teething runny nose: May 2010

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The World of my Baby -

Special Topic: Childbirth Education

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Hi Ronak,

WELCOME, BY ELAINE ZWELLING, R.N., PH.D.

WELCOME to this special topic newsletter where you can find out about
some of the important issues you need to consider as you prepare for
your baby's birth. With less than two months to go, you have to start
making decisions concerning your labour and the birth, and the best
way to do this is to be well informed about all the choices open to
you.

CLASS ACTION You're probably spending a fair bit of time now thinking
about what you will actually go through on the big day. It can seem a
rather daunting prospect. So one of the best ways to prepare is to
attend antenatal classes. There you will learn the ins and outs of
labour and birth, be taken through all the options available to you
and, if the classes are hospital-based, you should also get the chance
to visit the labour and maternity wards. The classes will explore how
you might feel physically and emotionally during labour, what you can
do to make yourself more comfortable, and, finally, how to care for
your newborn in the first weeks. You'll get to meet other couples due
around the same time as you, and get the chance to strike up new
friendships that can continue long after the babies' births.
Be Prepared
Your antenatal class curriculum
BABY BENEFITS TOO What's good for mum is good for baby (and can even
benefit Dad, too!). Here's the sort of information that wil be covered
in in your childbirth classes:
* GOOD FOOD How to maintain a well-balanced diet. Good nutrition not
only keeps you feeling your best, but also helps your baby grow and
develop in preparation for the birth.

* WORKOUT FOR TWO How to exercise safely during pregnancy, in
preparation for the birth, and to ease aches and pains. When you
exercise, your heart pumps faster and boosts your circulation,
increasing the blood flow to your baby. Your baby may show his
appreciation by increasing his movements and kicking when you have
finished your workout.

* R AND R The importance of rest and relaxation and some techniques
to help you through the pregnancy and birth. When you relax, your
calm, tranquil state benefits the little one inside too, and may
even affect his responses to stress in the future.

* BREATHE EASY How to breathe your way to the birth. Controlled
breathing techniques used during labour will not only help you cope
with contractions, but also send a good supply of oxygen to your
baby. Practicing your breathing before the birth can also help you
to relax and is beneficial to you both.

* THE MAGIC OF MASSAGE How to use massage in pregnancy and labour.
The soothing power of touch is particularly useful to ease general
pregnancy discomfort, and help you through labour. But it is
important for your partner to know how to massage safely and
effectively. Your baby will enjoy it too! It's a wonderful way for
you and your partner to communicate with your little one now and in
the future.

* GET INTO POSITION Using movement and different positions to help
ease discomfort during pregnancy, labour and delivery. You cannot
tell yet what positions will feel comfortable during your labour,
but knowing all the options will give you the benefit of choice.
Using movement helps with the discomfort of contractions, and can
facilitate your baby's progression down the birth canal and through
your pelvis. Certain birthing positions will also make things
easier for the little one by using gravity to help him squeeze his
way out into the big wide world!

To find out about antenatal childbirth classes ask your midwife,
contact the maternity ward of your chosen hospital, or try the
National Childbirth Trust who run their own courses. Whatever your
choice, you are sure to gain a lot from the classes and benefit from
spending time with others who, like you, are impatiently awaiting the
arrival of a new little family member!
Be Prepared
What to expect from your childbirth classes
CHILDBIRTH CLASS CHECKLIST Not all antenatal courses are the same,
although they will all cover certain vital topics including the stages
of labour, all the different ways you might give birth, the options
for pain management and skills you may need for the pregnancy, labour
and beyond. Every pregnant mother is entitled to free antenatal
classes if they are available in the area. But don't leave it to the
last minute as these can get very booked up. You might also choose to
opt for privately-run classes for which you will have to pay. Such
courses may offer more hours of tuition in smaller groups, and have a
particular emphasis on a topic that interests you, such as yoga or
natural pain-management techniques. The National Childbirth Trust
offers nationwide courses as an alternative to hospital-based ones go
to www.ntcpregnancyandbabycare.com

