Parenting Woes – Whose Problem Is It Really?

This post has been whirling around my head for more than a year now and I have debated whether it should stay there many a time, why? Because I know this post is going to be contentious, I can only anticipate the comments it will get and the possibility that I might offend many parents is huge. Maybe I’m posting it therefore out of stupidity? Nevertheless I do think it needs to be said so here goes. (I can always delete it later!).

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I’m writing my second book at the moment, called ToddlerCalm (published on October 3rd 2013 – plug over, sorry!), and it’s all about life with 1, 2, 3 and 4 year olds. I’ve just finished up a chapter on brain development, the aim of this chapter being the idea that if parents know what their child is and isn’t neurologically capable of doing and understanding that their expectations will change to something a little more realistic which in turn should hopefully reduce tension for the whole household. My next chapter looks at toddler sleep, again the premise being to myth bust many of the incorrect assumptions we hold in society regarding what a toddler should and shouldn’t be doing sleep wise.

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This then led me to think ‘who really has the problem?‘ Indeed I believe around 90% of what we believe ‘problematic’ when it comes to baby and toddler sleep and behaviour is OUR problem, not theirs. Only somewhere along the line it has morphed into being a problem owned by the child, when and why did this happen?

Is it because we are so ill informed today that we genuinely believe a baby should be sleeping through the night (no longer requiring night feeds) by 6 months? and should be happy to be independent in daycare at 9 months? Do we really believe that two year olds should share, never bite, whine, squeal or hit? Do we really believe that toddlers should understand our logical explanation of why we need them to ‘be good’ and ‘sit nicely’ in a supermarket trolley for an hour?

Incidentally these are ALL myths. In every single scenario I have mentioned above these expectations are incorrect, based on myths and ill informed opinions and NOT current scientifc knowledge. The fact of the matter is that the following are ALL NORMAL behaviours for young human beings:

  • Babies who still take night feeds at 6 months
  • Babies who feed very frequently, particularly in the evenings
  • Babies who wake regularly at night at 12 months
  • Babies who need the security of their parents and don’t go happily to daycare at 9 months
  • Babies who controlled crying or CIO does not work for, short or long term
  • Babies who only sleep when in close proximity to their parents
  • Babies who do not self soothe
  • Toddlers who only sleep when in close proximity to their parents
  • Toddlers who wake early in the morning
  • Toddlers who do not self soothe
  • Toddlers who still wake regularly at night
  • Toddlers who do not share
  • Toddlers who do not listen to you
  • Toddlers who hit/bite/throw/whine/squeal/tantrum
  • Toddlers who do not learn from consequences
  • Toddlers who do not learn from time out/naughty steps/reward charts
  • Toddlers who are not ready to potty train at age two
  • Toddlers who are ‘picky eaters’.

Every single thing on this list is NORMAL for our species, every single thing on this list is HEALTHY AND TO BE EXPECTED for a baby and/or toddler. Nothing on this list is ‘a problem’ in the pathological or developmental sense. I cannot highlight this enough. THESE ARE NORMAL AND HEALTHY BEHAVIOURS OF BABIES AND TODDLERS. They are not problems, at least not problems that belong to the babies and toddlers anyway!

We do however consider all of these problems don’t we? The thing is though these problems therefore do not belong to our children. They belong to US. Let’s not kid ourselves, we have a problem with our baby’s perfectly normal nocturnal sleep patterns, we have a problem with our baby’s needs to be with us beyond our comfort zone, we have a problem with our toddler’s behaviour, we have a problem with our toddler’s communication skills.

So, if the problems belong to us how to fix them? Currently, in our mistaken belief that the problems belong to our offspring, we try to fix them, fix our children that is. Through all manner of methods that have little or no scientific evidence that they are 1) effective, 2) safe – here I’m talking about your ‘Cry it out’, ‘controlled crying’, ‘dream feeds’, early weaning, naughty steps, time out, ignoring the behaviour and covering the child or a chart in reward stickers. Indeed the more antisocial behaviours in my list above indicate an unmet need in the child, why do we not seek to meet this need in order to extinguish the behaviour? Why do we inflict stressful methods on our children to fix a problem that is ours alone?

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None of these resolve the real root of the problem though do they? Because the real root of the problem is us, the adults, the parents. Our incorrect expectations, our misinformed beliefs, our inability or reluctance to modify our lives so that we can cope better with this normal (and transient I might add) behaviour. Our naive following of unqualified child experts. Our lack of proper social and economic support so that we can cope with OUR PROBLEMS.

Personally I find it so wrong that we try to fix our children when they are doing nothing more than the norm for our species, no, indeed the real fixing needs to be done to us and OUR lives. How do we do that? Keep tuned, that post is next on my list!

Sarah

Why Gentle Parenting is NOT Permissive Parenting

It’s a common misconception, those who parent their babies and children with respect and compassion are deemed “permissive parents”. These gentle permissive parents are seen as always letting their offspring get their own way, thus creating future selfish ‘me, me’ and ‘I want it all – NOW’ adults.

Many describe gentle parents as being “too child centric”. Often they are accused of “mollycoddling” their children or being “too scared to discipline them in case they make them cry”.

What these dissenters are really voicing however is a total misunderstanding of deeper infant psychology and the parenting philosophy they are attacking.

I am not disputing that there are some who follow gentle, or attachment, parenting principles who are permissive, but that isn’t unique to this parenting philosophy. Yes, some APers or GPers could do with learning more about the importance of positive discipline and implementing the strategies, but so could other parents who don’t follow these principles.

I have met some ‘extreme attachment parents’ (for want of a better way to describe them) who are adamant that their child should never cry because of them, that they should always be left ‘to experiment’ and to ‘express their freedom’, and are reluctant to discipline. They are the extremes though, not the norms. It is wrong to judge a whole parenting philosophy by a handful of extreme families (usually the ones reflected in the media because of their extreme ways!).

Compassionate, respectful parenting that is mindful always of the importance of attachment and the parent-infant dyad however never prescribed that parents should always let the child get their own way. There is no gentle parenting rule book that says children shouldn’t be set firm boundaries – in fact it is quite the opposite!

I describe Gentle Parenting as simply “parenting with empathy, respect, understanding and boundaries.” In my opinion the boundaries are just as important as the empathy and the respect.

Gentle parenting focuses on understanding and responding to a child’s needs and sometimes, often in fact, the child needs steering to help them to understand the demands and expectations of society and to develop an understanding of social rules. In order to do this we need to set firm boundaries and limits for our children and sometimes we need to discipline them too!

