Practical Advice: Birth Partners - what can they do?

After a pregnancy yoga chat this week, it seemed like many people weren’t aware of the ways in which a supportive birth partner can be truly a wonderful thing. And my partner certainly didn’t know how to help on the first time around. The second time he was truly brilliant. So with no further ado, here’s what your birth partner CAN do.

1. BE KNOWLEDGEABLE. Know what you both want / would like in terms of a birth. Know if she absolutely does not want something (eg pethidine). Know the principles of hypnobirthing if this is what she wants to do. Know whether she’s allergic to something. Know when she last went for a wee / last ate something. The birth partner can then feed this information to the ever changing staff without mum having to try to concentrate in the middle of a contraction. Why does it matter when she’s been for a wee? Because a full bladder can stop a baby coming out. A quick catheter and an empty bladder and then whoosh, 20 mins later our baby came out.

2. MEDIATE. Most birthing women are not at their most patient / communicative. A birth partner can smooth many difficulties. For example, I found a student midwife deeply irritating and muttered “get her out of here before I punch her” and he was able to find a better way to ask her to attend a different birth / step back and observe. Equally, when the midwife wanted me to sit and I didn’t feel able to, he was able to find a compromise that worked for her needs (my spine needed to be vertical for an epidural top up) without me needing to sit on my most painful part. Some women are silent labourers and midwives can sometimes not realise that the woman is as advancing in her birth as she’s not being vocal. A birth partner can diplomatically remind the midwife that she’s a quiet person but if she says she feels the baby is coming, that means the baby is coming. Ask the midwife to examine her to see what progress has happened.

3. BE PRACTICAL. Birthing women often forget to eat / drink and can run low on energy as a result. Women also lose track of time in labour. My partner reminded me that I was flagging and that I needed to eat something to get through it as I hadn’t eaten in four hours. Better to eat little and often then wait until you totally flag (if you’re a cyclist, you’ll know the expression “bonking” - better to eat before you bonk. This applies in labour too).

4. REASSURE. Some women like massage. Some need a hug in the middle of a long night. Some like reassuring chat. Some want to be left alone. Check in with her regularly as her wants / needs will change. You’ll need to be thick skinned as you will probably be told to get lost at some point. Please don’t take it personally. At some point (often at transition, just before the pushing starts), most women feel like they can’t do it. This is your point to look her in the eyes and say that '“yes you CAN”. Tell her she’s doing well.

5. ADVOCATE. When you’ve been waiting for two hours for something (an epidural, a meal, the hearing test for your new born), go and (nicely) ask where it is. Query choices with doctors for reasons why they’re recommending something, especially if it’s something she has said she didn’t want. Ask if there are alternatives. There are many routes through birth and you may be able to find compromises that better suit your family. Doctors and midwives are hardworking and have your best interests at heart but the NHS is oversubscribed and sometimes compromise or a gentle chivvy are needed.

Have I missed anything? Do please chip in - anything to help partners be more helpful and mums have a smoother birth!

Practical Advice : Do you need NCT? What are the options?

Many people choose NCT as their provider of antenatal information and as a way to meet other mums who are due around the same time. And that’s entirely logical and fine.   NCT is very expensive however (£300 if I remember rightly... ) and tends to have a strong emphasis on breastfeeding which can lead to feelings of guilt if that doesn’t work out. Socially too, some meet lifelong friends from the group of 4-6 mums and others, well, don’t.

So I thought it’d be worth letting you know about other alternatives to learn more about birth and afterwards, including my pregnancy yoga classes of course!

Keeping Active in Pregnancy / Birth Preparation Classes

• My pregnancy yoga classes, obviously. On a Wednesday evening in Claygate.

• Antenatal Pilates - in Claygate

• Swimming is also great. You can usually attend a normal aquafit class too if lane swimming isn't your thing. 

• Birth Preparation Classes

• Noobies run by midwives from Kingston hospital. Some classes based in Surbiton and some in Kingston

• NCT. The most commonly used course. Several evenings or a weekend of info. 

• Hypnobirthing. You can prepare to use hypnobirthing in your labour with a CD/book or with a course in person. I used Katherine Graves’ recording with my second pregnancy and found it super helpful for helping me to look forward to labour with a good sense of embracing the unknown.

