There must be so many pregnant women out there, as my blog is running hot and my inbox is clogged with questions!  So, I thought I would compile a list of the 3 most asked questions about pregnancy and birth from my blog and the women I teach.  Firstly, my background, I am mother to two beautiful boys 7yrs and 21months (still breastfeeding!), a Midwife of 9 years and a Lactation Consultant.  I work in a birthing unit, teach antenatal classes and run a lactation clinic at a pharmacy.

Question 1

How much pain will I be in during labour?

This is such a common question and most women will often ask their friends for the answer.  My standard reply to this question is how about learning some methods to cope with the pain, so whatever your labour feels like you are able to deal with it.  This takes the focus off the pain, which is something you cannot know, to something you can do.  You take the control back. 

It is very difficult to describe what type of pain you will feel, hence, the answer above.  Some people suggest putting a peg on your ear lobe and leave it there for a minute or pinch your ear lobe and gradually get firmer and firmer for a minute.  But really it is a question that has a different answer for everyone.  So learning more about relaxation and coping strategies is the key.  Strategies such as hypnobirthing, yoga and Lamaze will help you turn the pain into a positive.  Just really commit to learning and practicing the technique that suits you and allow it to become instinctual, this is how you will successfully cope with the pain of contractions.  To learn more about the many different relaxation techniques click here. 

Question 2

Is sex safe during pregnancy?

I have so many women ask this question and the answer is yes.  Sex is a great way to relax and bond with your partner; you may even feel really great about your growing body and want to have sex all the time!  If you have a low lying placenta (where you placenta grows close to or over the opening of your womb, cervix) then sex may be contraindicated as bleeding may occur.  Please check with your health care professional.   

Bleeding can occur following intercourse, usually during the later stages of pregnancy, most times there is nothing wrong, however, do check with your doctor or midwife.  If you are overdue sex can send you into labour, this is because semen contains prostaglandins which will soften your cervix and may trigger labour. 

Question 3

Do I need to prepare my breasts for breastfeeding?

This is a common question and the answer has changed over the years.  Women used to be told to toughen up their nipples with towels and other abrasive products.  This is not advised anymore, no preparation is needed, your breasts were made for breastfeeding and changes are taking place throughout your whole pregnancy. 

You may experience leaking of yellowish, thick fluid; this is normal and can happen quite early in the pregnancy.  Leaking or not leaking is not an indication of your ability to produce breast milk.

Women have different shapes and sizes of breasts, small or large breasts are both capable of producing enough milk for your baby.  Your nipples can be any shape and may even look pulled in – this is nothing to worry about now as your baby will pull them out whilst sucking.  True inverted nipples can be managed with some help from a lactation consultant when your baby is born.   

One thing you can do before your birth is to look at your breasts, feel them and get to know them.  Breasts are amazing and will give your baby protection, satisfaction and the best start in life.  If you want to learn more about breastfeeding a fantastic book has been written called “5 Seriously Simple Strategies to Survive Your First Week of Parenting and Beyond” written by Jenny Jones.  Jenny is a registered nurse of 40 years, a certified midwife of 36 years, a Lactation Consultant and an Early Childhood Nurse of 12 years.  Jenny has witnessed first hand the anxiety parents feel in the first week of birth…and gently guides you with her compassionate and nurturing advice.  This book will give you the confidence and arm you with the best questions to ask when learning how to breastfeed.  It is a free book when you download my natural childbirth education package, click here to find out how you can transform your birth and breastfeeding experience to one of joy and confidence.

If you have a particular question that you would like answered, please contact me through my blog and I will be more than happy to answer any type of question you have.  Enjoy your birth preparation and make relaxation part of your routine.

Hello to all the wonderful pregnant women who are nearly at their due date or over!  I know how you feel, I went 6 days over with my first child and it felt like 6 years!  I am wondering why we are constantly told a due date, I mean really, only 1% of babies come on their due date.  Babies are mature enough to be born from 37weeks and can go safely to 42weeks.  This is a gap of 5 weeks and we focus on ONE due date……insane!