Take for example a naturally curious two year old, forming a schema about the properties of liquids, the little bundle of exploration finds a bottle of mummy’s expensive shampoo on the side of the bath, the flip top lid allows the child to open the lid easily and the soft bottle allows for easy squeezing, the toddler is enthralled by the shiny, glossy, thick liquid coming out of the bottle and making patterns in the bath, over the bath towel and on the floor. How fantastic it is to then use daddy’s new toothbrush to move the liquid on the floor around into new patterns. The toddler is learning more about the properties of liquids in these ten minutes than she would in any science lesson!

In this example permissive parents would allow the toddler to carry on, reluctant to apprehend, knowing if they take the shampoo and toothpaste away the toddler will cry. This is not true gentle parenting though. A truly gentle parent would take the shampoo and toothpaste from the toddler, explain why they cannot play with them, offer them an alternative for ‘messy play’ with limits, such as using pouring toys whilst the toddler is in the bath, and sit with them during the resulting tears and tantrum that will ensue.

I agree it isn’t nice to know that you as a parent have made your toddler cry, but sometimes it is necessary. It is an important part of their development! Indeed it is a vital part of their development!

attachment parenting, permissive parenting, toddler tantrum Those who parent with compassion and respect are not afraid of making their child cry through their attempts at reinforcing limits, they are strong enough to sit with the resulting strong emotions that will surface in the toddler.

Those who parent with compassion set firm boundaries and are not afraid to reinforce them wherever necessary.

Those who parent with compassion know how important it is to say ‘no’ or ‘stop’, they don’t give the child a biscuit just before their dinner because they don’t like to upset the child, they don’t let their toddler climb over a relative’s sofa because ‘they are just exploring and being a toddler’.

Those who truly parent with compassion and respect value and understand the need for discipline and limits as much as they respect and value the need for attachment and love, for a child really does need both in order to thrive.

 

 Sarah

What Should you do When Children Lie?

Sometimes I am the parent I want to be and sometimes my parenting elicits the response I am hoping for. Before you think I am perfect (or indeed think I think I am perfect which is perhaps even worse!) I’d like to point out here I have many, many failings as a mother and frequently reach the end of my tether with my children, like every other parent and yes I shout too much for my liking too. I am no superhuman.

As I said though, sometimes things go really right, sometimes they click into place and I think “maybe I’m not doing such a bad job of this parenting thing after all?” – sometimes like yesterday.

My daughter is five. She is spirited, clever, funny and amazing. She also lies. A lot.

Yesterday I bought my son a new chest of drawers for his bedroom (that’s a whole other story actually, he won’t hang his clothes up in his wardrobe, I was fed up of him not putting them away. So rather than continuing the stalemate we discussed it – the upshot was he found hanging up too difficult – we therefore decided that the way forward was getting him an extra large chest of drawers so he could fold his clothes and put them away in that way, not hung like I’d prefer, but not on the floor where I hate them!), anyway we need help to manoeuvre the large chest up our teeny winding cottage staircase so they’re currently in our entrance hall.

Yesterday afternoon some large black dots appeared on the top of the drawers. Looking very much like they had been made with my large (thankfully not really) permanent black marker pen. I asked the boys who had made the marks, they all said their sister, which confirmed my suspiciouns due to the rather 5yr old looking marks and her obsession with drawing on everything at the moment.

My daughter however was not forthcoming with the truth, I asked if it was her? “It wasn’t me” she cried and stormed off sulking, despite her brothers being in the same room protesting that it was. I left it, hoping she would come back and confess to me, she didn’t. I went to her 20 minutes later, I found her curled up on the sofa in the playroom looking very sorry for herself – a sure sign of guilt! I asked her again and reminded her that lying to me was always worse than telling the truth, whatever it was that she had done.  She refused to talk to me. I asked her to take some time to consider whether she would like to talk to me and tell me what she had done and perhaps if she would like to tell me that she had made the marks that she would like to help me to clean them off.

10 minutes went past, she came quietly into the room sobbing saying “Mummy you hurt my feelings”. I asked if she would like a hug. She didn’t reply, instead she climbed onto my lap, pulled me tight and buried her head in my arm, sobbing. I hugged her back and told her I loved her. Once she had calmed down I asked her if she would like to tell me anything and reminded her she could help me to clean off the marks.

“I’m sorry” she whispered. “Would you like to help me clean the marks off?” – slowly she nodded, tears rolling down her cheeks. I said “I know you know that you shouldn’t have drawn on the drawers don’t you?” She nodded. I then said “Thank you for telling me the truth, I am very proud of you”. We hugged for a LOOOONG time before cleaning the drawers together.

Will she lie again? I’m sure she will (though I would like to think she was not fearful of telling me if she has done something she is ashamed of), will she draw on something again? Possibly, though I’d like to hope not! Did we build an understanding then? Did I hopefully instill a little of the importance of telling the truth and help her to trust and respect me? I hope so. I could have chosen to shout, spank, send her to time out or the naughty step, all of these would have been far quicker than the hour or two or took to resolve the situation and indeed I know most of these would have seemed a far more ‘normal’ way of handling the situation. Instead I believe what I did do has made a far greater, more positive mark and one that will help to set the scene for us in the future.

At the end of the day that’s what it’s all about, not marks on a chest of drawers. It’s only a piece of furniture. I can cover marks on furniture with a cloth. I cannot do anything to change the marks I leave on her personality forever more though.

Sarah

Big Babies – Birthing a Macrosomic Infant – Part 2.

This is part 2 of a two part blog on ‘big babies’ please CLICK HERE for part 1.

So What are Your Birth Options with a Big Baby?

Having birthed four big babies myself and through my involvement in the birthing scene ever since, I have come to conclude that if you are carrying a suspected large baby then you need to put a bit of extra planning into planning the birth. I like to use the acronym ACE IT to help plan a big baby’s birth.

Active

Remaining active throughout labour is important for all mums, but even moreso for mums expecting a big baby. Why is this? it’s a well known fact that being in a recumbant or semi recumbant (laying down/sitting back) position can reduce the pelvic capacity by up to 30% by preventing the sacrum from moving properly – that 30% is especially valuable when you have a larger than average sized baby on board. If a woman is left to birth actively, free from monitors keeping her confined to the bed, free from drips in her hands and free from an epidural leaving her confined to her back in bed, then she will instinctively move into positions that help her pelvis to open up and help her baby to rotate into the perfect position for birth. Many mums of larger babies will instinctively birth in a squatting or all fours position, also known as the Gaskin Maneuver – named after the inspirational American Midwife Ina May Gaskin.

