Every pregnant mother hopes for an easy birth with no complications, but things don’t always turn out the way the we plan. Sometimes mothers will need a caesarean section to birth their baby (30% of births were caesareans in Australia in 2009).

It can be very frightening when you find out that you have to give birth by caesarean section, whether it is in advance (due to medical issues such as placenta previa etc) or during labour when you are taken to theatre for an emergency caesarean section. Either way, it’s a good idea to read up on giving birth by caesarean section beforehand so you know what happens in the event of needing to go to theatre to birth your baby.

Please note that in an emergency situation, the procedure explained below may be slightly different as things may be rushed to save the life of either mother or baby.

A birth by caesarean section is where the baby is removed from the uterus, by an obstetrician, through an incision in the mother's abdomen. There are two types of incisions that can be made. The first is a classical incision, which is a vertical incision from the top to the bottom of the uterus. These are rarely done these days as they can cause more complications and take longer to heal. The most common nowadays is a lower segment caesarean section (LSCS) which is where the uterus is cut across the abdomen, just above the pubic bone, it is much easier to repair and lends itself much better to future vaginal births (VBAC).

Prior to your caesarean surgery you will need to remove all jewellery (or have it taped) and remove any nail polish so your vital signs can be checked. You will be given a small drink to neutralise the acids in your stomach before entering the theatre. A catheter will be inserted and you will also be given a drip, usually this will contain fluids and oxytocin, which will help your uterus contract after your baby is born. You will have heart monitors placed on your chest and a blood pressure cuff on your arm to make sure you are doing ok during the surgery.

To start the surgery, you will be given some sort of anesthetic, there are two options. You may have a general anesthetic, where you will be asleep during the caesarean section and wake up after your baby is born. Alternatively you can be awake during the surgery and be given local anesthesia through an epidural or spinal block. With a local anesthetic you will not feel anything from your chest down and as a result will not be able to move much for several hours after your surgery.

Once you are in the theatre, a screen will be raised at your chest so you cannot see any of the surgery taking place. The anesthetist will run ice across your stomach to ensure that you have no sensation and that the anesthetic is working properly. If you are having your caesarean section under local anesthetic your partner may join you once the first incision is made. He or she will sit by your head with the anesthetist.

To start the surgery, you will be swabbed with antiseptic and a small incision is made right above your pubic bone. The doctor then cuts through the underlying tissue and fat working down to your uterus. Once your doctor reaches the muscles, they will be separated manually to expose your uterus.

During this time you will feel some tugging and movement. The sensation is very strange & I liken it to having dental work done, in that you can feel the movement but there is no pain or skin sensation. It can be a little bit scary, but as long as you are feeling no pain then it is perfectly normal. If you do feel any pain, tell your anesthetist immediately and he or she will top up your anesthesia.

At this point, if you would like to view the birth of your baby, you may request to have the screen lowered. Your partner may also choose to take photos of the birth at this time.

A final incision is made, in your uterus, and your baby is pulled out, sometimes this needs the assistance of forceps. The baby’s umbilical cord will be cut and she or he will be held up over the screen for you to see. If you partner would like to cut the umbilical cord, let the midwives know in advance and it will be left long enough for him or her to cut on the warming table after the birth.

Depending on your hospital, you may be able to have your baby placed on your chest immediately after birth and checked later. Sometimes though your baby will need to be checked straightaway depending on his or her Apgar scores.

At this point, your surgery has been going for only about ten minutes.

While you snuggle with baby or the checks are being made, your caesarean section is being completed by all the layers being sutured back together. You may have staples, stitches or internal stitches, depending on the doctor performing your surgery.

This part of surgery will take up to two hours as the doctors work at stitching everything back together. It may sound like a long time, but it goes very quickly. If you are tired after a long labour you may fall asleep as they finish the surgery.

Once the surgery is finished you will go to recovery for a period of time, this is dependent on how you are doing after the surgery and how much blood loss you have had. You may be there for half an hour if all is well or up to several hours if there are any concerns about your health. If you baby is well he or she may stay in recovery with you and you can use this opportunity to breastfeed if you’d like to.

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When you get to the end of your pregnancy you are generally uncomfortable, tired and a little bit over it all. Mostly though, you just want your new baby out in the world with you. There are a few natural induction methods that you can try to get labour started.

Please remember that any attempts at inducing labour should be supervised by a health care professional. Please don't try any of these methods without consulting your doctor first.

Following are six of the dozens of options you have to try and induce labour naturally, in no particular order.

Sex

As I’ve heard some midwives say, “the best way to get the baby out is the same way you got it in there!” While you might be skeptical, there is actual evidence that having sex can help with inducing labour naturally. Semen contains prostaglandins, which is on of the hormones that help labour to begin. In fact, when you go into hospital to be induced medically, often it will involve having a prostaglandin gel placed near the cervix to help it to ripen.

Nipple Stimulation

Another natural way to induce labour is through nipple stimulation, either by yourself or have your partner help you. This method of induging labour naturally relies on the release of oxytocin. As with prostaglandins mentioned above, oxytocin is another one of the hormones needed to start labour. During labour, if you are given an IV medication to help a stalled labour or to induce labour, it is a synthetic version of oxytocin used.

