Don’t feel rushed through your antenatal appointments

I had lots of lovely midwives who looked after me during my pregnancies and the births of my two boys. But I also remember the bad one. She spoke so fast and in an accent that I had difficulty understanding. She acted annoyed when I asked her questions or to repeat herself, and I never felt like she was listening to me.

Every time I saw this midwife, I would leave the surgery in tears. She made me feel so unsupported and so insecure. If I had any worries about my pregnancy, I felt even more worried about them after meeting with her. It made me more timid about asking questions when I saw midwives, because I’d been made to feel that I needed to hurry through the appointment.

Having a problem with your midwife, or simply hearing all the time about how busy the NHS is and how strained midwifery services are, or even just a natural desire not to “make a fuss”, can lead to us not speaking up about our pregnancy worries.

A poll on the Babycentre website showed that more than 60% of women worried about wasting time when thinking about raising a concern, and almost 30% of women didn’t speak up because of it. This could lead to missing a chance to get medical help for a complication in pregnancy.

If things go wrong in your pregnancy, it is never your fault. But, you have a right to speak up and ask questions if you’re worried about anything, and trusting your instincts could lead to a problem being spotted before it gets worse. If you encounter a crap midwife who won’t help you, ask for a second opinion. And don’t let worrying about time-wasting or being a nuisance ever stop you from speaking up.

Tommy’s, King’s College London and Babycentre have launched the ‘Always Ask’ campaign to empower pregnant women to overcome fears about speaking to professionals about health concerns. These short videos aim to empower women to speak up and help them voice their concerns effectively.

The campaign is underpinned by a research-based project led by Dr Nicola Mackintosh at King’s College London. ‘The Re-Assure project’ aimed to enable women to share their safety concerns about life threatening illness in order to facilitate a maternity response. The project brought together women, health professionals, a writer and a digital artist to create an animation that follows a pregnant woman through her pregnancy journey.

The campaign also offers tips for speaking up in pregnancy, which have been gathered from women who took part in the project:

  • Don’t play it down – take your concerns seriously and others will too
  • Be specific – say what has changed, even if you don’t think it’s related to your pregnancy
  • Begin by saying, “I am concerned …”
  • Ask the healthcare professionals for their name
  • Make a list of all your concerns
  • Write down what you’re told
  • It’s ok to say you are feeling vulnerable and frightened
  • Before you leave that appointment – consider whether you have asked all your questions and are satisfied with the answers
  • If you can’t make yourself heard or you don’t agree or you feel uncomfortable, say “Let me think about that and get back to you”
  • If you are not happy with the response ask for a second opinion.

A good midwife would rather reassure you 100 times than miss a problem ONCE. If you are unsure, always ask.

This post is based on a press release received from Tommy’s. I did not receive any incentive to publish this information.

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Why birth plans are a waste of time for first-time mums

Is that a nice controversial blog post title? Well, it got your attention, right? Right. Okay, so birth plans might not be entirely a waste of time. But I think first-time mums in particular should be warned that they very well might be.

You see, when I was pregnant with my first child, nobody told me that a birth plan wasn’t really a plan. It’s more like a sort of wish list. To me the word plan connotes something that I have control over. If I plan to go to work tomorrow, then there is a 99% chance that I’m going to go. There are some conceivable events that could stop me from going, but in all likelihood, it will be purely up to me as to whether I follow through on my plan.

But when it comes to birthing babies, we have very little control as to how things are going to pan out. That is the truth that nobody told little old me. My birth plan was written on my heart. It had the following points:

  • I wanted to deliver at a midwife-led centre instead of in hospital
  • I wanted a water birth with only gas & air for pain relief
  • No induction
  • No epidural
  • No continuous monitoring
  • I was going to have a beautiful, calm, natural birth

I was so certain that these were the things that were needed to help me cope with the delivery. I also thought they were the best and safest options for me and my baby. However, at 10 days overdue I was showing meconium-stained waters with no other signs of going into labour. So this is the birth I got:

  • Birth in hospital instead of the midwife-led centre
  • I didn’t even go anywhere near a water birthing pool
  • I was induced
  • I had an epidural
  • I laid on my back the whole time, being continuously monitored
  • I screamed and cried and swore and was absolutely terrified and NOT CALM the entire time
  • I had an emergency c-section

It was the polar opposite of what I had wanted.

And I was absolutely heartbroken about it. I had spent so much time thinking about how it was all going to go down, and researching what the best things to do were. When I didn’t get to do any of those things, I saw myself as a failure. For me, failing to have the “natural” (read vaginal) birth I’d planned was like failing at something I thought I was born to do. I’d been gallivanting around telling my friends that my body was built to give birth. And it was. Just not the way I had intended.

I just wish that someone – anyone – had taken the pregnant me aside and told me just how unpredictable giving birth can be. And that at the end of the day, all that matters is that you deliver a healthy baby. So if you’re pregnant now or recently gave birth and are feeling disappointed by the experience, here are a few things that I think need to be said:

  • Remember that there is a possibility that all plans, wishes and expectations will go completely out the window on the big day. Accept that and don’t dwell too much on a future you can’t predict.
  • A lot of advice I was given from various sources made me think that I would need to “advocate” for myself during the birth. I would need to keep those doctors and midwives in line by making sure they knew my birthing desires at all times. But when it came down to it, I was too scared and in too much pain to argue about anything. I just did exactly what they told me to. And that was probably the right thing to do, but the earlier advice made me feel as though I’d failed myself by not pushing my agenda.
  • There is no nobility in facing unbearable pain. If you want the drugs, take the drugs! There is nothing to feel guilty or ashamed about if you use every single pain relief method available to you.
  • It doesn’t matter how the baby comes out. You will give birth in the best way you can, be it vaginally, via a caesarean or with other assistance.

So in my humble opinion, the best birth plan is a plan to go with the flow. How can you plan something that is different every time it happens, even for the same person? But if you think it helpful to write down your wishes with regard to your birth – of course go ahead. Just be prepared that when you’re actually in labour, you may want to crumple it up and throw it at someone – probably your partner.

And if, like me, you are unhappy about how your birth went, then talk to someone about it. Many hospitals offer a postnatal debriefing or counselling service where they go through your delivery notes and explain why things happened the way they did. I took advantage of this service myself and it made me feel so much better about my birth. I stopped blaming myself for it not going the way I wanted.

Before I had the counselling, I was afraid to ever give birth again in case it was equally awful. But the counselling showed me that every birth is different. When I did eventually have a second baby, everything went exactly to plan. Because I didn’t have one!

Tammymum
Petite Pudding

Hope and the jumping bean

I was inspired to try my hand at a bit of fiction by One Frazzled Mum’s writing in response to The Prompt linky on Mum turned Mom. This week’s prompt is hope. Please be gentle with me. I haven’t tried to write fiction since I was about 12. This is completely made up and not autobiographical or about any real person.

Hope stands at the window looking at the driving rain. She loves being indoors in her warm home while rain batters the window and the branches of trees bend in the wind. She cracks the window open and takes a breath of the air that smells of dry soil stirred by raindrops.

The rest of the house is silent and empty. She walks to the sofa and picks up her phone. No messages. No notifications. She opens up her Facebook app and starts scrolling.

All of the usual stuff is there. A friend from school who works as an estate agent has closed on another mansion. Political posts. Someone baked a cake. Someone else is on holiday. Several people have adorable children.

Hope checks her watch. Another ten minutes has passed. Some people think she’s old fashioned for wearing a watch. Most people just look at their phone. If she did that, she would have lost her phone a hundred times over. She checks the time a lot. She lives by the clock.

She hears the key rattle in the lock and feels that familiar little jump of happiness in her chest every time her other half comes home. It mixes in with all the nervous flip flops that were cavorting in her stomach and makes her feel sick again. As her partner, Peter, walks in the door, she rummages in her handbag for a piece of gum.

“Oh finally you’re back! We’re going to be late,” she says, anxious and distracted at the same time. She finds the pack of gum and pops a piece in her mouth.

“We’ve got plenty of time!” Peter says brightly. “Are you ready to go then?

Hope smacks her gum loudly and gives him a look. “What do you think?”  Then she stands up, grabs her coat and walks purposefully out the front door to get in the car. Peter follows.

The radio blares loudly when the car is first turned on. Hope loves listening to the radio on full blast. An Ed Sheeran song is playing. He’s one of her favourite artists, but not today. She quickly changes the channel, then pairs up her phone to the sound system so she can choose what music she wants to hear. Maybe a bit of Iron Maiden. Aggression and no fear.

Hope sits in the car with her hand on her stomach. She can’t feel anything really. Just like last time. She has felt just exactly the same as last time all the way through. A little bit sick. A little bit hungry. A little bit like her bra is becoming too small. Does this mean that it would happen again?

She had told her friends this time. She wasn’t waiting for this appointment. Last time it was harder to tell them when she was already grieving. When they couldn’t understand why she disappeared for a while. Why she was so sad – and is still so sad. Nothing is ever going to bring back what was lost, even if today brings good news.