Now for those of you who are over 41weeks and are facing medical induction head on, then I thought I would write to you about Natural Induction.  There are many methods that have been used over the years, none have been guaranteed to work 100%, it is just your own preference.  Before you start any Natural Induction method, please seek advice from your medical carer especially if you have any form of pre-existing medical condition. 

There are great ways you can try at home and then there are those methods that practitioners can help you with.  I will list the latter first, however, it is very important to ensure that the person treating you is qualified, and is knowledgable in pregnancy and birth. If they do not have appropriate training or knowledge of pregnancy and birth, this may be unsafe as extra care must be taken when pregnant and in labour.  Please find a practitioner that you feel comfortable with.

• Accupressure – Use of pressure points to stimulate labour.  Debra Betts has put together a fantastic document on acupressure for pregnancy, labour and post birth. 
• Accupuncture
• Homeopathy
• Sweeping of Membranes – strip and stretch, separates membranes from cervix
• Massage – Bowen Therapy
  

There are some fun ways you can try and Naturally Induce labour, the first one is sex.  Sex can firstly relax you and give your body time to forget about labour, which may in turn put you into labour.  Also semen carries prostaglandin which can soften and ripen the cervix ready for labour.  Recently a study has found that intercourse made little difference to inducing labour and no cervical changes were evident. This may have been the case in the study, but who can be relaxed when part of a study and be examined after sex!

However, sex can be a great way to relax, and contrary to the study, many mothers have found that they have gone into labour after having sex, especially during early labour. Even Ina May Gaskin, a long time natural and homebirthing advocate doesn’t think too much of this study as she has seen otherwise.

Another great part of sex is when a woman experiences orgasm, she produces oxytocin – the labour hormone. So while having intercourse seems to not be of much help, it can still play a role in the bigger scheme of things!

Another Natural Induction method is nipple stimulation.  Nipple stimulation will release oxytocin in your blood and hopefully induce labour.  You can use your hand and fingers to do this or a breast pump.  Do this for about 20mins, have a rest and repeat if you are up to it!

Raspberry leaf is another natural induction method that acts as a uterine tonic and can stimulate labour.  It also has an added benefit after birth for breastmilk production.  It’s generally recommended anytime after 12 weeks in a healthy pregnancy – make sure you check with your medical carer and a naturopath for doses and to see if it’s appropriate for you.

Now that you are armed with all these natural induction methods you may want to know what to do if you are in early labour to keep things moving.  Below is a list for you to follow if you are in early labour.

• Rest at night if your contractions will allow
• Walk around to stimulate your contractions
• Climb stairs – this will help your body work with gravity and get your baby into a great position
• Have a shower to ease the pain, try to avoid swimming and baths as it will counteract gravity
• Keep upright – work with gravity, lean into contractions as your uterus leans forwards during contractions, bend your knees and bend to about 45 degrees
• Keep busy to take your mind off labour
• Keep well hydrated, your body is working as hard as if it were running a marathon.
• Relax

I hope these natural induction suggestions help you on your journey towards birth.  Remember to relax and have faith in your body and your baby.  Enjoy the lead up to your birth and your birth journey.

I have written many posts on natural birth planning as I believe it is the key to a successful birth experience. Having your mind and body on the same positive page will give you an amazing birth experience. Today, however, I wanted to talk about breastfeeding, I want you to try and think beyond the birth for a short time and take in some great breastfeeding hints and tips.

The women I teach have many questions on birth, but when it comes to breastfeeding they are really not as interested, this is just because the birth is first and foremost in their minds. I can totally understand, it is hard to get past the birth, it is all consuming.

To help you have an amazing first breastfeeding experience I have put a list together for you to educate yourself about what physically happens to your body and your baby’s during the first hour after birth. I concentrate on the first hour because it is the most significant feed of them all. See below to find out why.