To release oxytocin, the recommendation is to massage your nipples by rolling them between your thumbs and forefingers for approximately two minutes and then rest for three minutes. Repeat this pattern for around 20 minutes.

Fresh Pineapple

The newest craze for inducing labour naturally is to eat freshly cut pineapple. There is an enzyme in pineapple (and also papaya, kiwi fruit and figs in a lesser amount) called Bromelain, which is believed to work in the same way as prostaglandins. The catch is that the enzyme is only found in fresh pineapple, so canned and cooked pineapple and pineapple juice aren’t going to help get things moving.

Spicy Food

The reason why spicy foods are suggesting as a way to naturally induce labour is because the food can cause spasms in the intestines. With the uterus being located close to the intestines, it may begin to contract at the same time. This induction method is usually classed in the realm of old wive’s tales but as long as you’re not suffering from heartburn it’s worth a try.

Castor Oil

Castor oil induction works on the same theory as spicy food, intestinal cramping causes uterine cramping and therefore a start to labour. This method will also cause your bowels to empty within a few hours of taking it. The biggest concern here is that your baby will empty his or her bowels as well which is quite dangerous, so please use this method only with strict medical assistance.

Acupuncture

To naturally induce labour with acupuncture, several acupuncture needles are placed in particular spots on the lower legs, feet and hands. Sometimes these needles will be stimulated with an electrical pulse, depending on the acupuncturist. You must be overdue before and have a doctor’s permission before attempting acupuncture to induce labour as it is quite effective and a lot of women will go into labour 6-48 hours after their first session.

While the following two things won’t necessarily induce labour naturally, they are both uterine tonics and will help with preparing your cervix and uterus for labour and birth.

Evening Primrose Oil

Evening primrose oil is a great source of prostaglandins and can be used to naturally induce labour from around 34 weeks. There are two options for using evening primrose oil, orally or internally, and both are quite effective at ripening the cervix.

The recommended oral dosage is two 500mg capsules every day from 34 to 38 weeks, at which time you can increase to 3-4 capsules per day.

It isn’t recommended to use the capsules internally until 36 weeks. At which time, one or two entire capsules can be inserted vaginally as close to the cervix as you can reach. It’s best to do this at bedtime, as the oil will pool at the cervix overnight while you are sleeping. You may have some excess oil discharge in the morning, so wearing a pad is recommended.

Raspberry Leaf Tea

The aim of raspberry leaf tea is to tone the uterine muscles and is thought to help your contractions be more efficient when labour starts. So whilst it isn’t a direct labour induction method, it can be quite useful. You can start taking the tea as a drink, which is quite bitter, or you can take capsules orally from around 28 weeks.

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My due date came & went without a hint of labour starting. I wasn’t surprised though as my first child was eight days late.

When I was two days overdue I had a long appointment at the hospital, where I had a stretch & sweep done & found out I was 3cm dilated, so at least things were happening. That afternoon I had heaps of braxton hicks due to the stetch & sweep so was getting ready for things to start happening. Two days later (40 weeks 4 days) I lost my mucus plug.

Next I had my 41 week appointment & it was quite a non event, basically I was given an appointment two days later to go to the Feto-Maternal Assessment Unit (FMAU) to be checked over & see what we were going to do next. The next day I had acupuncture & an acupressure massage done to start labour, I had one contraction walking back to the car but that was it.

My husband & I went to the FMAU ready to fight for our VBAC (Vaginal Birth After Ceasarean). I was told essentially I would be allowed legally to go to 40 weeks + 12 days at the maximum & I was already at 40 weeks + 9 days. Essentially the appointment concluded with me being booked in for ARM (Artificial Rupture of Membranes) at 7am in a few days time. Everything was favourable. I was still at 3cm, but my cervix was “very thin” and bub had moved a bit so was now only 1/5 engaged.

10pm that night, only a few hours after my ARM was booked I walked into my lounge room & felt a small gush & told my husband “Either I just wet myself & didn’t realise it, or my waters have broken.” For the next hour and a half every time I moved there was a small gush of fluid. I went to bed at around midnight, but managed to only sleep for an hour before contractions started.

I got up and paced the house. I had a hot shower that really helped with the back pain for a while & then got out to pace some more. At around 3.30am I felt like I wasn’t able to cope on my own so considered waking my husband, but decided to wait until 5am so he could get some rest. The contractions seemed to be coming pretty close together but I was too busy concentrating on getting through them to actually do any timing.

I ended up waking my husband at around 4am, as I couldn’t cope on my own anymore. He said the contractions were coming every 5-6 minutes and I didn’t believe him! He called the hospital & they were convinced I was close, even though I wasn’t convinced. In the end we decided to go to the hospital at around 5am. We called my parents & dad stayed at home with our son (who was still asleep) and mum came to the hospital with us. They almost called an ambulance for me as I was struggling to get in the car. I didn’t want to sit because walking & being upright felt so much better, but the thought of being taken by ambulance convinced me to sit for the 5 minute drive!

When I finally managed to get to the delivery suite (stopping every few minutes to breathe through the contractions) I was checked and still only 3cm dilated. I was devastated that I had done all that work to be at the same place as I started. Bub was checked & had a fetal monitor thingo put on her head & I as left to labour for a while. I varied positions, on all fours on the floor, kneeling in the shower/bath with water running on my back, walking, leaning against my husband… I started to struggle with the pain & not getting a break between contractions so had a shot of pethadine (which did nothing) and was told I was now at 4cm, almost halfway there!

An hour & a half later I convinced everyone I absolutely had to have an epidural, as the back pain was now intolerable. The anesthetist arrived & I had another internal to check dilation & I was at 8cm. I just knew that it was too late for the epidural, so this was it, 8cm and I had to do the rest on my own without drugs.

I had another internal a while later as I was badly needing to push but was only at 9cm. After another hour I was bleeding more than the nurses were happy with so it was decided that it was time to head to surgery for another ceasarean.

Off I went to theatre….. I was given the anti nausea meds and taken in for the spinal, all the while still contracting & feeling a huge urge to push.

At 12.06pm Juliette Catherine came into the world, with her hand on her face, a big dent in her head & looking very purple. She was kept by my side until she started coughing but then had to be taken down to the SCN (Special Care Nursery) to be put on oxygen. I was put back together & sent to recovery. My blood pressure was too low so I was kept in recovery for almost two hours until it stabilised. I was then taken back to the ward & told that I had lost just over 1.5L of blood so would need a blood test the next day to confirm if I’d need a transfusion (which I didn’t in the end).

I was then wheeled in bed down to the SCN & got to meet my baby girl & feed her for the first time when she was around 2.5 hours old.

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My first twinges, like period cramps, started around 3am one day about two weeks before my due date.

I had an appointment with my obstetrician that morning. I was glad to hear from him that things were progressing, I was fully thinned out, and to go home and wait for things to “crank up”.

Fake labour

By 3am the next day I was on the couch, taking a break from pacing around the backyard unable to sleep. The cramps were worse and about six minutes apart but didn’t seem to be fully fledged contractions. By dawn I was losing my patience.

On my next call to the hospital they said to come in for them to check me out. My husband and I headed in grateful for some activity. After testing the pad I had been wearing for amniotic fluid to see if my waters had broke, monitoring the baby, and warning me this could go on for days we decided to head home. Apparently I was in “spurious labour”, a fake one, which could even disappear altogether!

All about backs

Luckily that was not to be. I stood up and fluid leaked out. The waters had broke afterall! My obstetrician came in and declared I was half way already, 5cm dilated.

It was quickly decided my baby was posterior – head down but facing the wrong way, with the back of her head against my spine. All I could remember reading about a posterior birth was the word “excruciating”.

Being posterior meant her position was stopping the labour from progressing. Since the waters had broke action was taken. My labour was “augmented” with a drip of some concoction to get the contractions cracking and hopefully flip her around.

Getting through the contractions with gas

Before long I fully understood what people had been trying to tell me – you can’t talk through a contraction. The waves of pain washed over me as my husband clung to the read-out of them from the monitors to help him understand what was going on.

Eventually I asked for some gas. I had decided to avoid the drugs if possible. The gas really saved me; it kept my breathing measured, gave me a nice little head spin and got me through until my obstetrician declared it was time to start pushing.

A manually manipulated birth

Baby was still posterior but doing well according to the monitors. My obstetrician hoped to flip her around manually on the way out. I later understood it takes a particularly experienced and skilled doctor to do this.

With his hands up there and me pushing like mad we succeeded. After about 33 hours of spurious labour, 5 hours of all out contractions, and an hour of pushing Maggie Joy was born.

It is kind of common

I later learnt my brother was born in the posterior position. Two other mothers I met through my mother’s group also experienced a posterior birth. The end results varied, one had a emergency cesarean and the other delivered with the help of forceps. My sister-in-law later had a posterior birth as well. So, it seems kind of common to end up with a posterior baby. Happily, all babies and mothers are doing great.

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Births, Deaths and Marriages Victoria has an excellent Popular Names Search facility online where you can look right back to 1929 for the top 100 girl’s and boy’s names for inspiration. Find it here. This data isn’t publicly available for any other state governments.

Here are the top ten girl's and boy's names popular from the 30s to the 50s that is not popular right now anywhere in Australia.

Girls:

Margaret is a clear leader. It was number one through the 30s and 40s to drop to fifth in the 50s.

Elizabeth hung towards the bottom of the lists in the 30s through to the 50s.

Patricia and Barbara were big in the 30s and 40s but disappeared from the top ten in the 50s.

Judith, Helen and Lynette were popular from the 40s to the 50s.

The top choices in the 50s clearly changed away from previous trends. Jennifer, Susan and Christine where the top three for the decade, not seen in the decades before.

