Description

In the second part of this video, Midwife Claire Wood answers your pregnancy related questions.

Transcript

Nina Sebastiane: Women about to go through the experience of labor and child birth have got so many concerns and worries and you know having a Midwife around to be able to answer those is an absolute joy and actually we are extremely fortunate to Claire Wood from Queen Charlotte's Hospital in London in the studio today, who is a Midwife there and she is going to answer some of the questions that you've posed to us. Welcome to the studio. In my current situation, I have probably hundreds of my own to ask you. So let's start from some that have come through, will having inverted nipples prevent me from breast feeding once I had the baby. Claire Wood: I think absolutely not, in fact it's a widely held misconception that milk comes from the nipple, breast milk in fact comes from the areola which is the brown area around the nipple particularly the lower part. So inverted nipple as far as I am aware shouldn't prevent breast feeding in anyways, it shouldn't be hindered in anyway, the baby actually takes the aerola in to its mouth and sucks the milk out, of all that area. So it's not really contingent on, how a prominent the nipple is itself. But I think if any woman is concerned about that, I would certainly urge her to have a conversation with her midwife early on in pregnancy, just to put her mind at rest. Nina Sebastiane: Well I remember with my first baby, I had a real difficulties getting my daughter to latch on for the first bit, and it was, I was exhausted, frustrated and in the end I needed to be manhandled, if you like by the midwife in the hospital to kind of you know to show me how it was done, and to sort of get on with it to get started. Claire Wood: Well, clearly all midwives are there to help not only promote but to support and help the with breastfeeding and the successful establishment of breastfeeding, so I would say to any woman who is in hospital, she needn't to be struggling on her own, she should seek help from the midwives and all the staff, who are on the maternity ward are all trained to help with breastfeeding, whether or not there are difficulties but to help with the breastfeeding. So no woman should really go home from hospital with breastfeeding difficulties. Nina Sebastiane: I have got question here for you Braxton Hicks, I keep seeming it to have them, you know, should I be worried, should I be expecting the on slot of labor. Claire Wood: Braxton Hicks are really a sort of rehearsal if you like or bit of a practice for the uterus. They are generally painless contractions and women usually aren't aware of them other than their abdomen will suddenly become hard and it really is a sort of practice contraction. There's nothing at all to worry about. It feels quite different to a real contraction, so having a Braxton Hicks contraction at 36 weeks doesn't mean, you're about to go into labor. Nina Sebastiane: And she knows what you said, if I have I think I had pain in the middle night last night, did I work out with the stiff tummy, would that make sense. Claire Wood: Oh my certainly yes. Nina Sebastiane: Thank you, I have got a question here, my husband is very keen to know how soon we can start having sex again after our baby arrives, that's not my question by the way. Claire Wood: I don't think there's a hard and fast rule, I think as soon as you are comfortable is the answer, it would perhaps be kinder to allow for example the perineum to heal, if there's any perineal trauma just it will be more comfortable experience but I'm not aware that there's any hard and fast rule about 2 weeks, 4 weeks, 6 weeks or whatever. Nina Sebastiane: What about before giving birth, what if I'm in the late stages of pregnancy, I mean I'm sure, women are bit nervous about that time. Claire Wood: Again I think, it's very much what you're comfortable with, what you're comfortable with literally in terms of physically comfortable, and what's achievable and indeed one of things that we often encourage women to do is to have sex at once they are active, once the due date has come, as that may, if the cervix is favorable that may help to initiate labor naturally, yes. Nina Sebastiane: Really because that's to do with prostaglandin sperm, isn't it? . Claire Wood: And the semen yes. Nina Sebastiane: I have heard that. Now how is the baby induced and how over due does one have to be before that process kicks in. Claire Wood: How over due will vary from hospital to hospital and hospitals will all have very slightly different policies on when that process should take place, it won't vary about very much may be few days either way, so there's no universal answer to that and many hospitals will take a different views so depending on how old the woman is and a variety of other fact, in a normal pregnancy and induction of labor will very really take place before 41 weeks but again that may vary from unit to unit. The way that happens, there are various way in which babies are induced, I guess the most common is probably by use of a prostaglandin tablet or pessary that's inserted into vagina and helps to ripen the cervix but again that only works if the cervix is at a particular state of favorability for that. Nina Sebastiane: Now you obviously make, do you yourself make home visits after the babies are born or you are just based at hospital? Claire Wood: I occasionally undertake home visits, although the hospital where I work, there's a team who's solely to that particular part of midwife - a post nata l visiting depending on the model of care that a woman is having at whichever unit, she is having her