• Your baby’s whole body will change from receiving oxygen from the umbilical cord to using their lungs to breathe air
• Birth your placenta – usually15-30mins and can be up to an hour
• Oxytocin levels at their highest to encourages milk let-down
• Strongest suck in baby at this time so the first feed will imprint on your baby’s brain and will have subsequent successful breastfeeds

Knowing what physically happens in the first hour after birth will help you really plan and prepare yourself for this event. It is an amazing time that you can look forward to, not worry about. Just remember not to worry about feeling awkward when you first feed, you are not an expert at this stage and you are bound to feel a little uncomfortable.

If you are birthing your baby in the hospital, birthing center or at home there are some simple, yet powerful ways to maximise yours and you baby’s experience. I have compiled a list of things to educate you on the workings of your baby and what you can do to encourage your baby’s natural instincts. This will in turn give your baby the right environment to feed successfully.

1. Initiate skin-to-skin contact
2. Early feeding cues – eg fist to mouth, tongue protruding in and out, massaging your breasts with their tiny, beautiful hands and turning and mouthing towards your breast and nipple area. Recognise these early feeding cues as your baby will feed better at this stage. Crying is a late feeding cue and will create a more stressful environment when feeding
3. Try and keep handling of your baby to a minimum until the first feed is completed (partners allowed)
4. Leave weighing and measuring until after your baby’s first feed
5. Turn your baby towards you so their chest is facing yours gently guide your baby towards your breast by placing your hand between the shoulder blades allowing the head to tilt back so the chin comes in first to the breast

To really get the most out of skin-to-skin contact it would be beneficial to talk to your birth attendant and plan for this. You can take off your clothes when birth is imminent and ask your birth attendant to either place your baby gently on your chest or you or your partner could actually help with the birthing process and be the first to touch your baby and bring him/her to your chest in your own arms. This is an amazing feeling, you may not want this but then again it might give you something to think about!

If you are planning for a cesarean section then ski- to-skin contact can also be achieved. You can talk to your obstetrician and midwife about skin-to-skin contact and its importance. If this is something you really want then you must be persistent with your wishes and remind all staff during your cesarean section. Although there may be circumstances in which it is impossible for this to happen, most times babies arrive into the world with a big cry, and this beautiful noise will mean that your baby is breathing and ready to be placed on to the warmth and security of your chest.

I just wanted to talk briefly about your baby’s feeding habits in the first few days before your milk comes in. It is common for mothers to wonder if they have enough milk for their baby as they tend to cry often for a feed in the first few days. To give you a reason behind this will make it easier to manage. Newborns have a stomach the size of a marble in the first day, it then grows to the size of a larger marble and then to the size of a golf ball on the third day. If you think about this for a moment it does not take much to fill a baby’s stomach and even less time for them to empty it, therefore they are ready for another feed in only a few short hours, ranging from 1-3 hours. Knowing this fact will give you the insight to follow your baby’s cues and allow him/her to feed often. It is not spoiling if you give in to your baby’s needs, in fact, having their needs met will actually create a happier contented child.

I have one last point before your get back on to your Natural Birth Planning, I know, I am almost finished! If your baby seems to be feeding constantly for over an hour and not settling at all then you need to ask for help. It usually means your baby is attaching to the nipple and not to the breast surrounding the nipple. This will leave you with sore, painful nipples and an unsettled baby it also could delay your milk coming in. Positioning and attachment are crucial at this time and having help at each feed will create a wonderful, successful breastfeeding relationship. Below is a diagram of great attachment, have a look at it and then put it to the back of your brain so you can draw on it when the birth is over.

Now, I know you want to get back to Natural Birth Planning. If you would like some fantastic up to date information on natural birthing then take a look at my book “7 secrets to Natural Childbirth”. You will find wonderful information that will change the way you look at birth. If you are having a cesarean section you can find some great ways to relax and really turn your birth into the experience you want.

One more tip about breastfeeding just before your go…..I know I am pushing it!! I advise you to look at your breasts, feel them and get to know them. Marvel in the fantastic job that they will do – give your beautiful baby the gift of breast milk. It will line your baby’s stomach with the strongest defence system that can never be replicated by something man-made. This wonderful gift of human breast milk will keep your baby healthy for the rest of their life.

