Top 10 Tips for Labour and Birth

The UK's Royal College of Midwives has put together a Top 10 Tips for labour ad birth, as part of its Better Births Initiative/Campaign for Normal Birth. It's a great list, so I'm presenting an abridged version, but you can also read it in full list with more details here.


1. Labour takes time
Try not to watch the clock. Remember that each contraction is one less to go before you have your baby. Stay at home as long as possible and try and keep busy.
 
2. Create a happy birth environment
Think about how you can create warmth, comfort and privacy in your chosen birth environment. Think about changing the room temperature, lighting or position of the furniture. Think what you might take from home to make the room more comfortable for you.
 
3. Stay active
Changing position during labour and keeping active can really help. Try swaying, rocking, or wriggling your hips, walking, and going up and downstairs. Use a birth ball or other means of support, like your birth partner/s or midwife that lets you relax but helps you remain upright and mobile.
 
4. Understand all your options
Another useful tool for labour and birth is having a good understanding about what might happen and how you want to deal with it. Find out as much as you can about techniques to help you with your contractions, for instance: breathing, using water, massage, a TENS machine, complementary therapies or hypnotherapy (hypnobirthing), as well as other medical forms of pain relief and intervention.
 
5. Ask for help or reassurance
It’s very normal for women to feel that they can’t cope at some point during labour (usually towards the end) so ask for help if you need it. You could ask for some time alone with your birth partner so that he or she can soothe and encourage you and you can also remind yourself of your birth plan.

6. Make a birth plan
It can help to write a birth plan with your birth partner(s) so you both know what your preferences and plans for birth are. On the day, your birth partner(s) can help remind you of your birth plan and also update the midwife on your preferences during labour.

7. Trust your body
Women’s bodies are designed to give birth and most healthy women can do so without major medical intervention. Try to ‘let go’ and allow your body to work with you and for you.
 
8. Choose the right birth partner for you
For some women, their partner is the best person to be with them during labour and birth, while others might choose a close female friend or relative or perhaps even an independent midwife or doula. Whoever you choose, it’s important that you feel comfortable with them, that you find them calm and reassuring and that they are someone you can communicate openly with.
 
9. Stay positive
Feeling strong, happy and confident releases endorphins and a hormone called oxytocin that actually makes your uterus contract strongly and regularly. This in turn will help to relieve pain and also help you achieve a sense of well-being. You will produce more oxytocin if you try and avoid feeling afraid, anxious, embarrassed or angry, and if you remain upright and have privacy and support.
 
10. Cuddle your baby close after birth
Your baby will have strong instincts to bond and breastfeed straight after birth. Cuddling your baby on your chest skin-to-skin (without clothes, towels or blankets in the way) will help your baby stay warm and secure, begin to bond with you by gazing at your face and start to breastfeed successfully. Your baby may turn towards your nipple and open her mouth. You may like to help her find your nipple. If you have a caesarean, your midwife can still help you have skin-to-skin contact and breastfeed.

RCOM videos about positions for labour and birth
http://www.rcmnormalbirth.org.uk/birthing-positions-in-practice/short-videos-for-birthing-postions/
 

Delayed Cord Clamping Makes Stronger Babies

Numbers for sudden unexplained infant deaths, or cot deaths, have reached the lowest all-time record in England and Wales, according to new figures.

Experts have jumped in to attribute this to many factors including: fewer women smoking, warmer than average temperatures throughout the year, and a greater awareness of safer sleeping practices (back to sleep).

But another reason has been suggested by Amanda Burleigh at Optimal Cord Clamping #WaitforWhite. “Could this be a decreased incidence of immediate cord clamping perhaps?” she asks. “More babies are now getting their full quota of blood and other unknown goodies.”

Delayed cord clamping is finally becoming the default practice with babies receiving a third more of their blood if the cord is left until it goes white.

More blood equals more oxygen pumping around the baby's little body, which means an increased capacity for better breathing. This means the difference of around 150ml in their little bodies from a total available blood bank amount of 450ml.

In November 2014, NICE, the UK agency that provides national healthcare guidance, recommended that hospitals defer cord clamping from 1-5 minutes - the result is that now the majority of hospitals in the UK and Ireland don’t cut cords until they stop pulsating (around 3 minutes).

Whilst there is scant evidence linking cord clamping with improved neo-natal outcomes, the body of research is growing gradually.

Recent Swedish research suggests that it helps to improve children's fine-motor and social skills by age 4 years because of the way it boosts iron levels between the critical growth spurt period of 4- to 6-months. The extra store of iron prevents iron deficiency, which has been linked to developmental problems in both motor control and mental skills.

Sudden infant death syndrome (SIDS) struck 128 times in 2014 (ONS figures only show England and Wales), compared to 165 babies who died the previous year. When ONS first started recording these numbers, that number was 207 in 2004.

Overheating is a known risk factor for cot death and during cold winters the risk of the baby getting too hot under extra clothing and blankets is increased.

Here are some of the measures parents can take to lower the risk of sudden infant deaths:
  • Always place baby on their back to sleep
  • Avoid smoking when pregnant or around the baby.
  • Place baby in a separate cot or Moses basket in the same room as you for the first six months.
  • Use a good condition, firm, flat and waterproof mattress for baby.
  • Don’t sleep on a sofa or in an armchair with your baby.
  • If you smoke, drink or take drugs or are extremely tired, don't sleep in the same bed as the baby.
  • Avoid letting the baby get too hot.
  • Don't cover baby's face or head while they are sleeping or use loose bedding.
References:
Andersson, Ola. Uppsala University, Sweden. Published in JAMA Pediatrics. (May 26)
Office for National Statistics (ONS). Birth and Death Statistcis for 2004: England and Wales. (Aug 2016)