Nadene’s Birth Prep

Following on from my home birth story, I thought some might be interested in hearing my preparation for it. My biggest advice is that you DO need to prepare if you wish to have a physiological birth. I knew through hearing countless experiences in clinic that the medical system does not prioritise this, and so readily interferes with birth with interventions that most of the time, are not necessary.  

Now for a warning, what I’m about to share might challenge the normal modern-day narrative associated with childbirth. Like when writing my birth story, I feel the need to state a disclaimer to say that this blog should not be used as medical advice for your own personal situation. The decisions you make should be based on your own circumstances, research and discussions with the medical professionals in your birth team. I will however be giving an honest, personal account of my own experience and decisions, which was shaped by my professional knowledge and belief system as a Chiropractor. 

I have created links on each picture to the recommendations so it’s easier for you to access things. I hope this blog helps create some confidence and control with choices around your body, baby and birth. Happy reading!  

Mindset 

I had a very clear idea of how I was going to be entering pregnancy… with pure grit and determination, which is how I approach most things. I had a few “mantras” that I used to recite to myself before I even fell pregnant, and I believe this really helped throughout. I truly lived and breathed these sayings.  

1. Pregnancy is not an illness. I am not sick.  
2. Childbirth is a marathon, and I must train for it.  
3. I will not live off carbs.  
4. Childbirth is a rite of passage that requires little to no intervention.  
5. I trust my body to grow my baby and my baby knows how to be born.  
6. The human race, like other mammals, have been giving birth for thousands of years. We were literally born to do this.  
7. I must continue to exercise no matter how sick or tired I feel.  

I’ve been quite open about my fertility journey, and I feel very fortune that it wasn’t as bad as it could have been, but it still wasn’t straight forward. I knew very well that it was likely to be tricky for us (me) as I have three autoimmune conditions, including Polycystic Ovaries. So, I had mentally prepared myself for the psychological torture of it taking a while and potentially experiencing a miscarriage. In total it took us 10 months and 2 miscarriages, before we got lucky with our little one.  

The mental monthly battle of trying to conceive was absolutely awful! One quick way to turn any sane woman bat sh*t crazy.  I know friends with more difficult stories than mine, so I appreciate I am very lucky in the grand scheme of things. My heart goes out to anyone reading this who is in the trenches at the moment. The monthly rollercoaster is torturous and the amount of money I spent on pregnancy tests was ridiculous. Insisting that I needed to do another the day after a negative one… just in case it was now positive. The cost of the things should actually be criminal!!  

Knowing the stress that was occurring was probably contributing to the difficulties, I decided to take a leaf out of my own advice book …. And we got a puppy! A positive distraction is a great way of taking your mind off the monthly routine and it really did the job! The month we went through the process of adopting Arla, was the month it happened. We also weren’t even “trying”. No cycle tracking was a welcomed break, but only possible for me by a real-life distraction. My advice is to get the kitten or puppy, go on that holiday, move house or anything else that might be on the cards to get totally engrossed in. 

Food 

Changes in this department started for me during conception. As mentioned above with a collection of autoimmune diseases, two of which do not tolerate gluten well, I knew I had to get stricter with my part time gluten free commitment. In the last few months leading up to my successful pregnancy, I managed to regulate my periods for the first time in my life! I, without a shadow of a doubt, put this down to being gluten free. Having always had irregular cycles ranging from 32 to sometimes 55 days, I was ecstatic to get the last 5 months consistently between 28-32 days. I still didn’t have a clue when I ovulated though. I never could locate it when tracking, nor have symptoms.   

My diet is generally pretty good, as I follow a 80:20 rule. That 20% does seem to all occur at the weekends in the form of rose wine (when not pregnant obviously), crisps and hummus dip. This is thanks to my other half and the excellent modern-day man that he is, who is also known by our friends as my personal live in chef. Everything is home cooked with lots of veg, protein and non-processed carbs.  

I also was very conscious of my sugar intake, due to its aggravating link with PCOS and an unnecessary worry of potentially having Gestational Diabetes after my 20-week scan, as my baby’s abdomen was on the 99th percentile. These two factors were enough to raise an alarm and an oral glucose tolerance test was recommended. Something I will never partake in again after it made me feel so ill, and I feel like it couldn’t have been any good on the baby to have such a reaction. Check out the picture below of my glucose levels during the test.  

Being the control freak that I am to have the information for myself, I invested in a constant blood glucose monitor to check in and see what was going on. A great insight generally, pregnant or not, to see how your body reacts to certain foods, how you eat them and the effects of movement. Becoming a bit paranoid, I did this periodically for the remainder of my pregnancy. This will definitely be the route I take with my next pregnancy if GD is a concern again.  

Another mantra that I lived by… I was not eating for two. I also didn’t follow any of the guidance on soft cheese, rare meat, eggs and fish after doing a bit of research…. Oh yeah, the advice isn’t based on any! What a rebel! 

Research  

I would say researching EVERYTHING about childbirth was imperative in achieving my birth outcome, especially with all the little hiccups that occurred. Any of those could have railroaded me into having some heavy intervention if I had followed the hospital protocols and not been well read about each possible event to make an educated decision in the moment. Not one decision was made based on fear, or at the mercy of someone else’s opinion as if it was the first time I had heard about a particular problem.  

For those that haven’t had the stamina to read my ridiculously long birth story, I don’t blame you. To summarise, I had a long labour, pushed for 14 hours, blood in waters with “increased risk” of haemorrhaging, an ambulance on standby outside my house for 6 hours, meconium, deflexed baby head position, grade 2 tear declining stitches and a retained placenta of 4+ hours. The best bit is, there was no sense of emergency during my birth. I made calm decisions, which I knew were the best for me and my baby. I had no medical pain relief, very little monitoring (declined all VEs) and had only one intervention of a catheter on my request. Even that request was based on research that I had done, as I realised I hadn’t peed in hours and a full bladder can block the pelvis entrance and I sensed that was what was stalling labour.  

In my opinion, the worst thing you could do, is to not have a detailed and well researched birth plan. The medical maternity service will not guide you with real stats but will be based on fear of litigation issues and take the “just in case” approach. You have to advocate for yourself, and you can only do that with knowledge.  

Here are my recommendations of MUST reads, MUST follows and MUST listens… 

Books:

Social media pages:

Positive Stories  

As soon as you tell someone you are pregnant, the horror birth stories come flooding in! I knew it was important to fill my mind with positive ones. There is a huge section at the beginning of Ina May’s book that is one positive birth story after another. Go and immerse yourself! What I also got a real boost from was that there were so many stories included of “high risk” pregnancies that ended in beautiful physiological births without the recommended intervention. These helped fuel my fire of confidence to trust my body and helped me make sense of some of the “horror” stories, as they all tend to start with intervention which were linked to predictable outcomes.  

A friend recommended this Facebook group that was filled with birth stories. I loved it and often still read stories that are posted on there. It is full of like-minded women planning to have a home birth and educating themselves on the best way to navigate the system. I found it particularly comforting, as it can be a lonely place in this society when you have out of the ordinary beliefs. It doesn’t matter whether or not you are planning a home birth. This group is a great source of information with lots of birth stories.  

 Here are some of my favourite nuggets of evidenced based information…  

1. The safest place to give birth is at home. 
2. The first intervention to the cascade of interventions, is leaving your house. 
3. All births should be planned at home until there is a medical reason to be at the hospital.  

Language  

The language used around pregnancy and birth is terrible. It’s subconsciously disempowering, but you might have never thought of it in this way. Comments such as, “they won’t allow you to go longer than 42 weeks”, “you are only 3cms dilated”, “your baby is measuring too big”, “failure to progress” and the list goes on. Any comment that started with “they won’t allow you to…” … I’m sorry?! Who won’t “allow” me to do what with my own body?! Mind blowing terminology used in our day-to-day language between friends/family/acquaintances, but also with in the maternity services.  

Please note EVERYTHING is a choice! There were many things I declined during my pregnancy and childbirth, which some people seem shocked to know that it was even an option. I declined having my bump measured, a growth scan at 32 weeks, an extra consultant appointment because I declined the bump measurement, an internal examination during pregnancy when they suspected my waters were leaking, antibiotics for said water leak in case of infection, vaginal examinations during labour, regular foetal monitoring and getting in the ambulance during labour, and finally the placenta injection. A lot, right? 