Ten classic baby girl names from the 30s to the 50s in Victoria that are not popular today:

1. Margaret
2. Patricia
3. Barbara
4. Elizabeth
5. Judith
6. Helen
7. Lynette
8. Jennifer
9. Susan
10. Christine

Boys:

Classic names really come in to play with boy’s names. Biblical names like John, Peter, and David were big from the 30s to the 50s and are not seen on top ten lists in Australia today.

Robert was also very popular, steady in third position from the 30s to the 50s.

Ronald and Brian were popular from the 30s to the 40s. Ian appeared in the 40s and continued popularity into the 50s.

Kevin, Kenneth and Donald were towards the lower end of the 30s list and have not been seen since in Australia.

Ten classic baby boy names from the 30s to the 50s in Victoria that are not popular today:

1. John
2. Robert
3. Ronald
4. Brian
5. Peter
6. David
7. Ian
8. Kevin
9. Kenneth
10. Donald




Click here for Australia's widest selection of baby name books


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]]> http://www.ninemonths.com.au/classic-baby-name-ideas-that-are-not-popular-right-now/feed/ 0 http://www.ninemonths.com.au/a-father%e2%80%99s-presence-during-childbirth-not-always-best-option/ http://www.ninemonths.com.au/a-father%e2%80%99s-presence-during-childbirth-not-always-best-option/#comments Mon, 19 Oct 2009 06:55:43 +0000 Nikki Haynes http://www.ninemonths.com.au/?p=1904
11. Sex after Childbirth
12. Sex Following Childbirth

The Daily Mail have recently published an article on whether fathers should be present at the birth of their child.

For those fathers who make it through without fainting, the miracle of childbirth is an unforgettable experience. But their presence could actually be harming the mother and child, a leading obstetrician warned yesterday. Michael Odent claims having a husband or partner in the room at the birth increases the likelihood of a Caesarean section, subsequent marriage break-up and even mental illness.

A leading obstetrician says women are more likely to have problems giving birth if their partners or male doctors are present. He also believes it makes the labour longer and more painful because the woman is distracted by the father's anxiety.

Delivering children would be much simpler if women were left alone in the care of their midwife, he claims. 'The ideal birth environment involves no men in general,' he said yesterday. 'Having been involved for more than 50 years in childbirths in homes and hospitals in France, England and Africa, the best environment I know for an easy birth is when there is nobody around the woman in labour apart from a silent, low-profile and experienced midwife.

'In this situation, more often than not, the birth is easier and faster than what happens when there are other people around, especially male figures – husbands and doctors.' More than 90 per cent of births in the UK have a male partner in attendance, studies show. But Dr Odent claimed that having males present at the birth makes the mother tense, leading her to produce adrenaline.

This slows her production of the hormone oxytocin, which is vital for childbirth, thus extending the length of the labour. 'If she can't release oxytocin she can't have effective contractions, and everything becomes more difficult,' said the French doctor, who runs the Primal Health Research childbirth charity in London. 'Labour becomes longer, more painful and more difficult because the hormonal balance in the woman is disturbed by the environment that's not appropriate because of the presence of the man.'

Critics say there is little evidence to support his claims - Duncan Fisher, of the fatherhood advice website Dad Info, said: 'I think he's wrong and is not basing his argument on evidence either that it damages men or their relationships with mothers. Of course, not all men are nervous and a lot of women would be even more nervous without their partner there. Mothers want them there because it is not home.'

Mary Newburn, of the National Childbirth Trust, said there were now cultural pressures on men to attend the birth of their child. She added: 'There's such a feeling among women that "you got me into this, I have carried the baby for nine months and now I have to go through labour and birth, so the least you can do is be with me, and if you feel a bit squeamish, then tough. The most important thing is that the woman feels safe, secure and supported, so if she wants to have a woman around instead, that's fine.”

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The bills resulted from a review earlier in the year by Rosemary Bryant, Commonwealth Chief Nurse (a position established by Roxon), which concluded what Australian women by and large have been saying for years, that unless you’re privately-insured there’s not enough choice when it comes to giving birth, especially in a regional community. Roxon’s bills also added to the growing push for collaborative care, making midwives more central in maternity care as part of a team-based approach. It needs to be said, however, that doctors are not over-keen about the reforms.

If Roxon thought this major reform would get support from those who support choice in "birthing", she was wrong. The bills upset many homebirth advocates who wanted Medicare funding for midwives outside clinical settings like planned home births, and 'homebirth midwives to have professional indemnity cover.

Roxon’s bills established a publicly-funded professional indemnity scheme for midwives, but didn’t extend to services provided outside clinical settings where risks are much higher. Private insurers won’t provide indemnity cover for homebirth midwives because there’s too few of them to provide a premium pool, and homebirths are too high risk.
This hasn’t stopped some women suing after bad outcomes.

As Ms Bryant’s report notes, if one practitioner can’t be sued [and many homebirth midwives strip themselves of assets and require tight contracts against litigation, then some clients will try to sue other practitioners who were involved, e.g. obstetricians called in at the last minute when a homebirth has gone badly wrong. Other medical professionals are reluctant to become involved now for fear of becoming 'the litigee of choice'.

