait again).

So why is Informed decision making so important? Well, in my example I am happy with both my decisions, happy that we gave it a chance and didn’t jump into the more interventionist option and happy that that is now the right course of action. I don’t have to live with any regrets or “what ifs”. It’s also important to note that going straight for the GA extraction may be the right decision for another family.

When it comes to birth though it can be more than lamenting ‘what ifs’. The Birth Trauma Association in the UK has a comprehensive list of causes of birth trauma. Many of these occur when someone is not facilitated or encouraged to make informed decisions. These include: Feelings of loss of control; Impersonal treatment or problems with staff attitudes; Not being listened to and Lack of information or explanation.

When someone is facilitated and encouraged to make informed decisions, they often maintain their sense or control, develop positive relationships with staff, feel listened to and have appropriate information & explanation thus reducing the risk of birth trauma. Birth Trauma is diagnosed in approximately 6% - 10% of women who have given birth but research shows that up to 45% of new mothers have reported experiencing birth trauma. This figure is astronomical and if informed decision making can help reduce it I feel compelled that as many people as possible learn about it, hence this rather long blog and the fact that it is the central tenet of all of my classes and services.

Now, let’s look some maternity care examples.

Example 1:

Mary is at her 38-week antenatal appointment and is seeing the obstetrician (OB). The OB does a quick scan says baby is looking on the bigger side, takes a look at her notes and suggests that he book her in for an induction on her due date. Mary is taken a back and becomes anxious. She then remembers she has a tool for this situation and takes out the BRAIN acronym card from her purse that her antenatal educator had given her. Mary’s intuition was already telling her that this isn’t what she wants but realises that she needs more information to make an informed decision.

She asks the OB “Can you tell me why you are recommending induction?” (Benefits)

The OB explains that he feels the baby is getting big and it would be better not to let her go overdue in case he gets too big. Mary has already read the evidence on ‘big babies’ and isn’t yet convinced this is a good enough reason for her, but at the same time doesn’t want to go against her doctors advice.

She asks “What are the risks involved?” (Risks) At first the OB describes the risks of ‘big babies’ again but with a little more gusto. Mary clarifies “Thank you, you’ve explained that to me already, I was wondering what the risks of induction are?”. The OB goes on to explain that many inductions are carried out every year in the hospital without major event. Mary says that she has heard that more pain for the mother and fetal distress are risks of induction. The OB agrees that these are risks and also informed her that there is a risk of uterine rupture and post-partum haemorrhage (PPH) but that they will give an injection to reduce the risk of PPH.

Mary was really hoping for a birth without unnecessary intervention, so she asks

“Are there any alternatives?” (alternatives)

The OB describes the different types of ways that they can start labour but Mary doesn’t really like the sound of any of them so asks what the alternatives to induction are. The Ob says that some people try to get labour started themselves but that he doesn’t feel there is much evidence to support this and that medical induction is more reliable.

Mary askes herself

“What is my intuition telling me?” (Intuition)

She recognises that she still doesn’t feel like induction is right or her so she asks one more question.

“What happens if I decide against induction?” (What if I say no?)

Her OB reminds her of the reasons he feels it is best and when she asks again he tells her that nothing in particular will happen. That as long as her and baby remain well she will continue with her scheduled antenatal appointments as normal until she gives birth or decides on induction.

Mary is happy that she now has enough information to make a decision and declines induction at this point. She goes on to have an enjoyable birth and a healthy 8lb 7oz baby at 41 week & 3 days.

Example 2

Jessica has been in ‘active’ labour for three hours. The contractions are coming hard and fast but she was disappointed when the midwife did a vaginal exam and said she was still 3cm dilated. Jessica has in her birth plan that she knows what pain relief options are available and will ask if needed but don’t offer. After the midwife leaves Jessica says to her partner ‘I don’t think I can do this’, her partner gives her a big hug and feels her how proud of her she is. She also reminds her that pain relief is an option. Jessica is feeling better after the hug and continues to labour for another two hours.

The midwife comes in and Jessica asks for a vaginal exam. She is still three centimeters and the midwife tells her she things the baby had turned back to back and that might be why they are not moving down. Jessica and her partner try out different positions and movements to get baby moving down and the contractions become even stronger. Jessica tries gas and air for a bit but it s making her dizzy. She has already researched the risks and benefits of epidural and feel that it is now they right next step for her.

When it is in place she is content that she can now get some rest and enjoy the rest of her birth. A little while later the CTG starts beeping and the midwife comes in, she calls the Dr. Jessica asks what is going on and the dr tells her the baby is struggling a little bit. Jessica asks what this means, and she is told their heart rate is not recovering as they would like. They ask Jessica to lie on her side to see if this helps.

The babies heart rate is not recovering and the Dr suggests a caesarean section. Jessica asks is it an emergency, right now, and the doctor says that it isn’t yet but they are concerned. Jessica asks can they wait or are there any more tests to be sure. The Dr suggests taking a blood sample from the baby’s head to check oxygen levels and Jessica agrees but baby is too far up to complete the test. The babies heart rate drops again and Jessica asks for them to ‘get the baby out’ and agrees to a CS. The baby is born safely and although Jessica got a fright, and she is disappointed about the CS, she is happy she made the right decisions for her and her baby.

Example 3

Anastasia is 30 years old and pregnant with her first baby. She is very excited and looking forward to labour and birth. She has done lots of independent antenatal education and is confident in her birth plan.

Anastasia goes into labour at midnight and by 6am contractions are starting to come every 7-10 minutes, she continues labouring at home and is enjoying dancing with her partner and getting in and out of the shower. At 2 pm as she steps out of the shower he feels a ‘pop’ and something gushing down her legs. The liquid is brown in colour. She knows this could be meconium so she takes a picture, gets dressed and puts a pad in. Her partner calls their maternity unit while she does this and they advise to come in. Anastaisa and her partner agree this is the best course of action even though they were hoping to stay home until contractions were stronger.

They go in and Anastasia and the baby are assessed. There are no signs of fetal distress but the care providers are concerned about the colour of the waters and that they are still trickling in this colour. Anastasia really wanted to avoid staying in hospital in early labour so asks why that is what they are suggesting (the BENEFITS). They explain that they feel it would be safest to monitor the situation more closely in case the baby does go into distress. She then asks about the risks of monitoring of which she isn’t given any but she knows she’s not going to be able to move round so much and this might make labour harder. She asks are there any alternatives to staying in and being monitored and explains she’s worried about not being able to move around. Her care provider reiterates that they really feel she needs to stay in but offers intermittent monitoring instead. Anastasia asks to speak to her partner in private and they discuss. The decide they are comfortable with staying in and being monitored as she will be able to move around and they want to make sure baby is ok.

Later as Anastasia is pushing concerns are raised about the babies heart rate, the parents are kept informed and it is mentioned forceps assistance may be needed. Anastasia asks is it ok to have a few more minutes pushing and she is told yes, after three more contractions pushing the monitor beeps again and Anastasia asks for forceps assistance. Her baby is born on the next contraction with assistance. Anastasia is disappointed that her birth is not without intervention but overall feels it was still an amazing, positive experience because she felt respected and in control throughout.

Example 4

Michelle has gone into spontaneous labour at 41 weeks 6 days. She has laboured happily at home for 10 hours and is assessed at being 4cm dilated on admission to hospital. This hospitals policy is to admit to the delivery suite at 4cm so she is there with her partner. She meets her midwife and presents her birth preferences and the midwife murmurs ‘oh you’re one of those’ under her breath but Michelle hears it and becomes anxious. She puts her nightdress on and gets into bed and tries to relax. A while later she notices her contractions seem to be slowing down. Three hours after admission the midwife asks to do a vaginal exam to check ‘progress’. Michelle isn’t keen on this midwife but agrees as she is curious herself. The midwife says she ‘is still only 3cm’ and she will need to talk to the doctor. Michelle and her partner are worried. The doctor arrives and explains that she would like to start her on synthetic oxytocin to speed things up. With all the worry Michelle & her partner forget to ask their questions and agree. The synthetic oxytocin brings on strong painful contractions and Michelle is finding it harder and harder to cope. The midwife then mentions ‘fetal distress’ and goes to get the doctor. The doctor checks on the well being on the baby and tells Michelle that the baby isn’t tolerating the oxytocin very well and she’s been in labour ‘a very long time and must be getting tired and that they may need to consider a caesarean section at this stage’.

Michelle and her partner are worried about their baby but remember a question that they’ve learned that can also go along with BRAIN. Michelle says “Is this an emergency or do we have time to talk about it?”. (Emergency)

The doctor explains that the baby is fine for now but that may not remain the case but yes there is time to talk about it and asks what she needs to know. Michelle says “Why do you think a caesarean section is the best course of action now?” (Benefits) The doctor reiterated about the fetal distress and her being tired so Michelle asks the doctor to take her through the caesarean section process and the risks which the doctor does. Michelle doesn’t feel there is an urgency yet or that the benefits presented outweigh the risks of caesarean section.

“Is there anything else we can do to reduce the risk of fetal distress?” (Alternatives)

The doctor tells her they could turn off the oxytocin but that the contractions may then stop. Michelle asks

“Are there any other risks to stopping the oxytocin” (Risks)

The doctor informs her it may not stop the fetal distress and that she is already tired so may end up with a caesarean section anyway.

With all of this additional information Michelle feels comfortable in making a decision to stop the oxytocin and to try to get relaxed and moving again to see if this helps labour to start progressing again. She informs her care providers of this but also mentions that if the contractions do not start to pick up again within three hours or that the baby becomes distressed even without synthetic oxytocin that she would like them to reassess the best course of action. The oxytocin is stopped, baby’s heart rate stabilises, and Michelle gets in the shower alone. Soon her contractions pick back up and four hours later her baby is in arms.

These are just a few examples of situations that may come up where BRAIN can be used. Two people with the exact same medical situations may choose different options and neither is wrong. The important part is that the woman is the primary decision maker and that the care professional is there to provide unbiased and objective information so that the birthing person can make the right decision for themselves and their baby.

This is something I often say to couples that I work with

“You will make the right decisions for you and your baby as no one in the

world wants you both to be safe and happy more than you do.”

So, unless care providers actually believe that women will consciously make decisions that they know will harm their baby there is no reason for them to not provide the unbiased, evidenced based information we need to make the best decisions for ourselves and our babies. There is no good reason not to do this.

*(Unfortunately, there are many cases of obstetric abuse worldwide where this human right has been violated. This is never the victim’s fault. This will not be addressed in detail in this article however you can read more about it on https://www.makebirthbetter.org/blog/obstetric-violence-what-is-it )

Matrescence: The Becoming & Birth of You, The Mother

Mon, 03 Jul 2023 11:13:54 GMT

The Becoming & Birth of you, The Mother

In this guest blog post Charlie Jose Brown. Life & Motherhood Coach, takes us through the journey that is Matrescence

Motherhood is a profound and life-altering experience that goes beyond the physical act of giving birth. It is the forgotten right of passage, a transformational transition of ‘becoming’ & it leaves no women as it found her. There is nothing left untouched by Matrescence, it changes her physically, hormonally, emotionally, socially, economically, culturally & spiritually . Many mothers often speak of the shifts that continually unfold, she knows that her relationships have changed but doesn’t know how, she knows the way she views herself & the world has changed but can’t explain why, she knows everything has changed but lacks the language & acknowledgement to better understand herself & the ever unfolding shifts that occur as she transitions into & through motherhood. In this blog, we will explore what Matrescence is, delve into its various dimensions, and understand how it affects every mother.

Matrescence, a term coined by anthropologist Dana Raphael, (she also coined the term Doula) describes this profound process of becoming a mother as,

“The critical transition period which has been missed is Matrescence, the time of mother becoming. Giving birth does not automatically make a mother out of a woman. The amount of time it takes to become a mother needs study”

Matrescence refers to & acknowledges the developmental transition a woman undergoes when she becomes a mother but it was Dr Aurelie Athen that really gifted us the language to better understand the many shifts that unfold as we transition into & through Matrescence. Dr Athen likened this transformation to that of Adolescence , an experience that all mothers could understand not only because of their own unique & personal experience but also due to the extensive scientific literature we have available to us. We know & understand adolescence to be a confusing time, no longer a child but not quite an adult either. We know our bodies change, our hormones change, it’s a time of self exploration, learning, growing, evolving as we navigate the shifts taking place in & around us.

The exact same thing happens when a woman transitions into & through motherhood, because when she births a child, she also births the mother . A part of herself she has never met & with each child she births she unearths & unravels new depths she has never explored, she is no longer the woman she was, nor is she yet the woman & mother she will become. Matrescence gifts her the language, understanding & acknowledgement so that she can make sense of the ongoing shifts that happen in & around her.

Similar to adolescence, this is a time of ‘becoming’ . It is universal BUT unique to all women & there are 7 main shifts of transformation that every woman experiences of which we will explore.

Matrescence changes her physically , there are significant physical changes during pregnancy, birth & beyond along with hormonal shifts, weight gain, breast & brain changes to name a few. Research now shows that the changes within the brain are so profound, simply by looking at two brain scans, Dr’s can identify which of the two is a mother, so yes baby brain is a real thing & these physical & hormonal shifts can dramatically influence the way she feels about herself, especially when society's unrealistic beauty standards often place undue pressure on mothers to "bounce back" and regain their pre-pregnancy bodies quickly. It’s important to encourage & support rest, after all the only way to this planet is through the female body which to this day still blows my mind!

The emotional journey of Matrescence is one of duality & at times extreme contradiction as she feels a range of emotions, including joy, love, anxiety, fear, gratitude & grief as she navigates this ‘space between’ who she was & is now becoming. She can feel both gratitude for her children & the life she has, whilst mourning the loss of identity & the life she had. It’s also important to address here that many women experience postnatal depletion due to hormonal fluctuations, sleep deprivation, and the challenges of adjusting to the demands of motherhood in a modern world within a culture that offers little to no mother care & support. Many other cultures acknowledge this transition, the first 40 days postpartum are considered sacred as one day throughout this time represents one year of life & determines the long term health & wellbeing of the mother..

Matrescence affects not only the mother herself but also those around her, it impacts her socially as her relationships with partners, family, and friends shift. A new dynamic unfolds, unmet needs & expectations, little to no conversation around boundaries & support, old wounds reignited within the family & as all attention shifts to the children, the mother often feels invisible which can lead to anger, frustration & resentment. Open and honest communication, along with patience and understanding, is key to nurturing these relationships during this transformative period, ideally prior to any child's arrival, because with each child’s arrival the dynamic shifts again, the mother learns who she is now as a mother of two, three or more. Encouraging partners and loved ones to actively participate in the caregiving process can foster a sense of shared responsibility and strengthen bonds, acknowledging & validating the unseen, unpaid, physical, mental & emotional load a mother carries helps her to feel seen, heard & supported in a culture that doesn’t value the work she does within the walls of her own home.

The roles and responsibilities associated with motherhood can challenge a woman's sense of self . Many mothers find themselves struggling to reconcile their pre-motherhood identity with their new role as a caregiver, especially if their identity was very much connected to their career. It is important to recognise that motherhood does not diminish a woman's worth, individuality or aspirations, however as we have learnt this is a time of ‘becoming’ and as her identity shifts so too do her values, priorities & the ways in which she sees herself & the world around her. It is important for her to explore this season of her life in a way that makes sense for her & her family. Western culture primes mothers for burn out, she is expected to ‘work as though she doesnt mother & mother as though she doesnt work.’ It is essential for her physical, mental & emotional wellbeing & that of her family to create time & space that enables her to explore who she is now that she’s a mother, defining for herself what it means to be a ‘good mother’ & what success means in this season of her life outside of cultural rules & expectations that have been placed upon her.

When a woman births a child, she experiences an inner split, she becomes both the woman & the mother & whilst this can impact many areas of her life, it’s here she may experience significant economical changes regardless of whether or not she chooses to work. She may wish to stay home, or reduce work, with the rise in childcare it is expected that there is some degree of financial change, which can impact her sense of security. Many mothers with established careers prior to motherhood experience, competing devotions, torn between motherhood & her career, wanting to give her all to both but often left feeling so overwhelmed & exhausted she removes herself from the workforce or is even overlooked for job opportunities & promotions as it’s assumed now that she is a mother it’s no longer of interest. It is also reported that mothers when interviewing for a job alongside other females, without children are offered 7-13% less & so the impact of economical changes not only affect her but also the family unit as a whole.

Matrescence is an ongoing transformation, it doesn’t begin & end one time , it is a continuous transition of growth & evolution as she mothers her children, she too mothers herself. This transformation can be described as a deeply spiritual journey, unlocking superpowers she didn’t know were possible, fostering a deeper connection to self & others, it’s no longer about ‘I’ but rather the collective ‘WE’ as women, as mothers. It’s for this reason she mourns or feels sadness when she learns of hurt or harm to another child, she feels the pain of that mother as if it were own. She unlocks her capacity for more love, patience, kindness & compassion and connects to her own inner knowing, her intuition wired entirely to protect herself & her family.

Matrescence is universal, however it is unique to every mother as her experience of these shifts will be influenced by everything she is bringing forth into her mothering journey. How she was raised, how much support she has around her, the current cultural narrative, societal expectations, trauma, whether she or her children have additional needs to name a few. Matrescence changes a woman's life in profound ways & it’s important that she has this language available to her so she can make sense of these changes, without the language, the understanding & acknowledgement that what she is experiencing is real, she will often feel like she is failing, she will internalise these changes & think there is something wrong with her when this couldn’t be further from the truth.

Matresence matters because this language & understanding acknowledges all that she is & continues to experience. She can see herself with more kindness, compassion & learn to trust in herself, it creates a sense of safety for her to explore motherhood & this new season of her life, seeking support when she needs. On the days it’s challenging, she can give herself grace because she will know, it’s Matresence, this is a time of ‘mother becoming.’ with & alongside her children.

Planting seeds of awareness also allows her to see & speak to other mothers, creating honest, open conversations about the reality of this beautiful but also challenging journey of motherhood. How might your own journey of motherhood be different had you known all that was to unfold, had you been aware of the ongoing transformations & shifts?

If we whisper the words of Matrescence to all mothers she will know she is not alone, if we celebrate the incredible strength and resilience of mothers, we can create a society that values and nurtures the well-being of mothers & together we can change the way we view & experience motherhood in a modern world.

If you would like to take one of Charlie's amazing programmes you can find out more below

Nurture Her program:

https://charliejosebrown.podia.com/nurture-her-prenatal-yoga-wellness-course/8iwch

Motherhood WTF Happened.

https://charliejosebrown.podia.com/wtf-happened/8iwch

Charlie Jose Brown is every mothers biggest advocate & loudest cheerleader. She is a

Life & Motherhood Coach for mothers that no longer subscribe to the BS narrative that to be a good woman, a good wife, a good mother you have to give ALL of yourself to the point of depletion. She is a Matrescence Activist & Educator, CTC Master Therapist, Yoga Teacher, Writer, Women’s Circle Facilitator, Spiritual Realist & soon to be host of the Rebel Rising Podcast. She is on a mission to change the way we view & experience motherhood in a modern world by guiding mothers to reclaim, redefine & rewrite motherhood on their terms, their way for their family.

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Top Tips for Labouring Confidently at home

Mon, 03 Jul 2023 10:01:00 GMT

Staying home means home comforts

One of the most pressing questions for parents-to-be attending my Antenatal Courses is - When should we go to hospital? In this blog we will look at that question and also how to stay comfortable at home while labouring there.

The advice from hospitals is usually to come in, when contractions are lasting for at least a minute, are five minutes apart (from the start of one to the start of the next) and that this has been happening for at least one hour, or 1-5-1 as this may mean you are approaching 'active' labour. It is only when in 'active' labour that most hospitals will admit you to the delivery suite, before this you will either be encouraged to go home or admitted to the pre-labour ward - not the most comfortable place to be in labour.

Sometimes it can be hard with nerves and excitement to wait to this point and I always say if unsure call the hospital for reassurance and if not suitably reassured, go in - you can always go home again (yes you can!). The reality is, for most first-time labours the vast majority of the labour time will be spent at home, so it’s important to have some tools in your toolbox to get you through that nervous excitement!

1. Labour is Normal

Ok, so it may not seem very ‘normal’ if it’s the first time you’ve done it or seen it in real life, but I promise you it is. So in early labour when things have just gotten started and there’s a bit of an ‘ooh’ and ‘aah’ every so often but nothing too strenuous, carry on as normal! Do the shopping, make your lunch, sort through old photographs or tidy your press if that’s your thing. The longer we ‘concentrate’ on it, the longer it will feel.

2. Home Comforts

Take advantage of being at home. Eat your own food, rest in your own bed, watch your own TV. What makes you feel safe, comfortable, happy? Do those things. Comedies are a great distraction and help get the good hormones going.

3. Speaking of hormones…

Dip into that oxytocin potion! What is oxytocin I hear you say? Well, it’s the LOVE hormone but also one of the main players in labour and birth as it’s the hormone responsible for uterine contractions. So, what makes you feel loved? Or Sexy? Dim the lights, light a candle, have a cuddle…or more if you’re up for it. Semen is a prostaglandin (another great hormone for birth), and orgasms and nipple stimulation increase oxytocin.

4. Focus on you

Spend some quiet time focusing on your body and its sensations. The bath or shower is a great place to take some time to yourself and breathe. Warm water immersion can also diminish stress hormones and reduce pain. Other ways to relax and focus on your body is to have your partner massage you. Getting a bit of massage practice in during pregnancy is always a good idea as it helps you show your partner what you like and don’t like.

5. Focus on baby

It’s happening, sometime soon you will meet your long-awaited baby. Try to tune into baby, place your hands on your bump, feel their curves and their moves. Talk to them, silently or out loud. You could even write a letter to your baby, tell them how excited you are, how you can’t wait to meet them or whatever else comes to mind. A beautiful keepsake to give them when they’re older.

6. Use Birth Affirmations & Positive Self Talk

Affirmations and positive self talk help keep you in a positive mindset and reduce stress. Less stress = less pain. Not sure what affirmations to use? Download my free affirmation cards for ideas!

Parenting with Ease & Flow

niamh@mybabybeginnings.ie (Niamh Cassidy) — Mon, 15 May 2023 17:22:45 GMT

Just Hygge - The Danish way of Parenting

In this guest post Hayley McDonnell of justhygge.co.uk explains how following the Just Hygge way of life can support our own, and our whole family's, wellbeing. She share how we can prepare for parenting in this way and how we can implement it as parents.

Just hygge tips for new mums and dads

If you’re soon to become a first-time parent, a huge “congratulations!”. An occasion as significant as this can encourage a whirlwind of emotions, and it’s easy to feel overwhelmed and anxious as well as excited and proud. With some simple preparation and thought before hand the overt feelings of serenity and calm will be present so much more.

Let's start with a brief introduction to Hygge. The concept of Hygge (pronounced Hoo-ga) is synonymous with a feeling of cosiness and comfort. In real life, I understand Hygge as a philosophy that means you live your life with intention, ease and flow. I refer to this as Just Hygge. Hygge is a concept that you can adopt for your own life and lifestyle and incorporate in a way that suits you and in all decisions you make. Simply put I look for opportunities for peace and serenity in my life whilst maintaining a sense of satisfaction and fulfilment. This does not mean complacency it means consciously choosing to live an intentional life without external pressures.

The Just Hygge philosophy is for everyone and because the features of ease and flow coupled with peace and serenity are needed at all points in our life and I believe new parenting is absolutely one of those times. In contrast to other life experiences, we can rely on frame of reference to help prepare and navigate moving forward whereas becoming a parent for the first time this luxury is not available.

Under the guise of offering advice there is plenty out there, medical advisors, friends, neighbours, close family members and distant relatives too. Websites, podcasts magazines and local parent groups can be a source of information too and not always welcomed. These words are especially chosen for you to select what works for you and find the contentment and pleasure of becoming a parent for the first time.

A Just Hygge guide to preparing for a new arrival

The focus is on creating a safe space for time together as a family and for sleep times. Create spaces which are comfortable for sitting, gathering and just being present. The ‘me’ time is now shifted to ‘we’ time and this sense of togetherness is part of the Just Hygge lifestyle. It also allows you to be present in the moment, with your newborn and those who are important to you right now. You may choose to do some de-cluttering which in turn will give you both physical and mental space.

Soft lighting will develop the feelings of ease and flow and create a sense of peace and serenity in your home. Buy some light bulbs with a lower wattage, consider battery powered fairy lights and tea-lights.

Comfortable clothes that are both easy to wear and wash will mean you can spend more time with your baby than doing laundry. An extension of your maternity wear is an option. Choose clothes that you will feel happy to wear.

Warm blankets to act as a layer and make your space look and feel cozy can be made available. Try out different textures that are soft and soothing and buy them before the baby arrives.

Comfort food that tastes good and is good for health can be prepared in advance and then quickly and easily made available at the right time. Decide now what you would like to eat and take some time to pre-prepare.

A warm drink is a little but of luxury and is Just Hygge too. Invest in a cup with a lid that keeps drinks warm longer.

Prepare the time before the baby arrives by cutting back or detoxing from technology. With your hands soon to be full cuddling your newborn today is the perfect time to start. Keep any unnecessary technology out of sight and allocate times of the day that are technology free. Not only is this good for your health, but it’s also a simple way to practice being present in the moment which is a huge feature of the Just Hygge lifestyle. If you find yourself reaching for your phone then re-frame the moment as time to breathe and be present in the moment.

These Just Hygge suggestions are related to self-care and as an investment in your mental health and well-being. Self-care can be as unique as you are and the phrase ‘self-care ‘often conjures up images of rest and relaxation and may be difficult to relate to in the early stages of new parenting. The phrase reminds us of the need to look after ourselves emotionally, physically and possibly spiritually too.

The need aspect is vital as it marks a demarcation from the every day embracing of a new lifestyle as a parent.

“Hygge is about having less, enjoying more; the pleasure of simply being. It is generous and celebratory, a way to remember the importance of the simple act of living itself.”

– Louisa Thomsen Brits

The Book of Hygge: The Danish Art of Contentment, Comfort, and Connection

Self-care is not selfish and is synonymous with a Just Hygge lifestyle of ease and flow. Self-care is a crucial part of looking after yourself, as well as others. When you practice self-care you produce positive feelings, which boosts motivation and self-esteem leaving you with increased energy to support yourself as well as your loved ones. Self-care starts with tending to your own needs. Perhaps relate it to the flight – attendant safety talk on the plane when we are advised to put an oxygen face mask on ourselves first before helping others. Self-care is your version of that oxygen mask.

As a new parent, it may feel like your own wellbeing has taken inferiority over your baby’s, which can be a common occurrence. This is also a realistic expectation, this new baby relies on you, the parent to feed, clothe, protect, sooth and care in all aspects. It is true that you’ve gone from having just yourself to look after to now having a whole other life that’s completely dependent on you.

To practice hygge during this exciting, staggering milestone, make sure you find time to look after yourself. When your newborn is asleep or spending time with relatives, have a hot bubble bath, make a cup of tea, put on a fresh pyjama set, and snuggle up with your favourite book. Some days you won’t be able to do any of those things so just do what you can. If you buy a new cushion before your baby arrives you know at least you will be able to relax on that cushion whilst looking after your baby. That is an example of Just Hygge.

Help may be more freely available than what you would like, everyone has an opinion and most are relying on their own experiences and what worked for them. If you can do ask for help and know that you’re not alone! Both asking for and offering help encourages feelings of cosiness and serenity, you need to reduce feelings of worry and tension, and asking for help can tip the scales in just hygge’s favour.

The help needed can come in all guises from simply time to have a shower, a nap, a little bit of tidying whatever suits you. You may want more direct help and advice for example asking how to bathe your baby or soothe them if tired. Offering and receiving help encourages the release of endorphins which in turn reduce stress.

Try not to reach for your phone too much. As a new parent your responsibilities and duties have rapidly expanded, and what you want to focus on now has also rapidly changed. If you have time to scroll you have time to breathe – use this precious time to breathe deeply. You may have practiced this before the baby arrives so you have the experience of what to do before baby arrives.

Adopting a Just Hygge lifestyle it is hoped that you will create a happier, more soothing environment for you all as first-time parents. Reduced levels of stress, lowered depression and anxiety, increased optimism, and increased self-esteem are all positive benefits associated with practising hygge.

A note from the author

Living your life intentionally with ease and flow

Hi. I’m Hayley, founder of. ‘Just Hygge’.

A real welcome to you and my Just Hygge philosophy where I share all that is part of, living each day with intention and ease and flow at its core.

I have worked as a teacher/middle manager for over 24 years and run a busy family home life too. I embrace the Just Hygge philosophy and believe it can be found in the everyday moments at work, home and play so I can live with intention and ease and flow.

Finding our way through this journey of life I have worked through several transitions and in all honestly still do. Overtly I am a mother, wife, friend, sister, daughter and so on; despite these guises the one golden thread that runs throughout is the desire to be happy and live a life of truth. This is where the concept of Hygge takes prominence.

For me Hygge is focusing on living a life of intention and purpose and doing so with the essence of ease and flow. Making decisions with understanding of the who what why when and how, and then enacting those decisions with ease and flow at its core. With these values I can look after my mental health and well-being and I hope that the content I share provides a conduit to sharing this lifestyle has the same benefits to you too.

Find me at www.justhygge.co.uk

Relationship Changes after Baby

Tue, 04 Apr 2023 11:23:38 GMT

How to navigate changes in your relationship after becoming parents

Becoming a parent is a life-changing experience that can have a major impact on your relationship with your partner. Suddenly, the focus of your lives shifts from each other and your careers, hobbies and shared interests to the new life you are now responsible for. Women also experience significant brain and hormonal changes from pregnancy &birth and the process that is called matrescence. Navigating all of these changes can be challenging, most relationships will come under some strain, this is normal, but with some understanding and effort, you can come out on the other side with a stronger, more fulfilling relationship. This benefits not only each of your but your child(ren) too.

Communication is key

One of the most important things you can do to navigate the changes in your relationship after becoming parents is to communicate openly and honestly with each other. This isn’t the easiest thing to do, especially in the first few weeks where women are also navigating hormonal fluctuations, and everyone is getting less sleep than they are used to. Sometimes we expect that the other patent just knows what we are thinking or what we need but that isn’t always the case. It’s important that you both are willing to listen to each other's concerns, needs, and feelings, and to communicate your own. Make time to have regular check-ins with each other to discuss how you're feeling and what you need from each other. If you find it hard to articulate without getting upset sometimes sending a message with some details and asking to talk about it later can be helpful, but you are best paced to understand your relationship communication needs.

Embrace change

Becoming a parent inevitably means that some aspects of your life and relationship will change. It's important to be willing to embrace these changes and adapt to the new realities of your life. This might mean adjusting your expectations, letting go of old habits, or finding new ways to connect with each other that work within the constraints of your new role as parents. It might mean that some hobbies are no longer a priority of the amount of time you can devote to them is reduced. This is a normal part of becoming a parent, we are not ‘loosing ourselves’ and we do not need to ‘get our lives back’. Becoming a parent irrevocably changes your life, adjust to this season and be ready to embrace the next one.

Schedule ‘time away’

By time away I’m not talking about weekend trips of holidays (although they are good too!) I mean time away from being fully responsible for your baby. This might mean taking turns caring for the baby to give each other a break, even to have a shower or nap in peace or to get out for a short walk in the early days to as the early parenting fog starts to lift finding ways to incorporate exercise, hobbies, or other activities that help you feel fulfilled and energized as your baby gets bigger. When one person in the relationship gets more ‘time away’ than they other this can be a cause for tension or resentment. Many women feel that their partners lives have continued as normal while theirs has changed drastically. Find a way so that you both get time away, individually, and eventually together.

Seek support

Navigating the changes in your relationship after becoming parents can be difficult, and it's important to know that you don't have to do it alone, and that you were never meant to. Humans are meant to be raised in communities and extended families, not buy just one or two parents. We were never meant to do this alone and when we try t’s so much harder. Seek out support from friends, family members, or professionals if you need it. Joining a new parent group, getting help from family or reaching out to other parents who have been through similar experiences can all be helpful ways to get the support and guidance you need.

Practice gratitude

Finally, practicing gratitude for the good things in your life, even when things feel challenging is proven to be beneficial for everyone. Take time each day to reflect on the things you appreciate about your partner, your baby, yourself and your life. This may be as simple as

“I am proud of myself that I parented for another day”
“I appreciate when my husband makes me lunch”
“I am grateful for the cuddles I have with my baby”
“I am grateful for the wonderful care my girlfriend gives my baby”
“I am lucky to have a safe home”

Focusing on the positive can help you stay connected and grounded during this time of transition. This does not mean that you always have to be positive, negative emotions need space too, but also practicing gratitude helps keep balance in our lives.

To round it up - becoming a parent is a big change that can have a significant impact on your life and your relationship with your partner. Focusing on communication, time away, flexibility, support, and gratitude, can help you both navigate these changes and come out with a stronger, more fulfilling relationship on the other side.

On a side note, if you are breastfeeding and sleep is a major issue you can download my Free 'Getting more Sleep while Breastfeeding Guide' here.

Pregnancy Hormones

Sun, 12 Mar 2023 21:46:49 GMT

Hormones, hormones, hormones!

Hormones, hormones, hormones! Responsible for so much in relation to pregnancy sysmtptoms but also in growing our babies, birthing our babies and feeding our babies!

In this article I’ll focus on the hormones of pregnancy.

The First Trimester

When you become pregnant, progesterone and oestrogen rise significantly. Progesterone acts as a muscle relaxant, preventing your uterus from contracting until labour starts. However, it can also associated with irritability and mood swings, eeek!

Oestrogen helps to regulate progesterone while also sustaining the endometrial lining (lining of the womb that we shed when not pregnant – menstruation!). Oestrogen also promotes an increase in blood flow, which is important for nourishing the baby, but that extra blood flow has the side-effect of making your breasts achy and tender, ouch. It can also lead to that stuffy nose many women experience and can cause you to need a pee more often.

Human chorionic gonadotropin, or hCG, is known as the pregnancy hormone because it’s normally only produced during pregnancy. This is the hormone that shows up in pregnancy tests and is important because high levels of it indicate that the placenta is being created. However, it may also make you feel nauseous. Parents to be expecting multiples will have higher hCG so can often suffer with worse nausea or vomiting.

The Second Trimester

The second trimester is often met with a bit of relief when some of the early pregnancy symptoms may start to ease, but there’s still a lot going on. Your muscles and joints may feel uncomfortable, especially around your pelvis. This is thanks to relaxin, a hormone that helps relax the smooth muscles in the abdomen and pelvis.

Oestrogen and progesterone continue to increase and also stimulate the melanocyte-stimulating hormone. This triggers your skin’s melanocyte cells to produce melanin, which gives your skin colour. Therefore, some women may notice the “mask of pregnancy,” which causes brown or grey patches around the face. You may also notice a dark line appear that goes up your belly, called the linea nigra.

Cortisol also increases during pregnancy, but it’s not necessarily negative—it’s important for the developing baby because it can help regulate your metabolism and control blood sugar levels.

Human placental lactogen (hPL) is a placental hormone that changes your metabolic state to help get your energy supply to the baby to help them grow. It also has anti-insulin properties. Your body’s changing reaction to insulin makes a lot of sense in that it’s a time of rapid growth for the baby and a lot of energy is needed for this growth. Sometimes this can go a bit wonky and cause gestational diabetes ☹

The Third Trimester

Your baby is starting to fatten up this trimester and your body is increasing some of the hormones it will need postpartum. Oestrogen and progesterone peak around 32 weeks. You might notice swelling around your ankles and feet and while this can be related to the lymphatic system, oestrogen may also play a role because it’s indirectly involved in synthesizing salt and water retention.

Later in pregnancy, women can also experience heartburn because progesterone has relaxed the sphincter at the base of the oesophagus, allowing food and stomach acid to travel back up. Meanwhile, relaxin helps to loosen those pelvis muscles to prepare for birth.

Prolactin, a hormone that stimulates the development of your breast tissue to prepare for lactation, now ramps up. Prolactin is 10 times higher at the end of pregnancy than it is at the beginning. Though your body doesn’t produce mature milk until progesterone and oestrogen drop after birth of the placenta, it does start to get ready with colostrum, while you’re still pregnant - but that’s a topic for another day!

