Modern mama Midwifery

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The Midwife
“This is a calling. It is a calling to assist a mother as she reaches down to the depths of herself and the mysteries of the universe, to guide her, to help her past her obstacles, physical and psychological, to coax, encourage and reassure her, and to remain a point of detachment and calm.
The Midwife allows the mother to have the birth she wants, is sensitive and assists each mother differently according to her needs. The Midwife has extensive anatomical, medical and pharmaceutical knowledge. She knows all the points of contact with doctors hospitals and emergency services. She is aware of all the practical needs of the birth, such as food, noise, lighting etc. At the same time she is tuned into where the mother is, physiologically and psychologically. She may remain entirely in the backgrounded say virtually nothing yet be of the utmost assistance to the birthing mother. She may tell you to shout all the profanities you know at the top of your voice as you push, to release your full power and remove any last inhibitions. She is fully present. She understands the stages of labour and has seen many different births progress and go through their unique and universal rhythms again and again....”

Natural Birth A Holistic Guide to Pregnancy, Childbirth and Breastfeeding - Kristina Turner 2010

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Witching hour 🧙‍♀️, or as I believe it should be described witching “Hours” ⏰

The witching hour’s are one of the most common things parents talk about after having a baby because they can be very overwhelming. 😫

The witching hour is a time when an otherwise content baby 👶is extremely fussy😭. It typically occurs daily between 4:00 pm and 11:00 pm. It can last a few minutes to a couple of hours. For most babies, the witching hours 🧙‍♀️start to occur around 2-3 weeks and peaks at 6 weeks.

However, on a positive note it is temporary, very normal and part of your baby’s growth and development. 👍🙌👶

So let's look at this very normal developmental phase and how to make this somewhat easier 🤞

🧙‍♀️🤔What is the witching hour:
Usually begins at 4pm every afternoon and can last for several hours.
Characteristics of the witching hours are as follows:
👉Comfort feeding
👉Cluster feeding 
👉Clingy 
👉Cranky 
👉Crying 
👉Coming on and off the breast 

Yes, this is overwhelming 😩however I promise you this will not last forever. Try to accept the witching hour’s, as this is unavoidable. 
💗You got this mama! 

What is believed to cause the witching hours?

🌼Over stimulation 
Newborn can become easily over stimulated: bright lights and new sensations.

🌼Over tiredness 
Newborn babies can only handle being awake for so long, generally most newborns like to sleep after 60-90 minutes of being awake. 

🌼Unsettled tummy 
Babies digestive system is prone to digestive discomfort. Plenty of wind and gas! This can cause fuzziness and crying. 

🌼Wanting to comfort feed/suck
Babies can have sore tummy's or be feeling over tired or over stimulated, which results in comfort feeding.

🌼Filling their stomachs for a big sleep
If they are building up towards a longer sleep. The cluster feeding sustains them longer, making baby fuller. 

How can I support myself and my baby through this? 🥰

Swaddle tightly 
Hold
Shush
Rock and pat 
Offer a feed
Take to a dark room and help baby to settle

Other suggestions welcome mama’s! Share your experience💗

Entonox 💨
Aka ‘Laughing gas’ 😂

What is Entonox?

Entonox is a mixture of half oxygen and half nitrous oxide that is used to provide relief during labour.

How is Entonox taken? 💨

Is breathed through a mouth piece.

It takes only a minute ⏱to work and wears off quickly, so it can be used with each contraction.

Side effects of Entonox? 🤔

Some women find entonox makes them feel light-headed or sick. These side effects go away rapidly when you stop breathing the gas.

Entonox can also cause a dry mouth. Drinking sips of water 💦in between contractions can help with this.

Side effects of baby? 👶

Entonox has no known side effects on the baby.

✨Entonox can be used at any time during labour, and can be used for your whole labour.✨

Entonox can be really effective for many labours in providing some relief, and can also help with deep breathing during contractions.

📸 ❤️

✨Intermittent fetal monitoring ✨

During birth your midwife will ask to listen to your baby’s heart rate at regular intervals throughout the stages of labour with a Doppler/sonicaid.

