Pregnancy

  • Tips for labour birth and delivery

    tips-for-labour-birth-motherhood


    tips for labour birth and delivery

    My FIRST guest blogger Samantha Stigter shares her tips for labour, birth and delivery as an experienced midwife and new mum.

     

    One of the most common questions I would get asked as a midwife was, “Does it put you off having a baby?”. I had a fairly rehearsed response, due perhaps to constant repetition – an upbeat, “Labour and birth are short – lived, parenting appears much longer and more intense. Also, with the cost of living, they don’t move out until 30!”. Perhaps this was to mask that we had been trying to conceive for a while or I just didn’t feel like delving into what I really thought, labour shouldn’t be feared, rather embrace.

    “Labour and birth are short – lived, parenting appears much longer and more intense”

    As an observer to this phenomenal human experience, it did not deter me from wanting to go through it. I had come to realise in my role as a midwife that women can do incredible things and the human body is capable of being pushed (quite literally), to the limit. Yes, I always thought it was going to be a physical challenge, but I also took on board that there is a strong mind-body connection. Regardless of mode of delivery, birth demands every part of a woman, physical strength, mental strength and emotional strength. I have observed that preparation for this most thrilling and empowering day of welcoming a new life into the world, starts before conception.

    I then became a midwife who was pregnant. The question became, “Are you worried about going through it?”. The answer to this was always, “I don’t fear labour and birth and I am more concerned about 4-month sleep regression.” This was my mantra – ‘I don’t fear labour and birth’ (I am yet to experience Lily’s first sleep regression). For me, labour and birth always presented itself as an exciting challenge. Finally! I got to experience something I talked about every day, was a part of every week and had supported women doing for years. I’m excited to be able to share with you my tips for labour birth and delivery as a midwife and new mum.

    woman at baby showed smiling as she cuts her cake

    Tips for labour, birth and motherhood

    as a midwife

    1. Women and their partners who have done antenatal classes have a better understanding of what to expect and are better equipped to manage labour and birth.

    2. The shorter the birth plans (I prefer to use ‘birth preferences’), the less likely there is a variation from expectation. My favourite birth plan is always, ‘healthy mum and healthy bub’.

    3. Women who maintain a good level of fitness and health, both mental and physical, tend to cope better in pregnancy, labour, birth and their postnatal recovery– regardless of mode of delivery.

    4. Good preparation throughout pregnancy in all aspects of life is important because the birth of a baby changes identity, can strain finances/ relationships and creates new roles as parents.

    5. Over Complicating the process mentally can be a road block to allowing normal physiological labour and birth. In preparation for labour and birth I was also doing everything I would recommend to women, antenatal classes, regular chiropractor and acupuncture appointments, three cups of raspberry leaf tea a day from 34 weeks, having a bath while diffusing essential oils, hand expressing, Epi-NO’d my vag and did regular meditations and birth visualisation.

    For me, I found that this combination was useful in supporting what my body was already preparing to go through and I believed was already capable of with or without these preparation ‘tools’. My pregnancy fitness journey was also a significant factor in preparing for labour and birth. I incorporated swimming, walking, yoga, resistance training and of course, the moofitmoofit program. I strongly believe if I did not keep a good level of fitness during pregnancy, I may not have birthed my beautiful Lily Eloise, 4350 grams and 56cm long, vaginally or recovered the way I have been able to postnatally.

    black and white photo of woman hugging her baby girl

    tips for labour, birth and motherhood

    as a new mumma 

    1. Pelvic floor is important. I always knew this, but it became more apparent after my own birth. Pelvic floor, pelvic floor, pelvic floor. Oh, did I mention pelvic floor? Pelvic floor muscles and sphincters can’t be replaced! They can only be strengthened with daily exercises that can start in the early postpartum days and then maintained a few times a week. I have known of enough women who experience prolapse or incontinence (which makes my pelvic floor involuntarily squeeze just thinking about it), that this was a priority. Following up with a women’s health physiotherapist to look at abdominal separation and pelvic floor has also been really helpful. Considering my birth injury, I have had no incontinence or prolapse issues and just need to work on strengthening, which I attribute to good foundational fitness and recovery fitness. Learning to do postnatal exercises properly has been so valuable, especially connection breathing with my pelvic floor – Thanks Jess!

    2. Keeping the bowels working and not straining my butt! Whether it is prunes, movicol, increasing dietary fibre, increasing water, preventing being constipated that can undo pelvic floor strengthening is important.

