An A-Z Guide to Preparing for Baby (Part 1; A-M)

A is for Antenatal Preparation

The word Antenatal is an adjective referring to the period before birth or relating to pregnancy.

Congratulations! You are pregnant…

What next?

So, once you have got used to the idea, you will probably want to start planning, preparing & learning more about this tiny little miracle, growing inside of you...

Like many, you may start with - Books:

There are MANY books available to advise & guide you along your pregnancy journey & its

important to do your research & understand the authors level of expertise - Who are they & what makes them an expert!? (Is there work opinion based or does it have a good well researched & evidence based background?) 

Writers who use evidence based, up-to-date research with the aim to empower you with information to enable you to make your own informed decisions & understand all the options & choices you must make, will serve you best.

Here are a few suggestions to get you started:

Informed Is Best, by Amy Brown

Ina Mays Guide to Childbirth, by Ina May Gaskin

Let’s Talk About Preparing for Your Baby’s Birth, by Jackie Kietz

Your No Guilt Pregnancy Plan, by Rebecca Schiller

Nurture, by Erica Chidi Cohen

Gentle Birth, Gentle Mothering, by Dr. Sarah Buckley

Birth Without Fear, by January Harse

Babies are not Pizzas, by Rebecca Dekker

And for the guys - Men, Love & Birth, by Mark Harris (who also has an awesome online course called, birthing4blokes worth checking out too)

There are a whole host of antenatal preparation classes, workshops & education available both for free & paid-for. The NHS usually offer a few free antenatal sessions in the 3rd trimester covering such topics as, pain relief for labour, breastfeeding, & suggestions for ways your birth partner might support you, etc... Although very thorough & informative at some hospital trusts, they can also be quite hit miss at others. To find out what is available in your area, check out your local hospital website &/or social media & ask your midwife.

You can also get paid for education, information & support from other antenatal providers such as Private & Independent midwives, doulas & other birth workers both in-person, digitally & remotely. Word of mouth is a great way to find out what is available where, with whom & if it’s worthwhile.

To find Doula near you try – www.doula.org.uk

To find an Independent/Private Midwife near you try – www.imuk.org.uk or www.privatemidwives.com

You might want to do a class or course with your partner or one that is just for mothers or the birthing person. You might want to do a group class/course where you can meet other expectant parents & start to build a community of support. You might want a class that incorporates movement, exercise or relaxation such as a pregnancy yoga, dance or Pilates class... And do not forget about the benefits of learning breathing & hypnobirthing techniques too!

We are VERY lucky in the Solent area to have a wide variety of quality antenatal classes, courses & workshops - as well as investigating the benefits of working with a Doula, I would also recommend checking out; The Daisy Foundation Birthing classes & Parent Workshops, The local NCT, Hypnobirthing, Yoga & Pilates classes with local providers too. (See my “Local Support” page for links to other local practitioners)

 

B is for Birth

Birth (noun) the emergence of a baby from the body of the mother or other birthing person. The start of life as a physically separate being.

(verb) To give birth to a baby.

When you first get pregnant the actual birth can feel like a lifetime away, but it's amazing how quickly time can pass & there are many decisions to be made about how, where, with whom & possibly even when you might have baby! 

If you have signed up for some form of antenatal education or are working with a doula this can help support, you in finding out what all your various options are with evidence based information so you can make the right informed choices for YOU & YOUR baby.

Things to consider:

Where would you like to give birth?

At home, in a Midwifery Led Unit, at Hospital on an Obstetric Led ward?

The decision really is YOURS!

Your Health Care Professionals may make their own recommendations, & you should always ensure you have access to all the relevant information so you can make the right informed decision for YOU.

But... it can be just as safe to birth at home for a first time mum, a VBAC or even a vaginal breech birth, as anywhere else. It is about stacking the odds in your favour. Do your research, speak to your Doula, Antenatal Teacher, Midwife, Consultant, etc... & keep asking questions until you find the answers you need.

You may wish to check out my birthplace app on your phone which will show you you're local options - you may have the choice of more than one hospital trust, however if you may think you'd like to birth at home, you will need to ensure you are registered with the Trust that covers your geographical location. (E.g., to homebirth in the Fareham area you need to be registered with Queen Alexandra Hospital, Portsmouth. However, if birthing in hospital, you could choose from QA, Portsmouth Maternity Centre (PMC), Blake in Gosport, Princess Ann Hospital in Southampton or even the New Forest Birth Centre)

If you're interested in homebirth, you may find the Homebirth support group UK on Facebook & Instagram a good follow & there is a great (short) book called Why Homebirth Matters from Pinter And Martin publishers.  

Who would you like to support you during labour & birth?

Under "normal" circumstances it is usual for hospitals to allow 2 birth partners. This could be your husband, wife, life partner, baby’s Dad, your Dad, your Mum or Mother-in-law, a sister, friend or doula... whoever, you think will be the right person/people to support you during your birth. During the Covid-19 pandemic many hospitals have had restrictions in place, meaning you can only be supported by 1 birth partner - however, these should be beginning to be lifted now & if you are particularly high-risk, disabled, are under the perinatal mental health team (known as the Daisy Team at QA hospital) or just really feel you need that additional support person, please do discuss this with your Midwife &/or Consultant Midwife as they can help ensure you get the support you need when you need it.

Of course, if you choose a homebirth you are in control of who is allowed into your home, so you can have as few or as many birth partners as you wish!* It is also possible to have any older children present at your birth too, so they can be a part of welcoming their sibling(s) into the world. This is more common at a homebirth, but not unheard of at hospital births - this is something you may wish to discuss with your Doula &/or Midwife.