Ladies, you are pregnant, so excited, you have so many thoughts running through your hear…..is it a boy or a girl, am I okay, what should I buy?  There is one question that, in the beginning, women seem to overlook and it is one of the most important…………..Natural birth or drugs?

Early on most women are planning for a natural birth; however, as your pregnancy progresses and your tummy grows you wonder how much pain you will be in.  You seek out other women’s stories which are usually horror stories and you start to doubt yourself, doubt your ability and start looking at ways to alleviate your fear……well stop right there!

Consider this, you are a woman, you are strong, you are powerful and you are able to grow your baby therefore you will be able to birth your baby the way you first dreamt of.  You first have to start to look outside the box, start to wonder what type of things make you relaxed and incorporate these measures into your birth plan and journey.

Do you like soft music, massage, touch, water, yoga or meditation?  Any of these methods can be incorporated into a daily routine to practice relaxing and becoming aware of your wonderful and powerful self.  Becoming aware of your ability to birth your baby, creating a belief structure so strong that you become unstoppable in your quest for the natural birth you want.

Here is a question you can now ask your self, “How many natural birth techniques have you considered so far?”  There are so many different techniques that you can learn about and incorporate into your relaxation routine.  You can start by having a read of the list below and click on the method that best suits you.  Each method will take you to a fantastic jam packed information page that will give you the tools to create a truly amazing birth experience. 

• Acupressure and acupuncture
• Hypnobirthing
• Water birth
• Reflexology
• 3 R’s Relaxation, Rhythm and Ritual
• The Bradley Method
• Breathing Techniques 

I have interviewed the founders and educators of each method and they discuss the amazing benefits of choosing a natural birth method that suits you. 

So what you need to do is endeavour to create some time for yourself each day where you relax and reflect on how wonderful your pregnant body is and also reflect on your goal of birthing a beautiful baby calmly and easily.  This will in turn transform your birth experience into the dream you first wanted. 

Good luck and Enjoy your wonderful Birth Journey.

<a href="http://www.upchuckr.com/">Upchuckr.com Internet Web Directory</a>
 

What a question this is!  There was an article in The Sun titled ‘Home Births - Bad or Good?’  It was a really great article, giving you the pro’s and con’s.  The most sensible comment was that if a woman is healthy and low risk, and she wants a home birth, then why not?  The catch is the money…..will the government come good with their promise or let it slip into the too hard basket?

There are plenty of midwives and other health professionals who are willing to set up a standard of care and could have homebirths up and running in no time.  It is a question of whether the government wants our society to go this way.  I say let it….it is what women are calling for, or should I say begging for!  It is just unfair that women who can’t afford a home birth and really want one don’t get the chance to experience it.  This can change a woman forever…..women have an innate desire to birth and they have a plan in their head.  If this plan has to be based on the income she earns then it can change the course of her life, it can deny her the one empowering moment that forms the basis of who she is and who she wants to become.

As was mentioned in the article, many women feel their labour is going well until they have to go into hospital – then they get stressed and their adrenalin rises and slows down the labour.   This is so true, I experienced this myself and also have seen it as women come into the hospital.  I don’t know what it is but women seem to want to come into hospital as soon as possible, this, I believe, is where all the intervention and agony starts.  Women should be educated in their antenatal classes to stay at home as long as possible, this will give them a chance to feel more comfortable for most of their labour.  Women and partneres come into hospital expecting their baby to born soon, this almost never happens, it takes a woman’s body a good couple of hours to adjust to the change of environment and then labour can resume. 

The very experienced obstetrican comments on the debate, and he has valid points, however, he is coming from a position of high risk.  Midwives have a line that they cannot cross, as a midwife, I know this line and I know when a woman crosses it into high risk territory.  It is our duty of care to constantly assess this line and make a judgement on whether a doctor needs to be called.  It is our responsibility to do this and if we don’t we are liable and can lose our career.  Home birth midwives are so very aware of this and have back up plans.  A home birth midwife would not take on a case that had the potential to put the mother or baby at risk.  The comment made by the obstetrician that it is just too risky is his opinion and good luck to him,  but he shouldn’t put his fear on women who choose this option.  Fear is what makes things go wrong, a woman who is relaxed at home and has great midwives on hand will have an amazing home birth experience. 