If you've started to think about packing your hospital bag or what you might buy for it check out my free

Ultimate Hospital Bag list below

Why Staying at Home in Labour is a Good Idea

Wed, 22 Feb 2023 13:58:25 GMT

The content of this blog only provides general information that may or may not apply to your personal health condition or circumstances. The opinions expressed are strictly personal opinions and not the opinions or policies of any third party, including any health care provider, employer, educational or medical institution, professional association or charitable organization. Nothing in this blog content constitutes or shall be construed as constituting medical advice of any kind whatsoever, nor is it a substitute for professional medical advice, diagnosis and treatment. If you need healthcare advice or information, please speak to your care provider.

When to go to hospital?

One of the most common questions I get asked is when should we go to the hospital? So, you may be wondering why the title of this blog post is “Why Staying at Home in Labour is a Good Idea”. Maybe the idea terrifies you or maybe you’re just wondering why you would want to stay home for labour? Just to be clear, I’m not talking about home births here, I’m talking about if you are planning a hospital birth, staying home for a significant portion of your labour.

You might be thinking but wouldn’t it be safer and more comfortable to be in hospital? Well, here’s the thing - the clinical evidence and women’s descriptions of their experiences support staying at home for as long as possible. But here’s the crux of it - when it is safe and you feel comfortable to do so.

The ‘first’ stage of labour (from labour starting to being 10cm dilated) is typically the longest stage and is often described as consisting of two phases: the latent phase ( early labour) and the active phase. Early labour could last anything from a few hours to a few days and most maternity hospitals will not admit you while still in early labour so most people do spend a significant amount of time in labour at home.

There are differing thoughts around when labour changes from early labour to ‘active’ labour. Up until recently most western maternity services have described active labour as starting at 3-4cms dilation. Research by Freidman in 1955 is the basis of most units’ diagnosis of active labour at 4cm. This study looked at 500 white women’s labours and found that, for most, cervical dilation started to speed up from 4cm onwards. More recent research (Zhang et al. 2010) of a much bigger sample size (>62,000 women) found that most people did not dilate rapidly starting at 4cm. Rather, labour started to speed up around 6cm dilation . This was true for those giving birth for the first time and those who had given birth before. Before 6cm, many people went long periods without any dilation and still went on to give birth vaginally to healthy babies.

There is now a movement within the medical community for “6 to be the new 4”, so as to not diagnose active labour until 6cm. Depending on your maternity hospital or unit they may have an admissions policy based on what they deem ‘active’ labour to be. Even if your unit diagnoses active labour at 4cm it is helpful for you to know yourself that things do not tend to speed up until 6cms so if you are comfortable to remain at home longer you can do so.

Why do hospitals have policies that encourage women to stay home until in active labour? The answer is that the research shows us that the earlier you present to hospital in labour, the more likely you are to have intervention in labour or birth, without increasing positive outcomes for either you or your baby. Women who are admitted earlier are less likely to experience vaginal birth and more likely to have synthetic oxytocin augmentation, epidurals, caesarean birth and instrumental assistance. The summary being that the simple act of being in hospital increases these risks without making you or your baby safer and that is why we are encouraged to stay home during this phase.

Ok so staying home reduces the risk of interventions, why else might you like to stay at home? As mentioned, the latent phase can be long, even a few days. Having access to your home comforts and 24hr support from your birthing partner can lead to an easier and more pleasant experience. It may also help labour to progress naturally .

Let me break that down for you a bit more. Oxytocin, the love hormone, is also the contraction hormone. Oxytocin likes being warm, happy, and feeling safe and loved. In many maternity units, if admitted prior to the ‘active phase’, birthing partners are only allowed stay during visiting hours. Most people’s birthing partner is someone they care for romantically and/or who they trust implicitly. Having their ongoing support helps keep your oxytocin flowing which helps keep labour progressing. With oxytocin, we also produce our own natural endorphins which are the brain’s natural pain reliever!

Adrenaline, the stress hormone, is the enemy of oxytocin, so we need to try keep that at bay and who is better placed to know how to keep you stress free than your romantic partner or someone who really knows you and you trust completely? Your birthing partner should be someone who recognises your signs of being stressed and knows how to bring you back to a state of calmness. If your romantic partner doesn’t tick all of these boxes (and not everyone’s will) having an additional, or alternative support person can be helpful. This can be a friend, family member or a paid professional such as a doula.

So, at home we have our birthing partner’s undivided attention, what else do we have? Well, home is where the heart is right? It’s also where all of our stuff is, where everything we use daily to relax and rewind is. Most maternity units only want us to bring a small labour bag but at home you have access to so much more. You have your own bed and pillows, your own bathroom and shower or bath. You have your TV, easy access to your favourite foods and drinks, spaces to be alone and spaces to be together. If your latent phase is 12+ hours you’re going to want all this right? In addition to having all the home comforts we also have our local surroundings if we want to go for a walk or get some fresh air in the garden.

But, but, I hear you say, you still haven’t told us when we should go to the hospital ! I do an exercise in my classes where there are a number of scenarios and parents-to-be have to decide whether they are going to ‘Stay at Home’, ‘Call the Hospital’ or ‘Go to the Hospital’. It can cause a lot of interesting discussion! But basically, as long as you are feeling safe and well and baby is moving as normal you can stay at home.

Regarding contraction timing, you are unlikely to be in ‘active labour’ if your contractions are shorter than 60 seconds and the gaps between them are 5 minutes or more. If your contractions are at least 60 seconds long, are coming every 5 minutes (from start of one to start of another) and they have been doing that for a least an hour you are more likely to be at about 3cm dilation. However, at 3cm there is probably still a long way to go yet so if you are happy to stay home for longer you will likely still have plenty of time to get to hospital.

If you are worried, about either yourself or your baby, then you should call or go in. You always have the option to stay home if reassured on the phone or to go home if all is well after you present. There are a few reasons why you should definitely get in touch with your care provider or go in. These include (but are not limited to):

Any blood loss
Concerns re: baby’s movements
An unshakable belief that there is something wrong
Developing a temperature
Feeling confused, or being incoherent between contractions
Waters breaking and not being clear and/or smelling bad
Labour prior to 37 weeks gestation
Desire for additional pain relief

Or any other reason where you no longer wish to be at home and wish to be cared for in the hospital. Remember, we want to keep adrenaline at bay so no point staying home if that’s not where you are feeling safest.

In summary, if you are hoping to have a vaginal birth, and for things to go as smoothly as possible, then staying home for as long as you feel safe will support this process.

Pregnancy and childbirth can be an overwhelming and sometimes challenging experience. It's natural to feel anxious or nervous about giving birth, but positive affirmations can help ease your mind and bring you closer to a peaceful and joyful birth.

Expert Yoga Tips for Pregnancy

Sat, 14 Jan 2023 20:49:09 GMT

Top 10 Tips for Practising Yoga in Pregnancy

by Claire Corcoran from Stretch it Yoga

If you are pregnant or planning to get pregnant you may have already heard that Yoga is a safe and beneficial practice at this time. Indeed, yoga is pretty much an ideal way to nourish your wellbeing during pregnancy. As well as the obvious physical benefits, a regular Yoga practice can reduce fear and anxiety around birth and motherhood and may help you to enjoy your pregnancy more.

Many of the women that come to my pregnancy class have never done yoga before. If you are new to Yoga it’s a good idea to wait until the second trimester before beginning and I would recommend going straight into a prenatal yoga class. Remember it’s always a good idea to check with your doctor or midwife before beginning any new exercise regime.

If you have been practicing yoga consistently prior to finding out you were pregnant it is fine to continue if you feel up to it, however many women feel too tired or sick or worried in the first trimester and its best to listen to your body and your own intuition here. There is plenty of time to resume physical activity in the first trimester when your energy levels improve.

At this point, even if you are continuing on with your regular class or a home practice, it’s a good idea to start attending a specific pregnancy yoga class. There are extra benefits you cannot get in a regular yoga class, for example, birth preparation and support from other pregnant women.

As a Mum who practiced Yoga throughout her pregnancy and a Prenatal Yoga teacher with nearly 10 years experience, here are my top 10 tips for practicing Yoga in Pregnancy

1. Just Breathe

Yoga is all about the breath and pregnancy yoga is no different in that respect. In my pregnancy yoga class the first thing we do is learn how to breathe properly. That might sound silly, after all breathing is something we do unconsciously every minute or every hour of every day – of course we know how to breathe properly – right? Wrong actually, most of us are doing it incorrectly! Poor posture, anxiety, stress and pregnancy itself can lead to incorrect breathing habits. Once we nail breathing properly, we can begin to utilise the breath to help soothe the nervous system, creating a greater sense of calmness, promoting the production of pain killing endorphins and keep the body from tensing up too much. If you attend a prenatal class throughout the second and third trimester, by the time you enter the labour ward – you will be an expert at using your breath as a tool to help you birth your baby

2. Use lots of props and make plenty of space for your baby

Your body is undergoing so many changes as your baby grows and movements that used to be easy can become much more difficult. Props are an amazing way to help you feel more comfortable in yoga class. In my class we use birth balls, blocks, straps, bolsters, cushions and blankets and even the wall as props. Some classes will supply props and others will ask you to bring your own. Either way it is completely, 100% worth any extra time and effort. Using props properly will help you feel more steady, more spacious, more comfortable and able to get a deeper stretch and strengthen safely and effectively.

3. Be aware of changes in your centre of gravity and your balance and be ready to adjust accordingly

This one is related to the last one. Generally the larger your belly gets, the more your centre of gravity will change and the more this effects your balance. It is wise to make adjustments to accommodate. As the trimesters progress you may find a wider then hips stance in mountain pose provides a more solid base. Balance poses should be practiced near a wall or modified accordingly – for example you could move your foot from your upper leg to your lower leg in Tree Pose. Even poses that are not usually associated with balance may feel more wobbly so it may feel better to shorten your stance in poses such as warrior poses and triangle pose.

4. Focus as much on strength and stability as stretching and flexibility

Deep stretching can feel amazing in Pregnancy and can sometimes feel like exactly what your body needs but despite how it feels at the time, this is not always the case. This is particularly true in the third trimester. As your pregnancy progresses your body starts to produce more and more of a very important pregnancy hormone called Relaxin. Relaxin’s purpose is to make the ligaments of the pelvis a little bit stretchier so that our pelvis can widen and open more effectively during birth. However this can lead to increased instability in the joints, particularly the pelvis and lower back and this instability can be exacerbated by over-stretching these ligaments. So the focus should be on maintaining good mobility without overstretching. I encourage all my students to go to no more then 90% intensity while stretching, especially in the third trimester and I also emphasis working on building strength and stability rather passive stretching.

5. Keep it cool

During early pregnancy your basal body temperature increases. Later on in the pregnancy your core body temperature can be more susceptible to outside influence and it can be easier to over-heat. Doctors recommend taking care to discourage too much of a rise in core body temp. If you are attending a regular class that gets crowded arrive early so you can pick a spot that is closer to the door or window. I would caution against doing hotter, sweatier kinds of classes, especially in heated rooms. If you feel yourself getting over-heated take a break and drink some water. Don’t be afraid to ask the teacher to open a window as she/he might not be feeling as hot so may not realise. This is another reason why a pregnancy yoga class is a good idea – you will move more slowly and not be asked to do anything that causes too much heat in the body.

6. Minimise lying on your back

The main reason for cautioning pregnant women from lying on their back is because of the potential to compress the interior vena cava, which is a major vein leading from the uterus back to your heart. However If this is happening you will start to feel dizzy and light headed. If this does happen just roll over onto your left side (blood flow is optimal on this side), wait for any dizziness to pass and slowly sit up when you feel ready. Most pregnancy yoga classes will avoid supine (back lying) positions or spend very little time on the back which is another good reason to attend one!

7. Avoid deep, closed twists

If you are someone who has practiced a lot of yoga, you are probably aware of how beneficial twists are and how nice they feel. However, all closed deep twists are contraindicated in pregnancy ESPECIALLY in the first, most delicate trimester. There are a couple of very good reasons for this. The first is that closed twisting (which includes poses like Lord of the Fishes Pose, Chair pose twist or revolved Lunge Twist) involves deep compression of the abdomen which can cause strain to the abdominal muscles and restrict the blood flow. The second reason is that deep twisting can cause strain to the sacroiliac joints at the back of the pelvis which can become more unstable as your ligaments get stretchier and also in the spine.

But that doesn’t mean you cannot do any twists. Gentle open twists are fine and actually beneficial as they keep the spine mobile and help release tension in the back. The trick is to keep the twist nice and open in the abdominal area and focus on mobilising the mid and upper spine – where we all tend to be less flexible anyway – especially during pregnancy.

8. Avoid laying on your belly after the first trimester

It is recommended to avoid prone poses (poses that require you to lay on your belly) in the second and third trimester – they are generally uncomfortable anyway so it is pretty intuitive. Some people are happy to do them in the first trimester and they are considered safe so if you have been practicing prone poses before you found out you were pregnant please do not worry. However many prefer not to practice these poses once they know they are pregnant as it can feel uncomfortable and intuitively it can feel wrong to put pressure on the lower abdomen in this most delicate trimester.

Poses like crow pose are out as well because of the abdominal pressure.

In general, avoid poses that involve very forceful engagement and/or a lot of pressure on the abdominal muscles – so this applies to intense core work as well. Gentler core work like pelvic tilts for example are not only safe they are very good for the health of your core and pelvic floor muscles during and after pregnancy. We include many different types of pelvic tilts in prenatal yoga class.

9. Move slowly – especially when transitioning in and out of poses

Again – another simple straight forward one. Believe it or not most yoga injuries happen in the transitioning, even in regular classes and with pregnancy the chances of injury increase. Any pregnant Mamma will relate to the feeling of making a movement that was too sudden and feeling a sudden pain somewhere as a result. Slowing down is the key. For this reason faster paced yoga styles are not (in my opinion) a good idea. A prenatal yoga class will give you tips on how best to transition from the floor to standing and vice versa and will give you ample time to transition comfortably from one pose to the next.

10. To invert or not to invert?

A Yoga inversion is technically any pose that brings the heart down lower than the head. So that includes gentler inversions like puppy dog pose, standing forward bends, legs up the wall and downward dog. All of these poses are considered safe in pregnancy and I include modified versions of them all of them in my pregnancy yoga classes

So are more intense inversions like headstand, handstand, forearm stand and shoulderstand safe and beneficial in pregnancy. If you have been practicing inversions long before you were pregnant and feel comfortable continuing with them, this should not be a problem, although I would recommend checking with your doctor and moving your mat next to a wall for safety. Pregnancy is definitely not the time start doing inversions – for the same reasons that you might be advised not to take up roller-skating or skiing! For this reason I would never teach these kinds of inversions in prenatal yoga.

If you are practicing inversions in the third trimester and your baby turns from breech to head down please stop inverting at that point as a precaution to encourage your baby to stay head down.

Trust your body

Hopefully these tips may have cleared up some questions or concerns you may have about practicing yoga in pregnancy. Of course the most important thing is to trust your body and your own intuition. If something doesn’t feel right then think about how it might be modified to suit your changing body or simply drop it from your practice altogether.

Remember you are your own best guide and the Yoga is there to serve you and your baby, not the other way around.

If you have any further questions please feel free to get in touch. My website is www.stretchityoga.ie and my email address is Claire@stretchitoyoga.ie . I teach Pregnancy Yoga in Sutton, Dublin 13.

Christmas Mastitis

niamh@mybabybeginnings.ie (Niamh Cassidy) — Tue, 20 Dec 2022 18:46:55 GMT

Rates of mastitis go up over the festive period! Here’s some information on how to avoid common pitfalls.

Long Car Trips

Christmas often means lots of visiting and travelling in the car. Many babies like to sleep when in the car so there may be more time between feeds which can lead to engorgement which in turn can lead to mastitis. Plan regular breaks for long trips (its also safe for your baby not to be in the car seat for extended periods) and make sure to feed before leaving and on arrival.

Being Busy

Being busy with cooking, cleaning, entertaining and more can again mean missed feeds. Set a reminder to pause and feed in your phone just in case time gets away from you.

Relatives

Well meaning relatives can often want to help by holding the baby or bringing them on a walk. You’ve guessed it this can also lead to missed feeds. Also, some breastfeeding parents may feel uncomfortable feeding in front of some people and may unwittingly make feeds shorter, or more spaced out, than usual.

Over-stimulated Baby

With all the comings and goings and lots of different people about babies can become over stimulated and may have shorter or fussier feeds. If this is the case try to plan at least a couple of calm feeds in a quiet space away from others. It can also be nice to get some time away for yourself too!

Tight Clothes

You may like to wear fancier clothes or bras than usual and these may be tighter around the breast area. Make sure bras and clothes fit well and are not compressing breast tissue which can lead to blocked ducts or inflammation.

What to do if you notice blockages

If you feel blocked ducts or red hot spots bring your focus back to feeding your baby. You do not need to pump to relive this, feeding your baby as normal is recommended. A cold compress on the area for 10 minutes at a time can reduce discomfort and inflammation. Ibuprofen, as per packet instructions, can also be taken to help treat inflammation and fever if needed. This will be sufficient in treating most cases. However, if no improvement after 24-48 hours, or symptoms worsen, contact your GP or Out of Hours service as you may need antibiotics.

A Photographer's Birth Story

Mon, 05 Dec 2022 16:04:44 GMT

Johanna King is a documentary newborn & family photographer. I also happened to convince her to be my wedding photographer too. I loved her documentary and unobtrusive style and I knew she had to be the one. Johanna recently shared with me the story of the birth of her second baby and as an artist she has a fabulous way of telling a story so I just had to ask if I could share it with you too. The story starts on Dollymount beach...

Ever since baby Louis arrived into this world, I have wanted to write his birth story. It was a little bit more ‘dramatic’ than his big sister’s birth, but also a very powerful experience and I wouldn’t change anything about it (in hindsight).

Having taken part in a 4 Weeks Hypnobirthing course with the Rotunda, I had visualised my birth a lot towards the end of my pregnancy, but none of the scenarios involved my waters breaking (movie style) on Dollymount Beach.

4 minutes earlier, I took this photograph

I was 39 weeks and really thought I had more time.

The day before, the community midwifes measured my bump at 42/43 weeks gestation (I was at 38,5). After a very uneventful pregnancy, it was the first time I was booked into hospital for a growth scan. I never made it that far. One thing for sure, my bump was big and really high, even though his head was engaged. Looking back, I think there was just a lot of liquid in there :D

So, back to the waters breaking and the beach…

My mother had just landed in Dublin at 5pm. On the way back home from the Airport, I told her that it felt good having her finally here, that I could now relax and welcome this baby, knowing that we had the perfect minder for our big girl.

