Jen's Pregnancy Diary: Week 38

As I turned 38 weeks I felt back on track. I had reflexology with Jessie again and she brought me some more lovely oils.  Saturday was St Patrick's Day, but it was freezing so I brought the boys to the cinema to see Peter Rabbit. I thought between the parades and rugby match we would be the only people in the country there....I was wrong! We had to queue for 45 minutes for the tickets and book for the next viewing (in 40 minutes) so we hung around. The movie was very good and it was great to get out and about for the afternoon. 

Sunday brought more snow so we chilled out at home for the day. The boys didn’t even want to go out and play in it, they were totally over the whole snow thing. In fairness it was fairly blustery and yuck out so I didn’t blame them. 

On Monday Leon headed off to his friends birthday party in a play centre and Seth went to his friends for a play (they ended up going to Jump Zone and had a ball). While they were gone I did lots of Spinning Babies and some lunges/squats and sorted out the washing and a few bits around the house. After the party one of Leons friends came to ours for the afternoon and they played away.   

On Tuesday I had a real “get this baby back into position” day. It started with reflexology, then I went for a good walk, then I had shiatsu with Joanne Faulkner and used Moxa sticks to try to encourage baby to come back head down. I ended the day with spinning babies and then a bath with essential oils and listening to “perfect positioning” on my Gentlebirth app.

Our Cork DoulaCare Ireland team from l-r: Zoe, Mary, Claire and Jacquie at our Meet the Doula Event for World Doula Week in Cork. 

Wednesday I spent the morning dropping items for our World Doula Week events off to our doulas. I got a phone call from my GP to say my bloods showed that I have extremely low B12 and need to start a coure of B12 injections as soon as possible. She told me to go straight to her after my check up in the hospital. I am glad as I have been feeling very tired and breathless (presuming it was just normal end of pregnancy stuff). Hopefully with the injections I will feel a boast of energy before baby arrives.  Then I rushed back to take a DoulaCare Ireland conference call with a new business prospect. Mary and I are constantly working on growing the business end of things, while ensuring our clients remain at the heart of everything we do. We are excited to hopefully share some news over the next month or two! I finished the day with some body work and more Moxa sticks before bed. 

Thursday brought my hospital appointment. I dropped the boys to school and headed into the Rotunda. The midwives were all lovely and supportive as always. I met a new midwife called Bridget who spent a good bit of time with me asking how I felt and giving me space and time to chat. This midwifery support is so important in antenatal care (especially for me as I had wanted midwifery led care to begin with). They are all so kind and patient and really offer mothers space and time to process their emotions and get a clear focus on their thoughts.

When I saw my consultant she confirmed baby was still in an unstable lie, and my amniotic fluid levels were officially polyhydraminos (a medical term for too much fluid). The two combined creates a dangerous situation for baby, in that if my waters were to release the cord could get flushed out ahead of the baby. Of course the umbilical cord provides oxygen to the baby so that would not be a good situation if I was at home. She broke the news that I would need to be admitted . I negotiated heading home to pack a bag and explain to the kids what was happening. I collected them from school, then brought them both to McDonalds for a treat and we had a good chat. They both understood that both the baby and I were fine it was just for the doctors to keep an eye on things. I packed a bag and when Paul came home from work he drove me in. I was feeling pretty gutted as my mind movie of labouring at home, supported by Mim and Paul slipped away. The kids, especially Seth really wanted to be there too – Seth even learned how to do some back massages for the big day!  

The antenatal ward was pretty busy on arrival but the staff were all lovely. I had all the routine checks and everything was really good with baby and I. I have all my positive tools with me (Ear phones to listen to GentleBirth tracks, essential oils to keep my senses calm, my laptop to keep my mind busy writing or watching movies, books and so on). 

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On Saturday 24th at 38+6 weeks I lost my mucus plug, just as I was settling down for the night. I went into spontaneous labour (while on the antenatal ward).  Baby Kayla Rose arrived just over 3 hours later in an intense and quick, intervention free VBAC. She weighed 8lb 2oz and instantly we were head over heals in love. Birth story to follow soon x

Kayla Rose getting skin to skin after a very fast VBAC birth in the Rotunda Hospital 

Jen's Pregnancy Diary: Week 34

This weekend started off with a trip into town with the kids to see the Chinese new year celebrations. We went to where we thought it was, but the lady told me that is was on further down town. So we walked and walked but couldn’t find anything happening. I was in bits with my pelvic girdle pain and Leon's little legs were so sore. We sat down near the Liffy and had the sandwiches and crisps I had packed. We continued to walk but could not find anything. I started to ask people – eventually one person told us it was on next weekend (if you could have seen my face!) We had been in town about 3 hours at this point...aimlessly walking LOL I put on my Mary Poppins cheery voice - “That’s ok guys, sure we have had a great adventure and it was much better than sitting at home all day” They didn’t look too convinced. We went and had a hot chocolate and cake in a cafe. Then we pottered around some shops. We got a taxi back up toward the Ilac car park (where the car was) as I was fighting back tears with the pain, while trying to remain outwardly cheery. 