Also consider using water to labour and/or birth in. Relaxing in a birthing pool can help you move into amazing positions that you may not ordinarily be able to remain in on dry land, the water helps you to relax, helps labour to progress more quickly and importantly helps you to remain active and keep your pelvis open.

Confidence

This is all about what happens during labour if you are anxious. The major hormone released during labour, oxytocin, is incredibly fragile. If a woman feels scared during labour she will release catecholamines, the most well known of these being adrenaline. The release of adrenaline during labour causes two things to happen, firstly it inhibits the release of oxytocin, this causes the uterus to stop contracting effectively and can cause the labour to become erratic and slow, secondly when we release adrenaline we cannot release beta endorphins, nature’s own natural anaesthesia and feel good chemical. The contracting uterus also becomes starved of oxygenated blood which leads to a build up of lactic acid and thus pain (ever experienced severe muscle cramp?) and combined with the lack of release of our own natural pain killers labour becomes harder, longer and more painful (often known as “failure to progress”). By ensuring that the birthing mother releases as little adrenaline as possible we can help the birth to progress easily, safely and comfortably. By ensuring that she is confident about her body’s ability we can help her to experience the easiest birth possible.

One way to feel confident again is to read lots of inspirational books such as Ina May Gaskin’s “Spiritual Midwifery” . Marie Mongan’s “HypnoBirthing – A Celebration of Life” and Michel Odent’s “Birth Reborn” or by reading positive birth stories of women who have had easy births with larger than average babies. Perhaps your local NCT branch has a “big baby” mum on its experience register who may be happy to talk to you or perhaps you could consider classes such as http://www.hypnobirthing.co.uk/.

It may also be worthwhile looking into hiring a Doula. Doulas are non- medically qualified women who have experienced the ease and joys of natural childbirth. They view childbirth as normal, not a disease or sickness or something that a woman needs artificial help to achieve. A doula believes in a woman’s own innate ability to birth her own baby, she doesn’t so much support the birthing mother (as that would indicate that a woman needs more than her own wonderful body to birth her baby) rather she ensures that the woman can feel as at ease and undisturbed as possible so that the amazing act of childbirth can be, free from outside influences and therefore as easy and as safe as possible, she also helps antenatally by ensuring that the mother and father to be feel as confident as possible. You can find a qualified doula in your area by visiting http://www.doula.org.uk/.

Environment

All birthing women should think about the environment they will give birth in, often it’s a decision made very lightly without proper research. For mothers of big babies it is even more important that you choose the right environment for you – one where you feel safe, secure and above all else – relaxed. For some the close proximity of medical equipment in the hospital makes them feel at ease, for others they chose to remain in the safe environment they have nested in for so many months – their own home. In fact one could argue that if you are expecting a large baby, then the safest place for you to deliver is the place where you are least likely to be induced, constantly monitored, prodded and poked by registrars, timed and stuck on the bed with an epidural and also the place where you feel most comfortable of all – where would that place be? you guessed it – HOME!

I always swear that if my third baby (who weighed 11lb 3oz and had “sticky shoulders”) had been born in hospital, his birth would have resulted in a C-Section. I firmly believe choosing to birth at home with him (against my consultant’s wishes) gave me – and him – the best chance of a normal – and safe! – birth.

So, think about things that help you to relax and imagine the most relaxing environment you could be in to give birth, what is the lighting like? what noises can you hear? who is with you? what smells are there? what comfort measures do you have with you? Really work with the enviroment and on the day your work planning will pay off! You’ll find lots of tips in THIS ARTICLE.

Research statistics from your local hospital here: Dr. Foster Guide and research the possibilities of homebirth at the fantastic site http://www.homebirth.org.uk/.

Induction

As mentioned in previous pages, an induction for *just* a big baby is ill advised, it is not in line with statistical data and is not based on evidence based practice. When a pregnant mother is induced it opens the door to a whole cascade of interventions, it is often more painful and thus the chance of having an instinctive natural birth – so important for smooth & easy progress and no limiting pelvic capacity – is dramatically diminished.

If an induction is being suggested to you – question it!! if it is only for a “suspected

big baby” just say no!!

Another useful acronym for helping you out in this situation is remembering to use your “brains“:

Benefits –      e.g: “what are the benefits of an induction?”

Risks –           e.g:: “what are the risks of an induction?”

Alternatives – e.g: “what are the alternatives to an induction?”

Instinct –         e.g: “what does your instinct tell you?”

Nothing –        e.g: “what happens if we do nothing and let nature take its course?”

Smile –           e.g: Remeber to be polite – be confident & assertive not rude & aggresive!

Tests

Chances are, if you’re reading this you’ve probably been subjected to extra tests “just in case”, things such as growth scans and Glucose Tolerance Tests (GTT). These tests have not been shown to increase the survival rate of mother or baby, they have not been shown to increase the health of newly born mother and baby and they have not been shown to decrease birth trauma. One must ask then what is the point of them? what exactly *do* they do? If you have no other risk factors, if you just have a perfectly happy and healthy baby, ask your midwife or consultant exactly what these tests will add to the wellbeing of you and your baby? how will they use the results? what will it mean for you to be under consultant led care? and more importantly how will you feel? your pregnancy and birth is rapidly spiralling from the “normal” camp to “abnormal” and “high risk” – I refer you back to the “CONFIDENCE” point above. Don’t just agree to a test – question what it’s for, what the results will be used for and question if it is really needed or is just a matter of protocol and policy.

I’ll leave you here with a picture of my son, who was born at home in a birthing pool after am easy 4 hour labour. I  had no intervention at all and no need for any pain relief either. I enjoyed every moment of his birth. He weighed 11lb 3.5oz.

…and here is his sister who was born in a labour lasting less than an hour, again at home in a birthing pool, again no intervention, no pain relief and no perineal damage. She weighed 11lb 1oz.

Oh and by the way, I’m 5ft 1inches and wear a size 4-5 shoe.

Who said birthing big babies was hard?!

Sarah

Big Babies – The Curse of (mis) Diagnosing a Macrosomic Infant Part.1

Thousands of women are diagnosed with suspected big babies (or ‘macrosomia’ to use the medical terminology) every year, but this one simple label can have a profound effect on their birth.
Obstetric consultants often take the results of growth scans as gospel, scheduling elective C-Sections or inductions as a result of them, but how accurate are these estimates? and does early induction or elective C-Section really prevent problems if a baby is extra large? – you might be surprised at the answer!
…and even IF the baby is big, what’s to say that the mother will have problems giving birth? Some women have a great deal of trouble giving birth to a small six pounds baby, whilst others, like myself, can birth an eleven pound baby with ease. Then there is the issue of the nocebo effect – the creation of a medical problem when there was none initially, in short if you go looking for problems with ‘a big baby’, you dent the mother’s confidence, you induce her before her body and baby are ready and keep her immobile by monitoring constantly throughout her labour – the chances are her birth will be problematic, not because of the size of her baby – but because of the management of her labour. Yes the nocebo effect is particularly strong in modern day obstetrics.
So, even if the growth scan estimate is accurate how can anyone possibly know how YOU will birth? The only sure thing is that nobody knows how much your baby will weigh until it is placed in the scales after birth, or how your birth will go until after the event. I heard a great analogy from an obstetrician once, that likened trying to predict the size of a baby before birth, by ultrasound, to trying to guess the weight of a man, sitting in a bath full of water, in the room next door by measuring his waist and thigh bone. When you look at it like that it really does become apparent how ludicrous these gross measures we use are!
So How Accurate are Ultrasound Estimates of Foetal Weight?

Ultrasound is widely believed to be the most accurate method of estimation of foetal weight. Yet in 1988, Miller, Brown, Khawli, Pastorek & Gabert in “Ultrasonographic identification of the macrosomic fetus” found that the typical mean error ranges from 300 to 550g (11.6 to 19.4 oz). That’s around a WHOLE POUND! In 1992 Chauhan, Lutton, Bailey, Guerrieri & Morrison In “Intrapartum clinical, sonographic, and parous patientsestimates of newborn birth weight” found that ultrasound was the least accurate of the three methods, i.e: it was less accurate than the educated guess of the obstetrician or mother!  In their study “Pregnancy outcome following ultrasound diagnosis of macrosomia” Delpapa & Mueller-Heubach found that “In 66 of 86 women (77%) delivering within 3 days of ultrasound examination, estimated fetal weight exceeded birth weight. In only 41 of these 86 women (48%) were the estimated fetal weights within the corresponding 500-g category of birth weight” – That’s quite some difference!

Limitations in the sensitivity and specificity of ultrasound have been observed in many other studies but sadly despite these well documented limitations, health professionals continue to incorrectly believe that ultrasound is an accurate way of predicting macrosomia, this also despite the UK Government’s CESDI (Confidental Enquiry Into Stillbirths & Deaths in Infancy) report stating that “the inaccuracy of ultrasound estimates have been well documented. Indeed, it is possible that estimating fetal weight by late ultrasound may do more harm than good by increasing intervention rates”.
I’m sure many people can recount a story of a friend or relative who has been told their baby would weigh 10lbs only to birth a perfectly average sized 8lber, or those, as myself with my first baby (who subsequently weighed 10lbs) who were told “it’s completely average, a 7lber” only to find they were expecting a whopper. As a general rule of thumb growth scans are quite good at plotting the growth rate of a single baby over a time period following several scans, but as a one off, arbitrary measure, research suggests that “mother’s intuition” is more accurate!
So What to Do if You are Offered a Growth Scan?
If you are offered a growth scan (note you do not “have to have” one) you could ask what the results will be used for? For instance, will the results be used to benefit you and your baby? You could ask how accurate they are at predicting birth weight? Or you could ask if they have any negative effects or risks attached to them? (such as leading to unnecessary inductions or C-Sections). Some people also believe that Ultrasound scans themselves carry risks. Above all else, how will YOU feel about the result, how will you feel if you are told your baby is big? will it dent your confidence and potentially inhibit your labour? remember – the scans are being offered to you, as such you can politely decline them after carefully assessing the risks and benefits of them.
Why Are Some Babies Much Bigger Than Others?

If you believe the media you will probably think it is because we all eat too many chips. In reality there’s an awful lot more to it than that. It is true that women who develop Gestational Diabetes are more likely (a twofold risk in fact) to give birth to a larger infant, however this site is interested in those women who have not been labelled with any medical disorder and who seem to “just make big babies”. There are several known risk factors, aside from Gestational Diabetes, which can highlight certain women who are more predisposed to birthing a macrosomic baby, these are:
  • Multiparity (not your first baby)
  • Birthing a previous macrosomic baby
  • A prolonged period of gestation
  • Carrying a male baby
  • Parental Stature
  • Excessive weight gain during pregnancy
Genetics does seem to play a role though and often women will give birth to a very large baby with none of the above risk factors – in fact according to Boyd, Usher & McLean and their report “Fetal macrosomia: prediction, risks, proposed management” – 34% of macrosomic babies are indicated to be born to mothers with NO risk factors! similarly very obese women are just as likely to deliver smaller infants. Finally even with TWO of the above risk factors present, women are only 32% likely to have a macrosomic infant.
 
Why are We So Terrified of Birthing a Big Baby?
The female pelvis is PERFECTLY designed for birth…..no matter the size of the baby…..it is designed to open up to make more space for the baby…….and a baby’s head is PERFECTLY designed to gently mould, to make it smaller, so that it passes through the female pelvis with ease. Babies know how to get into a good position for birth, tucking their head tightly so that the smallest part presents first.
But when a women reduces her pelvic capacity, by being immobile on a bed, perhaps due to an induction – for a “big baby” or an epidural, because of the pain caused by the induction, or the fear caused by the constant “big baby” conversations everything gets a lot harder, words like”cephalopelvic disproportion” (CPD) – where the baby’s head is too big to pass through the pelvis and “shoulder dystocia” – where the baby’s shoulders get stuck – get used – needlessly.

If a woman enters labour free from fear and anxiety oxytocin (the hormone of labour) will be free to flow, her uterus will contract efficiently, endorphins (natural morphone like pain relievers released during labour) will flood her body, adrenaline will be kept to a minimum ensuring that her uterus is well oxygenated and making her as comfortable as possible. She will move instinctively into positions which freely open her pelvis, such as a squatting position (where the pelvis is said to have up to 30% more capacity) or perhaps on all fours – both superb positions for birthing a big baby.

