Integrated discussion, ideas, links and more


During the COVID 19 pandemic, when we ca not meet face to face, we are sharing as much useful information, ideas, links and discussion as we can.  Some of this is being done through WhatsApp communities, and you can join those here, and we are also storing that information on this page too.

Both Prenatal Yoga (Relax, Stretch and Breathe) and Mother and Baby Yoga include an integrated discussion or informal prenatal or parenting class.  These discussions are always interested and varied after each session I share more information, ideas and links.  Here are some of those follow ups, for anyone who might find them useful...


Perineal massage, a lot of good discussion and ideas:

There has been plenty of discussion this week on the RSB WhatsApp group about protecting the perineum during birth and how to avoid a tear on an episiotomy.  Episiotomies are not done so frequently in Switzerland - ideally there won't be any damage to the perineum at all, and the midwives here are quite hands on to help with that, but a tear is considered preferable to a cut - as it will usually be less deep and heal more quickly and more strongly.  An episiotomy is usually necessary for an assisted birth- one that uses ventouse or forceps.

 

Perineal massage, using water throughout the active labour (even if intermittently), spending time in the water or giving birth in the water, choosing particular positions and breathing patterns and making sure the midwife knows if you are fearful about tearing are probably all effective to prevent tearing.   Interventions (eg induction, or augmentation) can cause a cascade of other interventions which may include (earlier) epidural and therefore reduced mobility, less optimal position for baby and so bigger stretch for the perineum, and more likely use of ventouse, and therefore episiotomy). 

 

If it’s an option for you and appeals then the geburtshauses usually report extremely low rates of perineal trauma (for example 96% women have intact perineum at the Tagmond).  This is partly because of the lower rate of interventions; the protocols about the length of time for stages of labour are different (more time, which again leads to fewer interventions like augmentation) and very high rates of water birth, plus women using a v wide range of positions to birth in. If a geburtshaus is not for you you can absolutely recreate those conditions in a hospital setting, you may need to be more of an advocate for yourself, to consider the effect of any interventions that are suggested (the ins and outs of why there are more interventions in hospitals than home births and birth houses are fascinating and complex).

 

So to help avoid stitches:

In advance:

- perineal massage from 34 weeks (if this feels okay for you - if it makes you feel really stressed then that  might become counterproductive.  There is research that shows that perineal massage from 34 weeks has a statistically significant effect on reducing tears - but equally there are many women who never do perineal massage and don't tear)

- pelvic balancing work and pelvic floor work, basically what we do in RSB

 

In labour:

- staying mobile, upright/forward leaning

- using the bath or birth pool

- choosing not to have an epidural, or keeping the epidural low dose

 

During the second stage/pushing stage/ as the baby’s head is emerging

- telling the midwife you are worried about tearing, she can be hands on and also suggest positions and breathing

- panting or doing steam train impressions when the baby’s head is crowning

- using all fours positions/Sphinx pose over squat positions (but the midwife will guide/coach you with this.)

 

I rather like this article on this topic


Some Yoga links and ideas:

Please stick within your limits and if anything feels uncomfortable please stop.  Whether you are pregnant or have a small baby, now is not the time to be pushing yourself, instead yoga should be about finding what feels good and keeping yourself within that feel good place.

 

Some prenatal Yoga from Yoga with Adrienne (also nice with a small baby):  https://youtu.be/0cKnStmV1dI

 

Some Spinning Babies Yoga moves from our regular RSB sessions.  See also www.spinningbabies.com

 

Some Mindful Mama relaxations and affirmations to listen to:  https://www.penguin.co.uk/articles/2016/mindful-hypnobirthing/

A Mother and Baby Yoga session, with sketch drawings and song ideas

Guidelines

RCOG guidelines on corona virus in pregnancy:  https://www.rcog.org.uk/coronavirus-pregnancy

 

Coronavirus and Breastfeeding: https://www.llli.org/coronavirus/ 


Follow up from RSB discussions


In Relax, Stretch and Breathe on Tuesday 28 January we had discussions ranging from "what happens during a caesarean" to "how do I chose which hospital".  A common theme in prenatal discussions is the "am I allowed to" topics around personal empowerment and we explored that also.  Here is more information and links on these topics.  For more detailed information please get in touch.
Caesarean birth:
A couple of good links around caesarean birth:
¨https://www.facebook.com/watch/?v=246200439668411this is a great (and totally non gory) explanation of the surgery part of the caesarean - and explains why it is major surgery, with a long recovery time.
A nice film about what to expect in an (elective) caesarean:
Empowerment and asking questions:
Most of us, with our first baby, are overwhelmed with the whole experience of pregnancy and birth (particularly birth), the volume of information to process, the new experiences, the anxiety and fear generated by the way birth is talked about and represented. As such we do the sensible thing, we look for the experts to guide us. We all have our own hierarchy of experts, of who we trust, and who we trust more. The experts we have here in Basel are excellent - from your well qualified and very experienced child birth educator, to your obstetrician, to your midwife supporting you through the birth, and the teams of specialists who support them all. 
The biggest expert though, is yourself. The professionals are expert and excellent in their own fields, but only you are expert in yourself, in what you are feeling, what you want, ad what feels right for you (and actually you also have more expertise in your own baby, and what they are currently doing, than anyone else, as you are the only person who can feel it).
I will keep on talking about empowerment, about asking questions, about educating yourself and your partner. I know that these topics can be uncomfortable. I know that there are many people who are happy to “go with the flow” and “do as the professionals tells them”, and that of course is their choice. But I also know how wonderful and powerful it can be to be proactive, what a difference it can make to families experience as parents, with feeding, with protecting themselves from postnatal depression and with preparing their own children (many years in the future) for their own positive birthing and family experiences.
I like this blog post, by the excellent Bridget Supple, on this topic:
This is something we look at in more detail in prenatal classes.
Hospital choice:
As we discussed in class, for some people it can be really hard to choose where to have their baby. All of the hospitals and geburtshauses here have excellent reputations, as do the home birth midwives, so wherever you choose you will have excellent care and a safe, professional environment. Within that, each place has its own vibe and its own style. This padlet has information about them all, so that you can go and visit them, and see how they feel to you. Because labour is so shaped by the hormones that drive it (or stop it), it is really important that if you do have the option (and i appreciate not everyone does), that you choose a place were you feel safe, confident and relaxed - and as that will be different for each person, it is important to get a feel for yourself. For the dates of the upcoming English language information evenings please get in touch.