To say it was a disaster is an understatement, but I racked up almost 22,000 steps on my fitbit!

On Tuesday I went to my first physiotherapy appointment. I was actually surprised how bad I was when she started her assessment – trying to stand on one leg was near impossible without feeling like crumpling onto the floor. She told me my thighs and lower back muscles were overtight trying to compensate for the weakness in my pelvis. She worked on easing that tension (which was super painful, I was literally sweating) She then gave me exercises to strengthen my hips/pelvis. She also gave me a different belt for the symptios pubis. She had mentioned my pelvic floor was too tight, and that could have had an impact on my previous two births. I have always been very conscious of doing pelvic floor exercisers, as my grandmother has severe incontinence. Apparently I have been over doing it and a pelvic floor that is too tight can cause as much issues as a weak one. I had never heard this so I was grateful for the information. I felt better after the appointment, armed with some tips to help before birth.

Mary doing a Google Hangouts session with myself and Paul on VBAC support and birth options. It was really helpful 

Wednesday evening brought another GoogleHangouts call with Mary. We chat weekly, keeping up the running of DoulaCare. This time there was a difference...it was to chat with myself and Paul about our labour and birth. Mary offered Paul some wonderful tips and explained hospital policy and so on. I was amazed at how little Paul had taken in from me (as we had covered it all before!) He seemed to get really engaged in the conversation when it was coming from our Doula and took away some great understanding of the difference in policy around a VBAC mum.  It was really nice for us both to chat with Mary too, as I spend so much time on the phone/laptop with her ;)

On Thursday I had my 34 week check up in the Rotunda. I was called by the doctor first (normally I see the midwife first) He was a lovely young reg who was open to listening to me. I had my birth preferences with me in the hope we could get them signed off but he told me I needed to speak with Claire Burke at my next visit as she was the consultant.  He measured my belly, which measured 36 weeks. So he did a quick scan, measured baby saying she was measuring a week ahead but I did have a lot of amniotic fluid which is making my bump bigger. He seemed happy enough. I felt things were going well and then, as often obstetricians do...he came out with his random gem... 

So apparently at my 38 week appointment they will check if my cervix is favourable, if it is they would schedule an ARM (breaking my waters to induce labour) I sat shocked for a nano scond. Then I asked why they would intend on doing this, as a VBAC mum ARM is the only induction method I could have so if contractions didn’t begin he would basically be signing me up for a caesarean birth. He was a bit taken back by my reply. He said everything would of course be a discussion with me at the time and it would ultimately be my decision but the reason he would suggest it would be to “avoid another big baby getting stuck” 

He was a lovely young doctor, who clearly wanted to respect my wishes but perhaps was so institutionalised he presumed by offering interventions he would be saving my preference for a vaginal birth. 

After the doctor I waited for another hour to see the midwife to get my blood pressure and urine tested. All was well. I met a gorgeous midwife Jeannine, who is such a warm and caring woman. She is an active advocate for women and midwives – trying to maintain surroundings to facilitate normal birth. We recognised each other from social media and attending workshops and seminars. She was so lovely and listened to me with such kindness, encouraging me to stay strong and voice my wishes for my birth experience. The Rotunda really have some amazing midwives in their semi private clinic and I would encourage everyone to speak with the midwives about any concerns if you feel your doctor had not heard you. 

On Friday myself and Paul had our second antenatal with Mim. It was great to get her feedback on the situation as I know I am too close to see clearly (and probably think rationally) We had a really good chat about Paul's role in the birth and he felt so much better afterwards. She spoke to him about his chat with Mary and helped him to get everything clear in his head. Again, Paul was so engaged with Mim and opened up so much about his feelings around the birth. I was thrilled to have our Doulas facilitate that and allow us to find a balance and to feel prepared. 

That night Paul said he wasn’t sure if he had been brainwashed with all our Doula speak, but he was feeling so much better about the birth and even feels excited now that he knows how to support me while still ensuring both baby and I are safe. It was so lovely to hear – that’s what Doula support offers!

I attended a meeting at the end of the week to plan for World Doula Week. One of our team Lorna has extensive marketing experience and we also met with one of DoulaCare Irelands past client's who is an expert in the field of PR and campaign strategies. It was an amazing morning. We really focused in on what we want to achieve and how to go about it. Mary and I are so grateful for all the support we have surrounding us, helping us to learn and grow. 