The size of a baby then in a normal, physiological birth – where anxiety and “big baby” talk is not present – is largely irrelevant, it doesn’t make it more painful and it doesn’t make it harder! The following article, by midwife Gloria Lemay, is a MUST read for anybody worrying about birthing a large baby and wondering whether their pelvis is “big enough” Pelvises I have known and loved.

 

 

 

So, Is an Induction of Elective C-Section Not Necessary for a Suspected Big Baby Then? 

You may have been advised that it would be best for you and your baby if you are induced early? or perhaps an elective C-Section has been advised. You might have been told that you baby is much more likely to get stuck (also known as “shoulder dystocia”), but does the research agree?

Actually the vast majority of research into Macrosomic babies indicates that elective C-Section and induction for just a suspected large baby is a bad idea, deeming it unneccessary, needlessly expensive and not effective at preventing birth trauma to the mother or baby. When looking at induction the research is in fact even more scathing, with many suggesting that early inductions only serve to raise caesarean section rates without altering outcomes for the mums or babies.

Finally, just suspecting a macrosomic baby can lead to problems, with one study indicating that the risk of cesarean section was substantially higher (52 versus 30 percent) in pregnancies in which macrosomia was suspected, even after controlling for birth weight and other confounding variables. More importantly, the difference in the cesarean section rate was attributable to a greater proportion of failed inductions for the macrosomia in the group in which it was suspected.

Lets take a quick whistle stop tour of clinical research into suspected foetal macrosomia and birth outcome. Lets start with my favourite, a Cochrane Review looking at “Induction of labour for suspected macrosomia”, April 1998 suggested that elective C-Sections and inductions for a suspected big baby was a bad idea. The summary of the review is as follows. Important points have been highlighted:

“Babies who are very large (macrosomic – over 4500 g) can sometimes have difficult and, occasionally, traumatic births. One suggestion to try to reduce this trauma and to reduce operative births has been to induce labour before the baby grows too big. However, the estimation of the baby’s weight in utero is difficult and not very accurate. Clinical estimations are based on feeling the uterus and measuring the height of the fundus of the uterus, and both are subject to considerable variation. Ultrasound scanning is also not accurate. Induction, if undertaken too early, can lead to babies being born prematurely and with immature organs. The review of trials, assessing induction of women when it was suspected that their baby was above 4 kg, found three trials involving 372 women, none of them with diabetes. There was no evidence of any benefit in terms of caesarean section or instrumental births, or in outcomes for the baby. However, these studies were too small to be sure of the outcomes. Further research is in progress.”

The results section of the Cochrane Review also states: “Perinatal morbidity was not statistically different between groups (shoulder dystocia).”

In the Archives of Gynecology & Obstetrics, September 2008. Sadeh-Mestechkin, Walfisch, Shachar, Shoham-Vardi, Vardi & Hallak, in their study entitled “Suspected macrosomia? Better not tell” noted that:  “Our ability to predict macrosomia is poor. Our management policy of suspected macrosomic pregnancies raises induction of labor and cesarean delivery rates without improving maternal or fetal outcome.”

In 1994, in The Chinese Medical Journal, Yan, Chang & Yin, in their article “Elective cesarean section for macrosomia?” studying the births of 207 macrosomic babies concluded that: “Elective Cesarean section on macrosomic infants to prevent dystocia is not recommended because most of them can be delivered vaginally.”

In 2000, in the European Journal of Obstetrics, Gynecology & Reproductive Biology, Mocanu, Greene, Byrne & Turner studied the births of 828 macrosomic babies born over a 5yr period in their report entitled “Obstetric and neonatal outcome of babies weighing more than 4.5 kg: an analysis by parity” they concluded that:  “The poor antenatal predictability of macrosomia, the high rate of vaginal delivery and the low incidence of shoulder dystocia would not support the use of elective caesarean section for delivery of the macrosomic infant either in primigravidae * or multigravidae.”

* Editor’s Note: Primigravidae = First Time Mother, Multigravidae = Second or More time mother.

In april 1995 in Obstetric Gynecology in their research “The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience” looking at 227 births of macrosomic babies, Lipscomb, Gregory & Shaw noted that:  “Vaginal delivery is a reasonable alternative to elective cesarean for infants with estimated birth weights of at least 4500 g, and a trial of labor can be offered.”.

In 2006 in the American Journal of Obstetrics & Gynecology, Chauhan, Grobman, Gherman, Chauhan, Chang, Magann and Hendrix reviewed the evidence for performing an elective ceasarean or an induction for suspected macrosomia, in their article”Suspicion and treatment of the macrosomic fetus: a review.” they noted that:  “Due to the inaccuracies, among uncomplicated pregnancies suspicion of macrosomia is not an indication for induction or for primary cesarean delivery.”

In 1996, Rouse, Owen, Goldenberg, Cliver, in “The effectiveness and costs of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound” published in JAMA 1996.  estimated that “to prevent one case of permanent brachial plexus injury, 3,700 women with an estimated fetal weight of 4,500 g would need to have an elective cesarean section for suspected macrosomia at a cost of $8.7 million per case prevented.

Hmmm – perhaps that early induction isn’t looking like such a good idea after all? What are your birth options then? READ ON – to see part two – Birthing a Big Baby.

Sarah

Why it’s Good to Stop Saying ‘No’ To Your Toddler

I have just bought a new camera and whilst looking through an old SD card I found this shot of my daughter, taken when I think she was about 14 months old. She had emptied out an entire shelf of my kitchen cupboard, carried it all, bit by bit, into the hallway and then she started to experiment. First she emptied out all of the stock cubes and built a tower with them before unwrapping them and crumbling a few and mixing with a whole pot of dried herbs. Then she emptied the whole pot of salt out on the floor and began to make patterns with the (expensive Denby!) cup, mug and cinnamon jar in the spilt salt. Slightly out of shot is the empty packet of custard powder emptied before the salt and the open packet of pasta that had been crushed/thrown around and discarded. I don’t think she’d started on the vinegar by this point.

Look at how pleased she looks with herself, to my mind she’s thinking “hey I did good mum – look at this pattern I made and I did it all by myself!”

She is child number 4. If this had been child 1, 2 or even 3 the child in question wouldn’t have been smiling and I most certainly wouldn’t have been taking a photo congratulating her on her masterpiece. I would have been cursing, shouting and quite possibly crying and asking why she had done this to me? why did she have to be so naughty? why did she do these things when I was most tired or busy?