    3. Recovering slowly – I found it challenging to go from swimming until 40 weeks to needing to slow down postnatally. I did however do daily pelvic floor and integrated moofitmoofit exercises into my early weeks along with gentle walks. Stretching has also been very important, especially with breastfeeding and sore muscles! Once I saw a women’s health physiotherapist and got the all clear at 6 weeks, I was able to increase my exercise and also jump back into the pool.

    4. It’s the simple things that help support recovery – resting as much as possible, eating well and drinking lots of water, especially if breastfeeding. I keep reminding myself that my new “job” was to love and support Lily to grow and also do everything to help my recovery. Looking after myself physically, emotionally and mentally, helps me to better look after her.

    5. Being kind to myself – setting realistic expectations and goals on recovery is important. Fitting into my size 8 jeans is not the goal, but rather functional health and fitness is what I am working towards.

    Although my birth experience was not completely straight forward, I look back thankful for birthing a healthy baby and it actually being an incredibly empowering experience. 

    baby girl with head band on pink blanket smiling

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  • The Use of Magnesium Spray During Pregnancy and for Exercise Recovery

    Magnesium is an essential mineral that is used by the body for regulation of muscular contraction, insulin metabolism, blood pressure regulation, cardiac excitability, nerve transmission and neuromuscular conduction. The use of magnesium compounds have been widely used as medicinal and dietary supplementation, and its positive effects have been well documented. Along with being essential for many physiological processes it also plays a role in sleep, relieving muscle cramping, improving mood and reducing anxiety and depression. It can help relieve restless leg syndrome and is important for pregnancy and lactation. Talk about a super mineral!

    Magnesium During Pregnancy and for exercise recovery

    Magnesium helps contribute to a healthy pregnancy and has been shown to decrease the occurrence of certain complications like preventing pre-eclampsia (high blood pressure) and low birth weight. Its need during pregnancy is increased therefore many women don’t receive enough magnesium during this time.  One of the most common signs of magnesium deficiency is leg cramping which is experienced by 30- 45% of women, mostly at night and often becomes more prevalent from the second trimester onwards.  Using magnesium during pregnancy can help to decrease muscle cramps and can also help give relief from the muscular pain that persists days after a cramp.

    With magnesium helping to assist in muscle recovery its use after training can be an excellent way to gain relief from the pain and discomforts when DOMS (delayed onset muscle soreness) sets in. During exercise, magnesium levels are depleted with loss through sweat, urine and alterations in blood magnesium levels. This makes magnesium supplementation important for athletes or those who work out regularly as they will have a higher magnesium needs than the sedentary population. Many studies have shown that loss of magnesium affects performance however they haven’t yet been able to show that supplementation with magnesium will increase performance!

    So apart from oral supplement which most of us would receive from a basic multivitamin how else can you ensure you’re getting enough magnesium?

    Ever heard of Transdermal magnesium application? Transdermal magnesium is applied directly to and absorbed by the skin. This may sound like a new fad but transdermal application itself isn’t a new way to administer products with certain medications like pain relief and smoking cessation patches having been used for some time. The difference is magnesium isn’t a drug it’s an essential mineral to the body and its delivered in a natural form. Applying it transdermally ensures it doesn’t have to pass the gastrointestinal tract and can be delivered straight to the body’s cells and tissues. This is a quick and easy way to reap the benefits of this product particularly, if taking magnesium orally gives you gastrointestinal upsets.

    What happened when I started using magnesium spray?

    It wasn’t until I was about 19 weeks pregnant that I started getting muscle cramps during the middle of the night partially in my calves. My sleep also started being affected by more restlessness and frequent waking which meant feeling more fatigued throughout the day.  Wanting to improve my sleep and ease the cramping I went on the hunt for a magnesium spray to use and came across base recovery spray.  A lovely small business based in Geelong who sources their magnesium chloride (the main ingredient in magnesium spray) naturally from the dead sea. One thing I liked about the products that set them apart from other brands is the addition of essential oils. The sleep recovery spray has a hint of lavender to assist with sleep, relieving tension and calming the mind. Whereas the recovery spray has a touch of peppermint oil which assists in clearing the airways, boosting digestion and enhancing energy levels. I hate deciding on one product and felt these products had different purposes, so I decided to try both! The sleep spray to help with my leg cramps and restless sleep and the recovery spray to assist with muscle soreness from my workouts.