WHAT TO EXPECT Antenatal classes are fun, relaxed and truly hands-on.
You will be encouraged to ask questions and discuss any concerns you
have. The most important thing is that you leave the course feeling
you have gained a comprehensive overview of all your options for
labour and birth. A good course should broadly involve the following:
* An emphasis on pain management skills (relaxation, positioning,
massage, breathing), and labour support skills for your partner.
* A curriculum that empowers couples to make informed choices
* Class content that includes labour, birth, early postpartum (the
time right after the baby is born), newborn care, breastfeeding,
and adjusting to parenthood.
* Detailed discussions on medical procedures (such as foetal
monitoring, caesarean sections, episiotomy), medication, pain
relief, and a description of the medical team that might be
involved in the birth of your baby.
* Time for questions and discussion
* A friendly and supportive atmosphere If you think something
important has been left out of your course, speak up. And remember
to make notes in case there is something you want to discuss more
thoroughly at the following meeting or individually with your
midwife during your next antenatal check-up.
Be Prepared
Essential skills for labour and life
NEW SKILLS FOR BIRTH AND BEYOND Many of the pain-management techniques
you will learn in your antenatal classes can be helpful well beyond
the birth of your baby. Learning to breathe through the pain of
contractions and use relaxation to control discomfort and anxiety will
decrease the likelihood that you will need medication during labour.
Remaining drug-free could help the progress of the labour and is good
for your baby, since most pain-killing drugs can, to some degree,
affect your little one. In the meantime, the knowledge that you
possess these great coping mechanisms will empower you as you approach
the big day.

LOOKING AHEAD The new skills you acquire aren't only applicable now.
The same techniques can be very useful to help combat other types
physical discomforts and stresses you might experience during your
life. They can help you relax as you learn to breastfeed, or give you
the means to stay calm during the most trying moments of parenthood.

PREPARE YOURSELF The childbirth classes you have chosen will have
their own curriculums and, if you are paying for them, may offer
specialised tuition on certain relaxation, yoga and massage skills.
However, all antenatal courses will cover general breathing skills and
movement techniques commonly used during labour. Here are a few that
are well worth learning and practicing in the final weeks of labour:
* BREATHING THROUGH PAIN There are special ways to breathe that can
help you relax, focus and get through contractions. Your antenatal
teacher will show you how to breathe deeply between contractions
and puff quickly as each one peaks. Breathing correctly is
especially important for the second stage of labour when you have
to try to control strong urges to push. Using breathing to combat
discomfort and panic also allows you to keep calm in stressful
situations in daily life.
* PELVIC WORKOUT There are easy exercises you can do in preparation
for the birth that help to strengthen the abdominal muscles and the
pelvic area. Your midwife will demonstrate how to tighten vital
muscles you probably didn't even know you had! Pelvic rocking can
be useful to ease the discomfort of "back labour". This is when the
contractions are felt across the lower back rather than the
abdomen. Pelvic movements may also help the baby into an anterior
position (back of his head facing forward and his face towards you
back) ready for the birth. Pelvic exercises also generally help
improve posture.
* RELAXATION Step-by-step relaxation through the body helps you calm
yourself and unwind between contractions. This could also lessen
the pain of the next contraction. Knowing how to properly relax
your body is a life-long skill you will also be glad to have
whenever you're feeling tense.
* VISUAL IMAGERY During labour, visual imagery - creating a picture
of something pleasant in your mind - helps you focus your thoughts
away from the pain, and remain positive and calm during and between
contractions. At other times of stress, it can help restore a sense
of peace.