(*again, during the pandemic your homebirth team or hospital trust may recommend restricting the number of people present in the birthing room &/or who have contact with the midwives. However, if they normally live with you or have been self-isolating to be with you this may change things, but ultimately it is your home & your choice.)

How would you like to give birth?

What I mean is - would you like a water birth or a land birth? What position might you give birth in? On all 4's, laid on your side, squatting, a supported squat, on a CUB or birthing stool...? (Ideally NOT flat on your back with your legs in the air, as this will make things MUCH more difficult!)

Do you want to use movement, yoga, breathing or hypnobirthing techniques to help you give birth? Are you hoping to give birth as naturally as possible, or would you rather have a medicated birth?

Is your birth likely to be Induced?

Induction is the process of stimulating contractions before labour begins (naturally), to try to achieve a vaginal birth. This can be recommended for various reasons, but primarily should only happen if there is concern for a mothers or baby’s health.

It is completely possible to plan for & achieve a positive induction - however, much like

spontaneous birth, induction can be unpredictable & there is an increased risk of further interventions, which can ultimately lead to an assisted birth (the use of a ventouse or forceps to help birth baby vaginally) or caesarean birth. 

Again, there are books available to help inform you – Why Induction Matters, The Aims Guide To Induction of Labour & Inducing Labour: Making Informed Decisions.

Will you have a Caesarean Birth?

This is a surgical procedure, whereby baby is born through an incision in the abdomen, often because vaginal birth is considered dangerous for either mother &/or baby. This may be known & planned for in advance, such as with a medical condition called placenta previa, where the placenta is lying across the cervix blocking the entrance to the birth canal OR as an emergency where for example, baby has become distressed & needs to be born quickly.

Some people choose to opt for an elective caesarean - they may have experienced a traumatic previous birth which they wish to avoid next time, or they may have had a previous caesarean & wish to birth this way again. Check out – Why Caesarean Matters.

Whatever you decided, know that you always have options. There may be lots of discussion about “risks”, so try to ensure you & your health care professionals discuss YOUR individual risk factors, not just the statistical risk factors for certain population groups.... But - we will have more about this when we get to other letters of the alphabet! (M is for Midwife, O is for Obstetrician & Q is for Questions, etc...)

C is for Colostrum - a.k.a: Liquid Gold

(noun) the first secretion from the mammary glands after giving birth, rich in antibodies.

Colostrum is the thick, sticky, golden first milk produced by your body for your baby. It is said that the body can start producing colostrum as early as 16wks pregnant, although it is more common towards the end of pregnancy, in the third trimester. You may notice small droplets appearing on your nipples or just find that you have damp patches on your clothing or bedding. However, some people experience no leaking antenatally at all - this is not an indication of how "easy" or successful breastfeeding will be, so no need to panic!

Top Facts about Colostrum:

🟠 It is very concentrated (so a small amount is very powerful) & full of proteins, carbohydrates, vitamins & antibodies

🟠 It contains high volumes of white-blood cells & immune-boosting properties

🟠 The high concentration of colostrum, means new-borns receive all the nutrients they need in a small volume of milk. Their tummies are tiny at this

stage (about the size of a marble)

🟠 Colostrum also acts as a laxative, stimulating the body to produce your baby's first poo which is called meconium. All new-borns have this very dark stool and it is usually all passed within 24hours of birth

🟠 In the first 2-5 days after birth, your body will produce only colostrum. When the baby feeds regularly, this process stimulates the alveoli (within the breast tissue) and increases your milk supply. Eventually the colostrum will be replaced by more mature milk.

You may want to consider offering baby your colostrum, even if you are not planning on breast or chest feeding, or if you end up supplementing later.

If drugs were used during labour and birth or if you had an epidural, this can make baby lethargic and make immediate nursing trickier. If your baby cannot nurse right away for whatever reason, you can always express by hand and spoon, cup, syringe or finger feed baby. The benefits are well worth it!

What is antenatal hand expression?

This technique involves expressing colostrum during the final few weeks of pregnancy. It can also be referred to as colostrum harvesting and is advocated by some NHS Trusts. It is usually recommended to wait until at least 36wks gestation (as nipple stimulation has been known to induce contractions in some pregnant people)

If you or baby have a known medical condition which may mean you are separated from one another after birth, you are having a planned caesarean birth or induction of labour, you are having twins or other multiples, or you suspect the baby’s first feed might be delayed or baby may struggle to maintain their blood sugar levels, e.g. where the mother or other birthing person has gestational diabetes - then these are the types of situations when you may be encouraged to express colostrum antenatally, in order to better support you postnatally. 
You can usually pick up packs including instructions or guidance on how to hand express & sterile syringes to collect & store the colostrum in, from your midwife &/or doula. If you want to find out more about antenatal expression of colostrum you can find helpful guidance on the Association of Breastfeeding Mothers &  Le Leche League websites & be sure to speak to your own Midwife too.

If you'd like to know more about the magical superpowers of colostrum & breastmilk then check out The Human-milk Foundation.  

D is for Doula (well, did you expect anything else...!?)

(noun) someone, who is not usually medically trained, who is paid to provide guidance and support to a pregnant person during pregnancy, labour, birth &/or postnatally.

The word, "doula", comes from the ancient Greek meaning, "a woman who serves". Of course, these days, doulas come in many forms & we aren't all women or identify as women. This is important as every expectant parent should be able to find the right doula for them, to support them & their own unique set of circumstances.

