Pregnancy diary: week 38 – midwife appointment and antenatal class 3

And I’m still sitting here with a bump! I usually at least start writing this weekly post quite early in the week, as I can’t always guarantee how long I’ll get to write during Andrew’s nap later in the week, especially when I was at work and only had 3 afternoon naptimes a week. But this week I was less motivated to do that, just in case baby did decide to arrive early and it would have been a waste of time. But as there are no signs yet, I’ll give you a round-up of this week.

The worst part has been having a nasty cough, which Tom kindly passed to me after he caught it most probably at work (where the students all traipse into his office bringing in their start of term germs). It’s very frustrating not being able to take any medicine for it, particularly at night when I’d love to take something that would knock me out and make me sleep through the constant coughing. Overall in this pregnancy I’ve only had 2 cold-/cough-type ailments, which actually isn’t that bad – I remember getting about 5 when I was pregnant with Andrew, probably because my job involved being out in schools every day back then, wheres this year it’s been mainly office-based. I’ve been hoping that baby wouldn’t arrive until I’m over the cough, and I’ve been wondering whether there is some kind of internal mechanism in a pregnant body that prevents labour from starting if there’s any kind of illness present?! It would be nice to think so, but I have no idea whether this is the case.

The best part has been spending time (hours of it, mainly during nap times and some in evenings) finally making decisions on which cloth nappies to buy and where to buy them from. I’ve written about this in a separate post, to spare you all the info if you’re not into cloth nappies (unlike me – I’m hooked!), which I’ll publish when the ordered nappies arrive and I can take pictures of my lovely new acquisitions.

Apparently this bump still looks quite small for 38 weeks according to lots of people I meet who can't believe there's only just over a week until due date!

The more practical parts of this week have been my midwife appointment and third (final) antenatal class. The midwife appointment went well and overall things are fine with baby and me. My blood pressure was fine, my wee had no signs of protein, and I have no swelling of hands and feed (unlike when I was pregnant with Andrew and my wedding ring was getting tighter by now). Bump is still measuring bang on the average line of growth, and baby’s heartbeat is clear and a good fast speed. The only thing that wasn’t so good to hear was the dreaded phrase ‘back-to-back’! At my last appointment 2 weeks ago, the midwife said that baby was half-way between being front-to-back and back-to-back. She suggested some positions and movements that I could do to try and get baby in a front-to-back position, and I have been trying to do these when I can.

What’s the problem with back-to-back anyway? The so-called ‘occipital posterior’ position (or OP that’s now been recorded in my maternity notes) means baby’s back is facing my back, and this can lead to longer and more painful labour than if baby’s back is facing forwards to mum’s tummy. Having said that, it’s a generalisation, and I don’t think Andrew was in a completely ‘front-to-back’ position (the ideal) when the midwife came round for my 40 week appointment and said I was already about 3cm dilated, and he still managed to turn and be born after only 3 hours of real labour. It’s interesting when I look back and think that my instinctual desire during labour was to be on all fours – I’d heard about this position at yoga classes, but when it came to labour my body just automatically stayed in that position the whole time, I didn’t even need to think about it, it just happened! I wonder now whether that was my body’s natural way of encouraging baby to turn into a favourable position for birth. I’ll never know, but I find it fascinating how ‘animal’ labour was for me.

For now, my task is to try and get this baby to turn before I actually go into labour, to hopefully reduce the time it takes for baby to get into position during labour. This means crawling around on all fours, which can easily be incorporated into play time with Andrew who finds it hilarious, sitting backwards on hard dining chairs (leaning onto the back) instead of slumping on the sofa, kneeling on the bean bag, rolling my hips around whilst on all fours, and swimming on my front. Given how much this baby moves, it’s perfectly possible that he/she will move into front-to-back, side-to-back and back-to-back positions quite regularly on a daily basis over however long he/she has left in there. Various people who I have heard from since my appointment have told of different experiences with a back-to-back baby, some slow, some fast, some complicated, some uncomplicated, and some have even said that there baby turned into the back-to-back position during labour, despite being well positioned prior to labour, so there really is no telling what could happen. If I did have a slower labour, it might mean we actually make it to hospital rather than it happening extremely quickly at home. I do also feel as though my general level of fitness from all the walking and swimming I do will stand me in good stead for a straightforward labour, as the midwives commented on how fit I seemed, in looks and behaviour, when I gave birth to Andrew. So my overall feeling at the moment is that I would like to try my best to encourage baby to be in a good position for the start of labour, but at the end of the day, labour can be unpredictable and there’s nothing I can do about that.

Talking of labour, I’m glad that I managed to get along to the third and final antenatal class before going into labour. This class was also for the dads, so it was nice for Tom to come too and refresh his mind on supporting me during labour, birth and the early days with a baby, as well as meet some other dads who will be going through a similar experience. First we split into a mums group and a dads group; we talked about how we would like to be supported in labour, and the dads discussed how they thought they could best support us in labour – we then compared lists of points we came up with and the two groups’ lists matched pretty well.

Next, the dads had a run through what happens in labour with the teacher, to revise this like we did last week, and they also got a demonstration of various ways to wear the baby in a sling (as the teacher is a babywearing consultant). I thought it was a good idea to try and get dads interested in this, and Tom has said that I must show him how to use our new sling. Meanwhile, us mums were discussing strategies for looking after a toddler and a newborn once paternity leave is over and we ‘go solo’ with two little ones (eek!) This was a really useful exercise to share ideas, learning from others in the group as well as inputting our own ideas. Various things were suggested, but one of the main things we all thought of was that we are going to go out to groups and activities a lot earlier than we did with our first, so that the toddler is entertained whilst we can sit and feed the baby and rest a little. We also agreed that we would meet up as a group as much as possible, alternating which house we go to, so that our toddlers can play together and we can share with each other how hard things are. I feel very blessed compared to most others in the group that we’ll have quite a bit of help from family who aren’t too far away.

Then we split into small groups and discussed ways of helping to introduce smoothly a new baby to our toddlers, as well as thinking about potential issues of sibling rivalry and ways to deal with that. I found this very useful, and I feel more prepared for if and when problems arise that I need to deal with coherently. We’re still hoping that with a small age gap and that fact that Andrew is generally a very easy-going child, we won’t have too many issues, but it’s always hard to predict something like this and he may well surprise us.

Finally we came back together as a big group and went through some breathing exercises. These were one of the things that I specifically asked to cover in the class, because I’m sure my breathing in labour with Andrew was one of the reasons, along with being in the pool, that I didn’t need any pain relief drugs at all, not even gas and air. I found the handout from the birth preparation workshop we went to just before Andrew was born, and I’ve been practising the breathing techniques described on there, but it’s always good to go through these with an expert in person (the teacher is also a yoga teacher). I particularly liked the visualisation whilst breathing technique – when a contraction comes, imagine you’re on a walk up a hill, which starts off quite easy, then gets harder and harder as it gets steeper and rockier and you have to scramble up on all fours, but you finally get to the top and the view is worth the effort. I may well use this if I find it helps in labour.

As we were getting ready to leave, we talked about meeting up and one of the mums volunteered to send an email suggesting a date soon, as I’m due any day and there’s another mum who has a planned c-section date not long after my due date. It would be great to meet up and get to know each other even more than the time in the classes allowed. I’m so glad that this aspect of the classes has worked out, as that was my main reason for doing them. Who knows, maybe the dads will also have a get together or two – I’m sure they’ll be looking for ways to entertain the toddlers at weekends when they are in charge to give mummy some time with just the baby.

Having typed this kneeling upright on the beanbag, I’d better get back to some crawling and hip circling. Maybe I’ll be back next week with news of week 39 of pregnancy…. or maybe I won’t. Watch this space 🙂

Pregnancy diary: week 35 – birth plan

As yesterday was my last day at work (I’ll come back to that in a mo….), all of a sudden giving birth seems like a much more imminent event! So I thought it was about time that I write my ‘birth plan’. I thought I’d saved a copy of my birth plan for Andrew’s birth, but I have a feeling I didn’t back it up to the server (unusual for me, Little Miss Paranoid Doer of Back-ups) and annoyingly my laptop hard-drive died a few days after Andrew was born. The birth plan must be forever lost in an irretrievable gobble-ti-gook of 1s and 0s. But nevermind. I managed to find a great resource on the NHS choices website, which runs through the various points you might like to include in a birth plan. It even lets you save an online version of a birth plan that you create by ticking various multiple choice option boxes and then printing off a PDF, but I found this a little restrictive and preferred to write my own using ideas from the website.

Not much to say this week, other than it's a bump!

I’m not a massive fan of the word ‘plan’ in this context, because I don’t think labour and delivery are really things that you can ‘plan’ in the sense that I normally plan things (like what I’m doing next Monday morning at 10am, or when we will go on holiday next year, or what we’ll eat for dinner tonight, for example). Yes I have an image of what would be an ‘ideal’ birth, and actually I came pretty close to this with Andrew (lose the vomiting after the syntocinon injection and it would have been perfect), but I’m not so naive to think that there is no possibility of complications that might cause my ‘ideal’ birth to fly out the maternity hospital window. I’m optimistic that, given previous experience, the birth will go smoothly, but realistic that I have no control over the fact that it might not.

I remember when I came to write my birth plan for having Andrew that I didn’t know where to start. Although I had some ideas about what I wanted and didn’t want, I also had no idea how I would react to and cope with the pain once I was in labour, having never experienced anything like it before. So most of my points were couched in a ‘I’d like it to be as natural as possible but if I scream for drugs then please give them to me’ kind of tone. This time, of course, I know what it’s like, so I found it easier to write down what I hope for, complications and long duration notwithstanding.

This sets the scene for my birth plan, which I’ve set out below. I will print this out and keep it with my maternity notes, so that whichever midwife gets the job of helping us through labour will see it when she looks at my notes – this worked well last time, and she was keen to read what I’d written before doing much else with me. I’ve probably forgotten some important points, so if you think of anything I might like to mention, I’m all ears. Next week I have another midwife appointment, so I might have chance to go through it with her too, particularly as she’s coming to look at the flat in case of home birth necessity!

Ruth Cumming’s birth plan

This is not so much of a ‘plan’, because I’m not sure you can really ‘plan’ labour and birth, but rather it’s a list of things that I would like and not like to happen, if at all possible.

Location

My preferred place of birth is in the Rosie Birth Centre, because I had my son at the former MLBU, and I liked the relaxed atmosphere and received excellent care from the midwives, who helped me but did not take over.

However, if baby comes even faster than my son did (which was pretty fast), I may decide that I’d rather stay at home, because I’d rather not risk being in advanced labour in the car – I’d rather have a ‘home birth’ than a ‘car birth’!

Of course if there are complications, I understand that going up to the delivery unit in the main Rosie hospital would be necessary.

My birth partner is Tom, my husband, and I would like him with me at all times during labour, no matter what happens.

Labour and delivery

I would like to be in a birth pool during active labour (another reason for choosing the Birth Centre); this helped me a lot for my first labour.

If possible I would like to deliver the baby in the water. Last time the midwife could tell that being in the water was relaxing me too much and she was concerned that I wasn’t pushing as hard as I could during the final stage in there, so she suggested I got out for delivery. She was right, because I gave birth within minutes of getting out, as I pushed much harder ‘on land’. If this happens again, I’m not against getting out of the water if necessary, but would rather have a water birth if possible.

Last time I used a birthing stool for the final pushes – this worked well and I would like it again if ‘on land’.

I am happy for baby’s heartbeat to be monitored like it was last time – with a detached probe device every now and then, i.e. I’m not constantly hooked up to a machine so I can move around freely.

I will move around during labour before the pool is ready, and get into positions that I find most comfortable at each point. This could include getting on all fours (possibly on the bed) and walking around. But I hope to spend most of the time in the pool.

I hope to deliver in the water, squatting or upright in some other way, or if I’m on land, squatting on a birthing stool worked well last time. I do not want to be on my back, lying down or completely horizontal in any way.

If I am in the water for delivery, I would like to pick baby up myself from the water, and sit there skin to skin for a while until I feel I’d like to get out.

If I am on land for delivery, baby should be delivered straight onto my tummy, without being cleaned, so that we can have skin to skin time. This worked well for my son, and he latched on for a breastfeed almost straight away. I would like this to happen again if possible.

I would like the midwife to cut the cord (Tom is not particularly keen to do this).

I do not mind if there are trainee midwives in the room.

Possible drugs/interventions

For pain relief, I would like to try and use just natural methodsbreathing, movements, and the water of the pool. This worked for my first labour and I didn’t need any drugs.

However, if labour goes on for a lot longer than my first labour, I may decide on other pain relief methods. Gas and air would be my first choice. I didn’t find a TENS machine helpful last time, so I won’t try it again.

I would prefer not to have an epidural, but I can see that if I’ve been in pain for several hours and I’m exhausted, that this would be something I would consider and would want to be given if I decided on having it.

I had a 2nd degree tear with my son, so I’m prepared that this might happen again. I’d rather not have an episiotomy if at all possible, but would consider it if the midwife thinks it is necessary if baby was in trouble.

I would rather not have an assisted delivery with forceps or ventuose. But if baby was in trouble and therefore it was advisable to have these interventions, I would consider them.

After my son was born I opted to have the syntocinon injection, but in a reaction to this drug I vomited several times and felt nauseous for about 6 hours after the birth. I would rather not have the syntocinon injection this time, but if the midwife thinks it is necessary because I am bleeding a lot (and I know I’ve had a slightly low platelet count that might not help the situation), I am prepared to have the injection. I would like Tom to be able to stay for as long as possible after the birth this time if I am feeling sick.

I would like my baby to have the vitamin K injection or oral drops.

Breastfeeding

I am going to breastfeed and this is extremely important to me. I struggled with breastfeeding my son in the early weeks, but eventually got on track with it and have continued to feed him until now – I plan to tandem breastfeed if he still wants to continue after the baby’s birth.

So I would like my baby to stay close to me at all times and not be swaddled – I would like to remain in skin to skin contact for several hours after the birth, so that baby can feed off and on whilst lying on me.

If complications arise and I need to be separated from him/her, I would like Tom to be able to have skin to skin with baby whilst I am out of action. I would like baby to be brought to me as soon as possible if we are separated, and have help with positioning baby on me for feeding if I am in pain from a difficult delivery (e.g. c-section).