Get step-by-step instructions from Dr. Zwelling on how to perform
these valuable techniques.
Be Prepared
The maternity medical team
WHO'S WHO? During your labour and the birth of your baby, you may meet
a number of different professionals, each with their own specific
role. Of course, the medical team that actually ends up being involved
in the whole process will depend on how your labour is developing,
whether there are any complications, what sort of pain relief you opt
for, and finally how your baby is actually delivered. Below is a list
of people you may come across and a brief description of the job they
are there to carry out:

* The midwife will help you through the labour and conduct the
delivery of your baby if there are no complications. You may have
more than one midwife if your labour stretches over more than one
shift.
* An assistant or student midwife may be present to help out as an
extra pair hands during the delivery.
* An anaesthetist may be called if you require an epidural or need a
caesarean.
* An SHO (the most junior grade of doctor to get involved in labour
care) could be called for minor procedures, such as taking blood
samples or putting up a drip. They may also help out a specialist
registrar with an assisted delivery.
* A specialist registrar will be called in the case of foetal
distress to perform straightforward instrumental deliveries (using
forceps or a ventouse), or to perform a straightforward Caesarean.
* A consultant will be involved in complicated instrumental
deliveries or Caesareans. Medical students may be present to watch
certain procedures. If you would prefer not to have such an
audience, make your feelings known at the outset, and request that
no students be allowed into your delivery room.

Keep this list of important people in mind when you are writing your
birth plan, and rest assured that, whatever happens, you will be in
good hands.
Health
Birth Choices
KEEP AN OPEN MIND Whether you plan a home birth, a water delivery, or
prefer to opt for the hospital setting, the most important thing is to
be ready to just "go with the flow" on the big day. Having strong
preferences and feelings about how you want to give birth is
important, but nobody can foresee what will actually happen once your
labour gets under way. At the most basic level, your feelings may
dramatically change once things start to happen. For instance, you may
love the idea of a peaceful water delivery and have planned everything
down to the colour of your towels, only to find that in the midst of
contractions you suddenly can't bear the idea of dipping even your
toes into the birthing pool! You also have to be prepared for the
unpredictable: your labour may end up being very short with your baby
popping out before you even have time to unpack your bag. Or it might
progress so slowly that you end up being sent home several times
before finally being induced. Your baby may have to be monitored or
need a little help to come out. Or you could find that however much
you wanted to avoid pain relief, things just get too much to bear.
There are likely to be some twists and turns on the big day that you
simply did not expect. So stay open-minded throughout.

KNOW YOUR OPTIONS The best preparation you can do for the birth is to
find out as much as you can about all the different options open to
you. Know and understand all the different methods of pain relief
available to you - your antenatal classes will cover these in a lot of
detail. Learn the many different labouring and birthing positions and
practice them at home. You really cannot guess what will end up
feeling right on the day, so get comfortable with the idea of
squatting, kneeling on all fours, standing or lying back supported by
your partner. When the time comes, be ready to improvise, too: listen
to what your body is telling you, and follow your midwife's
suggestions. Have fun trying out any gadgets on offer in the delivery
rooms: birthing balls, stools, bean bags. Don't close your mind to
anything, but at the same time make your wishes heard from the start.
And remember, even if things don't all go to plan, whatever happens
the final outcome will still be the most wonderful feeling imaginable:
cuddling your beautiful new baby for the first time.
Health
What's all the fuss about water?
WATER AND LABOUR Have you ever noticed how wonderful it feels to have
a soak in a warm bath when you're tense or in pain? The same rule
applies in the late stages of pregnancy when the weight and pressure
of your baby lead to aching joints, and during labour, too, when the
contractions and your flurry of emotions make you tense up.

THE HEALING POWER OF H20 Sitting in warm water or standing under a
warm shower relaxes your muscles and alleviates discomfort. Using
water therapy (hydrotherapy) may help relax your uterus allowing it to
work more efficiently, and it is a good step towards lowering high
blood pressure. Most importantly, if you can stay calm during labour,
you will be more in control and better able to cope with the birth.