This is also how your midwife listens to your baby’s heart rate during antenatal visits❤️

✨Some benefits of intermittent monitoring:

🤰Comfortable for the mother
🤰Can be used in many different labouring positions
🤰Can be used underwater
🤰Reduces restriction

✨How does a Doppler /sonicaid work?

A fetal doppler is a type of ultrasound that uses sound waves to detect fetal and placental sounds.

🥰

Antenatal hand expressing!

One of my favourite topics to talk about with women towards the end of pregnancy✨

Antenatal hand expressing, which is also known as antenatal harvesting is using your hands to express colostrum from your breasts into a sanitised container, syringe or bag.

This is done while pregnant 🤰and usually around 36 weeks, some health professionals may also recommended from 34 weeks.

So what is colostrum?🤔
The first milk you make is called colostrum. Colostrum has high levels of antibodies, anti inflammatory cytokines, oligosaccharides and antioxidants - the perfect composition for your baby.

Some women will not have much colostrum, if any when beginning to hand express, however do not be discouraged by this.

After a few times of antenatal hand expressing you will start to find you get a little bit more colostrum each time.

There are many benefits to having stored colostrum for when your baby arrives. It helps to stabilise baby’s blood sugars, provides many antibodies which protect your newborn baby 👶against bacteria and viruses, as well as a laxative effect helping baby to poo 💩.

Storage:
🍃4 hours at room temperature
🍃2-3 days in the fridge
🍃6 months in the freezer.
Make sure to label each syringe with the date the colostrum was collected.

❗️Reminder: Before starting antenatal expressing have a discussion with your health care provider as sometimes ni**le stimulation can bring on contractions.

✨Third stage✨

Delivery of your placenta/ whenua/afterbirth🥰

🍃This is the last stage of the labour and birth process 🍃

The placenta is the organ that nourishes your baby👶 with oxygen and nutrients during pregnancy.

The birth of the placenta can either occur physiologically or via active management.

Physiological 👉🙆‍♀️Is a hands-off method. Where the placenta comes away on its on- this can take anywhere form a few minutes up to an hour.

Active management 👉Is a hands-on approach.
This is where you would be given an Injection of a medication called ‘oxytocin’ to assist in birthing the placenta. The oxytocin causes strong 💪contractions which help to expel the placenta more quickly. The midwife will then guide out the placenta by applying traction on the umbilical cord which is attached to the placenta.
👉Generally offered when there are risk factors &/or intervention in pregnancy or during labour and birth.

While awaiting the birth of the placenta its likely you will be enjoying skin to skin and can even start to see if baby would like to feed.

✨Current practice in New Zealand recommends physiological birth of the placenta unless it is clinically safer to offer active management✨

✨The all mighty cervix ✨

Do you know much about your cervix? 🤔


Your cervix is the lower part of your uterus (sometimes called the lower segment), and yup the cervix is fully attached to your uterus.

The average length of a cervix can vary, however generally a cervix is between 3-5cm in length.

During pregnancy 🤰your cervix generally stays long and closed, acting like a barrier to prevent baby from falling out of the uterus.

During labour and sometimes before labour, your cervix will begin to change, it will thin out, becoming as thin as a piece of paper 📝 and will also start to open.

Labour contractions are responsible for pulling your cervix up, causing the cervix to thin and open.

It is important that the cervix thins (also called effacement) and opens (also called dilatation), to enable baby to be born.

Usually your cervix needs to be fully dilated 🍈to have a va**nal birth. However there are also many other factors to help with birth, such as your baby descending into your pelvis and baby being 👶in a optimal fetal position.

The way a midwife can assess your cervical changes is by offering a va**nal assessment VE ✌️

Remember! cervical dilation is just one aspect of your labour and is not the only thing that determines how your labour is progressing! 👍

✨Delayed cord clamping ✨

Delayed cord clamping is a common recommended practice in New Zealand.
This is where the umbilical cord that delivers blood and nutrients to your baby is left unclamped after birth for at least 3 minutes (or until it the cord has stopped pulsating), allowing the blood in the placenta to travel back to your baby’s body which will increase their blood volume.