I say well done to women who choose this option and I hope the government can see a place for home births to be recognised, not dealt with under the radar.  Bring home birth to the forefront and let women have the choice to bring their baby into a calm, loving environment.

If you want to hear more on this topic and other ways to have a fantastic birth experience, then have a look at my book, it has many options and will give you the confidence to stand up and say how you want your birth to be.  Click on this link child-birth-options and let me know what you think.

I have just gone back to work in the maternity unit after having my little boy…..he is not so little anymore, he is 19months.  I had a really long time off with him and enjoyed every minute of it.  I am only working causal now so I am still breastfeeding and spending lots of time with him.  Above is a picture of me, just in case you want to put a face to my name.  There are also some videos on my blog if you have a look through my archives.

The reason I am writing this blog post is because I have been bowled over by the questions and concerns that are facing women whilst they are pregnant.  I looked after t wo women last night and they were both being induced at 39 weeks.  They were both wonderful women and really looking forward to holding their baby in their arms.  The problem was they didn’t know why they were being induced.  One woman had gestational diabeties and the other was perfectly healthy.  My question to all the women out there is ‘why won’t you ask questions of your doctors and find out exactly what is going on?’  I put this question to the women and they both replied with, ‘They didn’t want to ask a stupid question and feel inadequate!’

It is 2009, we are strong, we are educated, we have the internet, we have google and yet when it comes to doctors we are put right back in time to an era of control and dominance.  If women can excel in their careers, have children, have successful relationships, then certainly they can apply this wonderful knowledge and insight to their carer givers.  I urge women to ask as many questions as it takes to get the answers.

Now, working with doctors myself, I know that they are not forthcoming with information, it is like pulling teeth!  That is why it is up to the women to start extracting, one by one!  Look at the doctor in the eye and tell him/her that you are not leaving until you fully understand what is happening to YOUR body!  You have this right, your doctor has the knowledge it is just a matter of asking questions that bring it all out.

I know that it can be hard to do this, so you could start with the small stuff, like, asking the doctor how his/her day was.  This will start to build a rapport.  Most women are great at this, so use this skill to your advantage.  With just a simple open question, you will find that your doctor will become more open and you can then start to ask more questions.  It is great to ask questions when your doctor is performing tasks, such as taking your blood pressure.  You could say, how is it today and what does that mean.  Also, when your doctor is examining your pregnant belly you can ask what he/she is feeling, what position the baby is in, is my baby head down and what does that mean for my impending labour.

All these questions are a great way for you to get used to asking questions and to get used to learning more and more about your body.  Trust in your own skills and believe in yourself, your pregnancy is so short and it is so amazing if you can really be inolved both physically and mentally.

Women are so very self reliant, so it can be hard for some women to feel vulnerable in the presence of their care givers.  Just remember, they have knowledge, but you have the complete power within yourself to make fantastic decisions, so use it.

If you have any questions that you are scared to ask, then let me know and I will answer them for you.  I love to keep women informed and give them the best opportunity to really know their body, know their baby and have confidence in the two as a team.

Good luck with your journey.  I look forward to hearing from the wonderful pregnant women of the world.

Loretta

There is some great information on the internet and I have just come across a really content rich site.  Check out naturalparenting.com.au it is your online guide to parenting.

Natural Parenting has great articles, a business directory and a forum to see what other mums and mums-to-be are up to.  It is also really easy to search through as it is broken up into to catagories.  Take a look and enjoy your education.

I came across an article in the UK Telegraph, they are trying to cut costs and have put caesarean sections on the same rationing list as infertility treatment, cosmetic surgery and acupuncture.