As well as the powerful and potentially detrimental language used around a pregnant woman, I believe the language you use as a mother to be is just as important. I used very direct language around my birth choices. For example, I never said things such as “I want to try and avoid induction”. I would say “I will not be induced”. Do you see how this changes the control of the situation? As well as this being helpful with setting the precedence with your birth team, it’s also your internal narrative and this can influence your outcome too.  

Treatment 

I wouldn’t be a true Chiropractor if I didn’t practice what I preached. I received weekly, yes weekly, Chiropractic treatment for 5 months in the lead up and another 10 months during my pregnancy. This frequency does not match my recommendation to patients in clinic. Not because I don’t believe it’s beneficial, but due to the financial ick I have assuming patients won’t want to pay for treatment that frequently. I do feel it’s necessary to add that I paid for all of my appointments and was a financial cost that I justified with high value. I wouldn’t want you to assume I had this level of care only because it was free.  

After my first miscarriage, I thought it would be wise to continue having treatment to prepare my body and mechanics for carrying a baby. This was to enable a balanced pelvis and aid optimal birth position. I was adamant I was going to be fit enough to work until the very end. I believe the treatment was a big part of why I was able to continue doing my physical job, completely pain free, until I was 37.5 weeks and didn’t need to adapt anything.  

 I’m very aware that a fault of mine is struggling to switch off and relax, so I also treated myself to a few relaxing massages and facials during my pregnancy. Stress has a huge impact on the foetus. Much more than other factors that society place more emphasis on. Slowing down and tapping into the parasympathetic part (rest and digest) of your nervous system is essential. My favourite present was a pregnancy massage at Daylesford Farm. Go and treat yourself… It was heavenly!

Exercise 

This part of birth prep was absolutely essential in my opinion. Statistically it is known that women’s first labours tend to be the longest and most difficult one. For this reason, being fit enough to endure a “long” labour is critical. Hence my mantra that childbirth is a marathon, and you must train for it. You wouldn’t go and run the London marathon without some hard graft first, right?  

I believe the reason for a longer labour is for a couple of reasons. It is the first time your body has ever given birth, so the path has not been paved. Also, as a first-time mum, there can be some anxiety around the unknown birth process. Whether that’s a fear of pain or capability, but this stress will not aid labour. This is all so different with a second and I believe it’s helpful to not even have much time to really think about it, as you are busy running around after a little one.  

I made an educated guess that my miscarriages were linked to intense exercise, due to my first occurring when I was training for a half marathon and the second was during a HIT work out at the gym. OF COURSE I may be wrong, but with my autoimmune issues and the lack of energy that it comes with, it made logical sense that my body couldn’t cope with the stress I was putting it under and handle an additional process as a consequence. 

So before I fell pregnant for the 3rd time, I gave up high intensity exercise and just stuck to weight training and dog walking. I stuck with this regime for the remainder of my pregnancy and it paid dividends, as the midwife believed that the only reason I was able to withstand such a long labour was because I was fit throughout my pregnancy. Two to three times a week I attended the weight training classes at F45 up until the day I gave birth. Obviously some things needed to be modified as I got bigger, but it was great to keep fit and was an integral part of my postpartum recovery. More on that in my next blog…

Yoga 

For years I had heard many amazing things about Ann Carol’s local pregnancy yoga classes, so I signed up when I was 16 weeks pregnant and attended every week until birth. I actually believe this helped start my labour as my contracts started after a class when I was 39 weeks pregnant.  

Just to warn you, this class is quite different to conventional yoga. It is aimed around birth prep – practicing different positions, relaxation techniques and working on your mindset around birth. I loved the whole environment that Ann created. She welcomed women into her cozy living room on a Wednesday evening, where we could share pregnancy experiences and check in with each other, filling our thoughts with positive and empowering information. It was lovely to end each session with a guided meditation, a cup of tea and some pineapple whilst having a chat amongst us. 

Midwife Appointments

I feel very fortune to have experienced care from some really lovely midwives during my antenatal journey. I had an allocated midwife called Dani who I saw for the majority of my appointments. I sensed within the booking appointment that she was a like-minded person, and I wasn’t met with any resistance when I expressed my wish to have a homebirth. This was so reassuring as I had mentally prepared myself to be metaphorically armed with boxing gloves on, ready to fight for myself and my choices, which is just so tiring and stressful. Not conducive to the health of my baby. I had a real fear of the midwives and not being able to trust them due to a conflict in belief systems. For me, being given some important advice from someone who shared the same belief system as me, carried more weight than from someone who has an opposite one. I know not everyone gets the consistency of having the same midwife and I think this also can make a huge difference in experiencing a positive outcome.  

 As I have previously mentioned, I declined a few aspects of care. A key one to discuss was the measuring of my bump. This is notoriously known to be inaccurate, especially if performed by different midwives at each appointment, but can easily and innocently cause a cascade of events the leads to unnecessary intervention. I applied logic to this scenario. No one had ever measured my torso before a bump started growing, so how was the growth relevant to me and my starting point? Why did they measure it lying down when the bump reduced in size? I believed my body wouldn’t grow a baby it couldn’t give birth to… unless I had uncontrolled GD or a poor diet, but I didn’t. I didn’t want seeds of fear to be planted around having to give birth to a “big baby”. It’s natural to be nervous around the fact of having to push a baby out. I promise it doesn’t hurt any more or less whether you birth a 6lb or 11lb baby, but you certainly don’t need more mental worry placed on this. I wasn’t going to accept growth scans as they are also inaccurate in predicting baby size, so what was the point of potentially having something highlighted by having the bump measured. I felt confident that my bump was growing, and foetal movements were all normal.  

The aim of explaining this is not to persuade you to do the same, but to highlight that EVERYTHING is a choice. Tests, scans, appointments, routine and additional things, place of birth and even if you have a medical professional present at your birth. Now I did tell my midwife that if there wasn’t anyone available to come to my home-birth that I wouldn’t be going to hospital and I would free birth with my two birth partners. At the time, I did really mean this, BUT in hindsight I was so glad that I had the incredible midwives present at my birth. Very naughty of me to disclose this, but if you tell them your intention to free birth if the home-birth team aren’t available, they will make sure they get someone to you. 😜

Now for the consciences of people reading this, I was interested to find out that the most straight forward hospital births cost the NHS £3,500. This is one where you arrive and leave on the same day with no intervention. My home-birth didn’t cost anywhere near as much. So don’t feel guilty about the cost or resources. You are also not taking midwives away from the hospital, as the departments are separate. Community midwives attend home-births and hospital midwives stay in the hospital. This also means that the experience and belief systems between these two types of midwives can be quite different, and you are likely to receive different care and recommendations based on it. 

Antenatal Course 

I have to admit, I was quite disappointed with the face-to-face antenatal course that we enrolled on. I don’t regret doing it, as part of my reasoning for participating was to meet other mums that were having babies at the same time. It certainly did the job as we met one couple that are completely our cup of tea, I spent the majority of my maternity leave with the mum and I know we are going to be lifelong friends with our boys growing up together. However, one aspect of the course that was very frustrating, was where they were educating couples on what happens during birth, but did not include any physiological process of what birth was actually like. No hints, tips and tricks of how to promote birth naturally. You’d think this would be pretty handy to know right?!  

The whole birthing session of the course was centred around hospital protocols and procedures that subconsciously disempower women by planting seeds to doubt in believing that their bodies are not capable of giving birth without intervention, without being put on a timer or without pain relief. I was the only woman out of eight in my course that has not suffered with some birth related PTSD due to “complications”. I refuse to believe that 87.5% (7 out of 8 women) were incapable of giving birth without medical intervention. If the right information had been made available for these women to feel educated and empowered, I am sure that their birth outcomes would have looked a little different without birth trauma. This is just a small sample size of the population, but where the same story seems to apply with the majority of my patients.  

A great and reasonably priced online course that we did was the antenatal and hypnobirthing programme with Birth Ed. I could not recommend this enough and it’s only £97. Megan gives great information by the bucket load for all the types of birth. She teaches how to promote a physiological birth AND teaches about hospital procedures in the unlikely event that you require some help, but how to navigate the decision making in this instance to choose what’s right for you.  

During this course I also learnt how to breathe my way through labour to help with the pain, which is known as hypnobirthing. This was an insane technique and one that took me into an internal trance and completely away with the fairies during labour. JJ said I looked like I was on another planet with my eyes rolling into the back of my head and ability to sleep in the 2-minute downtime between contractions. I managed to sustain a long labour with no pharmaceutical pain relief, just by using this technique AND with the help of intermittent use of a TENs machine, a birth pool, a comb and hands bearing down on my back. Sure the contractions are painful, but they were momentary, and I have experienced far greater pain before. Another mantra that I would recite to myself, “Pain does not equal damage. Do not be afraid of the pain.” 

Doula 

Having a Doula was absolutely invaluable! It took my other half some convincing that the cost would be worth it, but he doesn’t regret spending the money now. I appreciate they are an expensive privilege, but I promise you won’t regret it either. Especially as first-time parents and feeling passionate about having a physiological birth, but needing someone to advocate for you and help you navigate the maternity system and decision making. 

We spoke to a few and found a great connection with Sinead Isaacs. I didn’t realise it was important to speak to several to find the one most compatible with you. I was initially under the wrong impression about the purpose of a Doula too. I thought they were there to act as your cheerleader, to encourage and guide you towards a physiological birth… I was wrong. I think this was because I envisaged a military figure, that shared the same belief system as me, shouting at me “you can do it” during childbirth HA! They are thought to be a professional second birth partner, with experience and who will advocate for you no matter what your birth preference is. They will not persuade or steer you towards their own preference, because of their own belief system and will provide you with lots of evidence-based research to help you make your own decisions.  

My justification for a Doula was that JJ and I had never had a baby before, but I knew I would appreciate the support of someone that had, BUT one that had the same belief system as me that I could trust. It was also peace of mind to know that she would be at my birth, when you aren’t sure what midwife is going to attend. You might have never met that midwife before. Additionally, I was concerned that even though my prediction was that JJ would be a calm and logical birth partner, I didn’t know in the situation of pain and fear whether he would wobble, panic and waiver. I needn’t have feared as he was an absolute solid rock during the whole thing. Our Doula even commented that she had never seen a birth partner stay so cool, calm and collected with every hurdle that arose.  

A doula package often includes several antenatal sessions, as well as the persons presence at the birth and a postnatal visit. The antenatal sessions were incredible for bringing JJ and I onto the same page. I had read so much around birth, so a lot of the information wasn’t new to me, but JJ hadn’t. So it allowed us to share the information together and make some decisions as a couple and talk through what birth might look like.  

I genuinely thought that we would only have a Doula for our first and once we knew what to expect with the following, we wouldn’t pay for another doula. After the birth, it was JJ that said how invaluable having Sinead was and we hope she will join us in the future. The extra pair of hands (literally – bearing down on my back during every contraction for 14+ hours), the mediator communicating between us and the midwives in the kitchen, helping us in our decision making with stats and facts and so much more, was worth every penny.  

Birth Plan  

My birth plan has become a bit of a running joke, due to the great lengths I went to in creating and even laminating it. I didn’t know how messy it was going to get! I thought some of you may find it useful and interesting to see it, so I have included the document at the very bottom of this blog. I used the Positive Birth Company template but added the visual birth icons to it. I was advised that the pictures are much easier for midwives and any other medical professional involved to scan through it quickly. 

I appreciate that I was incredibly lucky with the experience that I had with a Community Midwife that took the time to go through my plans for birth. Lots of things were discussed during that antenatal appointment, such as a breach presentation and my choices around that, timings around foetal monitoring as I didn’t want them as regularly as the hospital policy recommends, to how the baby would be resuscitated if it wasn’t breathing and more. Some big decisions to make and the reason why it’s so important to discuss these and have a plan in place, so you aren’t hearing of these complications for the first time in the moment. That’s when decisions can be made based on fear and not logic, without a chance to ask for more research and data.  

If you’ve made it to the end of another very long blog, I hope you have found it insightful, and empowering. This was my main intention with sharing the information. I hope you have gained one or two things that will help you in achieving your dream birth. My next blog will be sharing my postnatal recovery. I’ll see you there!