This week Mary was also invited onto Cork's 96FM Opinion Line as a Mum had contacted worried about her distance from the hospital and how she would manage in labour. Mary had a lovely chat with P.J who was very interested in the idea of a doula. You can listen back here to the interview: 

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Until next time...Jen x

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What Is Happening With Your Baby: 

© 2017 Scot Nelson, Flickr | CC-BY | via Wylio

• Your baby is the size of a cantaloupe this week. 
• Their brain is fully developed by this stage and if they need to be born baby's usually do really well (they may have to go to Special Care for a day or two but most have very few issues thankfully). 
• They are becoming rounder as fat layers continue to develop. These will help your baby regulate their body temperature outside of the womb.
• Your baby's lungs are still continuing to mature. 
• Their fingernails are almost fully formed. 
• If this is your first baby they may have 'engaged' which means they are head down and they are pressed deep into your pelvis ready for the birth. 

Week 34: What Might Be Happening To Your Body

• Exhaustion has probably kicked in again by this week (if it hasn't already!). A combination of hormones, restless nights (with lots of disturbance as you try to get comfortable or breaks to go to the toilet frequently). Your body will want to slow down - do listen to it
• You may have blurry vision. Or your eyes may be extra dry (due to a decrease in tear production). These changes are usually temporary though. Again this is all due to hormone changes which will readjust after baby arrives. Pop into your optician and get some eye drops and don't forget to let your HCP know if you have any issues with your vision so they can check it out. 
• Your breasts may feel heavier. 
• If your baby has engaged any breathlessness you may have been feeling will ease off and you will be able to breathe more freely. 

Week 34: Pregnancy Tip 

Perineal Massage

If you are a first time Mum there is some evidence that that Perineal Massage may help reduce your risk of tearing (have a read of this article for more information). If you are going to give it a try use a plant based oil (try to make sure it is unrefined. Mary our co- owner sells a perineal massage oil blend that you can find over on her website). 

This is a good step by step article on how to do Perineal Massage 

Top Tips on Writing Birth Preferences

Writing your birth preferences is important to do for a number of reasons:  
1. It gives you time and space to think about what you want for your birth
2. It opens communication between you and your birth support team
3. It helps you to familiarise yourself with hospital policies
4. You have time to compare policies with national guidelines, international guidelines and evidence based research.
5. It gives you a tool to remain in control and make informed decisions
 

Key points when writing your birth preferences

Keep your language open and positive. You have a chance to create the atmosphere you wish to birth in. Positivity is key and opens on a good relationship with your team.

Know your chosen hospitals policies. Each hospital has different policies around key factors in labour and birth. You are free to question these and even change hospital if you feel better suited to a different standard of care.

Know the HSE (national) and international guidelines / best practice / evidence. This is key. If you know what the evidence says then you can make an unbiased informed decision, rather than being swept along with a phrase such as “that’s the way we have always done it here”

Keep it to 10 points, or less. Anything more will negate the things that are important to you.

Don’t bother putting things in that are already policy in your chosen hospital (ie drinking water during labour) Again if you are familiar with your hospitals policies then you can avoid this.

Think about the atmosphere you want to birth in. Would you like the lights dimmed, music playing, limit the number of people in the room etc Or are you happy to have lights on, student midwives and doctors in the room etc?

Be firm on the points that are non negotiable for you once all is OK with baby (i.e. if you absolutely do not want an episotomy and would rather have a natural tear if it came to it). Some decisions need to be made in a split second and having discussions around the really important issues before hand are vital.

Create birth preferences for a Caesarean Birth preferences as well. This is a good idea for all the same reasons that are mentioned here. You can have the discussions, make informed decisions and then ‘park it’ to one side. You have your just in case covered, remaining in control. Then you can shift your focus back to the birth you visualise. It can be on the next page so your focus is not necessarily on this outcome if you are not planning to have an elective Caesarean, but it does mean that if things don't turn out as you had hoped you have something written up to help you create a dialogue with staff. 

Create your birth preferences with your birth partner. This is important as they will be your advocate for the day. Being aware of what you want and why will help them be a better advocate for you. 

Bring multiple copies so you have them for shift changes. Make sure your partner is aware they need to ask the team caring for you to read through them and discuss them with you both. 

Finally knowledge is power as they say - but trust in the process is also important. All the above are important and give you the knowledge to discover what you want for your birth. It gets the discussion out of the way before labour begins, as during labour it's important to park the conscious brain as much as you can. You body and your baby know what to do, they are an awesome team, made to work together. Let your advocate voice your preferences and allow yourself to go with your labour journey.

Here at Doulacare Ireland we will always helps our clients draw up their birth preferences after meeting with their birth doula for an antenatal visit. We listen to what is important for our clients and offer information on evidence based care that will enable them to be aware of what they might want to include in a birth preference sheet. We would always encourage clients to have some birth preferences to facilitate improved communication between clients and staff.