Category Archives: Other

Videos & Podcasts

Exciting … so many wonderful ideas and they are going to come to fruition … started to pull together some videos and other resources to provide an online class … with the option of a Skype or face time consult … plus some podcasting … need an injection of hours and more energy.

 

Induction of Labour – Lesley Gilchrist (Independent Midwife)

Kindly copied from the VBAC support group page with permission …

Many of you have asked about induction of labour and some of the statistics that are being quoted are quite out of date. I’ve cut and pasted this article from my blog (didn’t want to fall foul of the the ‘no business advertising’ and this is important). I am a midwife first and foremost, but also a clinical researcher hence the subject and it’s content. Please PM me for more details if you wish.
Thank you, Lesley  Link  http://www.bespokebirthing.co.uk/blogs/

 

First things first… I’m not suggesting for a moment that babies need to be evicted by a certain date, or indeed that by going past a ‘due date’ or ‘best before date’ your placenta will somehow disintegrate (some people do actually claim that your placenta will just ‘stop’ working). Evicting a baby from their comfortable home whatever means you use is still an induction, natural or not. What I’d like to do is talk you through the normal human gestation which should lead nicely to induction of labour.

The Normal Gestation for Humans

When you’re first given you due date, it’s calculated from the first day of your last menstrual period plus 9 months and 1 week. But, would it surprise you to learn that what’s classed as term (the period of pregnancy at which point your baby is expected to be fully matured and able to survive outside with only the support of heat, love and nourishment) is anything from 37 weeks of pregnancy to 42 weeks of pregnancy (World Health Organisation).

This wide variation in gestation makes understanding the ‘due date’ even harder to comprehend; how can it be that with a 5 week window of normal gestation that we can give one date from which to work out when your baby will be ready to be born? Surely, if a baby is naturally mature and ready to be born at 37 weeks then 40 weeks would be 3 weeks ‘too late’, equally, a baby not physically mature until 42 weeks would be 2 weeks ‘early’ if born at 40 weeks. And, more counterintuitive, what of the babies born at 36 weeks, they’re classed as premature at only 1 week before they reach maturity if they were those babies physically mature at only 37 weeks. But, a baby physically mature at 42 or 43 weeks, born at 37 weeks may be classed as ‘term’, how does that work?

My son was born at 37 weeks and weighed 4200g (9lb 6oz), he had beautiful long finger nails and dry skin, a sure sign that he was physically mature, equally I have seen babies born at 41 and 42 weeks still covered in their white, petroleum jelly like substance known as vernix, most usually seen in babies of an earlier gestation.

What I’m trying to say is that each baby is unique and will come when he or she is ready. The problem lies with the ‘estimated due date’ (note the word estimated there) that’s given to you at your first scan. This date is used to calculate everything from your maternity leave to the thorny issue of ‘post term’ induction (beyond 42 weeks).

Induction of Labour for Post Term Babies

There are numerous studies that have examined birth outcomes for babies depending on which point of the pregnancy continuum they were born. A Cochrane review found that fewer babies died if babies were induced at 41 weeks rather than 42 weeks or beyond, however they also acknowledge that ‘such risks (of death) were rare with either policy’.

To put it simply, if we induced every woman’s labour at 41 weeks the risk of a baby dying is 3 in every 10,000 or 0.03% compared with 30 babies in every 10,000 or 0.3% if we left them alone, so you see, extremely small numbers.

Another important point to remember; you do not ‘have’ to have an induction of labour and equally the medical and midwifery profession have no right to ‘allow’ you to go over your dates and wait for natural labour. It’s their duty to ensure that you have all of the information to make the decision about what’s best for you and your baby; only you can decide. If you do decide to wait for natural labour and decline their offer of induction of labour you should be offered monitoring of your baby’s placental function to ensure that he or she are happy and healthy.

‘What’s the Catch?’, I hear you ask

Well, hands up who’s had this chat with a midwife or doctor; the ‘baby dying’ chat? Now, hands up who, during that chat was also informed of the risks of induction? I suspect that not so many of you raised your hands to the second question. So what are the risks of inducing your labour? To be clear, I’m talking purely about post term induction of labour, this post is not about induction of labour for any other reason.

For first time mothers 2 studies found that induction of labour increased the risks of Caesarean section (a Cochrane study in 2013 found the opposite, however that study didn’t exclude those women having subsequent births, which may have skewed the data).