    I first used the magnesium sleep spray before bed with a spray on the sole of each foot and one on my abdomen.  It smelt amazing, not too much lavender which meant it was not overpowering to my sensitive pregnancy nose. The spray left a cool tingly sensation on my tummy and feet and I jumped into bed. I felt the soles of my feet become more relaxed and it didn’t take too long to drift off to sleep. I still had a few night waking’s that night and a small foot cramp which I would take over a leg cramp any day! Night two of using the spray I applied the spray to my feet and tummy and again got a slight tingly feeling. I also decided to spray the sleep spray on the bottom of my toddler’s feet to see if it helped him with his night waking also. I have now been using the sleep spray on us both daily, and it’s become one of his favourite bedtime routines. I am happy to say our sleep has improved and I’m not waking in pain from muscle cramps (insert happy dance)!

    The recovery spray I use for muscle soreness after my training and have been carrying in my handbag to use whilst at work. I reentered the workforce at 24 weeks pregnant as an oral health therapist after having almost 2 years off staying at home to raise my son. Dentistry is a demanding job both physically and mentally and although you sit down for a lot of the procedure the use of your arms, head and neck in sometimes awkward positioning can cause pain and strain. My first day back was exhausting and the next morning my upper back muscles felt practically sore, just like I’d done a workout. So before work the next day I sprayed the recovery spray on my back, neck and upper traps. Again, I felt a tingly sensation, but it felt like it took the edge off my discomfort and relaxed these areas. I had read that the tingling feeling was a sign that you are deficient in magnesium, however, I wasn’t able to find any evidence to support this claim so did a small experiment on myself. From personal experience, I have found the tingling sensation to decrease even when applying the spray to different areas (testing to see if the skin somehow got used to the feeling when applying in the same spot). So perhaps as I have increased my magnesium levels with regular use the sensation has gone away.

    How to use magnesium spray

    Magnesium sprays are incredibly easy to use. Simply spray the magnesium oil onto your skin and massage in. Or, for harder to reach areas, spray into your hands first before rubbing in.  If you don’t enjoy the tingly sensation you can dilute the spray with some water or coconut oil or rinse off after 20 minutes. I have been using the sleep spray about half an hour before bed with a spray on the sole of each foot and one on my tummy and the recovery spray I spray directly to sore muscles after work or exercising. Since using base recovery magnesium spray I am no longer getting muscle cramps at night, which is, in turn, improving my sleep and the muscle pain is eased after training and work.

    If you’re looking for an inexpensive, easy to use product to help relieve cramping, aches and pains and improve your mood and most importantly your sleep. Then you need to get yourself some magnesium spray!

    My top picks on where to buy magnesium spray

    Note: base recovery no longer supply their amazing product so a few other recommendations are 

    salt lab 

    hermosa and co

    References:

    KASS, L., Skinner, P. and Poeira, F. (2013). A pilot study on the effects of magnesium supplementation with high and low habitual dietary magnesium intake on resting and recovery from aerobic and resistance exercise and systolic blood pressure. J Sports Sci Med, 12(1), pp.144-50.

    Ragnar, R. (2015). Treatment with Magnesium in Pregnancy. AIMS Public Health, 2(4), pp.804–809.

    Tarjan, A. and Zarean, E. (2017). Effect of Magnesium Supplement on Pregnancy Outcomes: A Randomized Control Trial. Advanced Biomedical Research, 6(1), p.109.

    Tarleton, E., Littenberg, B., MacLean, C., Kennedy, A. and Daley, C. (2017). Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLOS ONE, 12(6), p.e0180067

    Supakatisant, C. and Phupong, V. (2012). Oral magnesium for relief in pregnancy-induced leg cramps: a randomised controlled trial. Maternal & Child Nutrition, 11(2), pp.139-145

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  • The Current Pregnancy Exercise Guidelines

    Keeping up with the current pregnancy exercise guidelines can be a little challenging. The guidelines differ slightly between countries and there’s always the challenge of myth vs fiction. Beginning or maintaining fitness during pregnancy has many health benefits for mum and her unborn baby. From reducing the risk of gestational diabetes, reducing aches and pains to lowering the risk of delivery complications ( there are so many more benefits, but that’s for another post!).

    It can however, be confusing as to what exercise and how much exercise is considered safe during this time. There are many myths surrounding pregnancy and exercise and the guidelines have changed and evolved over time to reflect what we know now as the most current and up to date recommendations.

    Sports Medicine Australia recommends the following pregnancy exercise guidelines –

    For Women who were not active prior to pregnancy – 150 minutes per week or 30 minutes per day commencing at low intensity and working towards a moderate intensity on most days of the week. This might include activates like walking ,cycling, swimming or strength training.