We were also in the middle of another heat wave, and I had been dying to go back for a sea swim, but didn’t want to chance it before she arrived, in case it brought on labour (from all the lovely feelings and endorphins).

During dinner, I was feeling restless and all I could think about was that sea swim (I have a history of feeling obsessed with sea swims if the conditions are perfect. Just me?)

So we agreed that I could go the next morning and that we could go and see the sunset after dinner, as it was such a beautiful evening. My husband drove (just in case), but we didn’t take anything with us: hospital bag or towels or any protections for the car.

We all left and made it to Bull Island. My husband dropped us as close to the beach as possible and went to park the car. My mum, my daughter and I started to walk (slowly for me) towards the beach, admiring the light on the sand dunes. It was really beautiful, as you can see in the picture above.

We made it to the beach. I took my shoes off and took the photo of our long shadows and then….. swoosh.

A big gush of warm liquid came rushing down my leg. Ooops.

I told my mum (who is a recently retired midwife and her medical brain kicked in so she wanted to know if the water was clear - it was!) and a mixture of disbelief and excitement sets in. This is it! My husband then started to appear at the top of the road and we waited for him while our daughter took some photos, not realising what was happening yet.

When my husband reached us, we told him, and a second rush of water came down. We told our daughter what was happening and she knew what it meant. She was beyond excited. Here is the exact moment captured by my husband:

He then jogged back to get the car, while we walked (slowly again) back towards the road. More water came down at every step, people passing us by. It was fairly surreal, and I was laughing at that stage. I wondered whether they would realise what was going on.

Once we got to the road, my husband arrived with the car. We put some shopping bags on the seat, but let’s just say that it still needed a good steam clean. To be honest, I’m not sure anything would have been enough to absorb all that came out during the drive home. I kept saying: “oh no, there is more coming”.

The funny thing is that a few days earlier, I was reading forum messages online about waters breaking (and the potential need for mattress protections) and most of the mums were saying: “You know, waters don’t often come gushing down like in the movies.” But for me, it really did :D

We got home around 8.45pm.

It’s all hands on deck. Everyone is helping, even our daughter. I get in the shower, put on dry clothes. My mother finalises the hospital bag with a couple of things she brought back from France. My husband makes sandwiches for himself ahead of the long night ahead.

My daughter fetches things and shares her excitement about her baby brother finally coming… I think to myself “she won’t be forgetting that day”.

The birth itself - Rotunda hospital

We end up leaving for the Rotunda at around 9.20pm. I’ve only had 1 or 2 short contractions (surges!) by then.

I sit in the back of the car on a pile of towels (remember, the front seat is soaked) and use my “Freya” app to time my surges. I just opened the app for the first time today and I timed 6 contractions between 9.28pm and 9.45pm, each lasting for 45-50secs and with 2 to 4 minutes in between.

I did my “up breathing” as best as I could (in for 4, out for 8). The surges were… powerful from the get go and I knew I wasn’t coming back home.

When we get to the Rotunda and check in at reception, I stopped using the app and never picked it up again. It was just too much to concentrate on.

With my daughter’s birth, the contractions stopped when I got to the hospital and this time is no different. They have me sit in the waiting room for about 10 minutes (not the most comfortable wait, in my now wet clothes and shoes).

Then someone called my name and asked me “Why are you here?”

I know it may seem like a logical question to ask in such a big hospital with so many people coming and going, but I had just told reception that I was in labour and had been waiting for a while now, wondering if they understood what it meant :D

Anyway, this lady leads me to the assessment area. My husband has to wait in the corridor. I gave him my phone because I had no pockets or bag and it was just “in the way”. The midwife proceeds to tell me that I will be getting a 20 minutes monitoring. Ah. “Can you let my husband know?”

Before she examines me, she reminds me that my waters breaking doesn’t mean active labour and they may suggest I go home. But I’m at 3 cms, and she confirms that I won’t be going home and starts the monitoring, then goes to find my husband.

I’m not sure how long I was there, but when she comes back, she says that we’re going to go to the labour ward and they will do the monitoring there. I had asked for the new labour suite with the birth pool.

She uses a wheelchair to bring me up so as not to wet the corridors with my every step. I’m thankful!

Off we go, and I am led into a “normal” delivery suite. Our midwife informs us that the birth pool suite is currently in use. I had prepared myself for this possibility but am still a little disappointed. I know water would have helped a lot.

In hindsight, it was all for the best as I would have likely only had time to get in and then out again, as you are not allowed to actually birth in the pool, just labour.

I’ll make the end quick: the midwife read our birth preferences and made sure to follow them all. The lights were dimmed and she didn’t interfere unless necessary.

There was a lot of faffing with the bluetooth continuous monitoring (the 20 minutes they HAD to do). The batteries were flat, it was beeping and it kept slipping down so I couldn’t move or stand.

Eventually she switched to the traditional monitoring with the cables. It was annoying me as I kept waiting for the monitoring to be taken off to “finally start my labour” as in: move around and follow what my body wanted, put some music on etc.

Long story short but and I ended up with the continuous monitoring until the birth itself, because baby was born at 00h09, 1h15 after I first lied on the bed.

Once the surges returned, they did with a bang. I felt like I had no respite in between them at all and felt sick.

I took a trip to the bathroom - down the hall - and when I came back into the room, I stayed standing, leaning over the bed.

I asked for the TENS machine and it helped somewhat for a few of them, then not anymore and I started to think that “I couldn’t do this” and my brain imagined alternatives such as epidural and even c-section.

I told my husband and he felt powerless. I told the midwife and mentioned the epidural even if I knew deep down that it would take too long. She said we could call the anaesthetist if I wanted, but told me later she took it as a sign that baby was coming fast.

It did cross my mind in between 2 contractions - I had heard a lot about transitioning - but thought it was way too soon.

“Luckily”, I didn’t have to wonder for too long and started to feel pressure. I was still standing in front of the bed at that time, the midwife keeping the monitoring in place. She encouraged me to lie down on my left side on the bed (position I had listed in my preferences for the 2nd stage) and very quickly, my body started pushing.

That part was sooo easy compared to the previous one, and so so powerful. The midwife gave me gas and air, but I didn’t need it anymore. The contractions were different and I could feel their impact. I used my breathing technique and my body did all the work, very quickly, very powerfully and in 3 or 4 contractions, baby was out.

WOW.

I cried. The relief I felt was unreal.

Look at this shot. It’s not the very first one or the most beautiful, but I like all the details in it. Both of us crying. The midwife removing the monitoring FINALLY. The Gas and Air mouth piece. The orange Ikea suitcase… My husband took hundreds of photos of the next few minutes and I am so so grateful.

My 3rd stage was as straight-forward, as short and as “easy” as it could be. Nothing like my first birth, where it ended up being the most traumatic part of it all (and I’ll spare you the details). This time, I was even able to get a shower before getting my well deserved tea and toast.

For our daughter, my husband took photos as well after the birth but I found myself missing photos of labour, the room, and details. He also shied away from anything too “graphic”. I didn’t know I would want these photos until much later.

This time, while labour itself was too fast to be photographed when you’re also one of the main actors, I have amazing photos of the cord, of the placenta, of the first feed. (See a couple of them at the end of the email).

We’re still missing photos with him in them, especially during labour and one of the 3 of us after the birth. Setting up the Interval timer wasn’t something I wanted him to worry about and we forgot to ask the midwife to take one, both times!

Anyway… that’s me done for now with my story. I keep remembering more details but I don’t want to bore you with them.

Like the fact that my husband started eating sandwiches at 11.30pm ahead of the long hours ahead - or so he thought. Even when the midwife said that the head was nearly born, he couldn’t believe it :D

Wow, just wow. I hope you enjoyed that as much as I did. If you'd like to learn more about taking gorgeous pictures of your own children Johanna has lots of free resources here

Or, if you know you want her skills documenting your family you can join her waitlist here

Johanna King Photography

johannakingphotography.com

VBAC Birth Story

niamh@mybabybeginnings.ie (Niamh Cassidy) — Sat, 26 Nov 2022 12:30:01 GMT

A Positive VBAC Birth Story by one of my clients

When someone is planning a Vaginal Birth After Caesarean they often wonder "can I do it?". Reading stories of those who have gone before can help give you confidence and reduce anxiety. I am very thankful to this client for sharing their story with me so that I can share with you. This is in their own words

A little story for you Niamh, thank you for all of your help you were a key part in me achieving my VBAC today. What you do for women is amazing ❤️

I almost can’t believe I am writing this but I achieved my VBAC at 40+3 to a beautiful surprise baby girl weighing 7.13lbs.

I made a point of reading positive VBAC birth stories every day throughout my pregnancy and I hope my story will give another VBAC mother the encouragement they need.

My first birth was in Oct 19 and ended in an emergency section due to ‘failure to progress’ passed 4cm and a “suspicious CTG” after 36 hours of Labour.

My partner and I want a big family so I was adamant to not be restricted based on hospital protocols around number of sections allowed and I also wanted to experience a natural birth myself.

I’m was under the care of the wonderful Roisin Lennon in SUH who was so supportive from day 1 and never once doubted my ability to have a natural birth. Without her care and holistic approach this wouldn’t have been possible.

From about 37 weeks I had been experiencing period like pains which I knew were my body preparing for birth. At 39+3 I accepted a sweep at clinic and instantly felt cramps and pains, not contractions but again a feeling that my cervix was changing. I lost my plug at 39+5 and began to feel really positive about my prospects of having a VBAC as none of this happened with my son. From 39+6 everything seemed to stop and I definitely had a few wobbles about weather or not I could do this and if I would actually go into labour spontaneously.

On the night of 40+1 I woke a few times with some dull back ache which was welcomed! At 40+2 these pains got progressively worse and needed my attention. After a day at home with my partner and son and a lovely evening in the park, labour really kicked off at 7pm. I laboured at home using my tens machine, a heat patch, paracetamol and a gentle birth app and a diffuser filled with lavender until 3am when we decided to head in.

On arrival I was traced, baby was doing great and a Vaginal Exam revealed I was 3cm but baby was back to back. I accepted Pethidine on the midwife’s advice and leaned over the top of the bed on all 4’s to help relax my pelvic floor and turn baby. 4hrs later at 10am I was examined again and had made no progress. I didn’t let this dishearten me (I had read so many stories about labour changing in a matter of minutes so this kept me focused).

I allowed the midwife to break my waters and got my second dose of Pethidine.

By 1pm contractions were coming 6 in 10minutes and I was really struggling to breathe through them. I was examined and delighted to find out baby had turned and I was 7cm!

Transition then set in and I was telling everyone who’d listen that I couldn’t / didn’t want to do it! Examined 10 minutes later and I was complete and ready to push!

I found the pushing stage exhausting and so difficult. It lasted 40 minutes and although it wasn’t what I wanted, it was guided by my amazing midwife Sally. They were concerned that baby was getting tired so used suction. This didn’t work as the cup kept slipping off and I managed to push my daughter out all by myself. I think I said “I did it” about 100 times! But I was so proud of myself at that point and so relieved it was all over!

I did so much during my pregnancy to give me the best possibility of achieving my VBAC. I would have loved a list like this when I started my journey so I hope it is of help to someone else!

VBAC course with the lovely Niamh from My Baby Beginnings
Hypnobirthing with the PBC
Daily use of the GBA - set to VBAC
Reading positive VBAC stories daily
Spinning babies daily activities
Daily Yoga (even if only 10 mins!)
Walking 10K steps daily
Bonding with my baby
10 mins daily on all 4’s to prevent Back to Back although this wasn’t the case!
Chiropractic care from 24 weeks
Reflexology from 34 weeks
Daily use of birthing ball
A supportive provider

My partner was an incredible support also I couldn’t have done it without him. He was my advocate and voice and knew my birth plan inside out.

I hope this gives someone the positivity they need heading into labour! Our bodies are amazing, but even more so are our minds!

If you would like to learn more about my VBAC Workshops and check my availability you can do so below

Plus Size Pregnancy & Birth

Mon, 07 Nov 2022 19:45:00 GMT

Guest Blog by Michelle Mayesfke, author of Fat Birth

Michelle is a certified birth and postpartum doula, childbirth educator, hypnobirthing teacher, yoga teacher and the author of Fat Birth . She has made it her mission to change the way people approach fat pregnancy and birth. Through her teaching and social media networks, she seeks to empower and educate plus size expecting parents-and their birth partners-so they may seek the positive birth they want and deserve

Orla was so overjoyed when she saw those two pink lines on her pregnancy test. She had always wanted to be a mother and it was really happening. Her joy soon began to fade during her booking appointment at the maternity hospital. As someone who had always been "the bigger girl," Orla was used to unsolicited comments about her weight- but the remarks by midwives and doctors made her wince.

"You need to be extra careful now. A person of your size can develop complications at any time. How did you let yourself get this big?"

Orla was constantly worrying about gaining "too much weight," developing gestational diabetes and she felt like she was harming her baby just by existing in a bigger body. The closer she got to her baby's estimated birth date, the more intense the feelings grew.

The disrespectful treatment Orla experienced may seem unbelievable, but the reality is that many plus size parents are treated differently because of their size. Weight bias is the collection of negative beliefs and opinions people have associated with weight. It may also be called anti-fat bias or fatphobia. In Ireland, people in bigger bodies are often portrayed as lazy overeaters with a lack of willpower and motivation. The reality is anyone can display these characteristics. These harmful beliefs and attitudes translate into discriminatory behaviours, weight stigma, which impact the support people of size receive. It creeps into maternity care more subtly or is very obvious, like the comment from Orla's doctor.

Pregnancy is already a time of vulnerability and the last thing anyone needs is a provider making them feel bad about their body. This is the information you need to know to ensure your best interest is the focus of your care.

FACT: Maternity Care is Fatphobic

Sadly, the medical community is rife with anti-fat bias and maternity care is no exception. One of the biggest flaws within Irish maternity care is its over-reliance on BMI. The body mass index (BMI) is an outdated form of measure created by a Belgian mathematician over two hundred years ago that was used for statistical purposes for large populations, not individuals. It uses a person’s height and weight ratio to create a number (from 18.5-40+) which is now nothing more than a facade of health or ill health.

This outdated body statistic still influences maternity care in negative ways. It places complex individuals into boxes, with those of us at the further (larger) end of the scale often being classed as "high risk." Once this label is given to someone, limitations may begin to take hold. For example, those with a BMI of 35+ require a consultant review to access what is standard care for others, including community midwifery clinics, using a pool in the hospital and for home birth support from community midwives.

Fatphobia presents in other ways, often experienced during antenatal appointments and labour itself. These are some examples:

Being told you must be tested for gestational diabetes repeatedly–beyond the standard two tests, both of which came back as normal. This is often fueled by assumptions that are not evidence-based, like all plus size people will develop gestational diabetes.
You are told to lose or maintain your weight during pregnancy “for the sake of your baby”, despite the fact that there is no correlation between how much someone weighs and how healthy they are.
A weight biased consultant believes fat* people are “too big” and “too weak” to birth their babies vaginally. They tell you a caesarean is the best option for you without leaving room for discussion.
You're told, “All big moms make big babies,” so an induction at thirty-eight weeks is suggested, although this is not evidence based practice.

Weight stigma experienced during pregnancy is associated with higher rates of stress and depression, an increase in disordered eating habits and higher weight retention following birth.There are also higher rates of intervention for plus size people, including the use of internal foetal scalp electrodes, inductions and caesareans. While this information may be hard to digest, the good news is there is so much you can do to improve your experience, work around the biases of others and ensure you have a positive birth experience no matter what path labour takes.

Size-Friendly Providers

Finding a size-friendly provider is one way you can advocate for yourself. If you are a private patient, you can hire a consultant who has the qualities you desire. Public patients can also request a new consultant, although this is not advertised openly. Alternatively, you may choose to hire a midwife publicly or privately for a home birth, as midwives tend to be more size-friendly. A size-friendly provider has the following qualities:

Awareness of their own biases

Provides compassionate support for people of all sizes and abilities
Does not class you as “high risk” based on BMI alone
Does not make assumptions about your level of physical activity and food choices
Treats you with dignity and respect
Understands the importance of informed choice

The Importance of Boundaries

Finding a size-friendly provider may be more difficult than you expect. It may also be impossible to find a consultant or midwife within your budget, who serves your area or who you have great rapport with. This is where setting boundaries can be even more important.

You can set boundaries in many different ways and they all vary depending on your preferences. For example, some people choose not to be weighed at all during pregnancy or have a “blind weight” taken—stepping on the scale and having the consultant or midwife write down the number without it being shared with you. This is important for people who may struggle with knowing their weight, who have a history of disordered eating or seeing the number go up and down.

If a provider keeps mentioning your weight during antenatal visits, you have every right to ask them to stop. This may sound like, “I am aware of my weight and how it may impact my experience, however, I do not want the rest of my pregnancy revolving around it.” People of size should not have to do this additional work, including having these difficult conversations and setting boundaries— but it is so important.

Getting Informed

Knowledge is power and this is especially important for plus size folks who are often given exaggerated risks during pregnancy. How information is presented matters. For example, a consultant may say, "You are three times more likely to have gestational diabetes due to your BMI." While this may be true, this is only presenting you with the relative risk—when one BMI category is compared to another. This does not tell you the actual risk of you developing gestational diabetes. When you look at the research, even those in the highest BMI category ≥40 have a 20% chance of developing gestational diabetes. This is three times the level of risk (6.74%) for someone in the 25 to <30 BMI category. This may sound scary or almost like a guarantee, but it is not the full picture. We could discuss this topic another way by saying someone with a BMI of ≥40 has a 80% chance of not developing gestational diabetes. When practitioners give these statistics, they are often only sharing the relative risk with no discussion about prevention.

You do not need to be a researcher to find statistics. A quick online search can help you and there are many other size-friendly resources.