Benefits of Delayed cord clamping:

At 4 months, infants born at term receiving delayed cord clamping had greater ferritin levels and increased brain myelin in areas important for early life functional development. Endowment of iron-rich red blood cells obtained through delayed cord clamping may offer a longitudinal advantage for early white matter development.
(J Pediatr 2018)

🙌✨2021 Review and research on Cord Management of the Term Newborn

Delayed cord clamping ✨👇

“Keeping the umbilical cord intact by delaying cord clamping for at least 3 minutes improves iron stores during infancy and supports health and development for the growing child. In preterm infants, delayed cord clamping reduces mortality by approximately 30%.”

“To warn for risk of jaundice and need for phototherapy after delayed cord clamping is not evidence based.”

“Intact cord resuscitation has been practiced for centuries at midwifery births, and has shown physiologic improvements in animal and human trails.

Full text available here)
https://www.sciencedirect.com/science/article/pii/S0095510821000415?via%3Dihub

Glorious ✨


📸 .birthphotography

✨The fourth trimester 🤱👶✨

This is classed as the first three months after your baby 👶 is born.

The term ‘fourth trimester’ is used to describe a period of change and development in the newborn, as they adjust to their new world outside your womb.

Your baby’s familiar surroundings which were the comfort of your warmth🥰, darkness 🌚, and muffled sounds🔈, have now changed to a noisy📢, bright ☀️ and often cold ❄️environment.
Some babies cruise and don’t mind this change.. however some babies may find the transition a bit more difficult - which is perfectly understandable!

The good news is there are things we can do to help this transition by using settling techniques when your baby is unsettled.

✨Skin to skin
✨Feeding and demand
✨Swaddling
✨Baby wearing - Tends to be a winner🥰
✨Swinging and movement
✨White noise

Newborn babies do not understand routine, however, they do find comfort in familiarity.

Cuddling, feeding and sleeping in the early days is just what baby needs.

Once your wee one is a few months old you can start to do things that distinguish between day and night.

Take your time to be with your baby 🤱

There is no need to sort out a schedule. ✨The fourth trimester is all about you and your baby getting to know each other✨

Newborn’s thrive on love and attention 🥰There is no such thing as creating bad habits!



Illustration - unknown

First stage of labour 🤰🤱

What is the first stage? 🤔
The first stage is split into two phases 👉The latent (early) phase and the active phase.

The first stage varies in time ⏰ for each birthing mama, trust your body and know you’ve got this👏. Each contraction is getting you one step closer to meeting your beautiful baby.

FYI
✨There are three stages of labour✨

🍂The first stage is when the neck of the womb (cervix) opens to 10cm dilated.
🍂The second stage is when the baby moves down through the va**na and is born.
🍂The third stage is when the placenta (afterbirth) is delivered. 

Swipe across to find out more about the first stage of labour ✨✨✨

✨Magical ✨

📸

Have you been told to sleep on your side from 28 weeks?? 🤰Here’s why…

Research has shown that going to sleep on your side from 28 weeks of pregnancy halves your risk of stillbirth compared with sleeping on your back.

What is the risk of stillbirth if I go to sleep on my back?
Stillbirth in the last three months affects around 500 babies. However, research has shown that going to sleep on your side halves this risk compared to sleeping on your back.

Why? 🤰🤷‍♀️
Lying on your back during the last the months of pregnancy (from 28 weeks) puts pressure on major blood vessels which can reduce the amount of blood flow to your uterus and oxygen supply to your baby.

Should I lye on my left or right? 👉🛌👈
Sleeping on either side is fine.

What if I can only sleep on my back?
Most women find it uncomfortable to sleep on their back after 28 weeks.
If you wake up on your back this is ok, it’s very normal to change positions while sleeping, no worries role back onto your side 👍
✨The important message is to start sleep lying on your side✨

Visit www.sleeponside.org.nz for more information!