    For women who were previously active prior to pregnancy and are experiencing an uncomplicated pregnancy physical activity 150- 300 minutes per week and 30-60 minutes per of moderate to vigorous activity day most days of the week. Exercise is encouraged to be continued until it becomes uncomfortable to do so or unless advised by your healthcare practitioner.

    You might be thinking well what exactly is moderate intensity?

    This will vary for the individual but, a good way to measure and monitor intensity is to use the Borg scale Rate of perceived exertion scale (RPE). The scale allows individuals to subjectively rate their level of exertion during exercise or exercise testing. An appropriate scale would be working at around 12-14 which means the exercise is somewhat hard, but you are still able to maintain talking throughout. To view the whole chart and gain further understanding of how exertion is measured please see the following link ( https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm)

    Muscle strengthening exercises play an important role for women throughout their lifetime. Strength training helps to increase muscle function, bone density ( which helps prevent osteoporosis), improves tendon, ligament and joint functions and improves posture and alignment. During pregnancy strength training can help to reduce lower back, neck and shoulder pain and prepare your body for labour and delivery.

    I love strength training! It makes me feel strong, regulates my mood and always helps to set the day ahead for me particularly when I train in the mornings.

    The current guidelines for strength training during pregnancy recommended by sports medicine Australia are:

    Frequency: min 2 sessions per week.

    Intensity: Sub-maximal intensity using own body weight, light weights and/or resistance bands (exhale on effort).

    Type: Work all large muscle groups

    Programming: 1 set of 12-15 repetitions of up to 8-10 exercises.

    You might have read this and thought, these guidelines recommend to only lift light weight! Remember these are generalised guidelines. What I consider light may be heavy to you or vice versa. It also mentions submaximal intensity. Submaximal means less than maximum effort or around 85% of your maximum effort . If you can safely lift weight and you feel strong, capable, comfortable and don’t experience any symptoms associated with lifting then there should be no reason to avoid lifting the weight. Some symptoms to watch out for may include low back pain, downward pressure on the pelvic floor, pain in the abdominal or pelvic region, urinary incontinence or the feeling of bulging or something falling out of the vagina. If you experience any of these please stop and seek assessment from a women’s health physiotherapist.

    When exercising during pregnancy it’s important women pay attention to the physical and physiological changes that occur to their body and as their pregnancy progresses exercises are modified to suit individual needs this is best done under the guidance of a pre and postnatal fitness coach. There are of course circumstances where women may have pregnancy related medical conditions such as preeclampsia or lower back injury where she may have been advised to certain types of exercise. Women should consult with their healthcare providers (GP, obstetricians, midwife, physiotherapist or exercise physiologist) regarding physical activity and exercise during and after pregnancy as your medical team are the ones that know you best and therefore will provide you with the best care and advice for YOU and your unborn baby.

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  • Exercising while pregnant and return to exercise postpartum

    Pregnancy was once considered a time for rest when women were advised to refrain from physical activity and exercise. I’m sure you have heard the old wives’ tale

    “Pregnant women should not work out if they have not worked out prior to pregnancy” or ” A pregnant woman’s heart rate should not go above 140 BPM (beat per minute) while exercising”.

    This misinformation is not only confusing for a new mum-to-be but saddening because it can impact the positive health benefits both mum and baby get from exercising during pregnancy.

    Exercising while Pregnant

    Before I was pregnant I spent 45-60 minutes exercising at the gym at least 4 or 5 times a week. It consisted of a little cardio warm up and a split gym weight lifting program (meaning I would train one muscle group a day, followed by a rest day). I now reflect on those days of uninterrupted, non-sleep deprived, somewhat relaxing gym sessions and realise how my training style has changed and adapted to suit my new life as a mum.

    My pregnancy was relatively easy and uncomplicated having only suffered from some slight nausea and food aversions in the early weeks and some lower back pain in the final months. At 15 weeks pregnant I even took myself to see my Doctor because I felt “too good” as I was convinced that this meant there was something wrong! Everything was perfect and ironically my partner and I felt the baby kick for the first time that night!

    I made a few adjustments to my training whilst pregnant like reducing the weight I was lifting and modifying any exercises that just didn’t feel right. One of my favourite exercises are barbell hip thrusts and barbell glute bridges. Traditionally, the barbell sits low across the top of the hip bones so once my belly started to grow it wasn’t possible nor did I feel comfortable to do this exercise anymore. So, I switched to using bodyweight and a loop band around the knees for extra resistance.