If you identify as plus size, a person of size, or any of the other terms used to describe someone in a bigger body, I want you to know this: you are worthy of compassionate, respectful care. Weight bias exists within the Irish maternity system but it is not something you have to accept. Finding a size-friendly provider, setting boundaries if and when needed, and getting informed on all of the topics that impact plus size birth will help you navigate your pregnancy.

www.limerickdoulaservices.ie

www.fatandpregnant.com

Instagram: @fat.and.pregnant

Resources:

1) Angela C. Incollingo Rodriguez, C. Dunkel Schetter, A. Brewis, and A.J. Tomiyama. "The Psychological Burden of Baby Weight: Pregnancy, Weight Stigma, and Maternal Health." Social Science & Medicine, no 235 (2019). https://www.sciencedirect.com/science/article/abs/pii/S0277953619303879

Michelle & I also did an Instagram Live November 2022 where we covered even more myths and evidence based information. You can watch the replay here

Weaning to Solids

Fri, 28 Oct 2022 18:01:29 GMT

Guest Blog by Laura Carbery, owner of Hungry Munchkins

Laura is a mum of 3 and is lover of all things food and cooking. She is a Ballymaloe trained chef, food product developer and a voluntary breastfeeding counsellor with Cuidiú . Laura is passionate about supporting parents feed their babies and children with confidence. Laura has also trained in the SOS approach to treating fussy eaters and loves to help parents create successful and stress-free mealtimes.

Starting Your Baby on Solid Foods

What your baby eats at 9 months is a picture of what your baby will eat when they are 5 years of age. The window between 6 - 9 months is therefore a really important time to introduce your baby to a huge variety of flavours and textures.
Babies’ iron stores are becoming depleted by 6 months of age, so the introduction of iron rich foods is required for brain development.

When to begin weaning

The World Health Organisation, HSE & SACN recommend starting solids when your baby is around 6 months. The exact timing of starting weaning will depend on your baby’s development.

Watch for these 3 main signs that your baby is ready to start on solids:

Head/Neck Control

Your baby has good head control and can sit up with minimal support.

Hand/Eye Coordination

Your baby can coordinate their eyes; hands and mouth so that they pick up food/toys and put it in their mouth by themselves.

Tongue Thrust Reflex

Your baby needs to be able to move food from the front to the back of their mouth and then swallow it. Babies who are not ready will push all the food back out of their mouth.

Some signs that can be mistaken for a baby being ready for solid foods:

Chewing fists – (may be teething)
Waking in the night when they have previously slept through - (sleep regression)
Wanting extra milk feeds - (growth spurt)

These are normal behaviours and not necessarily a sign of hunger or being ready to start solid food. Starting solid foods won't make them any more likely to sleep through the night.

Don't wean before 4 months (17 weeks).

Your baby’s digestive systems won’t have formed properly yet, so feeding them anything other than their milk before this time could be quite harmful.
There’s an increased risk of allergies, type1 diabetes and coeliac disease in babies that are weaned onto solid foods too early.

First Foods

The weaning process is gradual and takes place over 3 stages. Breast milk or formula is still the most important food for your baby up until 1 year of age. As solid food slowly increases, breastfeeding or bottle feeding slowly decreases. Continue to breastfeed on demand during weaning. As you carve out a new routine during the day to include solid foods, you may notice your baby having bigger longer breastfeeds, less times throughout the day or your baby might prefer to feed little and often throughout the day, for starter, before a meal, and dessert, after their meal! The aim is that your baby would be on 3 small meals per day by about 7 months of age. Each baby is different and it’s important to trust your baby and yourself.

How & when to start…

Pick a time to start when your baby isn't too hungry or tired. Best after your baby's mid-morning milk feed, then you have time to keep an eye for any possible reactions.
One new flavour a day for the first 1-2 weeks is perfect.
Make sure to leave plenty of time so as not to rush your baby and just enjoy the experience.
Start with 1 tsp of food and gradually increase the amount. Be led by your baby and feed to appetite - not portion size. There are no set portion sizes for weaning.
Starting weaning with green and white vegetables can help your baby get used to bitter flavours first before sweet. It can be more difficult in reverse if your baby develops a sweet tooth.

Baby Led Weaning or Spoon Feeding?

There is no one right way to feed your baby solid foods. Take your baby’s lead and see what works best for you and your family.
You can choose to serve your baby’s meal as a combination of purée (spoon feeding) + finger foods (BLW) or finger foods only if you choose to just do baby led weaning.
Finger foods are an important part of your baby’s diet to develop their hand eye coordination, encourage self-feeding and to increase their range of food and textures and these should be introduced from the beginning of weaning at 6 months.
It’s important that any finger foods offered should prepared safely and be soft enough that you can squash it between two fingers. As your baby becomes more skilled with finger foods you can then begin to challenge them with harder finger foods.
Babies don’t need teeth to be able to eat finger foods. Their gum are incredibly hard and you’d be amazed at how quickly they learn to eat different textures.

*Foods like cherry tomatoes, grapes, large blueberries etc. are the perfect shape for blocking the windpipe of a baby. Always ensure that these are halved or quartered so they are safe for baby to eat. Never offer whole or chopped nuts to a baby or child under 5 years of age.

But what if my baby gags?

It's important to know the difference between gagging and choking. Gagging is a very natural reflex in babies. It's designed so if there is anything in the back of the throat, they bring it up without getting into trouble.

When babies are learning to eat solid foods, often they will gag. They might gag because the food is cold or they've got too much stuck in their mouth. It might be that they don't like that food. They have a gag reflex, which is designed to eject this food that they don't like. It's completely normal and therefore nothing to be worried about.

If a child is choking partially, you might get some coughs and splutters. If it's a full blockage, there will often be no sound whatsoever.

Some signs that your child might be choking:

Face changing colour - often a deep puce followed by a blue. Sometimes a grey, blue tinge to the lips.
They can look afraid.
They can have their arms out towards you, almost like they're looking for help.

LOUD AND RED GO AHEAD . SILENT AND BLUE THEY NEED YOU.

I always recommend to parents to attend a Paediatric First Aid course before starting the weaning process so that they can relax and enjoy the weaning experience knowing that they are armed with the skills in case they ever came across a choking incident.

If you would like to learn more about Laura's upcoming Baby Weaning Courses check out her website hungrymunchkins.ie

Laura & I also did an Instagram live on the topic in October 2022, you can find the replay here

Baby Development: 0-3 Months

Mon, 17 Oct 2022 18:45:00 GMT

Guest Blog By Aoife McCarthy

Specialist Paediatric Physiotherapist

Aoife is a Specialist Paediatric Physiotherapist who has been working with Children for over 12 years. She set up her own private physiotherapy clinic over 12 months ago and since that time has gone from strength to strength. Her clinic - The Children’s Physio Ireland, is currently housed within The Compass Physio Clinic in Enfield, Co Meath. This specialist physiotherapy service provides physiotherapy appointments that are tailor-made for your child. Treating a huge age range including babies, children and young people of all ages. As a Mam of two, Aoife is passionate about all things baby and child development. In the below blog Aoife takes us through what to expect from our baby's development in the first three months of life.

First of all if you are reading this I wish you huge congratulations on the birth of your little one or on the upcoming arrival of your new bundle of joy!!!

If I’m honest folks, the birth of a new baby and all the adjustments that go with it are well…….interesting to say the least and most definitely a game changer on life as we previously knew it!!Quite often for new parents….or even second/third time rounders….we are not quite sure what to expect of our baby in those first few months so the thought around this blog is to give you a little insight as to what to expect from a physical point of view. It is also to give you some ideas of what to introduce with your little one in order to best prepare them for getting on the move in months to come.

What should I expect to see developing during this stage:

smiles!
fixing/focusing on faces or small objects
being able to track that object to both right and left sides
bringing their hands together
bringing their hands to their mouths
grasping small lightweight toys
reaching out to bat toys when placed on tummy
can lift head
starts to prop on forearms when placed on tummy

What should I encourage during this stage:

lots of positive feedback through touch, engagement and chatting/singing to your baby
encourage tracking your face/object the whole way round to their left and right, making sure they have equal movement to both sides
time spent in a variety of different positions including supported side lying, this is so important for thinking about rolling (in a few months time) but also the prevention of little flat spots developing on your baby’s head
tummy time!!

Whilst tummy time is so important, lots of parents can find this a little overwhelming. My best advice to you is to do small bits little and often and remember your baby lying on your chest is also classified as tummy time.

For the sake of ease and to give you a visual aid, I have included a link to a YouTube video I made this year centered around Ideas for Play with your 0-3 Month Old .

For more information about this, ideas for tummy time and more tips around baby/child development please follow along on Instagram https://www.instagram.com/thechildrensphysioireland/ or check out my website for further details https://www.thechildrensphysioireland.ie/ Wishing you the best of luck with your newest and most exciting adventure!!

Aoife Xx

Aoife also kindly came on Instagram live with me in October 2022 and answered parents questions about baby development. You can watch the replay by clicking the image below!

Let’s talk about Infertility, Pregnancy and Motherhood.

Mon, 10 Oct 2022 18:45:00 GMT

Let’s talk about Infertility, Pregnancy and Motherhood

Guest Blog by Dara Byrne

I asked Dara to do this blog as its such an important topic and one that isn't talked openly about enough, Dara is a certified Therapeutic Coaching Practitioner. Specialising in Infertility and Perinatal Emotional Wellbeing, Grief and Trauma Support. She is a mother of one after a long fertility and IVF journey and knows firsthand the importance of minding our emotional wellbeing while navigating infertility. She combines Coaching, Counselling, Psychology and Mind/Body Techniques to support women with their emotional wellbeing and reproductive and perinatal anxiety, grief, loss and trauma. Offering a safe space to feel seen, heard, acknowledged and like someone really gets it. Helping women feel confident, enjoy life again and see that no matter what happens they can handle it. Below are her words.

Unless you have been through an infertility journey you cannot really resonate with all three of the above headings.

Many will think of pregnancy and motherhood. That pregnancy will happen relatively easily and followed then by motherhood, possibly multiple times.

Both can bring excitement and indeed a rollercoaster of emotions as you navigate pregnancy and then the shift from woman to mother and the change in identity, relationships, energy, priorities and indeed the responsibility that comes with that title.

We then have the whole other realm of infertility. Something that definitely has to be experienced and lived through to for us to fully understand. It is a whole other level of emotional rollercoaster. An unimaginable and indeed unspoken level of heartache, loneliness, anger, loss, grief, trauma, anxiety, frustration, confusion and complete overwhelm to name just a few. It affects us physically, mentally, emotionally and financially. It affects our sense of self, identity, confidence, connection, relationships, friendships and so much more. Yet none of this is spoken about.

It is something that very much needs to be spoken about. To be acknowledged, to have women and indeed partners the world over, have that space to feel heard, to feel acknowledged, listened to and have all feelings, thoughts, experience, loss and grief validated. It needs to start now.

My own personal journey spanned over the space of a decade. With 7 years of TTC, 5 years ‘naturally’ and a further 2 with assisted treatment/IVF. These are 7 years that I can never get back. The pregnancy was one filled, in fact overflowing with, anxiety, worry and fear. Something I had longed for, for so long was not at all what I thought it would be. Something I deserved to enjoy, yet endured. Then motherhood again was not what I expected. I was completely blindsided by how I thought I would feel and what I thought it would be like. What it was actually like and how I actually felt were worlds apart.

Adjusting to motherhood is hard. Doing so with years and layer upon layer of grief, loss and trauma adds a new unspoken level of overwhelm. I felt so lost. I knew I was not depressed, but I also knew I was not ok and I had no idea why.

PREGNANCY AND MOTHERHOOD DO NOT CURE INFERTILTY. What do I mean by that? They do not make all the feelings of lack, loss, grief, trauma, anger, not being in control, sadness, frustration, loneliness, failure, not being enough or overwhelm magically vanish. Believing that they will (maybe they do for some, but it has not been my experience) only opens us up to a world of confusion and pain.

I do not say this lightly and I do not say it to frighten or overwhelm anyone. I say it from a place of knowing. From a place of personal experience and from a place of seeing it in others and hearing about it from the mouths of women having navigated infertility, pregnancy and motherhood. The ones that pushed through, squashed everything down and just kept going. Because that is what we do right?

WRONG. WRONG. WRONG.

It is so important to have space to feel seen, heard and held. To process feelings, thoughts and experiences. All of them. Right from the start of TTC. I believe my journey would have been very different had I had that support and that much needed space. I would have felt more confident, I would have understood myself more, I would have enjoyed my pregnancy and indeed the first few years of my motherhood journey. But I didn’t know. I wasn’t aware and I no longer beat myself up about it.

My past experience is not something I can change, there is no ‘do-over’. But I have awareness now. Knowing, confidence, understanding and compassion that I give to myself. That I now share in supporting other women, where ever they are on their journey.

I say this loudly and I say it with love. Dear reader, please know you matter. Know you are enough. Know that it is possible to feel joy, confidence and in control while you wait for your baby. That you can handle anything that comes your way. Give yourself the gift of time to talk about what is going on for you. No longer feel you have to park anything, forget, move on, let go. Instead embrace the you that you are now and know you deserve to enjoy life. RIGHT NOW.

Let’s change the way we connect with and support each other. Let’s create space for open and honest conversations about infertility, pregnancy and motherhood. Change is possible and it happens one conversation at a time. I hope this blog had helped you. If you would like support please do feel free to get in touch. darabyrnefwi@gmail.com or follow me www.fertilitywellbeingireland.com https://www.instagram.com/fertilitywellbeingireland/

Much love.

Dara xxx

Dara also joined me for an Instagram Live in October 2022. You can watch by clicking on the image below

Postpartum Self-care

niamh@mybabybeginnings.ie (Niamh Cassidy) — Tue, 23 Aug 2022 13:39:19 GMT

Resiliency in Parenthood

Recently, I did an Instagram Live with Tara Whelan from Resilient Emotions . Tara is a GP practice nurse, mum of two, a Perinatal Emotional Well-being and a Havening Techniques Practitioner. In this live we discussed the importance of postnatal physical, emotional and psychological wellbeing and easy steps you can take to build these up.

Something that struck me during the conversation is that when we are pregnant, especially the first time, we are very good at treating ourselves well and allowing others to treat us well too, but then when the baby is born all of a sudden it can be like we no longer matter and everyone else needs come first. And while a newborn baby's needs are great for us to be able to meet those needs to the best of our ability we also need to have our needs met.

Afterwards I was thinking about Maslow's Hierarchy of Needs and while Maslow has his critics I still feel its a helpful theory in most areas of life. If we consider the postpartum period often women's most basic physiological needs are not fully met. The need for nourishment (skipped meals?) , the need for water (where's that water bottle again?), the need for rest/sleep (hello newborn sleep timetable!) and the need for physical and health safety (lack of healthcare support when recovering from birth). When our basic needs are not met it makes it much harder for us to perform in the other areas of need. It makes it harder for us to focus on our relationships (including the relationship with our baby) and to to feel confident and happy.

So if there is a take home form my musings it is that a mothers basic needs must be prioritised, just as much as a babies basic needs must be. If you are currently pregnant have you discussed a postpartum plan to ensure your needs are met? If you have a baby are your needs currently being met and if not what support can you access to change this?

Tara has a lot of tips on this and you can watch the full recording here

Overcoming Birth Trauma

niamh@mybabybeginnings.ie (Niamh Cassidy) — Mon, 15 Aug 2022 20:19:48 GMT

What is birth trauma & how can I move on?

Trigger warning: This blog and the linked recording includes discussion of infertility, miscarriage, stillbirth, traumatic birth, birth interventions and NICU, so if any of these are triggering for you you may choose not to read on or to put in some protections for yourself while doing so

I recently did an Instagram Live with Niamh Healy of My Bump, My Birth, My Baby discussing Birth Trauma.

You can find the replay here .

In the video we discussed what birth trauma is and how it can be used as a catch all term for any trauma experienced around pregnancy and birth from preconception to the early postnatal period. Niamh takes us through some symptoms of this type of trauma including (but not limited to):

flashbacks
nightmares
intrusive thoughts
feeling disconnected
difficulty sleeping
anxiety

and how sometimes these symptoms are misdiagnosed as postnatal depression. We discuss how any birth can be experienced as traumatic and equally how a birth that may look traumatic on paper may not be experienced that way and how it is the experience of the person involved that matters. I myself experienced birth trauma during my first birth and also in relation to the early post natal period. My second birth, while it may have looked traumatic on paper - very fast, shoulder dystocia, 3rd degree tear, ambulance transfer from home to hospital it absolutely was not as I felt very safe with my midwife who I had gotten to know in pregnancy, who I trusted completely and who always treated me with dignity, compassion & respect. You can read my second birth story here.

We also discussed how the other parent or support people present can also experience birth trauma. Niamh then takes us through Birth Trauma Resolution (BTR) and how it can help you overcome the triggering responses. My biggest trigger after the birth of my first baby was the smell of the postnatal ward, often I would go into a public toilet and be hit with that smell and go back into a fight or flight response. Birth trauma resolution wasn't something that was available in Ireland at the time and I'd never heard of it. It took years and a lot of personal work for me to overcome that reaction.

Niamh explains how only a few sessions of BTR are needed to train the brain into putting the memory into the 'past' rather than something that can be relived in the present moment when triggered. I really wish this was something I had available to be back then as I've since seen the wonders it can do for other people. It is important to note that 80% of people who experiences a traumatic birth will process that experience effectively within 4-6 weeks and are not left with lasting triggers or symptoms but for the 20% of people who are still experiencing this after 6 weeks BTR can be life changing. If you would like to find out more about the work that Niamh and her colleague Mim are doing you can click here and book here. I know both Niamh & Mim personally and would feel very safe in either of their hands,

Breastfeeding Stages

niamh@mybabybeginnings.ie (Niamh Cassidy) — Fri, 05 Aug 2022 11:41:37 GMT

How long should I breastfeed for?

I am often asked “how long should I breastfeed for?” or some variation of that question. I usually reply saying that the World Health Organisation recommends that human infants are breastfed exclusively for the first 6 months of life and then along with complementary foods until two years and beyond. I follow this up with either a question asking what your breastfeeding goals are or a statement around how each family is different and will make different choices that are best for them and that every bit of breastmilk that a baby gets is beneficial for them whether its one feed or many. I also often do a lot of education of what to expect ‘next’ in terms of their baby’s development. This article briefly outlines the journey of a breastfed baby at different stages and may help you choose how long your journey will be.

One Feed

The first feed helps to stabilise baby’s blood sugars and the oxytocin release helps your uterus start to contract back to its usual size.

One Day

Through your colostrum (first milk) you pass antibodies to your baby to help protect them from the germs in their new environment. Colostrum is all your baby needs. Lots of people refer to it as ‘Liquid Gold’ as it is so precious.

Two Days

Your colostrum continues to act like your baby’s ‘first vaccination’ and it is the perfect nutrition for your baby, perfectly balanced to meet your baby’s needs. It also acts as a laxative, helping to clear the meconium out of their system. We can soon say goodbye black sticky poos!