The reaction from many homebirth advocates has been extreme and Nicola Roxon has been vilified across the blogosphere and deluged with letters and emails.

Many claim that the Government is seeking to ban homebirths, when it is doing no such thing, and claim - against considerable contrary evidence - that homebirths are as safe    or safer than deliveries in clinical settings, including birthing centres.

The missing fact in the virulent attacks on Roxon and her reforms -- which the Coalition have eagerly taken up in Parliament -- is that only a tiny fraction of Australian women choose homebirths - 0.22% of all births in Australia, according to Bryant’s report. Even in New Zealand, where taxpayers fund homebirths, the rate is only 2.7%. Moreover the rate was declining rapidly in Australia even in the 1990s, when homebirth-midwife insurance was available.

No one is stopping Australian women who want homebirths from choosing them. Nicola Roxon’s bills merely continue the current approach of not providing Medicare funding for homebirths and require that midwives are either part of a professional, accredited, indemnified, collaborative care model.

What should have been hailed as a major midwifery step forward in the Australian health system - long characterised by a maternity care approach dominated by obstetricians (usually male) has been drowned out by ideological attacks from a tiny unrepresentative minority.

AGAINST THE ABOVE [midwife author]

The issue of homebirth divides the community into those who think it is OK and those  who don’t. Often, no amount of evidence, opinion, or research will convince either side.
The above view is based on two incorrect pieces of information. The first is that "no one is stopping Australian women who want homebirths from choosing them". The second is that there exists 'considerable evidence' that home births are dangerous.

To start with the first. As of July next year it will no longer be legal to have a homebirth attended by a registered private midwife in Australia. This is a fact, the reason being that the state and Commonwealth governments are implementing a National Registration and Accreditation Scheme for health professionals.

As part of this scheme a health professional must hold professional indemnity insurance in order to register to practise. Private midwives are presently unable to obtain such insurance because there is no insurance product available for them to purchase: they form too small a collective to make it worthwhile for an insurer to provide that product.

The legislation currently before Parliament proposes indemnity insurance to some midwives. It is not at all clear who these midwives will be only that they are "eligible" and that they will work "collaboratively" and that they won’t attend homebirths. Extending this legislation to cover homebirth midwives is the only realistic way that homebirth with a registered private midwife will remain an option for Australian women after July 2010.
This is why so many have written to Nicola Roxon, visited their local MPs and made submissions to the recent Senate inquiry concerning this legislation.

The second piece of incorrect information is that home birth is an inherently dangerous and high-risk option. There is a body of evidence regarding the safety of homebirthing. The most recent published study (only a few months ago), of over half a million low risk births showed that women and their babies were as safe at home as they were in hospital. Even the Australian homebirth study published over a decade ago found that low-risk women were no less safe at home giving birth.

That study did point out that the practices of unregistered midwives versus registered practitioners was the issue of concern. The fact is that flawed research from the 1970s which falsely concluded homebirths were not safe has misinformed government policy for decades.

The UK Department of Health website states that "for a healthy woman experiencing a normal pregnancy with no major complications anticipated during the birth, studies have shown that it is equally safe to be attended by midwives in the comfort of your own home as to have your baby in hospital." The Department of Health in the UK has made one of its priority targets for 2009/10 to give more mothers-to-be the opportunity to choose to give birth at home.

One could write many pages setting out the breadth of evidence that supports homebirth as an option for women but would distract from the fact that at its heart this debate is not about safety or risk or insurance. It is not a turf war about whether obstetricians or midwives should be the most important care provider for pregnant women. It is about whether all Australian women have the autonomy to make their own choices about how they will give birth -- a fundamental choice about a fundamental life experience.

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There’s plenty of evidence to suggest that the support of a trusted, caring birthing partner can make the experience easier and a shorter experience for the mother Evidence shows that a birth partner reduces the likelihood of a forceps delivery by 40 per cent and a Caesarean section by 50 per cent. You'll cut your chances of needing a drip to artificially speed up labour, and of needing strong pain relief, such as an epidural. The benefits extend beyond birth, too, with higher rates of breastfeeding, better maternal and infant health, and a lower incidence of postnatal depression.

Around 96% of fathers attend the birth of their child, they want to be there at that special moment and is a powerful bonding experience. However many also says that they often feel helpless, so it’s a good idea to ask your mum of a friend to be present too, so that he can take time out if it all gets too much.

To prepare for the big day the partner should attend prenatal classes with you, read up on the birth process and hospital procedures, and talk to other parents about their experiences. Birth partners should also meet the midwife who is likely to deliver your baby. They also need to know your birth plan.

A birth partner has many roles (coach, comforter and just to be there); the art is sensing what you need and when. The key role is to help you relax, which makes contractions more efficient and helps labour progress more quickly. They can also make sure that you’re drinking enough fluids, provide snacks if your energy levels fall, and phone friends and family to let them know you're in labour.

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A Caesarean is meant to be a lifesaving operation rather than an operation of convenience. But figures show that many Caesarean deliveries are carried out where the threat of emergency does not exist.