TUB TIPS As long as your labour is proceeding normally, it's safe for
you to be in water. Depending on the facilities available where you're
giving birth, you can either have a warm shower, leaning against a
wall or sitting on a stool, letting the spray fall on your back or
abdomen; or lie down in a bath or birthing pool. If you're planning to
use water during the labour, bring a blow-up pillow or folded towel to
cushion your neck when you're relaxing. In the case of a planned
water-birth, your birthing partner can join you in the water, too (so
he or she might want to bring along a swimsuit).

On your hospital tour, find out if you'll have access to a shower or
bath. If you think you'd like to use water during the actual birth,
this takes more careful planning. You should discuss this with your
midwife well in advance to see what options are available in your
area, and check out
http://email.uk.pampers.com/cgi-bin1/DM/y/eCHDj0ceXKI0BLrv0Cch50Eb
.

For more information on water and birth from Dr. Zwelling, read Water,
Water Everywhere.
http://email.uk.pampers.com/cgi-bin1/DM/y/eCHDj0ceXKI0BLrv0Cch60Ec
Parents
Swatting up for the big day
SNEAK PREVIEW A great for fathers-to-be to prepare for the big event
is to attend antenatal childbirth classes with your partner. This will
give you a great insight into what awaits you both. It will also
provide you with lots of ideas on how to help your partner through it
when the time comes. If you want to do more, try reading books,
magazines and information pamphlets on labour and birth, and watch
videos that show what a vaginal delivery and a caesarean section are
actually like. Being well prepared will help you to be less anxious
and to know what to expect.
Parents
The role of the birthing partner
SHARING THE MIRACLE Witnessing the birth of a baby is a wonderful
experience, and one that your birthing partner will never forget. In
most cases, the baby's father will be the lucky one who gets to share
this extraordinary moment, but you may also opt for your closest
friend, your own mother or another member of the family. The important
thing is that you choose someone in whom you have absolute confidence,
with whom you feel completely at ease, and who you can rely on for
unwavering support when the going gets tough. Give it careful thought
and discuss it with your partner. You may feel that you would like
more than one person with you at the hospital. If so, explain the
benefits of having someone there to give him support too, especially
if the labour is long and he needs a break. It is also a good idea to
organise a back-up in case for some reason your first choice is
unavailable. Most close friends and relatives will jump at the chance
of witnessing a new little miracle!

JOB DESCRIPTION The birthing partner's job is a very important one.
It's not just about providing a hand to squeeze or being able to pant
loudly with mum! The main responsibility he or she will have is to
offer you complete support and encouragement, and keep you as
comfortable as possible during the labour and birth. You need someone
who is prepared to respond to your every whim on the big day, and not
be annoyed when you change your mind every five minutes. Someone who
is happy to pace the room with you or get down on the floor and try
out all the different positions you have learned. Someone who won't be
offended if you get irritable or suddenly ask to be left alone; who
will remain strong during difficult moments and be your rock if you
fall to pieces! Finally, it has to be someone who can be your voice:
represent your thoughts and feelings, and stand up for what you want
if, during your labour, you are unable to do so yourself. It's a huge
responsibility, but the rewards are even greater. Your birthing
partner will experience the whole amazing process, be the first to see
your baby's head emerging into the world, and get the chance to cut
the umbilical cord. It will also be their job to remain with your
newborn if you need medical attention or feel groggy after the birth,
or if, for any reason, the baby needs to be taken out of the delivery
room. Your birthing partner may have to endure quite a lot during the
labour and birth, but all will be forgotten the moment they cuddle the
beautiful newborn for the very first time.

Last Tip
Don't forget your homework
PRACTICE MAKES PERFECT An athlete will always perform better if she
has been practicing and perfecting her skills. The same will be true
for you in labour. If you take time at home to rehearse the pain
management skills you've learned in your classes, you'll be able to
perform the relaxation, breathing, and coping techniques automatically
and more successfully when you really need them. Allocate a special
time during your daily routine for going over the techniques. Fifteen
minutes practice a day during the last six weeks of your pregnancy
will make all the difference for the labour. And it will also enable
you to face the birth knowing that, once the big day arrives, you
won't be powerless and at the mercy of the contractions.

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