In addition to the increased risk of Caesarean section you also have the following:

Prolonged stay in hospital (increased risk of hospital acquired infection)
Increased reliance on strong pain relief (epidural for example)
Increased risk of forceps or ventouse birth (epidural doubles the risks for first time mothers plus)
Increased risk of forceps or ventouse birth (syntocinon increases the risk of fetal distress hence the need for continuous fetal heart rate monitoring)
Increased risk of Caesarean section (continuous fetal monitoring is extremely unreliable and detects problems in 6 out of 100 women when they aren’t any, hence the increased need for Caesarean section and forceps etc)
Finally, inductions of labour take a long time, especially if this is your first baby. The pessary that’s used to soften your cervix takes around 24 hours to work, that’s 24 hours before a midwife can even break your waters. You will then be advised to walk around to see if breaking your waters alone will start your contractions. If the walking around isn’t successful you will then be started on the hormone drip (syntocinon) which is given through a needle in your hand. Because of the risks of fetal distress with this hormone you’ll also be attached to a monitor recording your baby’s heartbeat for the entirety of your labour.
So you see, nothing is without risk. What’s important is that you are given all of the information need to make an informed choice. Ask the questions about risk of going over your ‘dates’ but equally, ask the questions of risks of induction of labour and their consequent risks

Natural Methods of Induction of Labour

As much as I am a staunch proponent of ‘baby knows best’ with regards to their date of birth I’m also fully aware that the ‘estimated due date’ and the NHS machine is a strong beast to fight against. So it is with a heavy heart that I’m going to give you some tips on how to start your labour naturally.

Acupuncture and reflexology
They will help to prepare you for labour; I believe the most likely reason for our 5 week window of a normal term pregnancy is in part due to our busy lives and constant need for adrenalin to fuel it (see my shrinking cervix blog). If you’re tense and have low levels of adrenalin constantly circulating then the hormones needed for labour don’t stand a chance. It may be that your baby was ready to be born at 38 weeks but your anxiety and stress levels are hindering your body’s ability to start labour off. Acupuncture and reflexology (some theorists believe) help to restore that natural balance of oxytocin and help to reduce adrenalin production. This, theoretically should allow your baby to decide when he’s due to be born but won’t help him come sooner than he’s ready.

Clitoral & Nipple stimulation
Both of these methods (start from around 36 weeks) help you to produce oxytocin, your natural labour hormone. Now, once you’ve produced this hormone, theoretically you should start to feel cramps as your uterus contracts under the action of this hormone. If done frequently enough this gradual contraction of your uterus may help to encourage labour and to soften your cervix and your baby’s membranes.

Raspberry Leaf Tea or Capsules
There’s no evidence that this actually works to start your labour off, however equally there’s no evidence that it doesn’t work and there’s certainly no evidence that it’s harmful, so crack on I say. What raspberry leaf does do though is to help tone your uterus to make your contractions more effective during labour.

Other Methods
Pineapple: you’d need to eat massive amounts of this which just aren’t feasible
Sex: no more effective than clitoral stimulation
Baths, curries, divination: they don’t work I’m afraid, but if you’re partial to any of these they certainly won’t do any harm.

Vital Links – for all birthing women

This was created by Karen Law a doula and body worker in Scotland.  It has been reposted here with kind permission from her.

Hopefully you will find the information you are looking for here. Please report any links that don’t work or any ideas you have for new links.

All of us here wish you luck in your quest of making an informed choice that is right for you and your baby and will be happy to answer any specific questions you may have on your own thread.

Good luck and happy researching:-)

“Here’s to the friends who come together

To share the search to know

To you I say hello forever

Love does not end, but it grows”

Hello Forever by Karen Riem

 

*LINKS*

Best places to start:

http://www.caesarean.org.uk/

http://www.aims.org.uk/

http://www.caesarean.org.uk/articles/VBACOnWhoseTerms.html

http://www.radmid.demon.co.uk/vbac.htm

http://www.rcog.org.uk/files/rcog-corp/GTG4511022011.pdf (RCOG VBAC guidelines)

 

Debbie Chippington Derrick’s recent Presentation on Natural Birth after

Caesarean:

http://caesarean.org.uk/presentations/NaturalBirthAfterCaesarean.html

Silent Knife: A book you MUST buy and read:

http://tinyurl.com/2mbhn5 but not necessarily from that site 😉

Another great book, Spiritual Midwifery:

http://tinyurl.com/ozs4u

http://www.inamay.com/books.php

If you have trouble coming to terms with your previous CS:

http://www.plus-size-pregnancy.org/CSANDVBAC/csemotionalrecov.htm

http://www.birthtraumaassociation.org.uk/

http://www.tabs.org.nz/

http://tinyurl.com/5gscd   “You should be grateful”

http://www.sheilakitzinger.com/ArticlesBySheila/BadBirthHaunts.htm

A Relevant Book Review: http://www.birthpsychology.com/healing/breview11.html

and another brief overview: http://tinyurl.com/p6cto

Info about how to obtain your previous Birth notes (see also TIPS at

bottom of post):

http://www.nhs.uk/chq/pages/1309.aspx?categoryid=68

Mary Cronk’s scar monitoring procedures:

http://www.caesarean.org.uk/articles/VBACScarMonitoring.html

Scar pain during labour (will try to find suitable links to add also):