The World Health Organisation recommends that the incidence of Caesarean section delivery should not exceed 10-15 per cent.

Yet in Australia, the rate is approximately 20 per cent, compared to five per cent thirty years ago.

In the 1970s the Caesarean rate worldwide remained constant at 5 per cent.

In Australia statistics vary between hospitals. However, if you are a women aged between 35 and 39 years and you are having your first baby in a hospital, you face a Caesarean rate of 40.4 per cent.

Earlier this year, British obstetrician Professor Fisk predicted that within the next ten years half of all babies would be delivered by Caesarean.

It cannot be denied that in emergency situations, Caesarean deliveries have saved lives. But where there is no emergency, there is no evidence to indicate that Caesareans reduce the possible trauma and risks of childbirth.

On the contrary, there is documentation to show that Caesarean delivery increases the incidence of respiratory distress in a newborn. It is known that the passage through the birth canal prepares the baby for independent breathing by massaging the respiratory organs and aiding the elimination of mucus from their system.

Furthermore, Caesarean delivery has a high incidence for post-traumatic stress syndrome for mothers and arguably also for babies. Many mothers need to overcome the psychological stress of missing the birth and may experience emotions of guilt.

Australia is not alone in experiencing an ever-increasing number of caesarean deliveries. In the United Kingdom, the figure is 20 per cent compared to 3 percent thirty years ago and in the United States, Caesarean deliveries comprise 25 per cent of all births.

So why the increase? There are several factors thought to influence these rising figures. In contrast, the Netherlands has a Caesarean rate of 7 per cent, thought to reflect a different clinical approach (rather than indicating a overall state of women's health).

One thought is that midwives and obstetricians have differing approaches.It is often suggested that midwives tend to take a more wholistic approach whereas the medical fraternity of obstetricians encourage more medical intervention with a view that safety is their main concern.

There is no doubt that this is largely influenced by current trends in medical litigation and it seems the paranoia about legal liability is not without foundation. A recent Senate Committee report confirmed the increase in medical indemnity premiums for all obstetricians in Australia as a further factor affecting the way births are carried out.

The increasing number of international celebrity mothers opting for elective Caesarean has been identified as having a malign influence on mothers-to-be.

In an age obsessed by body image, it has been suggested that women are following their Hollywood counterparts by rocking up weeks early to be induced, hence avoiding the final growth phase that further alters their body shape, and choosing to deliver by Caesarean section.

At London's Portland Hospital, the birthplace choice of many celebrity mothers, 950 out of 2,165 births last year were Caesarean and just 386 of these were emergencies.

Many women are misguided by being lead to believe that a vaginal delivery after a Caesarean is not advisable and in some cases not possible.

In Australia Birthrites: Healing After a Caesarean, is an organisation dedicated to helping women make informed choices relating to their birth and subsequent births. Birthrites has a particular interest in helping women heal following a Caesarean birth and supports women in their choice of a vaginal delivery after a Caesearean birth.

For further information: www.birthrites.org

Related posts:

1. The Baby Blues
2. Breech Birth

Raspberry Leaf Tea

Raspberry leaf is a reproductive tonic specific to pregnancy and childbirth. Herbalists called it a “partus preparator” and claim it is one of the best herbs for use in preparing for labour. It controls bleeding, is high in calcium and magnesium, stimulates the release of oxytocin and strengthens and calms the uterine muscles in preparation for labour. In preparation for childbirth, drink raspberry leaf tea daily.

In a concentrated form raspberry leaf tea can cause uterine stimulation. It is not recommended for women at risk of miscarriage or preterm labour. In most cases it is fine, but if you experience any stomach pain consult a medical practitioner.

Make Love

Studies have found that sexual intercourse during the last few weeks of pregnancy can help soften the cervix in preparation for labour. Some women are highly sensitive to the prostaglandins in semen.

Prostaglandins are fatty acids made naturally in the body and are found in semen in a higher proportion than anywhere else in the human body. Women secrete prostaglandins during the latter stages of pregnancy both to soften the connective tissue of the cervix and increase oxytocin production in the muscle cells of the womb in preparation for labour. Synthetic prostaglandin gel is often used to soften the cervix and womb to induce labour. Many medical professionals recommend sex during the last few weeks of pregnancy for these reasons.

Birth Plan

Many women consider making a birthplan as psychological preparation for childbirth. Although some perceive a plan as a “wildcard” it may be useful to have an outline of which you, your birthing partner and your medical professionals are able to work towards. Check out how to make your own birthplan.

Perineal Massage

The perineum is the area of tissue between the anus and the vagina. This area stretches tremendously during labour and birth and although pregnancy hormones help prepare the perineum for this, many women find it beneficial to massage this area regularly during the last few months. Such preparation can be helpful in minimising possible tearing or the need for an episiotomy. It is possible to massage this area yourself. Click on perineal massage for more information.

Be Active

Remaining active encourages circulation and the production of natural hormones, enhances energy levels and strengthens muscle tone in preparation for childbirth. It has been proven that women who are fit have safer and more positive birth outcomes. Health and fitness experts confirm that exercising regularly is more beneficial than exercising randomly. Regular exercise builds strength and stamina and reduces the possibility of injury.