If you have any sleeping tips for other mama’s feel free to drop them below👇🥰



Art by Kelly Colchin, Pinterest

Second stage of labour 🥰

Aka: Fully dilated until the birth of your baby

This stage can take anywhere from a few minutes to over 2 hours. Second stage varies in time for everyone⏰

This stage of labour generally takes a bit longer if this is your first baby👶, compared to your second or third, and so on.

During second stage your body will naturally feel a pressure sensation, pushy feeling.
At this point the body is pretty amazing at taking over and allowing your baby to come down.

You may have heard of involuntary pushing, or women saying “I could not control it, my body just knew how to push the baby out”. This is called your Ferguson reflex - which is where the involuntary pushing feeling comes from.
For many women it feels like you have the urge to take a poo 💩. This is just your baby’s head putting pressure on your re**um as they descend through your pelvis - generally a great sign your are close to meeting your baby 🌻

Sometimes the midwife may guide you on directive pushing, however if labour is progressing as normal we usually just let this process happen on its own. Sometimes women will naturally bear down and also few urges to push with the pushy feeling.

If you have an Epidural 🍃the midwife may help you with guided pushing (directing all your energy into pushing). Pushing right down into your bottom, pushing like you're doing a poo👉Using all your energy to push right down into your bottom.

Sometimes it can take a few contractions to get the pushes going well. Sometimes with epidurals women are able to move their legs, which means you can change positions and have gravity helping to bring your baby down.
Side lying positions can also be really good. And remember you dont need to be on your back

Tips during second stage👇
🌼⬇️Gravity is your best friend and helps baby descend through your pelvis and may even encourage your second stage to progress quicker
🌼Warm compress during the end of this phase on your perineum to help reduce extensive tearing
🌼Adopting a good position to reduce tearing - Hands and knees, side lying, *try to avoid lying on your back
🌼Breathing

It’s officially Homebirth awareness week 🏡🌼🤰👶

Home Birth can be a wonderful option for many women🤍
If you have a well low risk pregnancy and have been thinking about the option of home birth I encourage you to delve into the research surrounding home birth, and seek other peoples experiencing of home birth too 🏡
You may explore🤔 home birth and think this is not for me or you may think this is definitely for me.

We are so lucky in New Zealand to have so many options surrounded place of birth, and my biggest piece of advice is to birth where you feel most comfortable 🌼
Looking into each option whether this be home birth🏡, primary birth, or hospital birth🏥 enables you to make a fully informed choice around each option.👍

Also having supportive midwives and birth partner/s makes such a positive impact towards any birthing women. Being in a space where you feel safe and comfortable during your labour is vital to the birthing woman🌼

What research shows us about homebirth:

🏡Higher va**nal birth rates
🏡Increased physiological birth outcomes
🏡Better birth satisfaction for parents
🏡Less use of pharmacological pain relief options 💊💉
🏡Less chance of instrumental birth
🏡40% less chance of Caesarean section rates
🏡Less chance of PPH🩸
🏡Less chance of episiotomy
🏡Better APGAR scores for babies👶

🌻Some other Information:

Midwives who attend a Home birth will have the same equipment that is available at a primary birthing centre. Majority of midwives will also carry oxygen to have home birth.

Midwives are trained professionals in maternal and neonatal resuscitation.

🌼This beautiful photo was captured a few weeks ago at a homebirth I was privileged to provide midwifery care for🌼

Phenomenal!

I am in awe of what a woman’s body is capable of achieving! Such power in these images, and trust in her body throughout her labour and birth process.

Thank you for letting me share your precious memories 💜

📷The photo was taken on my new iPhone 12, which is a game changer for great photo’s! It even has a night mode so you can take photos in the dark!

Visiting A New Mama ✨

When visiting a new mama its most likely they will be tired, and this is because they are literally working a full time job - 24/7🤍

Now I dont know about you, but most jobs do not involve working 24/7, unless you are a midwife of course 🤣

Here are some simple ways you can help:

See what may need doing around the home

Simple ask her.. can I help do anything for you?

Is there washing, dishing or vaccuming that could be done?

Has she eating today? Nourishment is so important! You can never gift to much mum food for a new mama.