Three – Five Days

Your ‘transitional milk’ comes in. Breasts may feel engorged and a little tender but don’t worry this is normal and will settle down. Sometimes babies may find it difficult to latch so reverse pressure softening or a little hand expression can help shape the nipple so the baby can latch. Every feed is building up your supply and baby’s poo is moving towards mustard yellow and smelling sweet, really!

One Week

Your ‘mature milk’ is here. This looks more like what you expect milk to be like, less thick, more watery but still perfectly balanced for your baby. Baby may start to get a little more fussy, but don’t worry a feed will usually sort it out! Welcome to the world of parenting through breastfeeding, where boob fixes everything (almost, it won’t change a dirty nappy for you!).

Two Weeks

Baby will be back to, or almost back to, birthweight. They hit their first growth spurt and feeding is the answer! Have some good TV and snacks ready to go and relax through the evening (and sometimes daytime!) cluster feeds. Use it as a reminder to slow down, your body is still recovering from birth.

Three Weeks

It may feel like you’ve done nothing but feed for three weeks but rest assured this is normal and you are continuing to lay the foundations for a copious milk supply and a smooth breastfeeding journey. Remember, its ok for you to rest and to rest with the baby on the breast. You still have a lot of recovery to do. Slow down.

One Month

Baby is getting big! By exclusively breastfeeding until now your baby is less likely to develop a food or respiratory allergy as they grow. Baby may be becoming a little more alert and vocalising (crying) more. Remember, a feed will usually calm them, and yes its ok to put them to the breast every time!

Six Weeks

Another growth spurt! By feeding on demand until now you will have built up a good supply. Your breasts may start to feel softer or less full, this is normal. It doesn’t mean your milk is disappearing. Feed on demand though this growth spurt and many find things start to get easier after. You’ve found your breastfeeding groove! Breastfeeding for 6 weeks means that your baby now has less risk of chest infections for early childhood!

Three Months

You’ve guessed it, another growth spurt! Remember your baby is putting in the order for the milk they need to get through this period of rapid growth, things will settle down again in a few days. Isn’t it amazing that your body and baby know exactly what to do? Breastfeeding burns serious calories for mum and you may start to notice some weight loss without much effort over the next three months. After this growth spurt feeds may be much shorter and baby may become more interested in their surroundings as their eyesight improves. If you weren't already you now feel that breastfeeding is the easier option. Feeds have settled somewhat, there’s no bottles to sterilise and you can leave the house for any length of time without worrying about having enough milk with you! Stuck in a traffic jam on a bus? No problem, mum’s got milk!

Four Months

Distractibility can start to ramp up and the 'four month fussies' can make this an interesting phase! Some people find the need to feed in a quiet or dark environment to feed in. Parents often worry that their baby is not feeding enough but rest assured baby's know what they need and will take it in in their stride. Try to follow their lead with feeds and not stress if they are short or haphazard. By breastfeeding for four months you’ve reduced your baby’s risk of SIDS.

Six Months

It’s about time to introduce solids, by waiting until now to give anything but breastmilk you’ve reduced your baby’s risk of developing food allergies. Continuing to breastfeed while introducing solids helps baby’s gut process the new foods. There’s also another growth spurt about now so don’t be surprised if solids don’t replace any feeds just yet. Breastfeeding until now means your baby is more likely to accept a range of solid foods because your baby has been exposed to the different flavours within your diet through your breastmilk!

One Year

Wow, can you believe it’s been a year? Many of the benefits of having mother’s milk for this year will stand to your baby their whole life. Breastfeeding until now isn’t just about the physical health of your child, their emotional and social health also thrive as result and a child who was breastfed for at least a year shows better social adjustment when it comes to starting school.

Eighteen Months

I mentioned parenting through breastfeeding earlier. This will be your best tool during this turbulent developmental leap. You’ll be so glad to have something that works! The gymnurstics will keep you on your toes as baby feeds from every angle. Continuing to breastfeed means your baby is likely to be sick less and/or illness be shorter due to the continuing access to antibodies through your milk.

Two Years and Beyond

The World Health Organisation states that children should receive breastmilk until at least two years of age. Your milk is still providing your child with essential proteins, nutrients and antibodies. It takes between two and six years for a child's immune system to fully mature and your milk continues to complement and boost the immune system for as long as it is offered. The less your child feeds, the more concentrated in nutrients and antibodies your milk becomes. Amazing!

I hope you’ve enjoyed this brief timeline, please share it with any parents who may be interested! And remember, no matter how long you breastfeed your baby every drop of milk that they get is a wonderful gift to them (and you but that’s a whole other article!).

If you are pregnant and planning on breastfeeding your baby why not book a Breastfeeding Support Package so you have all the information and support you need to have a smooth and enjoyable journey.

Birth after Caesarean - a positive story

niamh@mybabybeginnings.ie (Niamh Cassidy) — Wed, 01 Jun 2022 09:27:32 GMT

A client story

I am always so happy to get a client story into my inbox and the generosity of clients to allow me to share their stories is something I am grateful for. This family had a previous caesarean birth and were planning a VBAC but wanted to know all their options. They were fabulous to work with and I think their story speaks for itself.

Hi Niamh,

I said I would drop you a quick message to share that we welcomed our second baby girl on 18th April. Baby girl arrived via planned caesarean section, weighing 6lb 15oz. She is a delight and absolutely thriving. We've been exclusively breastfeeding from birth and she is already up to 7lb 5oz.

After taking your VBAC class, we prepared a plan that we were happy with, which was that we would wait as long as we were comfortable for spontaneous labour and if that didn't happen we would opt for a planned section. After my previous experience, I really didn't feel comfortable accepting the increased risks of ending in an emergency section that come with induction of labour, or artificial membrane rupture.

My consultant was very supportive of this plan and all staying healthy and well was happy to let us go to 42 weeks with the plan to ask us to come for extra monitoring if we wished to wait longer than that.

Around 38 weeks I started to experience a lot of stop/start labour. I would periodically begin to have contractions that would build in strength and stay in a steady pattern for hours (1 contraction lasting about 60 sec every 5-7 minutes). However, they would keep going away. I even lost my mucus plug around 39.5 weeks. I figured this was all my body preparing and getting ready for labour. The stop/starts continued for 3 more weeks. At the same time, baby's growth had slowed down from about 34 weeks, to the point where by 39 weeks she had stopped growing entirely. My consultant was happy to keep monitoring since I had lots of fetal movement, blood flow in/out of placenta looked good and there was no other real cause for concern.

By the time I got to my 41 week check, I had stopped feeling comfortable leaving baby in there and asked if we could opt for the planned section. The entire experience was so positive and such a better delivery than my first.

Although I didn't end up with a VBAC, I am still so grateful for the class we did with you. The information you provided us with really helped us to decide what the right path forward for our family would be. The tips you gave for labour as well really helped me cope mentally and emotionally with the constant stop/starts. I felt safe enough to recognize them as false starts and stay home where they had the best chance to progress. And rather than start beating myself up or feeling down, I was able to just trust my body was doing it's job and whatever would happen, would happen. Rather than pinning all my hopes on one particular outcome, your course helped me to decide what was really important to me in a birthing experience and gave me the information to weigh up the benefits and risks day to day to make the best decision for me and my family.

I would definitely recommend anyone considering VBAC as an option to take a course with you. Even though it's not how our delivery ended up going, the tools and information helped us so much to make the experience extremely positive.

Thank you so, so much.

Wow, I hope you all enjoyed that as much as I did. What an amazing story of confidence, resilience and informed decision making. I was also very impressed by the support from the medical care provider which unfortunately can often be lacking. It just goes to show what the right information and support can do for a family. Well done again to this fabulous family and congratulations on the birth of your baby girl.

Preparing for Breastfeeding

niamh@mybabybeginnings.ie (Niamh Cassidy) — Tue, 10 May 2022 10:32:15 GMT

How can I prepare for breastfeeding? What do I need?

I often get asked ‘What can I do to prepare for breastfeeding?’. My answer is simple enough, get educated and get support. So, lets look at both of those ideas.

Education

There is a lot of information out there at our fingertips but not all information is created equal. I feel in preparing for breastfeeding your best source of information and education is from a breastfeeding expert who is also trained in adult education or training. There are only a small number of professionals who meet both of those criteria. In relation to being a breastfeeding expert that could be an Internationally Board Certified Lactation Consultant or an experienced Breastfeeding Counsellor who have also completed certification in antenatal education and or adult education.

You may notice I haven’t mentioned midwives. This isn’t to say that there are no midwives who are also experts in breastfeeding, there are many, but being a midwife alone does not a breastfeeding expert make and I see this every day in the postnatal clients I support and the varying quality of information and support they get from hospital based midwives, from exceptional, to very poor.

In relation to being qualified in antenatal education something you can look for is: are they trained by Cuidiu or the NHS? are they registered with FEDANT (Federation of Antenatal Educators)? or at the very least that they have a Trainer the Trainer Certificate QQI Level 6? Using these criteria means that your educator should be up to date with the best international evidence but also be skilled in teaching and helping adults learn. Some people can be experts in their field but without the ability to impart that knowledge in a way that people can absorb it can feel more like a lecture than a class or workshop. Ever had a teacher who couldn’t teach? Yea me too!

In addition to those two criteria mentioned I feel that live classes are better for learning that sticks with you, whether it’s in-person or online. Recorded classes for some topics can be great but there’s just so much involved in a Breastfeeding Preparation Workshop I find that parents-to-be get a lot more from a live class. It lets you ask questions as they come up and also to practice skills in real time. I would also suggest a small group class or a 1:1. In both of these you can ask your questions with ease and there is time for everyone’s questions. In large online classes, for example, often questions are only allowed in the chat box and the nuances of the question may be lost or not all questions are answered. Making it conversational improves learning and retention of the information and is also generally a much nicer experience.

Support

Having good knowledge of how breastfeeding works is a great stepping stone to getting off to a good start but support is also key. Your Number 1 supporter should be your partner, or if single, another adult who will be around during the post-partum period. This Number 1 supporter should attend your breastfeeding class with you; to be the best supporter they can be they need to have the knowledge too.

Your next level of support is your community. Is there a local breastfeeding support group? If you are in Ireland check out Cuidiu , La Leche League , Friends of Breastfeeding and the HSE . We always hear ‘it takes a village to raise a child’ and it really does but in Cuidiu we also believe it takes a village to support a parent. We were never meant to walk this journey alone so reach out to your local breastfeeding supporters and attend a group while still pregnant, you will be more than welcome. This can help you feel more comfortable attending once the baby is born but also give you an early sneak peak of what breastfeeding looks like. You might also meet your new best friend! I met my best friends, six of them, at breastfeeding support group almost 9 years ago. We transitioned from breastfeeding group, to coffee mornings in each other’s houses, to playcentres, to lunch dates, to nights out, to domestic weekends away and finally this year we have an international trip planned together! These ladies are an integral part of my village, maybe you’ll also find yours at breastfeeding group.

It can also be very helpful to find a local lactation consultant when still pregnant, whether you just hold onto their contact details in case they are needed or you choose to engage them while pregnant for a class or to prearrange breastfeeding support. If your local lactation consultant offers Breastfeeding Support Packages and you are in a financial position to avail of one of these they are a great investment in your breastfeeding journey, much more than any gadget or device that you could purchase. If you have private health insurance it likely your insurer will reimburse some or all of the fee.

So that sums it up really, quality education and support are the keys to preparing for breastfeeding and getting off to a smooth start. If you would like more I recently did a Breastfeeding Q&A on Instagram live and you can find the recording here to have more of your breastfeeding questions answered!

Also, while you're in preparation mode have you packed your hospital bag yet? If not check out my free ULTIMATE HOSPITAL BAG LIST , forget the rest, this has all the basics and the must haves that no one mentions!

Over 35 & Pregnant

niamh@mybabybeginnings.ie (Niamh Cassidy) — Wed, 04 May 2022 13:28:22 GMT

Ever been told you are geriatric?

Ok, now I’ve gotten your attention I do not thing you are old, or geriatric or of advanced maternal age . Age is just a number right? Mostly. Pregnancy over the age of 40, sometimes 35 used to be called geriatric pregnancy but is more often referred to as Advanced Maternal Age these days. But with more and more women giving birth later in life do we really need to be treated differently? Why do some doctors insist on inductions for all their 40+ clients while others don't?

Advanced maternal age (AMA) in Ireland is usually considered 40 years+ (although some doctors say 35+ and this is what's quoted in most international literature). In 2019 in Ireland the average age of women giving birth was 33.1 years. This is the highest average age of mothers at maternity, since the age of mother at birth was first recorded in 1955. In the same year 7.9% of births were to mothers aged 40 and over, that equates to 4669 babies born to mothers aged 40+ that year.

Despite the increasing age of mothers in Ireland there here is no national guideline on the management of AMA pregnancies and policies vary by unit and by doctor. Maybe there’s no national policy as there doesn’t need to be? But then why do so many care providers bring it up as a reason for an induction or other interventions.

I recently did an Instagram post on this and as you can see there were mixed experiences.

The main reason often cited for induction for older women in pregnancy is the increased risk of still birth as we age. Some people will be told that the risk doubles when they hit 40 and without an understanding of absolute risk vs relative risk that can sound very scary but a little more understanding can put some perspective on it.

Absolute risk of something is the odds of it taking place. In relation to still birth in over 40’s a large study in the UK (Jolly, Sebire et al. 2000) found the absolute risk of still birth in this age group to be 8.1 per 1000 or 0.81% compared to the absolute risk in the age group 18-34 being 0.47%. Both very low numbers overall.

If I were to present this as relative risk (comparing the risk of one group to the risk of another) without giving the absolute risk as context I could say that – “women over 40 have a 58% increased risk of still birth than women aged 18-34.” Which information would you find more useful? I know for me knowing the absolute risk is much more helpful in making informed decisions than the relative rosk without context. For information, the absolute still birth risk of women in the 35-40 age group was 0.61% so the risk does increase incrementally as you age, but only slightly.

The reality is that many women are giving birth later and many are still very healthy when doing so. Individualised care should always be practiced. The overall health status of the mother and her baby should be much higher on the list in recommending care pathways than her date of birth. And remember, if you are not comfortable having an induction without being given a reason that makes sense to you - you don't have to have one. It is always your decision.

If you would like to do an antenatal class that is evidence based, centre's you in your care and supports you to make informed decisions check out options below

What happens during a Caesarean Section?

niamh@mybabybeginnings.ie (Niamh Cassidy) — Mon, 11 Apr 2022 19:22:09 GMT

Always wanted to know more but afraid to ask?

As part of my Monday Night Live series on Instagram I covered Caesarean Births. Check out the video here .

You can also download my Caesarean Birth Handout by clicking below.

Home Birth after Caesarean Section - My Story

niamh@mybabybeginnings.ie (Niamh Cassidy) — Mon, 21 Feb 2022 11:19:51 GMT

Yes, its possible

Not many people realise that having a homebirth after previously having a Caesarean section is an option and while it’s not available through the Health Service Executive (HSE) here in Ireland hiring a private midwife is an option for those who can afford to do so. I am lucky enough to have been able to do this for my second pregnancy and acknowledge that not everyone has that privilege.

The World Health Organisation recommend that to save lives the national caesarean section rate should be between 10-15%. The rate in Irish maternity units in 2022 was 38.3%. This is important to note because it means that the topic of Vaginal Birth After Caesarean (VBAC) is a significant one in Ireland due to the number of women having caesarean births.

I am one of the women whose first birth ended with a caesarean and for whom this topic became important. I got home and got on with life with a newborn but as time went on realised I needed to heal from my birth trauma. As I went through this process I knew I wanted to avoid a caesarean for any subsequent births so started to research the topic of VBACs. One of the main concerns for VBACs is the possibility of uterine rupture (UR) due to scar separation. Research shows that uterine rupture in VBACs is rare. International research puts the rate at 0.7%. However, in the setting of a large Irish maternity hospital with strict guidelines for a Trial of Labour After Caesarean, the UR rate was 2 per 1000 overall, and 1 per 1000 for women in spontaneous labour who did not receive oxytocin augmentation (Turner et al, 2006). So the risk of rupture is rare but if this is the case then why are there so many stories of women being convinced to book an elective caesarean? Anecdotally some of the main reasons given by doctors seem to be that baby is measuring big, a twin pregnancy, or if a woman goes over her ‘due date’. My concern, having listening to many women’s stories was that scaremongering, without evidence to back it up, is often used to coerce women into 'elective' caesareans.

During my first pregnancy I thought that if all went well I would have a homebirth on my second. After the caesarean I thought this was no longer an option but as I researched VBACs and found them to be safe in most circumstances I thought I should be able to have a safe homebirth. Research shows that women are more likely to birth without intervention in a planned homebirth and that it is just as safe (if not safer) for low risk women. Having had a previous caesarean most care providers no longer considered me ‘low risk’ however as there was no reason for my set of circumstances to be repeated if I avoided induction the only additional risk was the slightly increased risk of UR. As this risk itself was still so low I lusted after homebirth but I knew it was against HSE policy so it would never be a reality. Then I heard of a private midwife company that had recently entered Ireland and was supporting mothers to have a Home Birth After Caesarean (HBAC). I refocused my research and started looking into the safety of HBACs. Again, from all the evidence I trawled through it became apparent that HBACs were actually very safe for uncomplicated pregnancies and that I was much more likely to be successful in my quest for a vaginal birth with this option as women who are cared for by midwives have a higher chance of having a VBAC. So when I got pregnant I contacted the private midwife company. I asked lots of questions and decided to send my notes from my previous birth to get reviewed by their obstetrician to see if I was a good candidate for HBAC. I was given the all clear and book my midwife, the wonderful Liz Halliday from Private Midwives Ireland.

This is my second son’s birth story.