Peter parks the car and they walk across the car park, through the sliding doors, up the two flights of stairs and down a long hallway. They enter a small waiting room and Hope walks up to the counter.

“I’ve got an appointment at 1:15,” she tells the receptionist.

The receptionist is distracted, doing twenty things at once. She asks, “Do you have your notes?” Hope hands them over. The receptionist takes them. “Take a seat,” she says.

Hope and Peter sit down on the hard plastic seats. There aren’t any magazines in the waiting room. Just various health-related leaflets. Hope ignores them and tries to check her phone, but she doesn’t have any signal. She grabs Peter’s hand and he squeezes hers in return. They wait in silence for what seems an eternity.

A woman calls Hope’s name. Her stomach jumps, flips and ties itself into a knot. Her eyes start to black out a little bit around the edges and she feels lightheaded. She has to take deep breaths to stop herself from total panic.

Hope and Peter follow the woman who called her name into a darkened room. “Right,” the woman says, “just lie down and lift up your top, and we’ll go ahead and take a look.” Mercifully, she doesn’t ask any other questions or say anything else.

“This might be a bit cold,” the sonographer says as she squirts gel on Hope’s stomach.

Hope holds her breath as the sonographer probes her stomach with the ultrasound wand. She pushes the wand into her stomach and Hope hears nothing. She moves it again and again. Hope takes a deep breath and then holds it some more. She closes her eyes tight.

Then, a swishing noise. The sonographer smiles and turns her screen to where Hope can see it. “There we go,” she says, “you take a look while I just take some measurements.”

Hope’s eyes fly open and she looks at the screen. She decides to hold her breath some more while the sonographer draws little lines on the screen with her mouse.

“Everything looks fine,” the sonographer says. Hope breathes out and finally allows herself to look – really look – at the screen. She sees a little jumping bean, full of life and potential.

If you’ve been affected by the issues in this story, please check out Tommy’s for support.

mumturnedmom
Tammymum
Keep Calm and Carry On Linking Sunday

New mums and mental health

A guest post by Sally Hogg

I remember when my son was born, people kept asking ‘are you enjoying being a mum?’ The answer in the very early days, was probably ‘no’. It got better, but it wasn’t fun at first. Yes, he was absolutely amazing and wonderful. But I hurt. I kept crying for no reason. I was so very, very tired. I worried whether I was doing things right, and – to be honest – I missed my old life. This was a momentous time, but it wasn’t enjoyable at first.

But I never said ‘no’ to that question. It was loaded with expectation. Asked by grannies, aunts and older mums who look back at motherhood through rose-tinted glasses.

Are you enjoying being a mum? New mums & mental health

There are many reasons why it’s hard to admit that you’re not having a great time as a new mum. It seems as if everyone else is doing fine and having a magical time. It seems like everyone expects you to be on top of the world, and it feels like failing – and perhaps a betrayal of your baby – to say that you are struggling.

Yet most, if not all, mums will struggle at some time. And for a significant proportion, this struggle may not simply be the normal rollercoaster of new parenthood, but something more serious. Between 10 and 20% of new mums (and around 5-10% of new dads) experience a mental health problem during pregnancy or the first year after their baby is born. To put this in perspective, it means that in any typical antenatal class or baby group, there is likely to be at least one person in the room who has a mental health problem.

Whilst postnatal depression is well-known, mental health problems for new parents are not just postnatal. In fact, experts now suggest that depression is more common in pregnancy than postnatally. Problems go wider than depression too. They can include, for example, anxiety, OCD, PTSD, psychosis, and eating disorders. Some of these problems will occur for the first time when someone becomes a parent, others may be the recurrence of an existing problem – perhaps one that has been well-managed for many years. Some people with pre-existing conditions are particularly at risk: any woman who has ever experienced bipolar disorder, for example, has a 50% chance of mental illness in the weeks after birth, although this can be very effectively managed with specialist help in pregnancy. The severity of mental health problems varies too. Thankfully, most will be relatively mild, but this is not always the case: suicide is actually one of the leading causes of maternal death in the UK.

Mental health problems can be very effectively prevented or treated with the right help, which is why it is so important to speak out early if we think something is wrong in ourselves, our friends or partners. If you feel you or someone you know has a mental health problem, trust your instincts and talk about it. It may be that they are just having a few bad days, but they will still benefit from a supportive conversation and, if they are ill, the sooner they can receive help, the better.

There are a range of options available to prevent, reduce or treat mental health problems. These include support groups, counselling or other forms of psychological therapy, or medication. The best option will depend on the nature and severity of a mum’s illness and her own personality and preferences. Midwives, health visitors and GPs should ask all expectant and new mums regularly about their mental health, and should be able to signpost mums to different sources of support.