    Now here is where the wives’ tales get it wrong!

    MOST exercises are considered safe and present minimal risk to mother and child however, modifications are required along the way to accommodate the physiological and anatomical changes that occur during pregnancy. There are always simplifications, modifications or a different exercise altogether that will target the same muscle group. If you feel uncomfortable, are in pain or feel unsafe whilst exercising please seek advice from a reputable trainer.

    The current guidelines for exercise during pregnancy as per sport medicine Australia are:

    For Women who were not active prior to pregnancy; 150 minutes per week or 30 minutes per day commencing at low intensity and working towards a moderate intensity on most days of the week. This might include activates like walking or swimming. To measure and monitor intensity it’s recommended to use the Borg scale Rate of perceived exertion scale (RPE). The scale allows individuals to subjectively rate their level of exertion during exercise or exercise testing. An appropriate scale would be working at around 12-14 which means the exercise is somewhat hard, but you are still able to maintain talking throughout. To view the whole chart and gain further understanding of how exertion is measured please see the following link (https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm)

    For women who were previously active prior to pregnancy; and are experiencing an uncomplicated pregnancy physical activity 150- 300 minutes per week and 30-60 minutes per of moderate to vigorous activity day most days of the week. Exercise is encouraged to be continued until it becomes uncomfortable to do so or unless advised by your healthcare practitioner.

    Medical Clearance

    It’s important that all pregnant women consult with their healthcare providers (GP, obstetricians, midwife, physiotherapist or exercise physiologist) regarding physical activity and exercise during and after pregnancy as your medical team are the ones that know you best and therefore will provide you with the best care and advice for YOU and your unborn baby.

    I continued modified resistance training until 36 weeks pregnant. After having an early labour scare I was advised by health professionals to reduce my training to light walking and spend the next few weeks resting and preparing for the birth and arrival of our baby. At 39 weeks, plus 3 days we welcomed a little boy after a short 4-hour natural labour. I remember feeling so amazed and proud of what my body achieved and honestly believe staying fit and healthy during my pregnancy made a huge impact on my pregnancy, delivery and postpartum recovery.

    I was cleared like most women at my 6-week postpartum check up with the obstetrician, and started exercises that helped to restore the pelvic floor and heal any abdominal separation (diastasis recti). My somewhat “regular” training style didn’t resume until 16 weeks postpartum. Ladies, if you are going to do one thing for yourself postpartum, please see a women’s health physiotherapist prior to resuming exercise!

    You may have been CLEARED to exercise but you have not been properly assessed without an internal examination or ultrasound to determine if it’s SAFE for you to exercise.

    It’s irrelevant what type of birth you had, caesarean, complicated, uncomplicated if you trained your entire pregnancy or even if you’re an elite athlete. You still carried a baby for nine months, birthed a baby and it’s very important to assess how your pelvic floor and core are functioning even if you feel like you have no problems post-birth.

    Return to exercise postpartum – what are the benefits?

    There are so many health benefits to exercising pre and post-natal. Not just physical benefits such as improving physical conditioning and helping to reduce postpartum weight but also the mental benefits like improving emotional wellbeing, reducing anxiety and depression. It can be challenging making time to exercise as a new mum. You’re tired. No, you’re exhausted, there are a million jobs to do around the house, your baby is cluster feeding and you can’t put them down! The list goes on but, there is always likely to be a barrier or challenge that SEEMS to prevent you from exercising. The trick is to get creative, break up your workout in smaller sections throughout the day. Exercise with your baby so you can still rest during nap time if you need to and find a way to incorporate exercise into your new daily grind.

    Some days it’s challenging, it doesn’t always go to plan and you don’t always get to finish what you’re doing, but it’s still exercise, it’s still worth it, and it sets such an important example for the little eyes that look up to you. We can be hard on ourselves about EVERYTHING as a parent so, even if exercise looks different than it used, accept the change, embrace the change and don’t put so much pressure on yourself to do what you used to or look like you used to. You are different, your body is different and guess what that’s ok! When it comes to postpartum fitness the recipe for success will be different for each of us but it all comes down to a few key elements. Staying positive, loving your post baby self, eating the right foods to nourish and heal your body and most importantly listening to your body and doing what you can, where you can.

    Blog post feature written for the lovely Chelsea. The Creator of the AHHMAZING breastfeeding friendly adjustable sports bra from(www.mamamay.com.au). 

     

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