…..but by number 4 I had learnt to stop fighting with my toddlers, by no. 4 I had learned to understand them and learnt how wrong I had been with my others. For my daughter wasn’t naughty – she was like any other perfectly normal toddler – inquisitive, eager to learn, enthralled with the world – there was no malice, no selfishness, no lack of empathy, no plotting against me, no bad manners and no feralness – all things I had thought about my previous three for far lesser acts of toddler experimentation!

What did I say to her after taking this photo? “look at the circle shape you made with the salt, it’s nearly time for dinner now – do you want to help me tidy this away and put it back where it should be?”. Why would I tell her off? if anybody did anything wrong here it was me, for underestimating her dexterity at scaling kitchen cupboards!

Further searching through my SD card revealed 3 more pictures of my daughter that wouldn’t have appeared in my albums of children 1, 2 or 3, like the one where she learnt about the sticky consistency of suncream and how it felt cold and wet (and I guess good judging by the amount she put on) when emptied on her skin and turned anything else she emptied it onto white:

Or the time she found my very expensive Estee Lauder lipstick and decided to copy mummy and put on her own make up (on the whole of her face, hands, clothes, wall and mirror):

and my favourite – the summer she discovered how good it felt to pick her nose at the age of  15mths – oh what a love affair she had with her nose that summer – almost every picture of her we took on our holiday that year featured her in deep though, a finger searching every tiny mm of the inside of her nostrils.

What would you tell your toddler if you caught them in any of the shots above? how many times had I reprimanded her brothers for being NORMAL, for being little scientists, for having a healthy appetite for the exploration of their world.

I remember my lightbulb moment well, it was about 5yrs ago, I was walking my then 2yr old son to preschool. I was tired, I was busy, we were late. My son was walking at the speed of a snail and an elderly one at that. The half a mile journey took us around an hour, why? because he stopped to look at *EVERYTHING* we passed – leaves, rubbish, birds, worms, drain covers, broken bits of pavement – it was all fascinating to him. I started off in my impatient adult tone “come on darling, we haven’t got all day, hurry up” and after a while I got it, I hadn’t noticed the fruit on that bush before – who knew we had a wild damson tree close to our house? and that worm, how fascinating it was when it looped and curled around itself, the dew on the leaves sparkling like little gemstones….and I realised how much I was missing as an adult and I realised how fascinating our world really was and how mean of me it was to pull my little boy passed everything he wanted to see/touch/smell/hear telling him to “hurry up”. I realised how utterly frustrating I must have been making life for him. I realised something had to change….

 

So next time you tell your toddler “stop”,  ”no” or “hurry up” – take a little time and ask yourself why?

Sarah

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What Rod? Our Experience of BedSharing to Age 4.

When my firstborn, arrived in 2002 Gina Ford frenzy was in full force. You weren’t a good mother if your baby didn’t sleep through by 12 wks and didnt have a routine you could set your watch by and you especially weren’t a good mum if your baby didn’t self settle to sleep in his black out blinded room.

I wasn’t a good mum.

My NCT class friends were good mums, their babies did what they wanted and what Gina said made them contented. Mine would only sleep at the boob/in my arms. If I put him down he wailed. They were good mums. I had failed.

So we tried controlled crying, I cried as much as my baby did. Then we moved onto Tracey Hogg. She made me feel a bit better, but not much. Every night we would try to get him to self settle, we would hold his hand/stroke his head through the bars of his £1000 handmade walnut cot that meant we couldn’t afford a holiday that year. Then we would slowly sneak out when his eyes closed trying not to creak the floorboard which made him wake and yell if we weren’t still holding his hand.

How I wish I had followed my instincts and let him sleep where he wanted and where I most enjoyed having him….but “good mums” didnt do that, good mums ensured they created confident children by making them independent as soon as possible at night.

My son is now almost a teenager and if he ever reads this will be mortified when I tell you he is desperate to sleep in bed with us as much as possible. He hates sleeping alone, has no confidence, is painfully shy and clingier now than he was as a newborn, when he hugs me I can feel the desperation and need in it still.

…..and then there was my daughter. She arrived 5 years after my first (with 2 more brothers in the middle). Five years of confidence, five years of wisdom, five years of regret. From day one (of her arrival in our own home) she slept in my arms. I gave her as much of me as she wanted and she I.

When she was 3 months we had her Christened. My Godmother rocked her to sleep whilst I fed and watered our guests. I bumped into her cradling my baby at the bottom of my stairs looking perplexed “where’s her cot” she asked me. I smiled. “She doesn’t have one”. “but where does she sleep?”………”with me”………”oh”. The silence spoke volumes. I knew what it meant……………

For 4 years 1 month and 14 days my daughter slept in my arms….and then it happened. One night she was fidgeting so much I couldn’t sleep. So I asked her to please keep still in our bed and suggested if she didn’t want to she could sleep in her bed (she has always had a bedroom and a bed that remained unslept in). It was 1am. She got up said “OK mummy” – walked across our hallway in the pitch black, got into her bed, pulled up the duvet and went to sleep.

The next night she announced “I want to sleep in my room tonight”. She took herself up, found her PJs and changed into them by herself and got into bed “reading” a book. I popped in to check and ask if she wanted me to read the story to her “no” she said, I asked if she was sure she wanted to sleep in her room “yes” she said. I asked if she wanted a hug “no” she said “but I want a kiss”. We kissed, said our “I love yous and God blesses”. She turned off her lamp and I left. With a tear in my eye.

She has spent every night since in her own bed. Our co-sleeping journey is over, a bittersweet ending of pride and letting go. How I miss her warm, small, soft body curled into mine. She gave me a gift  in those 4yrs of joy and I gave her one in return. The gift of true confidence and independence.

The NEWLY UPDATED Gentle Sleep Book – out now! If you would like to understand and learn how to improve your baby, toddler, or pre-schooler’s sleep WITHOUT cry-based conventional sleep training, this is the book for you!
sleepbook-1

Sarah

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Motherless Mothers – Mothering Without a Mother Figure

I am a motherless mother.

My mother died from breast cancer when  I was 21 and she 52 , 5 years before my firstborn child arrived. My journey as a mother has been bittersweet, I have loved finding a new dimension to myself,  I have loved viewing life with new eyes but I realise now how much I have lost, for it is only now I realise the true depth of feelings my mother had towards me, how much of herself she sacrificed for me and I wish I could say “thank you”.