I cannot help but feel that the dictionary definition of a doula is somewhat lacking... & I think anyone who IS a doula or has had a doula, would agree!

What are the benefits of working with a Doula?

⭐ A shorter labour - by up to 25%

⭐ You are 50% less likely to need a caesarean birth & 40% less likely to have an assisted birth

⭐ You are 30% less likely to request pain relief & 60% less likely to request an epidural

⭐ Physical & Practical Support - in the form of massage, rebozo, counter pressure, etc... help to create a calm environment, provide warmth, food & drink, assist with positions for labour & birth & to support the birth partner too

⭐ Emotional Support - continuity of care, listening, empathy, affirmations, supporting the birthing persons choices, reassurance, HUGS, supporting the birthing person & partner to work through fears & self-doubt, debriefing after birth

⭐ Informational Support - signposting to evidence based information so the expectant parents can make the right informed choices for them, helping to explain options in pregnancy & childbirth, supporting the partner to understand what's going on & how they can help support the birthing person, guiding you through the system

⭐ Advocacy - (this does not mean speaking for the person) amplifying the birthing persons voice, supporting their decisions, asking them what they want, creating space & time for questions & information gathering, facilitating communication, encouraging you to step into your own power

BOOKS 📚 Why Doulas Matter, by Maddie McMahon is a must read.

Finding a Doula: A personal recommendation is great!

Do you have friends or family who have used a doula?

Who did they use?

How did they find them? 

Many of the Doula training providers in the UK also have their own Doula Listings facility & many individual doulas also have their own websites & social media platforms.

I can currently be found on the following listings; Doula UK, Nurturing Birth & Hampshire Doulas, as well as my social media accounts. I am also happy to signpost to other local doulas who may be able to help if I can't.

You can find out more about the benefits of both Birth & Postnatal Doula Support here, on my website & please do get in touch if you'd like to know more about my services & if I might be the Doula for you. 

E is for Equipment

(noun) the necessary items for a particular purpose.

You may think this a strange inclusion to my A-Z of preparing for baby, but bear with me...

When you fall pregnant with your first baby/babies it often doesn't take long before your thoughts start to turn too...

What do I need to buy? 💰

It can be so tempting & exciting to start buying clothes, looking at nursery furnishings, decorating baby’s room, prams, car seats, teddy's, baby baths, cots, toys, soothers, nappies, towels, slings, changing bags, etc.... the list & options can seem never ending.

But let's just stop & think about it for a minute. What does a baby really NEED?

They need love; to feel safe & secure, they need food, clothes, nappies & a safe sleep space. But most of all they need parents who feel supported, empowered & have faith in their own abilities to parent. These things can't be bought in shops or ordered online - but they can be planned & saved for in the same way.

Would your money better spent on… antenatal preparation, parenting classes, a doula who will support your choices & help you step into your own power to birth & parent the way YOU want too? How about placenta remedies to support your emotional & physical recovery?
What about setting money aside so you can access quality infant feeding support such as an IBCLC &/or Tongue Tie Practitioner should you need it, or for manual therapy from a Chiropractor or Osteopath for you &/or baby to help you recover from birth? What about a Postnatal Doula who can help support you through the sleep deprived haze of early parenthood? How about a healthy meal delivery service for those early days, so you have fresh, nutritious, food to keep you going without the stress of going shopping or even having to prepare or cook in some cases...?

A baby, needs very few "things". What it needs, are a parent(s) who feel empowered with evidence based information to make the right decisions for their family. A parent(s) who feel supported & cared for themselves, so that they can focus all their energies their baby(ies) & new family.

However well "prepared" we may think we are for becoming parents, the reality can still feel like being hit by a juggernaut!

The transition to parenthood can feel overwhelming, exhausting & challenging - all perfectly normal responses, that don't mean you love your baby any less, but you will cope far better with the right support in place ❤ 

F is for Family

(noun) traditionally, a group of 1 or 2 parents & their children. 

Whether you are a solo parent, have a partner, are married, or have any wider family or not... bringing a baby into the world creates your own instant family & hopefully, you have the support of others, "blood" family or "chosen", around to help & support you. Whether your birth partner is your life-partner, wife, husband, mum, dad, sister, brother, friend, intended parent or even a doula, ideally you have a relationship of trust & care & they will have been involved with your pregnancy & antenatal preparation so they know what YOU want!

You may choose to have any older siblings present during birth too, to be involved in welcoming their new baby brother or sister into the world. After all, birth is a normal, natural, everyday occurrence & there is no need to exclude our children if we do not want too.
No one can predict what will happen during labour & birth - how you will react or how any partners will react either...!? It can be a difficult & emotional experience for them too - watching someone they love go through the transformative & intense process of birth.
If you are also working with a doula there may be times your partner needs them as much as you do. To seek reassurance that this is "normal", to aid communication, to help remind them what your birthing goals are & why, or to step in & give them a break to rest & regroup. It can be helpful to have someone who isn't emotionally attached to the birthing person in the same way, but has the experience & understanding of the birthing process to help guide & support you both. 

Do not be afraid to include your birthing partner as much as you can during your pregnancy. I think it is fair to say this has been one of the greatest challenges of pregnancy & birth during the pandemic! Unfortunately, partners have been kept away from scans, antenatal appointments & check-ups; missing out on hearing their baby’s heartbeat, seeing them on screen at the ultrasound & finding out the sex of their baby - not to mention being able to support, comfort & calm their pregnant partners during these appointments too.... Remember that you are well within your rights to video call your partner in on appointments & scans or record what is going on to share with them later.