I started loosing my plug on the Saturday night at 38 weeks and 3 days. I lost some more Sunday morning and had an increase in my Pelvic Girdle Pain. I thought it was a good sign that body was getting ready but didn't want to get too excited. I spent Sunday morning in bed while my husband brought our older son out shopping. I was lying there when at about midday I felt a bubble and a pop and some fluid leaking. I lay for a few minutes and decided to get up and put a pad on to see what was going on. Just as I got into the bathroom there was a big whoosh and waters flooded out. I text Liz to let her know what was going on and rang my husband but he didn't answer. I spoke to Liz then and as I wasn't having contractions arranged appointment for next day if nothing kicked off. Pains started shortly afterwards. They felt like period cramps at first so I thought not too much of it. My husband arrived home and I told him to take our first born for his “nap walk” and we'd decide what to do with him when they got back and he was asleep (as he still wouldn't nap at home without a walk!). But while he was gone the surges were coming regularly - every 3-5 mins and were getting stronger. I text him and told him to drop our son to his grandparents house around the corner instead of bringing him home. When he got back I asked him to call Liz and let her know what was going on, I think it was about 1.30pm, and she said to get in bath or shower and she was on the way. I got in and put in the plug and turned on the shower. I was on all fours and had the shower on my back. I didn't want to waste too much water, as would want to fill the pool later, so I was turning it on and off during surges. Liz arrived about 2.35pm and things were already fairly intense. I was still on all fours in the bath but had given up on the shower to save water. I was finding it difficult and hoping that things were at least progressing. She asked me would I like to be examined and I agreed. I was 5cm - that picked up my spirits a bit although I'm not sure I let that be known to anyone. A little while later I got out of bath because I thought I needed to do a poo but I couldn't sit on the toilet and Liz asked if the baby was to be born soon did I want to do birth in the bathroom or somewhere else, I had no idea that it could possibly be almost time! I had a few surges on all fours on the bathroom floor but pool wasn't full yet so then went into bedroom. I was told if I need to push that was ok but I wasn't having that urge yet and in my head I was thinking "already!?". Soon afterwards my husband shouted up that there was enough water in pool and so I made my way down the stairs. Liz said I could stop during the surges but I was determined to get in that pool! Surges were fierce intense and I was very vocal throughout, I was honestly surprised afterwards the police didn't show up with all the screaming I was doing! But even though it was all happening very fast and was extremely painful I wasn't afraid and I really think that helped. I had done a lot of preparation and Liz would repeat an affirmation to me now and again and at one stage she said that the surges were not more powerful than me as they were me. She also got my vision board that I had made and put it in front of me. These actions helped me refocus.

I was on all fours in the pool with my head resting on the edge and my midwife suggested I move into a squat position to try help get things moving again. My husband held my hands and supported me in that position in the pool, he kept reminding me how well I was doing and his support was very important and really helped me manage the intensity. I felt every millimetre that I opened so as things progressed I knew roughly where we were and I was eager for the head to be born. At about this point the second midwife arrived, just as or before head was born in pool. Unfortunately, the rest of him didn't come on the next surge as his shoulder got stuck. I had asked my midwife antenatally what would happen in the event of shoulder dystocia as baby was predicted to be 'big' so when I was told to get out of the pool I knew what was happening so I practically jumped out. With some supra pubic pressure from my midwife all 9lbs 7oz of baby came flying into the world at 4.05pm caught by the second midwife, just four hours after it all started. I announced baby had arrived and scooped him up and checked the gender. We had another boy! We had skin to skin and I birthed the placenta at the edge of the couch about a half hour later. At around 5pm we called family and announced the news, to say people were surprised was an understatement! Our eldest had only been dropped to his grandparents house about 1pm. I needed to be checked then as there were concerns about a tear. I had gas and air for the check (first pain relief all day) and it was agreed that it was a probable 3rd degree and best option was to be checked and sutured in hospital. Ambulance arrived for non-emergency transfer and off me and baby went to the entertainment of all the neighbours as ambulance was blocking the road. Hospital agreed was 3rd degree tear and I was brought to theatre and given a spinal for the repair. I was kept in hospital for two nights.

It wasn't exactly the calm birth of my imagination but the preparation I'd done helped with keeping the fear at bay and reminding me that I could do this. Homebirth care with a consistent midwife meant I never felt I was having a VBAC as after our initial conversation about risks and benefits I was just a woman giving birth like all others and it was never mentioned again. I cannot recommend midwife led care (whether at home or in the hospital) enough for all women to who it is available.

My birth experiences are the reason I trained as an antenatal educator and where my passion for teaching VBAC workshops come from. If you would like to book a VBAC Workshop with me click here

Breastfeeding Pitfalls

niamh@mybabybeginnings.ie (Niamh Cassidy) — Fri, 04 Feb 2022 13:41:04 GMT

& how to overcome them!

The Top-up Trap

This has to be the most common. Approximately 40% of parents who initiate breastfeeding leave the hospital giving at least some formula which can have major implications for breastfeeding. The first part in learning how to avoid this is to understand that Colostrum IS MILK. It is the first milk that our babies need and it is perfectly balanced for early nutrition and hydration. Many labours now include IV fluids, evidence shows us that this artificially inflates baby’s birth weights. I am far less concerned about a baby who has lost 10% of their birthweight if their mother had IV fluid in labour than if they didn’t. The reality is for babies who have had IV fluid through their mother in labour the starting weight should be taken 24 hours after birth but unfortunately this is not common practice in Ireland. The second thing to know about is ‘night two’. Lots of babies are sleepy and content during the first 24 hours of life but start to ‘wake up’ in the second 24 hours. The fuss at the breast, but also do now want to be put down, they only sleep for brief moments on the mothers chest and then start rooting and get distressed again. This change in behaviour can be difficult for exhausted parents in understaffed maternity wards to navigate and many turn to formula thinking their baby is ‘starving’. The heavy, large volume, formula then means the baby sleeps for 4 hours because they’ve just had their first Christmas dinner and their body cannot do anything else other than process the complicated food. This acts like a self-fulfilling prophecy and parents’ believe their baby was actually starving and continue to give formula ‘top-ups’ which has a detrimental affect on their supply and baby’s latch.

Not Enough Milk

Following on from above perceived low supply is a much bigger issue than actual low supply. Parents believing they have low milk supply can lead to unnecessary top-ups which can actually cause low milk supply. Giving baby formula milk in the early days and weeks is telling the body not to make that breast milk and can mean that full supply is never established. This isn’t as much of an issue if someone wants to combination feed with formula long term (although it can mean a shorter than planned breastfeeding journey). Understanding normal newborn behaviour and the fourth trimester can help parents avoid feeling that they do not have enough milk. If you feel you may have low supply the first step should be to seek professional support from an IBCLC rather than reaching for formula. It may be a lot less expensive in the long run! Also, at around 6 weeks some parents believe their milk has 'dried up', this can be because the milk supply starts to settle down at this stage and mothers may feel less ‘full’ and experience less, or no, leaking. Baby also goes through a growth spurt so if these things happened at the same time sometimes people believe their milk has dried up. Milk does not just dry up like that unless there is a very severe medical reason but the aren’t would be very ill or possible have taken a decongestant medication that is incompatible with breastfeeding.

Reflux

There is an epidemic of breastfed babies being mis-diagnosed as having reflux. When we as parents do not understand our baby’s behaviour we seek out information to help us. Unfortunately, the information we get back is not always correct. A lot of reflux 'symptoms' can be a misunderstanding of infant behaviour or caused by another feeding issue that hasn't been addressed. New baby groups are full of well-meaning parents telling other parents their babies have reflux. Firstly, reflux – the act of regurgitating food, is normal for infants. Secondly, GORD (Gastro-oesophageal reflux disease) is remarkably uncommon in breastfed infants. If a parent suspects GORD a full feeding assessment is the first port of call to rule out any other reason why the baby may be struggling. An in-home consult gives the IBCLC time to observe the baby’s behavour, assess a feed, assess for oral disfunction, address the parents’ concerns and to educate on normal vs concerning behaviours and what to look out for as baby grows.

It's important to know if any of these things affected your breastfeeding journey it was not your fault. Inappropriate breastfeeding advice and huge gaps in breastfeeding support means many families are being let down. If you are worried about any of these issues with your baby right now a consult may be of benefit. If you are pregnant and worried about facing these issues signing up for a Breastfeeding Support Package will provide you with the appropriate information and support to avoid them.

Back to Work and Breastfeeding

Sat, 22 Jan 2022 20:12:00 GMT

Many parents worry about returning to work after maternity leave and will they be able to continue to breastfeed, will their breastfed child be able to settle for another caregiver or will it negatively affect their breastfeeding relationship?

In Ireland, if a mother returns to work before her child is 6 months old she is entitled to breastfeeding or pumping breaks (this is due to be extended to 24 months but not date is set for this change yet) or have their working hours reduced (without loss of pay) to facilitate breastfeeding where facilities are not made available. The right to pumping breaks pre-six months is covered under Section 9 of the Maternity Protection (Amendment) Act 2004. The breaks can be taken in a number of ways, which way is at the discretion of the employer.

One 60 minute break

Two 30 minute breaks

Three 20 minute breaks

However, most mother do not return to work before their child is six months old as maternity benefit is for 26 weeks so are not entitled to these breaks. This leaves many mothers concerned about how they will continue to breastfeed on return to work. Some choose to extend their maternity leave with unpaid maternity leave (up to 16 extra weeks), to use up accrued holidays, to take Parents Leave or to take unpaid Parental Leave or a combination of them all.

If your baby is born prematurely, you can now take extra maternity leave. You get 26 weeks’ leave, starting from the day your baby is born, plus extra leave for the number of weeks between your baby’s actual date of birth and the date you had planned to start your maternity leave.

If you are a civil or public servant (including teachers), you may be entitled to breastfeeding breaks up until two years. Check with your HR department or Principal before returning.

Whenever you are returning to work many of the same concerns apply but I hope to alleviate some of those concerns below and share some useful tips.

1. If feasible take at least some of the additional leave mentioned, it can make it easier if they’re at least somewhat established on solids.

2. Don’t stress if you have to return at six months, babies are remarkably adaptable. Even if they won’t take a bottle they may take a sippy cup, open cup or straw cup of expressed breastmilk while you’re not there. Some parents even send it to the childcare provider to go on the child’s cereal or in their food if they won’t drink it.

3. If they’re relatively good with solids and water they don’t need milk while you’re gone - they’ll get what they need when you’re around. So, if you can’t pump at work, don’t stress, they’ll be fine.

4. There’s no need to ‘train’ your child to nap before you return, the crèche or child-minder will find their own way. Honestly, it happens! Make sure you are completely happy with your childcare and their approach to this.

5. If you plan on pumping when returning to work and your employer doesn’t have a policy on it past six months meet with your supervisor before you go back and ask to be supported to pump. Try to be relaxed about it rather than demanding. Many, many supervisors are flexible when approached in the right way. Going direct to your supervisor rather than HR means an informal arrangement between you both can be made which is much easier to get than a change in company policy.

6. If pumping at work ensure you have somewhere safe to store it (fridge or cool bag) and a room with a lock if you don't want visitors. Some mothers also put up signs on the door.

7. You don’t need to build a ‘stash’ before returning to work. Although a few emergency ounces in the freezer are always handy there’s no need to have pints of milk stored! See points 2 & 3 above.

8. In the first couple of weeks or months focus on work and breastfeeding/spending time with your baby until you get into the swing on things. Don’t put pressure on yourself to take on extra activities or overtime. Baby will need a lot of your attention when you are at home so be prepared for that for a while until they get used to the new situation.

9. Enjoy being back – enjoy peeing in peace, enjoy lunch breaks and hot coffee and adult conversation.

10. Get help – you can’t cook, clean, work, breastfeed, look after baby all on your own. If your partner is used to you doing the housework and cooking make sure they know they have to pitch in equally when you return to work, if not take over most of the duties, if you’re working full-time and feeding the baby.

11. Be prepared for the possibility of reverse cycling – where baby starts to feed more through the night to make up for lost day feeds. It can be tough but usually settles down after a little while.

12. Make sure you’re happy with your child care provider; it makes it so much easier to know they’re with someone you trust.

13. Be prepared to feel guilty for leaving them, it’s a totally normal reaction. You are not a bad mother for providing for them by working.

14. Don’t feel guilty about not feeling guilty! If you’re glad to be back at work and have that part of your life back, that’s ok too, we’re not all made to be stay at home parents.

15. Pee before you leave work (or before you go to collect baby if working from home), you never know when you’ll get the chance to go once you both get home!

16. And most importantly, don’t spend your last few months/weeks of maternity leave stressing about returning to work. Even the most dependent children adapt. Enjoy all the time you have together and have lots of fun!

These are just some basic tips but in my Back to Work consultations and workshops help you plan for all aspects of your return and to prepare for the changes once back.

To access my on-demand Back to Work while Breastfeeding mini course click here

Alcohol and Breastfeeding - The real low down

niamh@mybabybeginnings.ie (Niamh Cassidy) — Sun, 19 Dec 2021 10:34:25 GMT

Many women wonder can they have an alcoholic drink while breastfeeding; the short answer is yes, if you would like to you can. But let’s look into it in a bit more detail so that you can make a truly informed decision.

Does alcohol pass into your breastmilk?

Yes it does, the level of alcohol in your breastmilk is about same, or slightly less, as in your blood, it enters and leaves at a similar pace. Irish Law (in line with EU legislation) considers alcohol free products as having no more than 0.5% ABV. A 140lb/10st woman would need to drink about 13 pints in 5 hours to reach a blood alcohol level high enough for her milk to no longer be considered alcohol free under EU legislation. If she did that, chances are she’d be passed out (or in a coma) so couldn’t feed the baby anyway. To put a bit more context on it, someone would be visibly drunk with a blood alcohol level of 0.1%. So really, the amounts of alcohol ingested by a nursing infant are very small.

I’m not comfortable with any alcohol in my breastmilk, how long do I have to wait to feed?

That all depends on how much you drink. Alcohol levels are usually highest in breast milk 30-60 minutes after an alcoholic drink is consumed or 60 to 90 minutes when drunk with food. Alcohol leaves you system at approximately one unit per hour. A ‘standard drink’ and a unit of alcohol are not the same things in Ireland! In Ireland a standard drink has about 10 grams of pure alcohol. In the UK a standard drink, also called a unit of alcohol, has about 8 grams of pure alcohol. So, it will take about 75 minutes for an Irish ‘standard drink’ to leave your system.

Some examples of a standard drink in Ireland are:

a pub measure of spirits (35.5ml)
a small glass of wine (125ml, 12.5% volume)
a half pint of normal beer

Starting your drink while feeding the baby makes the wait for the next feed shorter for baby.

Does pumping and dumping make a difference?

No, pumping and dumping the milk will not eliminate the alcohol in your breast milk quicker as only time can do this. That said if you are not feeding your baby during the time that there is alcohol in your breast milk you may need to pump to maintain supply. If you do not wish to give the baby the milk you can use it in the bath, to help sooth nappy rash or even have it made into jewellery or a glass ornament!

Ok, I’d like to have a drink and not wait for it to leave my system, what else do I need to know?

Premature or low birth weight babies may have more difficulty processing even tiny amounts of alcohol
Newborns under 3 months have less developed livers for processing alcohol
It is not safe to bedshare if you have alcohol in your system
There is no research that guarantees the safety of consuming moderate amounts alcohol while nursing and equally none that proves harm
Heavy drinking can impact the milk ejection reflex (let down) which may lead to the baby being fussy at the breast and the amount of milk they take in for a few hours (they do tend to make up for it later though). Regular heaving drinking may impact milk supply and baby’s growth.
You can calculate your blood alcohol levels and how long before it leaves your system here https://www.alcohol.org/bac-calculator/

Breastfeeding - Beyond the Fourth Trimester

niamh@mybabybeginnings.ie (Niamh Cassidy) — Tue, 23 Nov 2021 09:30:02 GMT

Breastfeeding from 3 to 6 months

A lot of breastfeeding information focuses on the early days of feeding. This knowledge is so important as getting started is often the hardest part but for families feeding beyond what we know of as the Fourth Trimester (the first 12 weeks) there is often less information and support. This article looks at the next phase of feeding – from three to six months.

Three Months

At this stage many are comfortable in their breastfeeding, confidence has grown in relation to breastfeeding in public and the early challenges have passed. Around three months many babies will go through growth spurt and if cluster feeding had seemed like a thing of the past it can be a little bit of a shock. Don’t worry though it normally only lasts 2-3 days. After this growth spurt babies are often very efficient feeders and may only nurse for five to seven minutes each feed.

This age is generally a settled one where night time sleep has less breaks and where babies’ personalities really start to develop. There will be out loud laughs and little eyes lighting up when you reach out to pick them up.

By breastfeeding for at least 3 months you have given your baby a 27% reduction in the risk of asthma if you have no family history of asthma and a 40% reduction if you have a family history of asthma and between a 19-27% reduction in the risk of childhood Type 1 Diabetes

Another bonus is that breastfeeding burns significant calories for the nursing parent so you may start to notice some weight loss without much effort over the next three months. This isn’t the case for everyone however.

Four Months

Confidence continues to grow and many parents by now feel stopping breastfeeding would be more difficult than continuing. There are no bottles to sterilise, no formula to make up and less stuff to bring when you leave the house. Baby rolls over and bumps their head? No problem - pop baby on the boob and you’re sorted. Parenting through breastfeeding starts to take shape.

There is another growth spurt and a huge developmental leap. For some babies this can impact their temperament for a few days and their night time sleep for a bit longer. Try not to misinterpret this as a need to start solids, baby’s digestive system isn’t ready just yet, its just a normal development stage that will pass.

In relation to breastfeeding, we often refer to this as the ‘nosey’ stage. Babies are very interested in their environment and will often latch off to look around when feeding. Some babies become so distracted parents find they have to feed them in quiet spaces for a short period of time. Don’t let this stop you from getting out and about, if baby is too distracted to feed properly while out they’ll catch up later.

Baby may also be starting to roll over independently. If you bed share this may be something you need to think about. If nappy changes are becoming a bone of contention try placing a mirror beside the changing area as babies this age love to look at themselves!

By breastfeeding for four months you have given your baby strong protection against ear infections and respiratory tract diseases for the whole first year.

Five Months

Exclusive breastfeeding is recommended until around 6 months, you’re almost there! Babies will often be starting to sit up with support and may like to feed in different positions such as straddling your leg while sitting upright! Your baby should still be having at the very least 6-8 breastfeeds per day so while life is getting busier remember to fit in feeds during the day or they may ask more at night!

By breastfeeding to this point, your baby is more likely to accept a range of solid foods when the time comes in a few weeks. This is because breastmilk exposes babies to the flavours of their mothers’ diets. Keep an eye out for the signs of readiness which include

· Sitting well with support (not slumping in highchair)

· Being able to pick up toys and bring then to their own mouth

· Diminished tongue thrust reflex

All of these signs should be present before starting solids. Around 6 months could be anything from 23-29 weeks for these signs to occur. It’s important not to start too early (gut not ready and higher risk of choking) or too late (higher risk of food allergies).

