What pregnant women want

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Illustrations by Ayumi Takahashi

I came across this fascinating NYTimes article today on what pregnant women want. The author crunched some numbers on Google searches in 20 different countries and came up with all sorts of insights. In the UK top 5 queries about foods pregnant women want to know if they can eat prawns, smoked salmon, cheesecake, mozzarella and mayonnaise. Compare that to Singapore where top 5 food concerns are about green tea, ice cream, durian, coffee and pineapple. I ate all this (except for durian) without even thinking of checking! But then, I ate a plate of oysters in front of my US colleagues accompanied by their worried looks and questions “Are you sure you can have this?”. As it turns out I am pretty relaxed about these things, so do your own research.

Among other concerns “preventing stretch marks” seems to be in the lead for US, Australia, Canada, the UK. But others, like Ghana, India, Nigeria, either don’t have them or are not concerned as much. I suspect it is the former because stretch marks seems to be determined by genetics – I googled that one too.

It is a fun article, go read it now.

Overdue and what you can do

You worked until the week of your due date. Your hospital bag is packed. Your have a new haircut and a fresh manicure. Your due date has come and gone. Your mother in law is posting baby-related messages on Facebook every day. You are tired of saying to all the friends and relatives: “No-no, the baby is not here yet”. You are too heavy to move, too uncomfortable to sleep. You cannot plan your social life more than one evening in advance – and you have seen all movies worth seeing in the local cinema. But this baby of yours is not in a rush.

I am speaking from experience here.

10% of women will go over their due date. 40 weeks, 41 weeks, 42 weeks, and still no sign of contractions. What to do? Well, you always have a choice of medical induction (in fact, your midwife or doctor will suggest it stronger and stronger as time goes on). But if you want to avoid it, what else can you do?

My pregnancy was low risk and I was referred to a local birthing centre. The midwives there were really nice, but they never discussed with me the topic of “being overdue”. Their usual response was “oh, it can happen any day now, may be even tonight”. In their world people either came with contractions or disappeared back to the hospital labour ward. So I had rather a harsh landing when the doctor I saw on my 41 weeks + 5 “visit to discuss my options” said “OK, and now we are going to induce you”. It was not what I wanted. What I wanted was a list of actions to try to go into labour naturally. I wish I had it handy on my due date. So I wrote it all down in this blogpost.

Disclaimer: You can try these things once the baby is considered “full term” – from week 37. Always check with your doctor/midwife first in case of any contraindications. There is no scientific evidence that these methods help bring on labour. In most cases, either noone has done a clinical trial on them or the clinical trials have been small and inconclusive.

But it is hard just to sit and wait so you may as well do something that may help and will not hurt.

  • Acupuncture. Go to an accredited acupuncturist who specializes in pregnancy and women’s health. Ask midwives or mums in your antenatal class. And once you get one good specialist they will recommend others. This is a small world and people tend to work together.

  • Reflexology (foot massage). Personally, I found it more enjoyable than acupuncture.

These two methods are not cheap (£60-70 per session and you may need a few sessions). Cheaper (or free) alternatives:

  • Homeopathic medicines, for example, Caulophylum 200C. Ask your pharmacist for the right dosage.

  • Aromatherapy using clary sage, nutmeg and lavender oil to stimulate contractions (or just clary sage).

  • Have sex. Semen has prostaglandin which can help ripen the cervix. Medical induction also involves prostaglandin pessary.

  • Walk up the stairs sideways. It can help the baby head to engage.

  • And then, I guess, eating pineapple, dates and hot curry (but only if you like them).

According to this clinical trial raspberry leaf tea doesn’t bring on labour, but shortens the second (pushing) stage.

UK NHS recommends induction at 41 weeks + 5 days. If you are in private care your doctor may suggest induction as early as 41 weeks. There are also some medical conditions (like gestational diabetes) where doctors will recommend an earlier induction, say, at 40 weeks. Most people would go for an induction at the recommended time, but often they don’t know that they have a choice. The choice is to “wait and see” and opt for continuous monitoring. I had to come to the hospital every 2 days to get the fetal heart beat monitored. I also requested and got an extra ultrasound scan after 42 weeks (it only took the midwife 10 minutes, confirmed baby’s position and showed us that there was enough amniotic fluid still).

If you are considering not going for medical induction, educate yourself about risks of prolonged gestation. NHS will give you a booklet that talks about the risk of stillbirth increasing from 2-3 per 1000 to 5-6 per 1000. Here is an American article talking about other risks (that I found informative and quite scary).

Here is a good blogpost talking about risks of induction itself: Should I stay or should I go.

Here is a website with stories of women successfully giving natural births past 42 weeks. There are also a lot of positive stories about women having an induction and a good birth experience afterwards. It is easy to find evidence whatever your view is.

In the end, I had to go for a medical induction at 42+4 because my waters started leaking. But then I felt that at least I did everything I could.

NCT course – do or don’t?