But there are other ways to involve your partner. Encourage them to talk to the baby - read, sing, tell them jokes. We know that baby can hear their first sounds from approximately 18wks & by 24wks the ears are rapidly developing. Once born, they will recognise the voices of their parents & respond to them. As soon as you start to feel movement, encourage your partner to place their hands on your bump to feel them too (this may take some time, be patient!)

You may like them to massage your shoulders or feet, apply moisturiser or oil to your bump, etc... Anything you can do to help increase oxytocin will help you to not only increase the bond between you & your partner but will lay the foundations for bonding & building good attachment with your baby too. As well as prepare you both for labour & birth.

If you take antenatal preparation, birthing or parenting classes - take them together. Groups & classes such as The Daisy Foundation, The NCT, Hypnobirthing classes & the Informed Pregnancy Birth & Beyond Group are all great places to start locally. There is also Dadz Club & Birthing4Blokes, specifically for Dad's & groups & classes specifically for the LGBTQI+ community too - check out, Birth Keeper Doula, Nanny Kimbo & the Queer Parenting Partnership.

Pregnancy is also a great time to start building new friendships with other expectant parents. This can become invaluable to both of you, particularly in the postnatal period. These then become your new tribe or parenting village as you support one another through the transition to parenthood & so your “Family” grows.

G is for Gas & Air (& other types of pain relief)

(noun) A mixture of nitrous oxide and oxygen in the ratio 1:1 commonly used as a mild analgesic and anaesthetic in medicine, particularly during childbirth.

Gas & Air: or to give it it's proper name - Entonox, is one of the most well-known & commonly used forms of pharmacological pain relief for labour & birth. It can be used for maternity unit & hospital births, as well as for homebirth too. It is a tasteless, odourless gas inhaled during a contraction, usually through a mouthpiece.  Research has shown G&A to be an effective method of pain relief when compared with a placebo of 100% oxygen. Studies have shown it is comparable to opioids, such as pethidine, without the unwanted side-effects.

Many birthing people like it because it gives them control over their own pain relief, it helps to focus their breathing & serves as a distraction. Another benefit is once you stop breathing it in, it leaves your system quickly, meaning if you decide you don't like it, you can simply stop using it. It is not thought to have any harmful side effects, but some people may experience nausea &/or vomiting.

A TENS Machine: TENS stands for Transcutaneous Electrical Nerve Stimulation. It is a drug-free form of pain relief that you control with a hand-held device. 

It works by sending mild electrical impulses via sticky pads on your back, these stimulate the nerves that run to the spinal cord & block the pain transmitters. It also encourages the body to release natural pain inhibitors called endorphins & provides a distraction for the brain helping to restore a sense of control, lessening the anxiety that can delay or stall labour. There is a lack of research into the use of TENS, however, many birthing people report it useful when used from early labour. TENS Machines for labour have a boost button, giving you additional support during contractions/surges. Although some report it feeling "irritating" or disliking the sensation, it is not thought to have any known side-effects. If you do not like it, simply turn it off & take the pads off. You may be asked to remove the TENS if continuous monitoring of baby is required. 

TENS machines can usually be bought or hired & are not hugely expensive. 

Paracetamol: although generally considered safe to use in labour, the advice from midwives to "take a couple of paracetamols" in early labour is now under question as to its usefulness. In fact, some think, that this may be leading to longer periods of early or "latent" labour, as it may interfere with the body’s ability to produce prostaglandins, which are an integral part of the labour process. Read more here: Sara Wickham

Codine: is also often offered in conjunction with paracetamol (in a hospital setting) however; this is an opiate drug & therefore can have side-effects that may affect you &/or baby, including constipation, drowsiness, nausea & vomiting & breathing difficulties.

Oramorph: Is morphine in syrup or tablet form. This is sometimes offered if you go into hospital early for support, but aren't yet in established labour, to help you rest & conserve energy. Some women can also return home after taking this instead of having to remain in hospital. Side-effects can include nausea, vomiting, dizziness, sedation and respiratory difficulties & these can effect baby too.

Pethedine: is an injectable form of pain relief given into your thigh or buttock. It is available in hospital & can (in some areas) be prescribed by your GP for a Midwife to administer at a homebirth. Sometimes, diamorphine is used instead. It takes approx. 20mins to work & lasts between 2-4hrs, so it is not recommended if you are thought to be close to the 2nd ("pushing") stage of labour. It has the same effect as morphine, although its side effects do not last as long. These side-effects include nausea, vomiting, dizziness, sedation and respiratory difficulties & these can affect baby too.

Water: being in water can help you to relax & help to perceive the contractions as less painful. The buoyancy helps with being active, eases aches & pains & can help you to find a more comfortable position. Some birthing people also report finding the use of running water, such as a shower helpful too. If using a bath or birth pool both your temperature & the temperature of the water will be monitored by your midwife. You can usually find at least one pool room on a labour ward & more in maternity units. At home you can buy or hire a birth pool to use.

You can find further information on the use of water for labour & birth on The NCT website.

Epidural: this is a powerful & popular form of pain relief where a local anaesthetic is injected into part of your spine to temporarily numb the nerves carrying pain messages. It is considered very effective & only numbs you from the waist down, so will not affect your mental ability to focus & means you can rest. If you have a mobile epidural, you should still be able to move about & feel your baby moving (however, these are not available at all hospital trusts) It takes approx. 20-30mins to work & can take several hours to completely wear off.

An epidural is often recommended if you are having an induction of labour &/or augmented labour (the hormone drip to increase labour) It may also be used for a caesarean birth. An epidural can only be administered on a labour ward setting or in surgery & you may have to wait for an anaesthetist to be available to do it. It "may" slow labour down due to not being able to feel what is going on. An epidural can lead to an increased chance of having an assisted birth (e.g., the use of ventouse or forceps & an episiotomy). Side-effects include - severe headache which can last for days if left untreated, the need for a catheter, itchy skin, feeling sick, low blood pressure & temporary &/or permanent nerve damage. Read more on the NHS website.

Alternative Therapies: there are also a variety of drug-free alternatives you might want to investigate such as, hypnosis & breathing techniques, yoga, aromatherapy, acupressure & acupuncture, massage, rebozo, homeopathy or reflexology - all of these will need time, research & practise, throughout pregnancy to prepare you for labour & birth.

If you are not sure, then do your research, speak to your antenatal provider, your Midwife, &/or your partner. Use your BRAIN tool & keep asking questions! 

H is for Hormones

(plural noun) any of various chemicals made by living cells that influence the development, growth, sex, etc. of an animal and are carried around the body in the blood.

There are 4 main hormonal systems at play during labour & birth these are:

💧Oxytocin (the love hormone) released during sex, orgasm, birth, breastfeeding & generally the touch of someone we love. This is where the phrase, "what got the baby in, will get the baby out!" comes from (although not an accurate description for everyone).

Anything that helps us to relax & feel good is beneficial, so laughing, cuddling, massage, touch, kissing & orgasm can all help with the build-up & release of oxytocin which will have a positive effect on your labour & birth.

Oxytocin stimulates powerful contractions that help to thin and open (dilate) the cervix, move the baby down and out of the birth canal, push out the placenta, and limit bleeding at the site of the placenta.

💧Beta-endorphins (the hormones of pleasure & transcendence) Endorphins, the bodies naturally occurring opiates... (like morphine or heroine) & beta-endorphins reduce pain & suppress the immune system, so it does not act "against" the baby. If you become stressed during labour, it is the beta-endorphins which can inhibit oxytocin & slow labour down. Beta-endorphins also help with the release of prolactin in labour, preparing the body to breastfeed/chestfeed.

For women who do not use pain medication during labour, the level of endorphins continues to rise steadily and steeply through the birth of the baby. (Most studies have found a sharp drop in endorphin levels with use of epidural or opioid pain medication.) 

💧Epinephrine & Norepinephrine (the hormones of excitement) or adrenaline & noradrenaline - a.k.a. the "fight or flight" hormones.

Women who feel threatened during labour (for example, by fear or severe pain) may produce high levels of adrenaline. Adrenaline can slow labour, stop it altogether or in the later stages, even speed things up. Earlier in human evolution, this disruption helped birthing women move to a place of greater safety. Creating an environment of safety, having trust in your care providers, feeling unobserved, relaxed & confident will help keep adrenaline under control during your labour & birth.

💧Prolactin (sometimes referred to as the "mothering" hormone) Your baby also produces prolactin in the womb & your prolactin levels increase throughout pregnancy, peaking at birth. It is an important hormone for breastfeeding/chestfeeding.

To maximize your body’s ability to follow its natural processes, it is a good idea to seek out a birth setting that supports this. Out-of-hospital birth settings and one-on-one continuous labour support, such as doula care, can help create conditions that enhance your body’s natural production of helpful hormones and keep disturbing hormones in check. 

Postnatally sudden hormonal and chemical changes that happen in the days after birth are responsible for what is known as "the baby blues", which can occur on or around day 3. This may make you feel down or depressed, emotional or irritated and likely to burst into tears at any second, but this is very normal. However, if you feel that what you are feeling is more than that, the feelings do not pass or they continue for longer than expected, then please do reach out for support from your partner, midwife, health visitor &/or GP, as you may be experiencing postnatal depression or postnatal anxiety, which you can receive support with. 

I is for Infant Feeding

(noun) feeding an infant, the act of supplying food & nourishment.

Breast/Chest feeding is the biological norm - breastmilk is free, always available & tailor-made for your baby. Any breastfeeding is beneficial, even if you go on to supplement with or completely formula feed later, but exclusively breastfeeding your baby for 6 months offers a lot more protection.

Benefits include;

• antibodies that help your baby fight infections like tummy bugs, diarrhoea, colds & chest & ear infections.
• the perfect combination of vitamins and nutrition, for baby - it is also much easier to digest than first infant formula.
• breastfeeding reduces the risk of sudden infant death syndrome (SIDS), also known as cot death, and childhood leukaemia.
• breastfed babies are less likely to develop diabetes or become overweight when they are older.

There are benefits and advantages for you too –

• your uterus (womb) will gradually get smaller day-by-day, but breastfeeding will help speed this up.
• it is a lovely way to feel close & strengthen the bond between you and your baby.
• it lowers your risk of breast cancer, ovarian cancer, osteoporosis (weak bones), diabetes & cardiovascular disease (conditions affecting the heart or blood vessels).
• if you are exclusively breastfeeding, this will help burn off about 300 calories a day.

There are many benefits of continuing breastfeeding after 6 months: breast milk protects your baby from infections & there is some evidence it helps them digest solid foods too.

WHO, UNICEF & The NHS recommends:

• early initiation of breastfeeding within 1 hour of birth.
• exclusive breastfeeding for the first 6 months of life; &
• introduction of nutritionally adequate & safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.

It is highly recommended to fully prepare yourself for breast /chest feeding. Many hospitals offer antenatal preparation & education around what to expect. You may also find private course & classes available in your area &/or online from IBCLC's (International Board-Certified Lactation Consultant), Breastfeeding Councillors, Peer Supporters, Doulas & other birth workers. It can also be helpful to check out what breastfeeding charities such as, The Breastfeeding Network (BfN), The Association of Breastfeeding Mothers (ABM), Le Leche League (LLL) & The National Childbirth Trust (NCT) can offer too. These are also the groups to turn to postnatally should you find yourself needing support, as well as your midwife & health visitor. 

The National Breastfeeding Helpline (NBH) is open 7 days a week, 365 days a year, from 9.30am - 9.30pm to help support you too & is operated by BfN & ABM Peer Volunteers. 

You may find the following resources helpful:

* The start4life leaflet, "Off to the best start", shows you how to hand express & attach your baby at the breast - available on the Unicef website.

* The Kellymom website is an excellent source of breastfeeding help, tips & information organised by topic, so you can use key words to search for the info you require.

* The Breastfeeding Network website has link to evidenced based info including the Drugs in Breastmilk factsheets to support you with finding medicines & treatments that are safe to use while breast / chest feeding. For more complex support concerning nursing with health issues & medication you can contact the Drugs in Breastmilk Information service for support from a highly qualified & trained breastfeeding friendly team of pharmacists via the Facebook page. 

If you are struggling to exclusively breastfeed & top-ups are being recommended, ask for support with a feeding plan you are comfortable with.

Can you express the extra milk needed?

Would donor milk be an option for you? (Yes - milk sharing & milk banks are a thing!)

Or finally, would the short-term use of formula top-ups be beneficial?

You do not have to use a bottle to give those top-ups either - you could use a syringe, cup, finger feed or use an at breast supplementary system (SNS) depending on your situation - Although I would recommend seeking professional support in these cases.

Unfortunately, sometimes breast / chest feeding does not go to plan: due to medical issues or just plain lack of support & understanding, parents find themselves switching to formula feeding. If this was not part of your plan, it can feel devastating & really have a negative effect on both your mental health & parenting. Please do not be afraid to talk to people about this - even if it takes a while before you feel ready to do so, seek support to work through those feelings & what has happened. But please know - it is not your fault & you have not failed!
Some parents will choose to formula feed from the start & that is their choice to make - we must all make the right informed decisions for ourselves & our families & no-one else has the right to do that for us. (Or to judge us for it!) 

A lack of support & good evidence-based information can often be the experience of formula feeding families too. To find more information on formula feeding check out the Channel 4 Dispatches episode on infant formula, the start4lifeuk booklet "A Guide to bottle feeding", both of which can be found on the Unicef website & the First Steps to Nutrition website too. Whatever milk is in your baby’s bottle it is recommended that you practise responsive & paced feeding, e.g. - following the baby’s lead & appetite. You can read more on this again, on the Unicef website. 

Of course, it is important to say, that infant feeding doesn't have to be an either-or choice!

It is entirely possible to mix feed a baby - so some breastfeeding & bottle-fed donor milk &/or formula milk. This can become particularly important if you do not have a full milk supply, it means your baby is still getting all the benefits of breastmilk, however small a volume that may be. 

Lucy Ruddle (IBCLC) has penned a book on this subject called "Mixed Up - mix feeding by choice or necessity", which I can highly recommend.

Other informative books on the topic of infant feeding: 📚

* The Positive Breastfeeding Book, by Amy Brown

* Why Breastfeeding Matters, by Charlotte Young

* Why Breastfeeding Grief & Trauma Matter, by Amy Brown

* The Womanly Art of Breastfeeding, from Le Leche League

* When Breastfeeding Sucks, by Zainab Yate

* Relactation, by Lucy Ruddle

* The Big Letdown, by Kimberley Seals Allers

J is for Journey

(noun) the act of traveling from one place to another

I want to discuss a different kind of journey... Our journey to motherhood / parenthood.

For some, it is something long planned, wished & prayed for - for others, a total shock or surprise! Either way, you are going to need time & support to navigate this new path. Now is the time to build your parenting village & community. Those who will love, support & raise you up whenever you need them too. 

They say, "It takes a village", & that can be oh so true! The more supported you feel as a new parent the better. I am not 'just' or 'only' referring to partners - after all, there are many awesome single parents out there. Really, I'm talking about all the other people we surround ourselves with - those journeying alongside us. The ones who listen with empathy but do not try to "fix-it" or change us. Those who signpost to evidence-based information so we can make our own informed decisions. Those who sit with us through the highs & the lows - who hold the baby while we nap, who pick up the groceries or make us a meal or a hot drink when we need it. Who help keep us sane & recognise us as being more than a parent! 

Choose these people carefully: They may already be in your life, you may meet them at antenatal classes, baby groups, or even online - but ensure that they are "your people", & they make you feel safe, loved & appreciated. 

Your journey to & through parenthood will be long. It may take unexpected twists & turns, it may occasionally go "off-road" or be diverted, but with the help & support of those around you, you can keep going, get back on track & even enjoy it ❤

 

K is for (Vitamin) K

(noun) any of a group of vitamins found mainly in green leaves and essential for the blood-clotting process. They include phylloquinone (vitamin K1) and menaquinone (vitamin K2). 

Vitamin k is offered to all new-borns in the hours immediate postpartum. It is recommended to prevent a rare bleeding disorder called, Vitamin K Deficiency Bleeding (VKDB) previously known as, Haemorrhagic Disease of the Newborn (HDN). It is very rare but can be very serious, which is why all parents of babies born in the UK are offered an injection of Vit K for baby just after birth, even though almost all of them will not benefit from it. If parents prefer not to give an injection, it can also be given orally in several doses over a few weeks.

Risk Factors for VKDB.

* Babies born before 37wks

* Babies born via assisted or caesarean birth

* Babies who are bruised at birth

* Babies with liver problems or were poorly at birth

* Babies who had breathing difficulties at birth

* Babies whose gestational parent took drugs for

epilepsy, to prevent clots or for tuberculosis during pregnancy

* human milk fed babies are also thought to be more prone to VKDB than formula fed babies, but this is because formula is highly supplemented with vit k. 

It is thought that most parents do take up the offer of Vitamin K - BUT - you do not have to. It is your legal right to decide & healthcare providers are NOT allowed to try to coerce or force you into agreeing to any intervention or treatment. 

In babies who did not receive Vit K at birth, around 0.25% - 1.7% will develop classic Vitamin K deficiency bleeding. 5 - 7 per 10,000 babies will develop late VKDB.

Babies are born with naturally lower levels of Vitamin K (compared to older children & adults) although it is not understood why this is.

For evidence-based information & explanations about VKDB & Vitamin K supplementation see the following, Aims & Dr. Sara Wickham. 

 

  

L is for Labour
(noun) practical work, especially when it involves physical effort
(verb) work hard, make great effort physically &/or mentally
(Birth) the last stage of pregnancy from the time when the muscles of the womb start to push the baby out of the body until the placenta is born.

Unlike what you may have seen on the TV or in films, the start of labour tends not to be particularly dramatic. Your waters are unlikely to break in the middle of the supermarket sending a tsunami gushing through the aisles, knocking passers-by off their feet... (lol)
In fact, only about 15% of expectant parents experience rupture of membranes before contractions start & it is possible for them not to rupture at all, resulting in your baby being born in the intact amniotic sac (caul) - this is known as a "veiled birth" or being born “en caul” & is considered by many, to be lucky!

Labour is split into 3 "stages" - the 1st stage also known as "early labour", the 2nd stage, also known as the "pushing" stage (the part when the baby(ies) are born) & the 3rd stage, when the placenta is birthed.

How will I know I am in labour?
There can be several signs that labour might be starting, these can include, a "show" (losing the mucus plug that has kept the cervix sealed during pregnancy), backache, period-like cramping, clearing of the bowels & even irregular contractions starting. This is the latent phase of labour when your cervix begins to soften, thin & open (or dilate) ready for baby to be born. This 1st stage is usually the longest & can last just a few hours or sometimes several days. It can also be longer in a first pregnancy. During the latent phase it can be a good idea to try & stay calm & comfortable. If labour begins at night, sleep if you can! If you are labouring through the day, continue to eat & drink - you will need your energy later. Trying to keep upright & gently active can help your baby move down into your pelvis & help the cervix to dilate. A gentle walk, rotating/bouncing on your birth ball, yoga, breathing exercises, massage, or having a warm bath or shower can all be helpful ways of helping you manage during early labour. Whatever will help to get your oxytocin following & keep you relaxed & comfortable.
Even if you are planning to birth in a Midwifery Led Unit (MLU) or hospital, staying at home for as long as you feel able can be beneficial.

When should I contact my Midwife/Labour line?

• your contractions are regular and you are having about 3 in a 10-minute period, lasting 1-1.5mins in length

• your waters break

• your contractions are very strong, and you feel you need pain relief

• you are bleeding

• you cannot feel your baby’s movements

• you are worried about anything 

Established labour or active labour is generally deemed to be from the point you reach 4cm dilated & contractions are becoming stronger & more regular. This is the point where (if birthing in hospital) you will be admitted &/or moved to a birthing room.
However - if you do not have any vaginal examinations (V.E.'s) then you won't know how dilated you are. There are other ways to establish how far along you might be & midwives are trained to use these, along with their judgment & general observations to ascertain this without the need to perform a V.E. See the following for more info on V.E.'s – Aims,
And these links, for alternatives – Wonderfully made Bellies & Babies .

As you move through this stage of labour you may want/need to try some different things to help you manage the sensations - this could be as simple as a change of position or breathing techniques or maybe trying some alternative pain relief, e.g., getting in the birth pool, trying some gas & air, or asking for an epidural. 

Whether you are planning to birth at home, in a midwifery led unit or in hospital, your Midwife will monitor & observe you & your baby, help with pain relief, keeping you calm & can suggest ways to help labour progress if needed. (More about Midwives next...) They will also advise you if anything changes & if you may need to consider something that may not be on your birth plan. Even in labour, there will usually be time to discuss your options, ask questions & even to get a second opinion. So do not be afraid to take your time & ensure you make the right informed choices for YOU & YOUR baby.  
Towards the end of the 1st stage, contractions are stronger & your cervix is almost fully open (10cm) you have reached transition - the point at which we are moving between the 1st & 2nd stages of labour. Some will experience a "rest & be thankful" phase where labour may seem to have stalled or slowed down. Just because you are fully dilated doesn't mean you should "push" right away - listen to your body & don't be rushed. It is also at this point when some may suddenly have a wobble. Many women & other birthing people will express self-doubt & can benefit from additional emotional & physical support from their birth partner, doula &/or midwife at this point. 

Your contractions switch now & instead of opening & drawing up the muscles of the womb to open the cervix, they are now pushing down to move the baby through the birth canal & out into the world. Some will feel the need to "push" & will begin to naturally bear-down, working with the body to move baby down. Some will feel like their body is doing it all for them, this is known as the foetal ejection reflex. Sometimes you or your midwife/consultant may feel that some directed, or "coached" pushing is needed. (This is often the kind we see on TV - where the birthing person is on their back, feet in the air, knees to chest, holding their breath & pushing with all their might!) There may be occasions where coached pushing like this is deemed necessary - maybe baby is in distress, or mum is tiring, or maybe the 2nd stage has been going on for quite some time, etc... however, following your instincts, trusting your body & the process, is usually the preferred way for your baby to be born.

If you are having twins, the first baby is usually born in the same amount of time as a singleton would be. The care provider will then want to check the position of the second baby & if all is well, the second baby is likely to arrive far more quickly than the first! (If baby is in a trickier position, then some help may be required to birth the second baby).

So, congratulations, you have birthed your baby(ies) - it can come as a surprise to find that the work is not quite over yet though!

The 3rd stage of labour comes after the birth of baby when the placenta is born. Your Midwife will have spoken to you during pregnancy about your options for this stage:

A managed 3rd stage:
You will be given an injection of either syntocinon or ergometrine into your thigh, quickly after baby is born. It speeds up the "delivery" of the placenta, usually happening within 30 minutes of having had your baby. Your midwife will push on your uterus and pull the placenta out by the umbilical cord. It lowers the risk of heavy blood loss but may also make you feel sick or vomit & can increase your risk of high blood pressure.

A physiological 3rd stage:
No medical intervention. The placenta detaches & comes away on its own. It can be quite normal for this to take up to an hour. Skin-to-skin contact & breast/chest feeding can help it along, by making your body produce more oxytocin, as can an upright position. Considered safe for "low-risk" pregnancies.

Of course, there is a 3rd option - wait & see:
If all's well & no intervention is needed, great! But if it is taking a while (longer than an hour usually) the midwife is concerned about excessive bleeding, or you just change your mind... then the injection can be given at any time.

Along with your decision on how to birth your placenta, will also come the question of when to clamp & cut your baby's umbilical cord. When baby is born, up to a 3rd of their blood supply can be in the placenta & cord. Research now tells us that by delaying the clamping & cutting of baby's cord & “waiting for white” we can ensure that all of that blood drains through into baby - this has huge health benefits for baby & best practice is considered to wait at least 3-5mins before cutting the cord. However ideally, we should be waiting for the cord to stop pulsating. If all is well, you can leave baby attached to their placenta for as long as you wish & some people even prefer to have a lotus birth which involves waiting for the cord to naturally detach from baby, which will happen several days after birth. The placenta is treated with herbs, salt, etc... to help preserve it & is kept in a bag/container which is moved around with baby, until it drops off by itself. (More about Placenta's when we get to P!) 
Read more about birthing your placenta here:Dr Sara Wickham, Aims

 

M is for Midwife
(noun) a person, usually a woman, who is trained to help women & other birthing people when they are giving birth.
 
The word derives from the Old English mid, "with," and wif, "woman," and so originally meant "with-woman," e.g. - the person who is with the mother or parent at childbirth.
The word refers to midwives regardless of gender.
 
Midwives train for 3yrs to get their degree & must then register with the Nursing & Midwifery Council (NMC) to practice midwifery & use the title midwife or registered midwife. Midwives are practitioners in their own right in the UK. They take responsibility for the antenatal, intrapartum and postnatal care of women up to 28 days after birth. Midwives are the lead health care professional attending most births, whether at home, in a midwife-led unit or in a hospital - although most births in the UK happen in hospital now.
 
Many midwives also work in the community. The role of community midwives includes making initial appointments with pregnant people, managing clinics, undertaking postnatal care in the home, and attending home births.
 
Portsmouth (PO1-6) are very lucky to have Portsmouth Maternity Unit (PMC) & a community continuity of care team called the “Athena Team”. Gosport are also soon to benefit from their own continuity of care team & Blake Maternity Unit updated & open for births again too. As maternity care continues to grow & develop, we hope that the families of Fareham can soon benefit from their own community team too.  
 
Hampshire Hospitals also have a wonderful case loading community team known as the “Blossom and Bloom” team who facilitate homebirths & births at Andover Maternity Unit.
 
And Princess Anne, Southampton have a Homebirth Team & the beautiful New Forest Birth Centre too.
 
Most midwives work within the NHS providing both hospital and community care, but a significant number work independently, providing care for their clients within a community setting. However, recent government proposals to require insurance for all health professionals is threatening independent midwifery in England. Read more about the
campaign to support them via the Aims website or on Instagram, IMUK & Private Midwives.  
 
It is a midwife's job to take care of your health & medical wellbeing & that of your developing baby. They can make recommendations, but remember they are just this - recommendations. They should help guide & support you to make the right informed choices for YOU & YOUR baby. You can request or decline support, information, a second opinion or any interventions, as you see fit & you must give your explicit consent before anything happens. Your midwife should be able to answer all your pregnancy & birth related questions & if they can't, they should be able to find out or signpost you on to further evidence-based sources or other practitioners who can help.
 
You may wish to follow/support: Radical Midwives & Birth Rights.