  • There are loads of hypnotherapists around and I personally know Meghan (also a student midwife which is reassuring) and Sophia. Do feel free to recommend any others that you may know.

Post Natal Classes / Help

This is more helpful/important than you might think. Most people are focused on the birth and don't quite get beyond that. BUT caring for a newborn is a whole new world and help is helpful!  You may have an amazing mother / sister nearby to walk you through it all (lucky you!) but if not, it may be worth learning more. 

• My NCT classes explained how to change a nappy and wind a baby and explained how important it was to breastfeed and that was about it. I subsequently learnt A LOT from a local night nanny who came and spend three hours with me talking me through all the issues I was having and helping me resolve them (not least me using the clever Gro Swaddle upside down. Oops).

• Kingston Hospital offer a one day parentcraft course

• Post Natal Doula. This is a person who's trained to help you, at home, learn how to become a mother. Help with breastfeeding, winding and so much more. 

• I also found a huge amount of support via my mumsnet group of people who were all due at the same time. 6 years later, there are 42 of us in a facebook group, offering friendship, support and laughter, every day.  We've met, we've sent parcels, flowers and care packages when people have needed them. I love my mumsnet group. You can find people due in the same month here. 

Also there are plenty of ways to meet people after your baby is born , for example

• at rhyme time at the library (10am on Wednesdays and Thursdays

• at baby massage courses,

• Mother and baby yoga (classes are starting in September 2018),

• Buggyfit

• sling meets

• and via websites (mummysocial, mush and others).

Practical Advice : Pelvic Pain in Pregnancy

Disclaimer: I'm not a doctor, I’m a yoga teacher, so if you are in pain, always see your GP.  I have had experience personally and professionally of Pelvic Pain in pregnancy and this is my overview, intended as an information starting point, rather than intended to replace the valuable knowledge of medical experts.

Terminology

Pelvic Pain in pregnancy is often called PGP (Pelvic Girdle Pain) or SPD. SPD (Symphysis Pubis Dysfunction) technically refers to the pain in the front of the pelvis (the Symphysis Pubis) but is often used as a general term to cover pain in the pelvis generally.

During pregnancy, all pregnant women have a hormone called relaxin, which relaxes ligaments. Useful when giving birth, enabling the pelvis to open and the baby to come out via the birth canal, too much relaxin can affect the stability of the pelvis during pregnancy, resulting in pain. The Symphysis Pubis gap can increase hugely and this destabilises the pelvis, meaning bones can click and grind together. And yes, it is as sore as that sounds!

Pain.

It can hurt in the lower back, in your hips, at the front or the back. It can vary from daily discomfort to excruciating pain resulting in women requiring crutches and/or bedrest. However, there CAN be solutions, for many women. I went from not being able to walk 500 yards without severe pain to being back to normal.  If you have SPD in one pregnancy, you will likely be affected in subsequent pregnancies, with the impact felt earlier in each subsequent pregnancy.

Solutions

Physiotherapy

Generally, a physio should be able to set you on the road to recovery. Referral from your GP should be relatively quick in pregnancy, though this does depend on your area, of course.  This can include manipulation to free up movement in joints, as well as prescribing exercises to build up the muscles of the pelvis (and thus support the pelvis whilst the ligaments aren’t doing their job).

Once you’ve been prescribed exercises, it’s really important to do them as regularly as you’ve been asked to do them (often, daily, for a month, to see real improvement).

A physio may also prescribe a pelvic support belt to support the pelvis whilst you’re building up the muscles. Some people find these very helpful, whilst others don’t. Some local authorities provide these free of charge whilst others require you to buy them yourself.

In each person, the muscle weaknesses will vary, so whilst waiting for your physio referral to come through, I would recommend an all round course of exercises, intended to target all the major muscle groups. Remaining active, and building up muscle strength is important, but please listen to your body and STOP when you’re in pain. Rest is as important as specific exercises (both hard to achieve if you have a job / other children, I realise).

Tiger Pose

       Keeping back straight, looking down at the floor, alternately lift right arm and left leg and left arm and right leg.

      If your pelvis pain is very bad, don’t lift the leg, just extend the foot along the mat, out behind you.