Nipple Stimulation

Breast and nipple stimulation can produce a strongly contracting womb and for this reason is sometimes encouraged to restart a labour that has stalled. Nipple stimulation is also though to enhance the ability to breastfeed both in milk production and particularly for women with inverted nipples.

Water

Many women have discovered that being immersed in water can be comforting in the lead up to labour. Lying in warm water increases venous pressure promoting the return of blood to the heart more efficiently. It also enhances cardiac action and slows the pulse rate. Total relaxation in the warmth and comfort of a bath may also help the uterus to contract more effectively. Water counteracts the force of gravity and reduces pressure felt from inside the body.

Meditation

Meditation is a most powerful way to relax the mind and promotes a greater ability to cope with stress, shock and trauma. The increased awareness experienced during meditation is medically supported by a definite pattern of electrical activity in the ‘thinking’ part of the brain called the cerebral cortex. The brainwaves associated with this electrical activity are called alpha waves. Similar waves are found in calm, dreamy states, such a sleep. It is thought that these brainwaves have a beneficial effect on the body’s natural control processes, slowing the heart and lowering the blood pressure.

According to English Childbirth Educator Sheila Kitzinger, ninety percent of childbirth is determined by what is going on in the head. A clear and focussed mind has a greater chance of leading to a positive labour. If you view the pain as productive and with a purpose, your body and mind will be more dynamic in its response.

Herbal Medicine

Herbal medicine has been used for centuries to help women prepare for childbirth. The following herbs are noted for their medicinal value in inducing labour and preparation for childbirth:

Squaw vine tones the uterus, urinary tract and bowels and is used to prevent bleeding, enhance labour and promote lactation.

False unicorn root tones the uterus, aids delivery and balances hormones.

Wild yam regulates hormones, is anti-inflammatory and antispasmodic, reducing cramping and toning the liver.

Dong Quai is noted in traditional Chinese medicine for its ability to encourage blood flow to the uterus.

Peony is known as a foetal calmer and is used with Dong Quai to regulate hormones and soothe the uterine muscles.

Withania is a traditional pregnancy tonic helpful to relieve stress, promote sleep and boost energy.

St Mary’s Thistle helps digestion and cleanses the liver.

You or your herbalist may prepare the following 200 ml formula for use after the 34th week of pregnancy:

Herbal Formula for Labour

Red Raspberry Leaf 20 ml
Nettle 20 ml
Squaw Vine 30 ml
False Unicorn Root 20 ml
Withania 50 ml
St Mary’s Thistle 30 ml

During the 34th week, take 2ml daily, the 35th week take 2 ml twice a day, the 36th week take 2 ml three times daily, the 37th week take 5 ml twice daily, the 38th week take 5ml three times daily, the 40th week take 8 ml three times daily. If the practice contractions are too strong, stop and start from the beginning with 2ml daily again.

Aromatherapy

Aromatherapy is the use of essential oils as a healing tool. It works through olfactory stimulation, the sense of smell, to directly affect the limbic system that controls emotions. It can be applied via massage, compresses, inhalation, bathing, oil burner or room spray.

Jasmine is noted for its properties in preparing the uterine muscles for labour. Prepare the following blend for use in the labour room:

Labour Blend

50 mls base oil (either grapeseed, sweet almond or coconut oil)
3 drops jasmine essential oil
3 drops rose essential oil
3 drops neroli essential oil

Reflexology

Reflexology uses pressure points on the feet to help induce labour and numb pain. Based on the concept that the entire body is reflected in the feet, it is viewed as an effective but non-invasive method to stimulate the body’s natural processes. Although it has not been possible to successfully explain why it should work, there is proof that it does. According to studies in England, regular reflexology treatments from mid pregnancy seem to lead to shorter, easier labours. It is believed reflexology stimulates the release of the hormone oxytocin that helps contraction of the uterus. Some midwives in Australia are familiar with the reproductive reflex points located around the ankles.

The point located in the natural depression on the inside of the ankle helps the uterus prepare for birth. In the final month of pregnancy, you or your partner can massage and press into this point.

Rest

Tension and fatigue tend to increase labour pain. Many women find it necessary to sleep separately from their partner in the final few weeks of pregnancy. While any women experience disrupted and uncomfortable sleep in the last few months of pregnancy, it is common for women to enjoy a most extraordinarily satisfying night’s sleep the night before labour begins.

Pressure Point Therapy

Acupressure, acupuncture and shiatsu involve stimulation of pressure points along the body. The concept is based on the principle that separate lines called meridians supply energy or “chi” to related organs. Pressure points are located where the meridians run close to the surface of the skin allowing access to the flow of “chi”. Scientists agree that activating pressure points encourages the release of endorphins and enkephalins within the body. As well as promoting wellbeing, they induce relaxation and are affective forms of pain control during labour.