Ask her how she is feeling, and offer to watch/hold the baby if she would like to go to the toilet, have a shower, a nap or make a cup of tea.

Every little bit of support helps ✨

What did you find most helpful as a new mother?


Art by

The toilet 🚽~ Birthing position

The toilet is a powerful tool to use during labour.
Sitting on the toilet helps to open up the pelvis and help baby to descend further.
Gravity is also on our side here too✨

A lot of women feel their contractions increase in intensity when adopting this position on the toilet. So if you feel like labour is stalling have a sit on the toilet and see what happens🌻

Our body’s naturally open up and let go when sitting on the toilet. The same muscles that relax when we pass urine or take a poo, are the same muscles that let the baby come through to be born.

You can either sit on the toilet facing the wall and rest you head on some pillows, or you can sit on the toilet facing outwards. Or alternate!
Do what ever feels right for you✨

Did you adopt this position during your labour? What did you think?

🥰I have supported many women to birth their baby/s in this position! It’s a goodie!

Setting up your birth space!

Yup it’s your space where ever you birth☺️
Own it mama!

Have you ever seen a cat😽or a dog 🐕have babies???
They usually like to be in a dark quiet space feeling unobserved… And guess what humans are exactly the same.
✨So create your primal environment that is right for your bubba to be born into✨

Find things that bring you comfort and make you feel safe✨
Feeling as comfortable as possible to make all of your beautiful oxytocin (the love, happy hormone) flow!

🌼Keep the room nice and dark.
🌼Smell ~ Essential oils, diffuser.
🌼Candles. Avoid candles in hospital - battery candles are fine.
🌼Eye mask and headphones are really good for getting into your zone.
🌼Photo’s - May being you comfort.
🌼Birth affirmations ~ place them around the room. Remind yourself you are awesome and can absolutely do this!
🌼Watching videos - movies. Distract yourself.
🌼Have your pillow and dressing gown. These familiar smells can being comfort, releasing oxytocin.
🌼 Any music that makes you feel relaxed and rocks your boat go for it!
🌼Soft touch
🌼Bath and shower

Reminder🥰
If you are in a birthing centre or hospital you do not need to be on the bed just because it is in the middle of the room.

✨Do the things that are really comfortable for you✨

You and your baby know what to do🥰
Give your body time⏰
Good things happen with time✨

What worked for you to create your ultimate birthing space? 💕

Placing your baby on your bare skin encourages your baby to feed as soon as possible after the birth + lots of other fantastic benefits 🌸

Newborn babies are generally placed straight onto their mothers as soon as they are born.
This skin-to-skin contact with you after birth is good for your baby’s physical health and helps you to bond with each other.

Research has shows that Skin to Skin👇

✨Stabilises Temperature, Blood sugar levels, Breathing, Heart rate, and Oxygen levels.
✨Bonding and comforting baby
✨Calms both mother and baby
✨Increases breastfeeding success
✨Stimulates digestion and an interest in feeding.
✨Stimulates the release of hormones like oxytocin (love hormone), endorphins (happy hormone)
✨Allows baby to come into contact with mothers friendly bacteria. ✨Building baby’s microbiome.
✨Helps your placenta to come away off the wall of the uterus
✨Reduces blood loss post birth

Wow🥰

Alcohol & breastfeeding

Many women who are breastfeeding may want to drink 🍷, but have concerns about any possible effects on their baby.

Here is some Information to inform you😀
When you drink, alcohol passes from your stomach into your bloodstream 🩸and from there into your breast milk🥛. The level of alcohol in your breast milk is approximately the same as the level in your blood. These levels peak about 30 to 40 minutes after you’ve had your drink, and then they both start to drop as your body breaks the alcohol down.

If you do choose to drink, it is safest to avoid breastfeeding for 2 hours ⏰afterwards for each standard drink you have. A convenient time to have a drink is as you are breastfeeding or just after you have breastfed your baby. This will allow the alcohol to clear from your breast milk between breastfeeding sessions.