Many parents are now preparing for a return to work. Linking in with a peer supporter or a lactation consultant can be helpful to talk through this transition.

Six Months

Once you are ready to start introducing solids you can take it at your own pace. Some parents choose to start with single foods, while others introduce a variety early on. Some choose to offer spoon feeds while others choose baby led weaning (offering table foods).

Timing of breastfeeding and solids isn’t that important if you are feeding on demand. You may not find much of a change in feeding patterns at first so just go with the flow and let baby lead the way. As baby starts to become more stabilised on solids you may find that you can leave them with a caregiver for a number of hours with just solids and water and then breastfeed while home.

If you have returned to work you may find you and your baby use breastfeeding to reconnect and that for a period you baby may breastfeed more at night.

By breastfeeding for 6 months you have given your baby significant protection against eczema during their first 3 years of life and a 19% decrease in risk of childhood acute lymphocytic leukaemia and a 15% decrease in the risk of acute myelogenous leukaemia.

So that rounds up our look at breastfeeding from three to six months. If you have any questions please reach out!

Pregnancy Hormones

niamh@mybabybeginnings.ie (Niamh Cassidy) — Mon, 22 Nov 2021 09:09:39 GMT

What hormones in pregnancy do and how they make us feel

Hormones play a huge role in pregnancy, from getting pregnant, to staying pregnant and bringing us to childbirth. In this article we will explore the role of some of the different hormones in each trimester.

The First Trimester

When you become pregnant, progesterone and oestrogen rise significantly. Progesterone acts as a muscle relaxant, preventing your uterus from contracting until labour starts. However, it is also associated with irritability and mood swings can be a side effect.

Oestrogen helps to regulate progesterone while also sustaining the endometrial lining. It promotes an increase in blood flow, which is important for nourishing the baby, but that extra blood flow has the side-effect of making your breasts achy and tender. It can also lead to that stuffy nose many women experience and can cause you to need a pee more often.

The Second Trimester

Cortisol also increases during pregnancy, but it’s not necessarily negative—it’s important for the developing baby because it can help regulate your metabolism and control blood sugar levels.

Human placental lactogen (hPL) is a placental hormone that modifies the metabolic state of the mother during pregnancy to facilitate the energy supply to the baby. It also has anti-insulin properties. Your body’s changing reaction to insulin makes a lot of sense in that it’s a time of rapid growth for the baby and a lot of energy is needed for this growth.

The Third Trimester

How can Partners support Breastfeeding?

Wed, 23 Jun 2021 10:59:00 GMT

I want to help with the baby but I don’t know what to do

Sometimes partner's of women planning on breastfeeding worry that they may feel left out or not useful once the baby comes. They also worry that all the work may be left to the mother. This does not need to be the case, there are plenty of opportunities for the non breastfeeding parent to engage in baby care and bonding with their baby while also supporting the breastfeeding parent. Some of the things you can do include:

Ensure she’s comfortable

Does she need more cushions? A blanket? Are her shoulders hunched? Offer a shoulder rub to help her relax.

Get in the bath…

…with the baby. Make it a bonding and playful routine for you and the baby.

Wear the baby

Most babies are happy to sleep on anyone’s chest. Get to grips with babywearing so baby can nap with you and your breastfeeding partner can nap in bed.

Cuddle & Play

Next to breastfeeding there's nothing newborns love more than a cuddle and being in arms. As they come more alert you can play with your baby by singing and talking to them.

Change the nappies

Breastfeeding on demand in the early days is busy work. Take on the nappy changing and dressing duties, including during the night.

Change the sheets

Weekly. The early post-partum period can be sweaty. Clean sheets will always be appreciated.

Be a cheerleader

Tell her how good she’s doing. Tell her how proud of her you are. If she’s having a wobble, listen, wait until she’s finished and then ask her what she needs.

Learn about breastfeeding

Your partner may be the one doing it but she needs your support and understanding. That will be much easier if you understand the process, normal newborn behaviours, common difficulties and what supports are available.

How to Prevent Birth Trauma

Wed, 05 May 2021 20:04:00 GMT

This is not an easy subject to discuss, its probably not one that any first-time pregnant person wants to think about. Yet, so many women I meet tell me they are afraid due to stories they have heard from others. Firstly, it’s important to know that people are 10 times more likely to tell a negative story than a positive one. Its just human nature, so you will likely hear more negative birth stories than you do positive ones. For this reason, I suggest that pregnant people seek out positive birth stories, they are a great way to prepare for birth and to get oxytocin flowing during early labour.

What is Birth Trauma

Birth trauma is distress experienced by a birthing person during or after childbirth. While trauma may be physical, it is also often emotional and psychological. Birth trauma is not just about what happened during labour and the birth. It can also refer to how the person is treated in labour and the post-partum period and how she is left feeling afterwards. Birth Trauma affects up to 30% of people who have given birth with approximately 4-6% experiencing Post Traumatic Stress Disorder (PTSD). This means that most people do not experience birth trauma, however the numbers are still very significant and maternity services need to be addressing these numbers and bringing them down.

What can Midwives and Obstetricians do to reduce the risk of Birth Trauma?

Treat women as the central decision makers
Provide birthing families with objective information needed to make informed decisions
Speak to them kindly
Treat them with respect and dignity
Do not perform any exams or procedures without explicit informed consent
Respect informed refusal
Communicate effectively and ensure understanding
Answer questions happily and objectively
Access support for any personal or vicarious trauma
Provide care with confidence
Support a woman through any fears or anxiety
Support the role of the woman’s chosen birth partner

It is often not the mode of birth, rather how women felt they were treated during labour, birth and the post-partum period that is an indicator of whether or not they will go on to describe birth trauma or to experience PTSD.

What can pregnant women do to reduce the risk of Birth Trauma?

Be educated on the process of childbirth and what to expect in the hospital
Attend an independent Antenatal Class
Trust yourself as the primary decision maker in your and your baby’s care
Learn about informed decision making and practice it prior to labour
Labour at home for as long as it safe and comfortable to do so
Keep mobile to help labour along
Learn about different interventions and how they work. Discuss birth preferences for many variables with your partner and health care provider
Choose a supportive birth partner. Add a doula if possible
Seek perinatal mental health support in pregnancy if you are prone to anxiety or depression
Practice relaxation and calming techniques that you can use in labour
After the birth if you experienced it as traumatic:
Talk to a supportive care provider in the hospital about what happened
Talk to your GP or PHN
Talk to your loved ones
Ask for practical and emotional support from friends and family
Use self-help measures, such as rest, exercise and practicing mindfulness

Treating Birth Trauma

For many women the distressed feelings associated with a traumatic birth will dissipate within six weeks after birth. If after this time (or if the distress is debilitating before this time) the distress is ongoing seeking treatment is advisable.

The main treatments for birth PTSD are specific types of talking therapy:

Birth Trauma Resolution (BTR)

BTR therapy uses a variety of fast and effective tools and techniques. A birth trauma memory, once stored in the emotional memory bank of the brain – may elicit anxiety and a panic response (fight or flight) when anything reminds it of the trauma. BTR is way of removing the strong emotional charge that is attached to the birth trauma memory allowing for successful treatment outcomes, often in as little as 2-3 sessions.

Trauma-focused cognitive behavioural therapy (CBT)

CBT which is specifically designed to treat PTSD.

Eye movement desensitisation and reprocessing (EMDR)

In this treatment a therapist guides the participant to make rhythmic eye movements while recalling the traumatic event. The eye movements are designed to stimulate the information-processing system in the brain and to help process the traumatic events, and speed up re-adjustment and recovery.

‘A woman, as long as she lives, will remember how she was made to feel at her birth’ – Anna Verwaal

Breastfeeding Myths & Facts

Sat, 17 Apr 2021 10:32:00 GMT

There is a lot of misinformation out there so I'm hoping this blog will help combat it!

FACT

Breast milk contains antibodies that help your baby fight against infection. Recent research has also shown that antibodies against Covid 19 can also be passed to baby!

MYTH

Breastfeeding involves several food restrictions. Breastmilk is made from our blood, not the contents of our stomachs. Most people who are breastfeeding can continue to eat all their favourite foods. Some food proteins can be passed into milk and if baby has an allergy this may be an issue but for the vast, vast majority of people there are no food restrictions.

FACT

Breastfeeding burns between 500-600 calories a day. We are biologically designed to lay down extra fat stores when pregnant just in case there is a famine after the baby is born so that we still have fat to burn to make our baby's milk!

MYTH

Most women don’t produce enough milk. The vast majority of women can produce enough milk to feed their baby(ies) (and more!). Appropriate levels of feeding in the early days and weeks are vital however for this production capacity to be met. For the small percentage of women who biologically cannot produce enough breastmilk they can still usually breastfeed with additional milk given as needed. Skilled lactation support is very beneficial in these cases.

FACT

Breastfeeding reduces your risk of ovarian and breast cancer, heart disease, and osteoporosis and the longer you breastfeed, the larger the benefit.

MYTH

It's normal for breastfeeding to hurt. Breastfeeding should not hurt. Some women may experience some tenderness at latch on in the first few days but this shouldn't extend for the entire feed or beyond this time period. When breastfeeding hurts it is usually because the baby is not attached properly and adjusting positioning and latch can resolve the issue.

FACT

Breastfeeding can reduce baby’s risk of many diseases later in life. These include:

Type I and II diabetes
Hodgkin’s disease
Leukaemia
Obesity
High blood pressure
High cholesterol levels
Crohn’s disease
Ulcerative colitis
Asthma
Eczema

MYTH

You need to toughen up your nipples before breastfeeding. This is most definitely an old wives tale. Please leave your nipples alone, they are designed perfectly!

FACT

Breast milk changes during every feed and over time. Breastmilk changes in composition over the course of a feed with usually more fat being produced later in the feed. Breast milk also develops more antibodies and a higher fat content once your little one enters his or her toddler years and is regularly eating complementary foods to ensure they still get maximum benefits.

MYTH

There is no way to determine how much breast milk the baby is getting. What goes in must come out! Keeping an eye on wet and dirty nappies and weight gain are two ways to know that baby is getting enough milk.

FACT

Each breast functions independently. This means you may have different levels on supply in each breast, especially f you or baby favours feeding on one breast. It also means that women with only one breast can often still fully breastfeed their babies.

MYTH

Modern formula is almost the same as breast milk. Breastmilk substitutes are a lifesaving invention and also provide choice to those who do not wish to breastfeed. They provide adequate nutrition for a growing baby. Formula does not contain the antibodies found in breast milk and it is not tailored to the growth and needs of individual babies. It is made from cows milk, not human milk and it contains higher concentrations of vitamins and minerals that make it more difficult to digest. Breastmilk has hundreds of ingredients, many still to be discovered and understood that cannot be replicated in formula.

FACT

Breastmilk contains Human milk oligosaccharides (HMOs) which act as a food source for microbes and drive the growth of a healthy community of gut bacteria. In laboratory studies, potentially disease-causing bacteria grow poorly - or not at all in - the presence of HMOs, while ‘good’ bacteria like Bifidobacteria thrive, protecting your baby’s gut, and overall, health.

MYTH

You can't take medication while breastfeeding. The vast majority of medications can be taken while pregnant and if a recommended medication is not suitable there is usually a safe alternative. Women do not need to delay treatments due to breastfeeding. The Breastfeeding Network UK is a reliable, evidence based, source of information for you discuss with your prescribing physician or pharmacist. Alternatively, they may contact the National Medicines Centre in St James Hospital, Dublin for up to date advice on medications while breastfeeding.

FACT

A third of all respiratory infections in infants could be avoided by breastfeeding. Also, risk of hospitalisation from lower respiratory tract infection is 72 % lower in infants who are exclusively breastfed for more than 4 months.

MYTH

Because breastfeeding is biologically normal - it's easy. Babies are born with the reflex to look for their mother’s breast. However, as many mothers have not grown up with witnessing breastfeeding they may need practical support with positioning their baby for breastfeeding and making sure their baby is correctly attached to the breast. Breastfeeding takes time and practice for both mothers and babies and they need appropriate support during this learning phase.

What is Breastfeeding Success?

Sat, 10 Apr 2021 11:07:00 GMT

What is breastfeeding success? To me breastfeeding success is whatever you define it to be for yourself.

So what is it what does this mean?

This might mean that for you breastfeeding success is the first feed after the baby is born so as to provide them with immunoglobins from your colostrum. It may also mean that you breastfeed your baby until they naturally wean themselves at whatever age that might be. Or anything in between. Breastfeeding success looks different for all people. It can be a combination between feeding at the breast and breast milk feeding using an alternative device. That device might be an at-the-breast-supplementer, a cup or syringe, a bottle or any variety of tools that may be used to provide additional milk. Breastfeeding success may also be never feeding directly at the breast and giving breast milk to your baby using one of those devices or something else that you choose to use. breastfeeding success may be combination feeding. It isn't defined by the amount of breast feeds our baby gets, its not defined by how the baby gets the breast milk, it is not defined by how much breast milk the baby gets and is not defined by how long we breastfeed for.

Breastfeeding success is defined by our own journeys and over the course of that journey what we consider success may change. Initially we may have wanted one thing for our breastfeeding journey and that might change due to any number of factors but that doesn't mean that breastfeeding has not been successful what it means is that our priorities changed, our situation changed and that we made decisions based on what on what was happening at the time .

Breastfeeding isn't an all or nothing situation. Breastfeeding can journeys can take many different turns and have many different variables of experiences from one family to the next. What I want for parents who wish to breastfeed is that no matter what path their breastfeeding journey takes that they feel successful, that they feel that they met their own breastfeeding goals, whatever they may be. My purpose is always to ensure that, when I can, a parent doesn't stop breastfeeding or change the way they are breastfeeding or breast milk feeding their baby out of fear or out of lack of knowledge, that they do it with the information and support that they need and that they can feel happy supported and empowered in their breastfeeding journey no matter what turns it may take.

Doctors, midwives, lactation consultants or social media do not define you breastfeeding journey. You do.

Partner Support in Labour

Fri, 15 Jan 2021 21:05:00 GMT

Just what is the partners’ role?

There once was a time when fathers considered their job during labour as getting some pints in and pacing up and down the pub or hospital corridor smoking cigarettes. Culture, hospital practice, family make-up and expectations have changed. Pregnant people now, more often than not, view their other halves as partners, as best friends, who they want, and need, to be there during labour. I’m still surprised at how often I’m asked if partners should attend my antenatal classes. The answer is - that whoever you plan on having present during the birth can, and should if possible, attend. For the most part this is usually the other parent and/or romantic partner.

Often, I can sense at the start of a class that many birth partners feel that they don’t have much of a role to play in the labour and birth, but throughout the session I build up a picture of their significant importance. Then, towards the end of the class, I do an exercise about partner support. I split them into two groups - pregnant people and partners, and ask them to answer, “what do I want my partner to do for me during labour?” and “what can I do for my partner during labour?” respectively. It’s the only part of the class that I separate them, and I always enjoy the reunion. I usually get the partners to go first and I watch the expectant parent. I watch their delight and surprise at how right their loved ones got it, at what the partners thought of that they hadn’t, and I witness that swell of love. And then I look back at the partners, the relief that they got it right, the confidence that they have an active role to play. In its entirety, it is truly momentous.

A number of themes emerge from both groups regularly:

Practical

Remember the hospital bags, know the route and parking options and bring chargers and snacks
Know the birth plan/preferences
Sort any other children and manage family communication

Advocacy

Inform Health Care Providers of the birth plan/preferences
Remember the BRAIN questions (What are the Benefits? What are the Risks? What are the Alternatives? What is our Intuition telling us? What if we wait or do Nothing?)
Be mine and our baby’s voice
Be educated on our options

Support

Be present:Stay calm, at least outwardly. Especially at home, don’t keep suggesting we ‘go in’ if I’m happy at home
Be patient: Encourage and reassure me, tell me that you love me, that I’m doing a great job, that you’re so proud of me
Listen: Ask what I want
Keep me calm: Back me up, stay on my side
Protect the labouring and birth ‘zone’, facilitate oxytocin (the love, labouring & birth hormone!)
Remember what transition looks like and remind me
Remember different positions and breathing techniques if I need a reminder
Encourage me in our birth plan but respect my decisions if I deviate
Facilitate pain management (be that massage, aromatherapy, water, pharmacological or any alternative we have discussed or is offered)

My own pro-tips for partners that complement the above include;

Pack the hospital bag yourself, or at least unpack and repack it so you know what’s in it
Know what size clothes your partner may wear after birth so that if a stay is longer than anticipated, or something is forgotten, you can pick it up easily
If there’s a parking app that covers the hospital area download it and sign up before labour
Be gentle but firm in your management of family communication and remember supporting your partner in the moment is more important than any communication with family
Don’t just know the birth plan/preferences, understand them, believe in them
If the labouring person is being offered an intervention that you (collectively or singularly) are unsure of ask “do we have to decide right now or do we have time to discuss it alone?”
Believe in yourself: no one wants your partner and baby to be safe and happy more than you
Remember that, ultimately, the choices lie with the pregnant person
Know what she knows, read the books she’s reading, ask for blogs and references. Keep dialogue open and frequent during pregnancy
Practice physical support measures during pregnancy (e.g. massage, acupressure [practice on yourself if only safe during labour] and the double hip squeeze [Google it!])
Don’t be offended that if in the moment she doesn’t want any of the physical support measures practiced during pregnancy
Make your partner feel like a goddess, because she is, she is literally life giving, be in awe

Michel Odent (famous woman-centred obstetrician and childbirth expert) said “Reduced self-control, as an effect of reduced neocortical activity, appears as the main factor that makes human birth possible…for a woman to give birth easily by herself, without any pharmacological assistance, there is a time when she cuts herself off from our world, forgetting what she has been taught, forgetting her plans, and behaving in a way that might be considered unacceptable for a civilized woman: for example, screaming or swearing…When …Nature is understood, it becomes easy to analyze and summarize the basic needs of a laboring woman: she needs to feel protected...”

Partners are a vital part of a positive birth experience. They have a role in protecting the labouring space, making the labouring person feel safe and loved and allowing her to switch off her ‘thinking brain’ (neocortex) and to let nature take over. The birthing person will remember how you made them feel during this immense, influential, life event, make sure you’ve done your best, there’s no more that can be asked of you.

Quote from: Odent M (2020). Do we need midwives? Midwifery Today 132: 10-11.