Self -help acupressure points useful in preparing for labour:

• Spleen 6
• Bladder 32
• Kidney 3
• Bladder 67
• Bladder 23
• Gall Bladder 21
• Stomach 36

All these points are to be avoided up until the 34th weeks of pregnancy and then can be used a frequently as desired and during labour. For exact location of these pressure points see Using Acupuncture, Acupressure & Shiatsu

Bach Flower Remedies

The Bach flower remedies are extracts of plant sources preserved in a small amount of alcohol. Although medical research has failed to come up with an explanation of the effectiveness of the Bach remedies, it is accepted that there is a physiological basis for its benefits. Many people use the remedies and swear by their effectiveness. Dr Edward Bach developed his remedies primarily for self-help use. There are several ways in which you can use the remedies. The most common is to put two or three drops under the tongue every four hours to dissolve slowly, or alternatively add two or three drops to water or juice and sip slowly.

The following remedies are particularly useful in preparation for labour:

Rescue Remedy

A compound of five of Bach’s original essences, cherry plum, impatiens, rock rose, clematis and star of Bethlehem. Take a few drops on the tongue every hour during labour. Rescue Remedy can be used as a compress following caesarean section, tears or episiotomy. It is also available in a cream for bruising.

Cherry Plum

For panic and fear of losing control

Clematis

To enhance concentration and focus

Gentian

For confidence and courage

Hornbeam

To renew mental and physical vigour

Olive

For complete exhaustion

Rock Rose

For extreme fear, panic, terror or hysteria

Walnut

To ease all transitions in life and protect from outside influences

Bush Flower Essence

The history of flower essences can be traced back thousands of years with many cultures recognising the benefits of flower essences to treat emotional health and wellbeing. The following essences are useful in the latter stages of pregnancy:

Wild Potato Bush

Wild Potato Bush is recommended to relieve frustrations that may arise due to physical restrictions and limitations. It is also useful to induce sleep when sleeping becomes uncomfortable.

Grey Spider Flower

Encourages calmness, courage and faith. Useful for feelings of fear or terror about the coming birth process.

Kapok Bush

Recommended for use during labour for persistence, strength and determination when you may feel like giving up.

Macrocarpa

Ideal to promote stamina and endurance during labour.

Confid Essence Drops

To inspire confidence in ability to cope.

Emergeency Essence Drops

Recommended to reduce panic, distress and fear, Emergency Essence Drops is a popular combination for use during labour, after difficult labour or where there has been big loss of blood.

Arnica

Arnica is a well-known homeopathic preparation used to heal bruising and promote a rapid recovery. Homeopaths and naturopaths recommend taking arnica once a day as an oral preparation four days before your due-date. Taken as a 30c potency, the dose should be repeated at the start of labour and again just before delivery. It is thought to speed labour and aid muscle relaxation, reducing pain.

Massage

Massage is one of the oldest forms of healing. Both medical professionals and alternative therapists acknowledge the profound benefits of massage. Positive psychological, physiological, emotional and spiritual effects can be achieved.

Massage assists the body’s natural healing process by boosting circulation, improving the supply of oxygen and nutrients to the tissues, and draining the lymphatic system of toxins and lactic acid. When combined with acupressure, it is an effective pain relief tool during labour. Ask your birthing partner to deeply massage your lower back, buttocks and feet.

Massage on the lower back and sacrum eases pain and the reproductive system receives blood and nerve supply from lumber 3 and lumbar 4 in the lower spine.

Yoga

Yoga is a relaxing, safe and effective form of exercise during pregnancy in preparation for childbirth.

Janet Balaskas, a pioneer in Active Birthing, incorporates yoga in her philosophy, believing it provides the key to a comfortable and healthy pregnancy, improving strength, vitality and flexibility.

Yoga promotes stillness of mind, creating a greater capability to focus. It relieves stress and anxiety, encourages hormonal balance and increased stamina. Many women consider yoga a most empowering way to prepare for labour, childbirth and becoming a parent. It helps lower blood pressure, aids efficient digestion, strengthens the pelvic floor muscles and reduces constipation.

Practitioners claim one session can promote a bowel movement within the subsequent hour. Yoga also increases muscles tone and helps back pain.

Pilates

Pilates is a body conditioning discipline that focuses on the breath to achieve improved flexibility and strength for the whole body. The emphasis is on developing a strong central core from which to move with particular focus on the abdominal, back and buttocks. Because it is a non-aerobic, no-impact system, the basic exercises are ideal during pregnancy and childbirth because they are gentle and slow.

Pilates helps improve posture and teaches body control and stress management. It strengthens the pelvic floor muscles in preparation for childbirth. Pilates can be practised from the beginning of the second trimester.

Breathing

Breathing techniques are an integral part of labour and childbirth. Most antenatal classes teach a form of breathing that encourages focus and concentration during labour.

There are various types of breathing but there are no rules about how you ought to breathe. When you are in labour your body will tell you what to do. Tune in to your own breathing pattern and do what works for you.

Many women say that adopting a particular breathing pattern has helped them control labour pain almost up until the delivery. In most cases the emphasis is on lengthening the out-breath, following it the very end. Ideally, breathing techniques should be practised from mid pregnancy. 

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