One standard drink is approximately:

🍷100ml (small) glass of wine
🍺330ml of beer
🍶a single (30ml) measure of spirits.

Keep in mind that not all wine and beer is the same strength. One standard drink will be contained in a smaller volume if you are drinking ‘strong’ beer or fortified.

If you decide to drink alcohol make sure you have enough milk expressed for your baby prior to starting drinking, or you wait enough time after your last drink to feed your baby.

Make sure that your baby has someone looking after them who is alert to their needs.
Make sure that you have safe sleeping arrangements for your baby prior to drinking alcohol.

🚫Never drink alcohol and sleep with your baby.

🤰🚫Avoid drinking alcohol when pregnant, there is good evidence that this is harmful (unlike drinking while breastfeeding)

So what about ‘pumping and dumping’ Nope, no need to pump and dump when drinking alcohol! This is so incorrect!
Pumping and dumping does not speed the elimination of alcohol from your body.

Only time will reduce alcohol from your breasts.

Download the Feed Safe NZ App
This App contains official recommendations from the NZ Ministry of Health.

By all means don’t drink alcohol if you do not want to, but if you do want to drink alcohol here is the information so you can do it safety and feel confident and informed in your decision ❤️

A stunning work of art truely representing the beautiful partnership between the midwife and the birthing woman.

Picturing the true essence of why midwives choose this vocation🍃❤️

Midwives have the privilege of being with women through their journey, one of which is such a momentous part of life.

Every minute is so worth it when you see what women are able to achieve🌼

Midwives support women along this journey, because women matter, their thoughts matter, their body matters, their journey matters!
There is so much beauty when you see a woman being empowered, and taking control of her experiences.

Midwives are a guiding light, supporting women in their journey of becoming mothers.


📷

You baby’s cord 👶

After your baby is born the umbilical cord is generally clamped and cut. The part that is still attached to your baby is the umbilical stump.

Over the next few days the stump will begin to darker, shrivel up and generally falls off between day 5-14.

Caring for the umbilical cord stump✨

🍃Generally the stump does not need to be clean at all, however some parents may choose too.
🍃Use only water to clean the baby’s belly button area
🍃Keep the stump dry by going around the base gently with a cotton tip or gauze.
🍃Try to avoid the nappy sitting and rubbing on the stump. You can fold the top of the nappy down to avoid this.
🍃Never try to pull the stump off even when it look like its ready to fall off.
🍃After the stump has fallen off the belly button will dry out quickly over the next day or 2.

When the stump is falling off they can smell very offensive so please do not be alarmed by this.
There may also be tiny spots of blood. This is ok.

When to have concerns😧

The area around the cord is red, hot to touch, is oozing puss.

Umbilical area is bleeding regularly, or a lot🩸

If you every have concerns contact your health care provider.

Ahhh.. That’s what your doing in there little baby! That explains a lot! 😂😆

Giving birth is one of the most significant and memorable experiences of your life, and you will carry this memory forever.

The benefits of a positive, well informed birth are profound and long-lasting. Preparing for this moment by empowering yourself with knowledge and equipping yourself with practical tools you can use in labour is a great way to have your best birth.

The acronym to remember during your journey B.R.A.I.N 🧠

Using the Brain strategy when making decisions in pregnancy, labour and birth and postnatally enables you to make informed choices that are right for you, and your baby. Definitely one to put in your toolkit!

So lets look into the B.R.A.I.N…

🍃B=Benefits
What are the benefits of the option/s you have been given?
🍃R= What are the risks associated with the option/s you have been given, and how could this impact me and the baby.
🍃A= Alternatives
Are there any alternative to the option you have been presented with?
🍃I= Instinct
What is your gut telling you? Trust your instinct!
🍃N=Nothing
What will happen if you do nothing for an hour or the day? How will choosing to wait or doing nothing effect you and baby.

It is always ok to ask questions at any time during your pregnancy, labour and birth and postnatal period.
Never feel you’re being difficult by asking questions or challenging professionals. It is very Important that you understand all of your options.

You have the right to have the birth you want✨
You have the right to ask all the questions✨