Email me and I shall pass on a good description from someone who has

experienced this and had a HWBAC nevertheless!

For those attempting a VBA2C:

http://www.homebirth.org.uk/vba2c.htm

http://www.plus-size-pregnancy.org/CSANDVBAC/vbac_after_2_cs.htm

http://www.plus-size-pregnancy.org/CSANDVBAC/VBA2Cstories.htm

And a birth story: http://www.homebirth.org.uk/bernadette.htm

http://www.caesarean.org.uk/articles/ElectiveSection.html

And risks of UR with VBA2C or more:

http://medicalcenter.osu.edu/mediaroom/press/article.cfm?ID=2835&i=17

4 links about pushing I wish I’d known about:

http://www.birthinternational.com/diary/archives/000558.html

http://www.birthpsychology.com/messages/push/push.html

http://www.midwiferytoday.com/articles/pushing.asp

Birth Without Active Pushing

http://www.harcourt-international.com/e-books/pdf/465.pdf

 

Optimal Foetal Positioning:

http://www.homebirth.org.uk/ofp.htm

Twin VBAC:

http://www.homebirth.org.uk/vbactwins.htm

http://www.radmid.demon.co.uk/twinbirth.htm

OK so it’s on Homebirth site but I thinks it’s relevant. Overdue:

http://www.homebirth.org.uk/overdue.htm

Also: http://www.infochoice.org/ic/ic.nsf/icy/12?OpenDocument

To scan or not to scan:

http://www.homebirth.org.uk/big.htm#2

Just say NO to induction:

http://www.birthrites.org/inductionRisks.html

http://www.kentmidwiferypractice.co.uk/induction.htm

http://www.radmid.demon.co.uk/induction.htm

http://www.mother-care.ca/bishop.htm

Natural Induction methods:

http://www.lifepassages.net/NaturalInduction.html

Perineal Massage:

http://www.birthingnaturally.net/cn/technique/perineal.html

Early Labour Mistakes:

http://www.birthingnaturally.net/birth/progress/elmistake.html

The most recent Cochrane Review

Continuous cardiotocography (CTG) as a form of electronic fetal monitoring

(EFM) for fetal assessment during labour:

http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD006066/frame.html

When trying to argue your case AGAINST monitoring:

http://bmj.bmjjournals.com/cgi/content/full/322/7300/1436

http://tinyurl.com/l4s9r

Birth plan inspiration:

http://homepages.picknowl.com.au/caressa/common/birthplan.htm

The Third stage:

http://www.homebirth.org.uk/thirdstage.htm

http://tinyurl.com/3cv7z9

http://www.cordclamp.com/

If you need to make a complaint about your Maternity care:

http://www.aims.org.uk/complaint.htm

And relative risks of VBAC  :-):

http://www.gentlebirth.org/archives/vbacrisk.html

Epidural anesthesia risk chart:

http://www.kimjames.net/Labor%20Side%20Effects.htm

What you need to know about midwives and homebirth:

http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=1446

A web site where you can download 21 leaflets about various aspects of pg,

labour and delivery:

http://www.infochoice.org/ic/ic.nsf/welcome_consumer?openform

Shoulder Dystocia, a very long link to read through with links at the bottom:

http://www.radmid.demon.co.uk/shoulders.htm

If you suffer from SPD:

http://www.plus-size-pregnancy.org/pubicpain.htm

http://www.pelvicpartnership.org.uk/index2.html

What about slow and/or long labour:

http://www.birthingnaturally.net/birth/progress/alslow.html

http://www.rcmnormalbirth.org.uk/default.asp?sID=1103622088724

Gestational Diabetes:

http://www.plus-size-pregnancy.org/gd/gd_index.html

Birth stories!!!:

http://www.vbac.co.uk/stories/

An outdoor birth!:

http://rachyllgyne.tripod.com/thebirthofgreyforestwalt/index.html

Runa’s Birth (a homebirth), a book to read to, and discuss with, your

older child:

http://tinyurl.com/rzxno

or Hello Baby by Jenni Overend: http://tinyurl.com/yg28qv

 