baby, if that might be undertaken by the midwife, she already knows or it might also depend but all woman will receive visits in the home usually up until about the tenth day after baby has born or until the cord the baby's umbilical cord falls off as usually as a sort of rule. Nina Sebastiane: And again you can have question answered there and instead of just you know getting ready, getting used to being home with baby, that's the time to. Claire Wood: Yes I think that most women find that are very much -- look forward to the coming to midwife's visit because any of those little anxieties that they have stored up since the last visit, they can discuss with the midwife and often it's just talking to someone who has seen these things many times before and it's very reassuring Nina Sebastiane: Okay we have got yet, my hasn't turned and gotten into the right position, I'm worried its going to be breech is there anything I can do? Claire Wood: Well if the baby is breech, properly breech as in head up, as opposed to some other normal standard presentation, there are, yes there are some things you can do, one that does have a reasonable degree of success is undertaken by obstetricians, in fact, not midwives and that's called External Cephalic version and that's where obstetrician literally turns the baby round abdominally Nina Sebastiane: I have seen this in a TV show recently actually, it's quite incredible. Claire Wood: It doesn't always work, there are all sorts of reasons that we don't have time to go into why sometimes it doesn't work, sometimes babies just like being the wrong around and will flip themselves back. Nina Sebastiane: I have read that you can actually do things post, with your posture because I mean us lazy western women tend to sort of be lying like this all the time slouching backwards, I have heard sitting forward makes a difference. Claire Wood: I don't know sitting forward, if anything, I think that might compound the problem, I think possibly getting on your knees and having your shoulders lower than -- Nina Sebastiane: Yes that's what I mean being. Claire Wood: But not sitting, on the floor. Nina Sebastiane: You are almost like on the palms and knees. Claire Wood: Yes because they are not sort of encouraging the baby to sort of turn his head round but I don't know if that has ever been sort of rigorously evaluated so but it's worth a try, anything is good to be worth a try. Nina Sebastiane: Absolutely if in doubt, give it a go. Now I'm sure lots of women have concerns about partners being you know in attendance during the labor and what their specific role can be to support, any tips for the dads watching would be done. Claire Wood: I think there role is enormously important because after all they are the person who knows the woman best and as much as the woman may build up a good rapport with the midwife intimately and the partner is really the key supporter I think emotionally. So I think they should be confident of how valuable they are, I think often they feel that they don't really have much to contribute during the labor because they are not the expert but actually they are the expert in that woman, so I think that role is very important, to support and encourage and just be with the woman particularly when things get difficult to women, when they get it bit tough and just not to panic as well, I think that's also very important but it's important for them to keep cool head and keep a clear head and often that can be a very decisive factor in helping women to get through difficult stage. Nina Sebastiane: I have got question here says, I'm a very small woman and 'm terrified about giving birth to a large headed baby. Claire Wood: I'm not quite sure what a large headed baby means or would look like babies tend to have a head that is in the correct proportion to their bodies and women tend to have babies that are in the correct proportion to their bodies, occasionally a very small woman will for some reason make a very big baby perhaps because if there's an enormous disparity between size of her and her partner but on the whole women have a babies that's the right size for them. I think if that anxiety is then borne out and the woman does feel that she's got very big baby, she is carrying a very big baby then she need to have a conversation with her care givers to discuss the best course of action. Nina Sebastiane: Okay and what about VBAC, people will don't know what that stands for Vaginal Birth after Cesarean, again lots of women have fears, don't they about possibilities of having a normal birth after having past a complicated labor the first time out. Claire Wood: Well I certainly don't think it's something that women should fear having had the cesarean section, I guess there are sort of two answers to that, there are some risks with Vaginal Birth After Cesarean section, the principal one is the rupture of the uterus which happens in less than half a percent, well one half to 1% of cases I think is the documented risk. So it's a very small risk but it is a risk and I think that's probably what women hear and tend to focus on but actually I think for women who has had a very difficulty time previously and perhaps had a cesarean an emergency cesarean section for whatever reason having a normal natural birth subsequently can really restore her experience of child birth but again that's something that she would discuss with her care givers intimately, so that everybody was working towards the same objective and understood what the possible scenario as well. Nina Sebastiane: Claire it's been fascinating talking to you once again thank you very much for joining us in studio. Claire Wood: Thank you.