I wish I could ask her about my birth, I wish I could ask her how I was fed, I wish I could ask her what I was like as a baby, what she enjoyed the most and what she found the hardest. I wish I could share her wisdom, I wish I could share her stories. I wish she could meet my daughter (and of course my sons) and pass down that feminine knowledge another generation. Although I often say I now feel complete since having children,  in many ways I feel far less than a whole, I am a mother now, a wife, a friend and more, but I am no longer a child to anybody (my father died 3yrs after my mother) and only now do I realise the importance of that dynamic and the sharing of parenting wisdom through generations. I guess the saying is often true “you don’t realise what you had until it’s gone”.

Please let me add here though, I am not writing this post for pity –  do not need any, I had 21 years of wonderful closeness and I know I am lucky. I am also not writing this to be about me. I am writing because I realise now how society has lost value in mothers, how we have lost value in Grandmothers, in great grandmothers and in those feminine feet who walked in our footsteps before us, how we have lost value in female knowledge and the family in the raising of a child. Our society now is so masculine, so materialistic, so authoritarian. We have lost our way, we *need* a maternal influence, whatever our age, whoever we are.

I realise that many mothers may feel too that they are motherless in a way, even though their parents still remain alive, as I have said already, I feel incredibly lucky for the close relationship I had with mine when she was still here, I had 21yrs of closeness  and sharing with her, some I know spend their whole life seeking that closeness from a mother, still alive, who is for some reason or other unable to give it.  I have often seriously thought about “adopting a granny” for my children, an older, wiser feminine influence. I feel too their life is not wholely complete without one.

I’m sure many of you have read “The Red Tent” and thought wistfully of a society so masculine and blood thirsty and yet quietly run and steered by a deep feminine and maternal presence. Of such sisterhood and understanding and acceptance. How do we return to this ethos? how do we once again hold the matriarchs dear and close at the head of society? much like this:

The Jamaican matriarch is the center of our society. Women here have long been leaders in their homes, churches, and communities – and now they are becoming the engineers, computer programmers, architects and, yes, prime ministers of our future. It is the natural next step.

~Mercedes Dean

Think how different society could be if we truly valued motherhood once again? think how different our own experiences of parenting could be if we returned to a time with tribal matriarchs, whether they share our DNA or not, who could support a new mother through her own transition. I think in many ways being motherless is what has steered me on my path, in many ways I do act in a maternal way towards new mothers who attend my classes, by passing on what I lack helps me to feel whole and I hope helps them too.

In many ways today in our society we are all “motherless”.

I do hope I live to see the day that it changes, the day modern society realises what they have lost from their past in their quest for the future.

Sarah

Why do Mothers Judge Each Other?

Bear with me, this is going to be a bit of a ramble,  I’m not quite sure what I want to say – or how to say it and I certainly don’t have any stats or science to back me up here, but this has been bothering me an awful lot lately.

Why do mothers judge other mothers?

and no, I didn’t say ‘Why are mothers judged’ – that’s a whole other blog post!

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I bet some of you are thinking “but I don’t judge other mothers”, but honestly, I think *all* mothers judge other mothers in some ways, some far less consciously and far less vocally than others, but I truly don’t think there is a mother out there who has never judged another – why? because I think it’s a vital part of becoming a mother, of learning about ourselves, testing our mothering skills and hopefully, ultimately, gaining confidence in ourselves.

Judgement

noun

1 [mass noun] the ability to make considered decisions or come to sensible conclusions

I know I have judged other mothers, but when I really think about who I’ve judged, the who doesn’t really matter – when I think about the why, now that gives me answers.

Why did I judge that mother when she trained her baby to sleep through the night? (answer: because I didn’t feel secure in my decision not to do it even though I wasn’t happy with my baby’s sleep and the hour it took us to get him to sleep at night, because her baby *did* genuinely seem more ‘contented’ than mine).

Why did I judge that mother who breastfed a one year old, surely that was weird and must be more about her than her baby’s needs? (answer: because I gave up breastfeeding at 6months and everytime I saw her feed, as well as the small intake of breath at the oddness of it I felt a stab of regret that I wasn’t still doing it and that her baby was benefitting from her milk in ways mine never would from his ‘follow on’ milk).

Why did I judge that mother who breastfed until 6mths? (answer: because I breastfed a four year old and there was a small part of me that wasn’t strong enough to cope with the dirty looks, the clearing rooms and the ‘shouldn’t you have stopped that ages ago’ comments – *should* I have stopped it ages ago? maybe they were right, maybe it was all about ME and not my daughter).

Why did I judge that mother with her forward facing pram, chatting away to her friend and ignoring her baby? (answer: because I was uncomfortable in the sling, my son was crying and I felt like crying too, struggling with my bags of shopping and wishing I had a buggy to hang the bags from).

Why did I judge the mother whose baby slept in his own cot in his own room from 12 weeks? (answer: because  I was desperate for a night’s sleep without a foot in my back laying on the meagre 5 inches of mattess that was left for me, wondering when my daughter would ever decide to leave our bed).

Why did I judge the mother who dieted and regularly visited the gym when her baby was only 6 weeks old? (answer: because I felt self conscious about my body and my appearance).

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“Criticism of others is thus an oblique form of self-commendation. We think we make the picture hang straight on our wall by telling our neighbors that all his pictures are crooked.”  Fulton. J. Sheen.

Why did I judge? because I was insecure.

Why did I judge? because I was not truly confident in my decisions

Why did I judge? because in a way that judgement was self talk, self directed, a maternal hypothesis you might say. I was weighing up the issue, trying to decide which way to fall, which path to take.

“People hasten to judge in order not to be judged themselves.”  Albert Camus.

Judging others helped me to test my maternal hypotheses, judging others helped me to feel confident with my choices, judging others helped me to be secure – judging others was ALL about me. The judgement was never about the other mothers, it was all about me and the more upset I got at others? well actually the more whatever they were doing unsettled me and the true issues were with myself. The more I think about it though, the more I think that this judgement is a necessary part of the adjustment to motherhood. I’m not condoning judging out loud – far from it, ideally it will all be internal chatter only.

What do you think?

Sarah

How to Create a BirthFriendly Calm Birth Environment – Wherever You Are!

I am a huge homebirth advocate, all of my children were planned homebirths (only 2 of the 4 were actually born at home though – that’s a whole other blog post!), but the more I work in the birth field the more I am becoming convinced that it is not the actual *place* of birth that matters. It’s *what* and *who* is in the place that has the strongest influence. I have been at some homebirths that felt anything but relaxed and ‘homely’ and I have been at some hospital births that have been amazingly relaxed.