There are also things that we can do ourselves to improve our mental health. These may be enough to overcome mild mental health problems, but won’t be sufficient in themselves for women who are more seriously ill. Activities associated with reducing depression and anxiety include socialising, exercising, getting more sleep, and active relaxation (things like mindful mediation or having a massage). These can feel very hard to do when you have low mood and a new baby, which is why it’s good to talk to family and friends so that they can help you to take care of yourself.

Sadly, there are gaps in services in the UK, and some professionals don’t have the skills and knowledge they need to detect mental health problems and give women the support they need. You may need to be persistent and assertive in order to get help.

Things are improving though: the Maternal Mental Health Alliance (a coalition of over 80 charities and professional bodies) is doing a lot to raise awareness and improve services, and earlier this year, the Government announced over £350 million to fund new services.

Parenting is a rollercoaster, and it’s not one that we’ll always enjoy. For most new mums, the highs of this rollercoaster should far outnumber the lows, but a significant minority will be less fortunate. If you feel the balance isn’t right, don’t suffer in silence. You aren’t alone and things can get better.

Sally Hogg is chair of the Oxted & Caterham NCT branch. She also runs the Mums and Babies in Mind project for the Maternal Mental Health Alliance.  They offer some useful self-help guides about recognising and facing maternal mental health issues.

I would like to publish as many stories about maternal mental health as I can to spread awareness. If you would like to write a guest post with your own story or perspective, please email me: themumreviews (at) gmail.com.

Petite Pudding
Tammymum
Diary of an imperfect mum

I was so scared of a VBAC but I had one anyway

In the UK, the current NHS policy is to encourage women to attempt a Vaginal Birth after Caesarean (VBAC). I’m aware that in the USA and in many other countries, they have the opposite policy, in which they believe it safer for women to always have a caesarean if their prior birth was a caesarean. So while I recognise it’s quite progressive that the UK encourages VBAC and that there’s quite a lot of evidence to show that they are relatively safe, when it came my turn to have my second baby and VBAC was suggested, I was terrified. I spent a lot of time trying to find information for women who were scared of attempting VBAC, but all I could find were campaigning sites that were all in favour of it. This was in 2014 and I think there is more out there now, but I thought I would share my experience anyway in case it helps someone.

My first labour was induced at 10 days overdue after meconium-stained waters (baby got distressed and had a poo in the amniotic fluid). After 20 hours of labour, I had an emergency caesarean. This was followed by my baby being in special care for pneumonia caused by complications of the birth – probably from breathing in the poo-water.

In my second pregnancy, the one thing I wanted to avoid more than anything else was for my baby to be sick again. I blamed being overdue combined with the emergency caesarean for my baby’s illness. So I figured that an elective caesarean, in which I could be calm and know exactly when everything was going to happen, was the best option for me.

However, the NHS tried really hard to convince me to have the VBAC. I received special consultations from a “Birth Choices” midwife. I visited her armed with the NICE guidelines about VBAC which delineated the risks of the procedure. These guidelines have since been updated to be more positive about VBAC. She listened to my concerns and agreed to book me in with a consultant to discuss it further.

The consultant told me she was quite confident that I would have a successful VBAC, but she understood my absolute refusal to go overdue or to have an induction. I also didn’t want to be lying on my back strapped to a foetal monitor, which is generally recommended for VBACs. But the consultant told me it’s possible to take breaks from the monitor to walk around, and sometimes even to have a remote monitor that allows you to move.

To mitigate my fears about going overdue/being induced, she booked me in for a scheduled caesarean at 41 weeks, with the plan for me to have a few sweeps before my due date came along in the hopes of getting things moving.

Now, in my first pregnancy, baby basically never dropped into my pelvis, so they couldn’t even do a sweep. This time, I had two sweeps, and I went into labour just one day past my due date.

Now, no sort of birth is a walk in the park. But this time baby came in about 4 hours altogether and delivered without any complications. He still ended up in special care due to feeding problems, but that’s another story.

So really I just wanted to write down my experience in the hopes it might reassure anyone else who might also find VBAC, and with it the possibility of another emergency caesarean, scarier than an elective caesarean. My healthcare providers gave me so much advice and support and it turned it around for me.

My main advice is, whatever your feelings about the sort of birth you’d like to plan for your second and subsequent pregnancies: stick to your guns. If you have a strong preference, it is their job to convince you otherwise (if necessary), and make you feel safe. Don’t let them bully you into something you don’t want. But if they can change your mind legitimately, like they did for me, now that’s another story.

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