Cat / cow stretches

-      Come onto all fours with hands underneath your shoulders and knees hip distance apart      

-      curl your spine as you exhale, looking at your baby (it can be more pronounced than as seen in the above image)

-   Then inhale, bringing the head upwards, to look at the horizon.   Be mindful not to arch the back too much (pregnancy arches the back already, so you’re aiming for a gentle extension).

Exhale, arch the back and look at your baby once again

      
Pelvic floor exercises

This helps support the pelvis from underneath – definitely important for stability of the whole pelvis, not just to do with retaining wee.

Hip bridge

- lie on your back, feet up by your bottom, hip distance apart, toes facing forwards.

-   Lift the pelvis, whilst pushing knees away.

-   You’re aiming for a straight line between shoulders and knees.

When you’re stronger, you can then aim to --lift the buttocks, straighten right leg (so it’s in a line with your torso – knees)

§  bend right leg and place foot back down on the floor

§  Keep lifting the buttocks, straighten left leg

§  Bend left leg, place foot back down on the floor

§  Lower the buttocks to the floor.

Squats
- squat evenly through both feet, ensuring pushing through heels

- emphasis on the bum going backwards rather than the weight going straight down.

 Seated Exercises

-      towel between knees, clench and hold

-      squeeze glutes,

-      hold in core, hold
each hold for five secs, five times daily.

Lying down exercises

-      Pilates Clam (lying on one side, knees bent, legs on top of each other. Keeping the feet together (touching), lift the top knee, using your bottom muscles. Gradually lower the knee.

 -      Single leg raises with toes pointing towards ceiling

Osteopathy / Chiropractic

Some people find that the pain is more concentrated in one hip than the other. This can be due to misalignment and Osteopaths / Chiropractors can be brilliant at sorting that out. This solution is very unlikely to be funded by the NHS, however, and you will need several visits, so it’s worth giving the physio option a good go.

Daily Tips

DO

-      Use a pillow between your knees in bed.

-      Try to move with legs together (eg swing legs together when getting in and out of the car). Some people find sitting on a bin bag helps with the swivel action. When turning over in bed, keep the knees together.

-      Carry a child in front of you, or on your back instead of on one hip.

-      Sit down to put on tights / trousers.

-      Do your pelvic floor exercises
Try to ensure you have good posture – this doesn’t mean ramrod straight, but a neutral spine. 
Try to minimise stair climbing. Effectively for me this meant trying to be less forgetful!

DON’T

-      don't cross your legs (this misaligns your pelvis)

-      Swim breaststroke. If you’re a keen swimmer, either swim crawl, or if that too is sore, then use a pull buoy between the thighs and just use your arms.

-      Stand for extended periods (sit down for ironing, for example)

-      Stand with the weight on one hip, particularly if carrying a child.

-      Carry heavy loads on one side. Rucksacks instead of heavy handbags on one shoulder. 

More Pregnancy Yoga dates for April, May and June

Due to the great response to the Monday pregnancy yoga classes in March (most have been fully booked) I've decided to add in some extra dates for April, May and June. They're now available to book, so if you're keen to continue your pregnancy yoga journey, do book in and I look forward to seeing you very soon for stretching and strength of body and mind. 

New dates available at Pregnancy Yoga

I've just released a new tranche of pregnancy yoga dates - booking dates are now available until end of May.

So do book now if you're interested in coming along over the next couple of months. Dates are likely to fill up quickly. If you subsequently find you can't make a date, I'm happy to issue a refund so long as more than 24 hours notice is given (or if your baby arrives). 

Keep on breathing

Two of my pregnancy yoga mums welcomed their babies to the world this week. One four weeks early, one a week late, but they both said that long, focused, exhales, helped them with their births. So we focused on the Golden Thread breath this week in class. 

As a summary : 

Relax your jaw / face / shoulders.

Big inhale

As you exhale (slowly), through the nose, have the lips only a tiny bit apart, as though you'd just get a piece of paper in between your lips. Then slowly exhale, visualising a golden thread coming out of your lips, leading you to your baby.  The lips are relaxed (not pursed). 

Some people prefer to visualise a rope, which is pulling them over the stormy seas of contractions, to your baby. 

Whichever visualisation works for you is fine.