Some women may debate that it is taking away options, however, is a caesarean section really an option, is this just saving women from making a huge mistake?  Have we just become too frightened of childbirth and seen too many celebrities opt for a caesarean?  I will put it to you in another way, would you choose to  have all your teeth removed and wear dentures just to skip the pain of dentist visits?  I think not, if we can just think of caesareans as a great option if we medically need them, then our view of having an elective caesarean will change.

Have a read of the article and let me know what you think.  I really believe this is a great especially when you look at the statistics.  For example, a study in 2007 found a mother opting for a caesarean was four times more likely to die than by choosing a natural birth.  Would you put yourself and your family at the mercy of these statistics……I think not.  So how about we continue to educate ourselves on childbirth and save the caesarean for if and when we need it.

Family and friends are supposed to be there to support you in your childbirth decision, but what happens when they don’t?  I have had many, many questions from women all over the world who are dealing with this everyday so I thought I would write about how you can cope with the opinions of other people.

To research and prepare for your natural childbirth is difficult, you have to really listen to what your body is saying and follow your instincts.  To become fully prepared and ready for your natural childbirth is such a great feeling, howver, this feeling can be easily lost by someone making a negative comment. 

The biggest point that I would like you to take away from this article is that you may never be able to convince your loved ones that you are doing the right thing.  But the good news is that this is not your job, you need only be sure of what you want and continue to have faith in your baby and your body. 

If your choice is to have a home birth or a water birth at home or even a natural birth in the hospital, your loved ones may think this is unsafe and put enormous pressure on you to change your plan.  This pressure can be unrelenting and continue on throughout your whole nine months of pregnancy.   So how do you deal with this?

Firstly, remember my point above, you may never change their opinions and know that it is not your job to do so.  I have compiled a list of ways in which you can discuss your natural birth issues with your loved ones:

• Fully plan for your birth and have back up plans, for example, if your are birthing at home make sure you have a trusted, qualified attendant and book into the nearest hospital so as to call upon their services if needed
• Sit your loved ones down and let them know your plan, explain to them that it is not a discussion, merely information
• Acknowledge that you are aware of their concern, however, you have researched what you want and are happy with your decision. 
• Reiterate that this is not a forum for negative thoughts and ask them to kindly keep their opinions to themselves.
• Explain to them that it is scarey being pregnant and planning for the birth that you want and ask them for positive support.
• Direct your loved ones to relevant websites where they can learn about what you are planning.  Let me know if you need help with this.
• Find those loved ones that support your decision and spend more time with them.
• Make sure your partner is included in your decision making, being a strong team will help combat any negative people.
• Praise yourself everyday on the amazing job you are doing.  Not only are you growing a baby, but your are planning for the best outcome possible for your beautiful baby.

You get one chance to prepare for your birth, you have 9months and when it is all over you are the one that will benefit.  You will remember your birth forever, you will tell your child how they came into this world and your successful birth will give you confidence in all areas of your life.

When I was pregnant with my second child, I really wanted to have a natural birth so I, like so many others, researched until I was just about ready to pop.  I decided on hypnobirthing as a way to cope with labour.  I learnt, I practised and I visualised my dream birth everyday but I was constantly fighting the negative thoughts.  I was working in a birthsuite when pregnant and discussing my birth plan with my midwife friends, most were supportive, however, there were a few that felt it was all just hype and that I will call on the drugs when it came time.  To these people, I asked them to be supportive, and if they couldn’t, then I removed myself from thier company and surrounded myself with the friends who supported me.

I think most people don’t even know that they are being unsupportive so you must point it out.  This may be enough for them to change their tune, if not, then leave.  A woman’s mind is so vulnerable during pregnancy, it takes real effort to keep positive and on the right track.  So surround yourself with positive people and go over your plan daily, visualising your outcome, visualise your baby in your arms and your dream birth realised.

I have written another article on how to stay positive during your natural birth planning, it is called ‘Natural Birth – How To Stay Positive’.  Have a read and implement the strategies into you own routine.

If you have a specific questions about dealing with negative people then let me know, I am happy to answer any questions so as to keep you on track for your amazing birth.  Good luck and make your birthing dreams come true.

Episiotomy…….Why?   For those of you who don’t really know the correct definition, an episiotomy is the cut performed on a woman’s perineum (the tissue between the vagina and the anus) to allow the baby’s head to emerge more quickly during pushing. If you know your anatomy, you also know that a baby whose head is already pushing on the mother’s soft tissues on the perineum, has cleared the bony pelvic passage, and is thus minutes away from being born. 

So why are women cut?  To put it simply, it is at the attendants discretion, this can be an OBGYN, doctor, trainee doctor or even midwives.  Some attendants prefer to cut and believe it is for the best, others refuse to cut unless it is absolutely necessary (I agree with the latter). There are times when an episiotomy is necessary, for example, when a baby’s shoulders are stuck and more room is needed to maneuver the baby out.  Also if the perineum is just too tight and the head won’t emerge and the baby is compromised then an episiotomy may be needed.  More often than not, this situation will fix itself with a position change.  For example from back to front or to kneeling or standing.  Usually a woman will tear to allow the baby to emerge, this is the much more gentle option and will heal much quicker than a surgical cut.  Usually a small tear will heal on its own as it will fit together neatly, no stitches needed.

According to the WHO (World Health Organization), there is no need to routinely administer this cut, which severs skin, nerves and muscles in this sensitive area, and is the equivalent to a third-degree tear. The prevalence of third-degree tears in home births or birth centers with minimalized medical intervention is 0.3%. That’s 3 women in 1000. By contrast, in Hungary, 70% of first-time mothers receive this cut. The rationale: to prevent fourth-degree tears despite the fact that scientific studies have shown that routine administration of an episiotomy actually increases, rather than decreases, the incidence of fourth-degree tears.  If you can picture this, a women is pushing her baby out and the doctor puts a little cut in her perineum to aid in the quick arrival of her baby.  Now, once a cut is performed, the skin has a weak point and as the baby rushes passed this cut, a bigger tear can follow on down the line of the small cut leading to a larger tear.  Therefore, the woman has been surgically cut and then tore resulting in a much larger tear.  This area will then need extensive stitching and time to heal, not to mention the risk of infection.

So why does a woman receive an episiotomy?  Well I will list the reasons so it is easy for you memorise and avoid:

• The baby’s heartbeat is uneven, or too low at this stage, which is totally normal. 
• If a woman is lying on her back whilst pushing this will reduce the diameter of her pelvis by approximately 28%, creating a smaller outlet for her baby and adding to the uneven heartbeat.
• If the woman is trying to push against gravity, ie, on her back, pushing uphill.  The shape of a woman’s pelvis is curved up at the opening of the vagina, thus, lying on her back will create a steep exit for the baby and longer time for the head to be sitting on the perineum.  Most doctors have a time limit in their head and will cut if this time has expired!! Ridiculous!

To recap, lying on your back, pushing up hill and reducing the size of your pelvis will all contribute to your chance of an episiotomy.  So what can you do?  Here is a list of do’s:

• Labour in an upright position to widen your pelvic outlet, this also allows your baby to descend at its own speed.  Your tissues will have had an opportunity to adjust to the pressure of the baby’s head if you are in control.
• Feel when your tissues stretch and pause to give them a chance to adjust and accommodate the size of your baby’s head.

So ladies, get to know your perineum, use a hand mirror and have a look at this area, touch and feel it.  It is meant to stretch and it is a fantastic, elastic part of childbirth.  Don’t fear the perineum, imagine it stretching and imagine the warmth flowing through your body as it allows your baby to emerge out of you and into your arms.  WOW, got to love your peri (midwife talk for perineum)!

If you have a look at my book link you will see that I have interviewed some great, world acclaimed natural birth experts.  They have very strong views on episiotomies and voice them with great passion.  You just have to hear what they say, it is amazing.  Just imagine being armed with all this information before you go into labour…….you will be strides ahead of the rest.

Good luck with your natural birth and please contact me if you have any questions.