Whenever I work with a couple antenatally I always suggest they put a lot of time and effort into planning their birth environment as much as possible and most importantly they focus on a portable birth environment, no matter where they are planning to have their baby, because we all know what happens to the best laid plans……homebirth transfers, midwife shortages, birth centre closure….sadly none of these are uncommon. The following is a list of multi sensory tips that I discuss with expectant couples with the hopes that they can birth in the calmest environment possible, wherever the physical location may be.

1. Think about Lighting – Sight

Hardly any rooms (home or hospital) have truly oxytocin/melatonin friendly lighting. Bright light is a huge inhibitor of labour progress, hence why most women prefer a dimly lit environment to birth in, the light source too is nearly always natural: sunlight, moonlight, starlight, firelight, candlelight…How best then to replicate this ambience in a room with bright electric ceiling lights and nothing else? and often a room where you are unable to light candles (compressed gas!) or plug in lamps to the mains. I am a huge fan of battery operated fairy lights and LED candles. I have a huge selection of battery operated lights in my doula bag, the majority of them came from cheap pound shops, my favourite though are my colour changing tea lights, bought from Amazon about 5 years ago they’re still going strong after numerous births and no battery changes! dotted around the birthing room they create a beautiful relaxing vibe. To add a little more light I use a Wonderbulb on the floor in the corner of the room (underneath a chair to diffuse the light). The combination of the wonderbulb and tealights gives just enough light to a room at nighttime. I also have some waterproof colour changing spa lights which are great stuck onto the side of a birthing pool, gently lighting the water in rainbow colours.

For daytime births I always suggest mums pack a pair of big sunglasses, which have 2 uses 1) sheilding the mum from bright daylight if the room she is in has inadequate blinds/curtains and 2) giving the mum much needed privacy due to the lack of eye contact.

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To me, lighting is the most important part of the birthing environment, it can have such a big impact on the mum’s oxytocin levels and is so easy to rectify!

2. Think about Scent – Smell

Our sense of smell is our sense most closely related to our memory. This can work either for or against us. The smell of medical equipment, the smell of antiseptic, the smell of hospitals, the smell of latex gloves……can all bring up unpleasant feelings for us, most often triggering the release of adrenaline (which in turn can slow labour and increase pain levels). Whereas the smell of nature – plants, flowers, the ocean, the smell of our home, the smell of chocolate, vanilla, baking cakes….can all encourage us to relax and feel good. I find the easiest way to scent a room during labour is to use aromatherapy oils. I always suggest mums to be ignore advice for ‘good oils to use during labour’ and instead go to a shop selling a large array of oils and find a smell that reasonates with them. For the mums I have worked with this has ranged from vanilla to orange oil and frankincense to lavender, it’s rare that mums pick the same scents, though lavender and clary sage do crop up lots (interestingly both on the ‘recommended for labour’ list!). The important thing then is to use that oil, build up a connection with it (check it’s safe to use during pregnancy!), use it whenever you relax: in the bath, when you go to sleep, during a massage….and really build up that conditioning. So many forget the importance of this, expecting a ‘labour oil blend’ to work magic on the day, the real magic though comes from the conditioning of the oil before labour!

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The best way I have found of scenting a room during labour (bearing in mind you need to avoid naked flames in hospital!) is to use a battery operated aromatherapy diffuser such as this aromafan – which really is as good as using an oil burner, I have had my trusty fan for many years now and it has served me well at many births – with massive impact for little outlay. After birth it’s also great to use to help children fall to sleep at night and particularly when they have a cold or stuffy nose (with ravensara oil for little ones).

3. Think about Music – Sound

Lots of mums to be make a ‘labour playlist’ containing their favourite songs. It’s amazing how many of these songs however are fast paced. Ideally the perfect labour soundtrack will be composed of 60-70 beats per minute (BPM) – the same as a healthy resting pulse rate – which can help the brain enter into a relaxed state, also known as ‘alpha state’. It is possible to purchase special ‘alpha music’ – such as that by famous composer John Levine.

ImageAgain – just like the smell section above this music needs to be conditioned, spend some quiet time each day relaxing with your music, condition it to relaxation and slow breathing, if you have a massage, facial or reflexology take it along with you and ask the therapist to play it whilst you relax. On the day a well conditioned piece of alpha music can have strong relaxation results, even better if you pack some headphones to drown out external noise too!

4. Think about tactile objects – Touch

Not just touch from another person, here light stroking can often be more beneficial than a heavier massage, the sort of stroking we are so familiar with and is already deeply conditioned with relaxation and often heavily conditioned to calming from our own mother, but think about anything else that may be touching your skin. My whole family are like Linus from Snoopy with his favourite blanket – we love to curl up on the sofa with our soft throws and blankets. My youngest son and I each have a fake fur throw that instantly relax us, whereas my daughter loves her knitted baby blanket. Also – my own pillow means instant relaxation to me, taking my throw and my own pillow into hospital with me massively helped me to relax and has done for many of the mums I have supported during labour.

The last point I would like to add here is that of water. Much is written about waterbirth, but the other benefits of water are less so: showers aimed on the back of a labouring mum, a water feature gurgling away in the background, a deep bath (even better with some waterproof spa lights – see above!) – all of these can have powerful effects even if access to a birth pool is not available!

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5. Think about Food and Drink – Taste


I always suggest couples pack a labour feast, not just to munch on during labour (if they feel like eating), but for afterwards too instead of the obligatory toast! I think it’s really important here to remember the birth partner, what is he or she going to eat and drink? and where is it going to come from? if it’s to be purchased on the day it means the mum is going to have to be left, or more often it means the partner goes without as they don’t want to leave the mum. I always suggest partners pack themselves lots of (not loud crunchy or smelly!) food and drink as well as packing snacks for the mum.

On this note it’s really important that the birth partner thinks about all of the above too, what will he or she do to stay comfortable? what will he or she do to stay relaxed? what will he or she do to not get bored? This last one is vital! I have seen too many bored dads pacing the floor and asking “how much longer?”!! So always suggest partners may like to pack newspapers/magazines and yes – even games consoles/laptops and IPhones to play games on!

I hope this list helps you to prepare for your birth, always remember you can control most environments and make them as birth friendly as possible, whatever and wherever your original plans – it is always possible to retain some control over your birth environment.

Do let me know any tips you have for creating a good portable birth environments! Happy BIRTHday!

Sarah