Fibroids:

http://www.radmid.demon.co.uk/fibroid.htm

(which has lots more links at the bottom) and

http://www.fibroidnetworkonline.com/index.php

 

Some info from Lamaze:

http://www.lamaze.org/institute/about/statements.asp 

10 Month Mammas!:  UNFORTUNATLEY BIRTHLOVE.COM NO LONGER EXISTS. I WILL BE TRYING TO FIND SIMILAR INFO TO REPLACE THIS LINK. WATCH THIS SPACE

http://www.birthlove.com/free/ten_month_mama.html

 

So baby’s not in the best position:

http://www.spinningbabies.com/

http://www.homebirth.org.uk/ofp.htm

http://www.gentlebirth.org/archives/position.html

If baby is Breech:

http://www.radmid.demon.co.uk/Skills.htm

http://www.breechbabies.com/contents.htm

http://www.birthinternational.com/articles/andrea13.html

http://www.mother-care.ca/breech.htm

http://www.moondragon.org/obgyn/pregnancy/breech.html

Optimal Foetal Positioning:

http://www.homebirth.org.uk/ofp.htm

If you want to find a Doula:

http://www.doula.org.uk/

http://www.douladirectory.co.uk/

A French site on Doulas:

http://www.doulas.info/english.php

And one for  Doulas in Austria:

http://www.doula.at/index.php

 

If you have Group B Strep:

http://www.gbss.org.uk/

…and want to stay at home:

http://www.homebirth.org.uk/gbs.htm

 

Polyhydramnios:

http://www.babycentre.co.uk/pregnancy/complications/apolyhydramnios/

http://www.gentlebirth.org/archives/polyhydr.html

http://www.homebirth.org.uk/htwostories.htm

 

When to have another baby:

http://www.caesarean.org.uk/FAQ.html#preGap

A MUST for everyone, how I’d prefer to have a CS:

http://www.guardian.co.uk/family/story/0,,1656246,00.html

Having difficulty deciding between VBAC and elCS:

http://www.childbirthconnection.org/article.asp?ClickedLink=274&ck=10168&area=27

 

NLH – Women’s Health – Professor David James: NICE/NCCWCH Caesarean

Section Guideline

http://tinyurl.com/m9dmo

 

Hypnobirthing:

http://www.hypnobirthing.co.uk/

Hypnosis:

http://www.homebirth.org.uk/hypnosis.htm

 

Milk Banking;

http://www.ukamb.org/about.htm

And a way to find out what’s local to you!:

http://www.drfoster.co.uk/localservices/birthGuide.asp

 

A British Independent Midwife:

http://www.marycronkmidwiferyservices.co.uk/

 

If only these American ladies were your MW:

http://www.sheilakitzinger.com/

http://www.inamay.com/

http://www.glorialemay.com/

 

Pelvises I have known and loved By Gloria Lemay:

http://tinyurl.com/javu6

A great site from a lady in Glasgow who says everything we believe in:

http://www.yourbabyyourbody.co.uk/default.html

VBAC in France, AVAC!!:

http://www.cesarine.org/avenir/avac/

A great Ozzie website, Joyous birth:

http://www.joyousbirth.info/

Another FABULOUS site from Oz:

http://www.cares-sa.org.au/

And a mw in Adelaide:

http://members.essentialbaby.com.au/index.php?act=ST&f=20&t=264271

An American site:

http://www.empoweredchildbirth.com/faq.html#12

And one from Singapore:

http://www.expat.or.id/medical/vbacinsingapore.html

 

Our MSN VBAC site:

http://groups.msn.com/vbac

A good Baby site:

http://www.askdrsears.com/
An Alternative to Tampons:

http://www.mooncup.co.uk/wc.php?u=1019

 

Also attached to this thread is an RTF file worth reading!

menstrual_cup.rtf – Taken from Natural Health Magazine, Aceville

Publications, January 2007

 

Mothers Milk Marketing Board:

http://www.lactivist.co.uk/
For turning those stupidly long links into manageable sizes:

http://tinyurl.com/create.php?url=about:blank

for understanding the shorthand:

http://www.babycentre.co.uk/refcap/545155

A few more of our own:

VBA2C – vaginal birth after 2 CS… and so on depending on the number.

HBAC – home birth after cs

HWBAC – home water birth after cs

elCS – elective cs

emCS – emergency cs

FTP – failure to progress

FFS & WTF – We leave that to your imagination !!! LOL