When we were preparing to become parents, my husband and I were thinking whether we should do a NCT parent education course or not (NCT is National Childbirth Trust in the UK).  We didn’t really need the course because we had read a few books and planned to go to parent education course that was offered by St. Mary’s hospital for free. And NCT course would take longer (two weekends instead of one day) and would cost £287 – definitely something to stop and think about!
I asked a few friends who did it whether it was worth doing, but their reasons didn’t convince me. Some did it because it was the timing of their hospital course didn’t work for them, some did it because they preferred to get the extra knowledge by talking to people rather than reading books. Everyone said that the reason you do it is to meet other new parents in your area and become lifetime friends with them (no pressure). However, London is such a transient place that it is hard to form lifetime friendships. Most people will have their first child and then move. In fact, this is what happened to most of my friends.
In the end, we cracked Mr Piggy and did the course.
Was it worth it? For me, definitely yes.
The best thing was meeting the people who lived in the same area with a due date within a month of our own. Same area is important because after birth 40 minutes on the tube will be an insurmountable obstacle. And due dates are important because even if your kids are two months apart the mums’ relationship becomes quite one-sided (one mum already solved all the problems and is teaching the other one) which soon becomes awkward for both parties.
We are still in touch with our NCT group and meet regularly. Mothers email each other frequently, asking for advice and sharing tips and frustrations. It was not unusual to type an email at 1am in the early days – and get a response straight back (yes, the “1am feed”). You have someone else in the same boat. This support network is really valuable. I only realised it once I had the baby.
The second best thing is that we got on NCT mailing lists and Facebook groups. So now I get invitations to a lot of local baby-related events, like coffees and courses. And there I make connections and meet more people from the same area with babies of the same age.
Finally, I got the list of lactation consultants from our NCT instructor and later found out about breastfeeding drop-in clinic. This turned out to be extremely valuable (and saved us money on expensive lactation consultants).
Can you get all this without doing the course? Yes, you can. You may already have support network in your area (your mum and sisters or friends). You can join NCT lists without attending the course. If you meet local mums at one event (say, yoga class or local library) your connections will start growing like a rolling snowball. It is simply easier if you do the course because this kind of happens for you (and in the early days if there is anything that is easier, I will vote for it).
What about the knowledge? I think it really depends on the instructor you get. Our instructor at St. Mary’s was brilliant (and a mum of four). Our NCT instructor was super helpful and gave us lots of resources to explore in addition to the course (which I only finished recently, six months after the course). Though the ultimate thing with the baby is learning by doing.

Before the baby comes, part one: prepare for breasfeeding

You would think that breastfeeding is something that should happen easily and naturally. After all, if it didn’t, humanity would not have survived, right? However, out of all things that I had to master with my newborn it was the hardest one. I knew it would be from my girlfriends, so I prepared for it. I attended a breastfeeding course with NCT, I printed a couple of articles showing the right latch and breastfeeding positions, I watched a few videos, I learnt “nose to nipple, tummy to mummy” mantra. This was all very helpful, but still I did not prepare enough.

What else could I have done?

First of all, I should have gotten an email and a phone number of a breastfeeding consultant (or a few) that I could call straight away if I needed them. I hoped that my sister-in-law (who works as a lactation consultant in Australia) would be sufficient. She was very helpful to call in the middle of the night, but you need someone locally, in your home, the same very day because your baby is not getting any food! Ask friends for a recommendation beforehand, ask a birthing center, ask your parent education instructor. I got a consultant from NCT and not only she was good, but she also charged reasonable amount (£80 per session). If you just search on the internet you will end up paying £250 or more in an emergency.

Secondly, I should have taken notice of the “breastfeeding clinics” in my area. Luckily, my husband found one through NCT – at that point I wasn’t capable of searching the internet. These are usually weekly drop-in sessions where one can ask questions and get advice on correct latch, etc. You will probably end up going there a number of times at different stages (i.e. in the beginning to correct the painful latch, check for tongue-tie, when your baby loses that latch every other minute, when you need advice on how to introduce a bottle, etc). They are much cheaper (or free) than getting a breastfeeding consultant, but we couldn’t get to ours in week one, as we could barely leave the house – that’s why we needed the consultant to come to us.

Thirdly, I should have gotten a good breast pump in advance and tested it. I got one from a friend, but the suction on it wasn’t strong enough. I found this out from the midwife who came to visit, so I ended up buying a breastpump in a hurry. You can also rent one from NCT (they have industrial strength ones). I bought one for the both breasts because I realised after sitting awkwardly crouched for half an hour 8 times a day that it is worth paying more.

Finally, I should have gotten some formula, bottles, nipples and steriliser all set up and ready to go – just in case. And also found out how much formula to give to the newborn – see an example here. You know, I didn’t want any formula at home because I wanted to make every possible effort to breastfeed. I thought that by not having formula I would remove the “temptation” to just give the bottle and persevere in breastfeeding. I was afraid that once the baby gets the bottle he will never want to breastfeed (rubbish! I had to bottle feed in the first week until we both figured out how to latch – and now my baby is happily sucking from the breast). What I didn’t realise is that you cannot teach the baby to take the breast, they need to learn. And they cannot learn when they are screaming their lungs out. Luckily, I had some formula at home after one couple in our mums & babies group almost had to go to A&E on Sunday night. We had to rapidly sterilise the bottles and teach ourselves how much extracted milk and formula to give to the baby.

Looking back at our first week with a newborn, we could have saved ourselves a lot of stress. Our baby screamed a lot and we didn’t know why. I suspect it was hunger. Once we sorted out breastfeeding (in week 2) the loud screaming stopped. So next time instead of shushing and rocking I would try feeding first.

Resources about breastfeeding:

  • Kelly Mom – terrific resource on breastfeeding covering all sorts of topics like increasing milk supply, pumping, reflux, baby allergies (myths and truths), cluster feeding, etc

  • Australian Breastfeeding Association – has a lot of useful information, including videos

This post is part of “Before the baby comes” series: