What this blog aims to bring you

Structural and Cranial Osteopathy before and after Pregnancy

Jessica Shaw BSc (Hons) Ost Registered Osteopath

Pregnancy is a time of huge physical, emotional and mental change in a woman’s life as she prepares to bring a new life into the world – a change which will turn her world upside down.  Structurally, women’s  bodies must adapt to the growing foetus which includes an extra 20 lbs on average of water, foetus, placenta and blood.  Hormonal changes also soften ligaments in preparation for birth.  This means that many women  experience aches and pains.  Many of us are also choosing to have babies later on in life too, which can mean our bodies don’t recover quite so quickly from the strain of pregnancy and birth, and have a history of back injuries before getting pregnant.  Often the birth experience can be quite physically and emotionally traumatic for the mother, yet once the new baby comes along, all attention is on him/her and the mother’s aches and pains from delivery, breastfeeding, lifting and carrying get sidelined.

Osteopathy can really help women adapt to these changes during pregnancy and after delivery in a gentle and effective way.  Realigning the pelvis during the pregnancy helps avoid pain as the baby gets bigger and may help prepare the pelvis for a natural uncomplicated delivery.  For those already in pain, osteopaths can help with specific issues such as disc problems, symphysis pubis dysfunction, neck and shoulder, rib, hip, low back and sacro-iliac pain.  We can even help with heartburn, headaches and aching, swollen legs!  After delivery it is a good idea to have an osteopath check your spinal and pelvic alignment so as to avoid problems later on – typically we see women with neck and shoulder pain from breastfeeding, lifting and carrying – add the lack of sleep and stress of a new baby and it’s a recipe for tension.  Being out of pain helps you cope better with all these new demands and contrary to popular belief treatment is gentle and painless. 

Pain in pregnancy

When thinking about having children many people associate pain with childbirth. However there are ways to cope with this pain (drugs being the most common option!) as it is short term and its there for good reason: or your baby would never make its entrance! However chronic pain during pregnancy is not something which is publisized or well managed .

One of the most common causes of chronic pain is SPD or pelvic instability. Some 5% of pregnant women suffer from it. Fortunately many only have pain between their legs towards the end of the pregnancy but for some it happens all the way through and can leave them severely disabled. I should know as I am one of these women.

I pride myself on being a positive thinker. When I am stuck I look for ways to solve the problem, learn and move on. However I have discovered over these last 9 months this is very tough to do when I am constantly feeling pain. It grinds me down. My attention span shortens. I dont feel myself. I am unable to go about my normal activities: playing with my son on the floor, walking with the buggy, socialising with friends. My husband might say the positive perspective is that it kept me out the shops this Christmas!

It has given me an insight into what it must be like to be permanently disabled. I am fortunate to know that my condition will get better after the birth. I wonder what it must be like to deal with this day after day knowing it may never get better? What would I do?

One of the biggest frustratations is being constantly told ‘there is nothing you can do’. I dont believe there is ever ‘nothing’ because doing nothing is actually doing something. Thanks to the internet I have found a number of resources that have worked successfully for me and have made a real improvement to my life over the last 5 months.

PINS http://www.pelvicinstability.org.ukis a charity in Scotland who provide a network of people who can offer services to help. These include people to speak to who understand what its like to suffer from this condition. Professionals who are willing and able to treat your symptoms to enable you to be pain free and are willing to try to help. I cannot thank them enough for giving me hope and allowing my precious last few months being pregnant to be ‘realively’ comfortable. Not comfortable enough to do it again though!

Midwifery support

I am by no way your model pregnant women. There aren’t many medical conditions that I haven’t experienced during my journey through pregnancy. As a result, I would be the first to admit I dont want to do this again. Not to me or my family. I know its only 40 weeks and that the result is a life time with someone special but its because of these special people in my life, that I dont want to go down this path again.

Being a life coach and NLP master practioner means I have many resources which I can use to keep me positive and manage these challenges. I wonder how I would have felt without them AHHHHH!  Because of my work you may think that my life is always ‘balanced’ ‘positive’ ‘fulfilling’. It’s like thinking policemen never break the law or doctors look after their health. Yes, we all know better but sometimes we choose worse.  I think that’s what makes me an even better coach-I understand what its like to make poor choices as well as good ones.

The media, I feel, portrays a more romantic picture of pregnancy with posed photos of healthy pregnant mums managing to look after their family and attend the latest opening of their new film (when did they fit the filming in!).  A few may give a real glimpse to what it might be like -Billy Piper (she referred to herself as a space hopper!), Charlotte Church who tells it how it is and is still a hands on mums.

What I have found disappointing is the lack of emotional support during this time. When the midwives look at my notes, which they have to do each visit because I have yet to see the same midwife twice in the first 35 weeks, they sigh empathetically, comment on how difficult it must be and then go onto their ‘do you have  sample for me’ routine, so as not to keep the next bump waiting even longer.

I appreciate that the NHS doesn’t have the capacity to manage every condition. However there are always other people or experts who do. These may be charities and private alternative therapies. When I have mentioned what treatment I have had eg Cranial Osteopathy and physio they agree that this is useful but no one, has mentioned where I can might get this specialised help.

Some government departments say they cannot recommend private practice and get round this by giving a number of alternatives so as not to be bias to one. Fantastic give us a choice. At present I only have the internet, trial and error and other mums. This takes time and money both of which are limited.

If there was a cancer drug out there which wasnt provided by the NHS, would your specialist tell you about it?

I feel I cannot explain to my midwife how I really feel about what is happening because she doesn’t know me and I if I deviate from the routine, I make the next mum wait even longer then the usual 15-30 minutes delay.

For me, I would appreciate seeing the same person before and after the birth so that we can skip the formalities and talk about what is really happening. They can also tell how things are with me because they know me. Wouldnt that be more fulfilling for them too? Please, please, please reconsider case load midwifery, like the Albany practice in London, who have some amazing results for lowering intervention and increasing mothers well being.

Until then, I’ll be delighted to stick to two healthy children! http://www.albanymidwives.org.uk/albanymidwiveshomepage.php

Working Outside the NHS Box

by Carrie Macintosh (Independent Midwife)

Ok, so I’m an independent midwife.  What’s that?  I hear you ask.   Well, it’s just as it says on the tin – I’m a midwife, but I’m independent, therefore, I don’t work for the NHS or anyone other than the clients who employ me.

When I began my training as a midwife, I believed that I was embarking upon a career where I would be helping people, building up relationships with families and helping to bring new life into the world.  My time in university focused on not only the clinical skills and science knowledge I needed to do the job, but on communication, psychology, reflection and counselling skills.  Imagine my shock and dismay then to discover that there are far more skills required to be a midwife in the NHS that they don’t teach you at University – such as the ability to simultaneously “care” for three women in various stages of labour in three separate rooms, build up relationships with said women over a period of a few hours, sometimes minutes, in order to understand their needs.  All  the while trying to do all the necessary associated paperwork (LOTS).  Other things I didn’t bargain on were the bullying culture in the NHS. Working in an environment where you constantly have to argue and justify your care plans simply to try to help the woman you are caring for achieve a normal birth wears you down very quickly.  

Midwifery is often described as an Art AND a science.  The art is in being with woman, TRULY with woman, understanding her needs and knowing when all that is needed of you is to be there and do nothing.  So here’s the science bit……and it’s a well kept secret….Woman’s body + conception + full grown baby = design capability to give birth(most of the time)  The missing bit in the equation is that the medical profession has little or no faith in that fact.

Midwifery, like medicine, is supposed to be an evidence based profession.  Policies and clinical decisions should be based on best possible evidence.  However, it appears that many policies and decisions are based on a desperate bed shortage and the need to move women quickly through the system.   There are many fantastic midwives working within this system who desperately want to provide good care to women and despite a shortage of beds, money, equipment and staff etc they do so but there is only so long that a human being can carry on working within such a stressful environment before they become burnt out.

Faced with all these facts, it became clear to me that if I wanted to be a Midwife in the true sense of the word then opportunities to do that were few and far between in the NHS so I took the leap of faith and set up independently. 

Working as an independent midwife means that I meet the woman in her own home at whatever point in her pregnancy she decides to contact me.  I have had calls from women who have just done a positive pregnancy test on the first day on their missed period and I have had calls from women in labour suddenly realising that their midwife is not supportive of their birth plans.   Once a woman has booked her care with me then I see her at each antenatal appointment, in her own home, and at a time that suits her.   Appointments usually take around an hour, sometimes more, and this gives both of us LOTS of time to get to know each other, discuss her plans for the birth and do all the other clinical checks required.   Most of the women who book their care with me choose to birth at home and I go on call for their birth at 37 weeks pregnant.  If women choose to give birth in hospital then I attend her home when she is in labour and we mutually decide when the best time to head to hospital is and I accompany her and act as a birth supporter and advocate once she is in the hospital.

 Continuity of care is not only beneficial to the pregnant woman but it actually makes my job much easier when caring for that woman during labour.  I don’t need to spend time looking through her notes to find out information about her or to ask her endless questions during a time when all she should be doing is concentrating on having a baby.   The main benefit though I think is during the postnatal period.  When I have attended the birth of that baby it is so much easier to make assessments of the baby’s wellbeing when I am then the midwife visiting that mother and baby daily.  Conditions such as jaundice are easier to monitor when subtle changes in baby’s skin colour are a very subjective measurement.  I also visit for 28 days postnatally (more commonly 10 days in the NHS).  I have found that many of the common problems postnatally, particularly with breastfeeding, do not materialise until after the first couple of weeks and this is often a time when I find that more support is needed.

My one dislike of working independently is the need to charge women money for a service which I believe should be free.  The Independent Midwives Association is currently campaigning for all women to have access to independent midwifery care.  More information is available at www.saveindependentmidwifery.org.  Something I do to give something to ALL women and not just the women who pay for my services is help out in running two support groups.  The Birth Resource Centre in Edinburgh runs a monthly homebirth support group for parents thinking about or planning a homebirth on the first Sunday of every month.  I attended the group as a pregnant mum and have continued to attend to help answer any questions of prospective homebirthers. 

Earlier this year I also got together with another independent midwife, Jenny, a mum of 3, Rachael and student midwife Kim to set up a group for pregnant women/parents, other health professionals and basically anyone who was involved in working with pregnant women and families.  We wanted to provide a forum for pregnant women/parents to ask questions in an unhurried environment and find out information in order to make decisions about their care or the care of their baby/child and also to gain support from others who had possibly been through similar situations.  Choices for Childbirth has been running in Portobello for seven months now and is providing very popular with mums/couples attending from all over the Lothians.  We have a set topic each month where we will cover subjects such as waterbirth, place of birth, pain coping strategies and sometimes have a guest speaker.  The second half of the meeting is always devoted to general chat/questions.

Given the huge variances I have described in the two different midwifery jobs I have done many of you may be wondering why not every midwife would want to work in that way.  Well that is another article in itself…..

www.mcmidwives.co.uk

www.choicesforchildbirth.co.uk

www.birthresourcecentre.org.uk

Flexible working

Here is a link to a useful debate on BB4 on flexible working. It mentions some of the research which has recently been done with small businesses and showed that productivity nearly doubled.

http://www.bbc.co.uk/radio4/youandyours/listenagain/tuesday.shtml

Subconscious Breastfeeding

Imagine that you could feed your baby without the risk of sore nipples and enjoy that feel same feeling that you get after you have eaten chocolate or had great sex (or both at the same time!). Totally comfortable and hummmmmm. All you have to do is lie back and enjoy…….

No I haven’t been at the vodka but I have just seen the Biological Nurturing video by Suzanne Colsen.

Suzanne explains that at present 3/4 of all mothers experience some kind of problem breastfeeding so surely this option is worth looking into?

It was introduced to me by ‘Saint’ Karla Napier a lactation consultant at Edinburgh Royal Infirmary. She helped me through some very dark days of my life when I felt unable to feed my baby and helped restore my confidence as a new Mum.

From the amazing video footage Suzanne shows suggests that we have been over complicating basic survival mechanisms which have evolved over millions of years. Why wouldn’t we humans have learnt to feed ourselves? What ever made us think we knew how to teach babies to feed and they didnt know themselves? By allowing baby to use its subconscious basic instinct, baby can latch on in 360 different ways ans using gravity stay in place while Mum can sit back and cuddle. And you don’t even have to wash up afterwards!

www,biologicalnurturing.co.uk

Buggy talk

Another consideration when you have found a buggy that fits into the car, bus and house! http://www.dundee.ac.uk/pressreleases/2008/prnov08/babybuggies.htm

Our mums would tell us there is a lot to be said for ‘pushing the pram’ and this research backs these good habits. Our babies dont care if they have the latest suspension and this seasons colours, just that they can see our faces and hear our chat. At least we have a calming effect on someone in the family!

Getting flexible working you want

Tips on what to do before maternity leave by Antonia Chitty

If you’ve got a baby on the way you may be thinking about your options for flexible work. Here are some pointers to help you find the flexible work that will fit with your family, whatever stage you are at.

Star by talking to a range of mums and find out how they combine work and family. I thought going back to work 4 days a week would leave me plenty of time: I was wrong. I felt I didn’t have enough time with my daughter and couldn’t fit in all my work either. Other mums’ experiences will give you a range of views and you can work out if your plans are realistic.

Look at your budget

Work out an ‘essentials’ budget, to see whether you could afford to give up work. You may not plan to do this, but could feel different in 6 months time. Remember that you won’t spend as much money on fares, expensive lunches out and work clothes. Look at other things that may change: you might go out less often once you have a new baby, but equally, babysitters can add to the cost of the evening when you do get a break. Think about the cost of childcare: ask about childcare vouchers to keep the costs down if you return to work. If you are getting maternity pay from your company, check what amount you would have to repay if you decided not to return.

Check your rights

You have the right to ask for flexible work if you have a child under 6, or a child under 18 with special needs. These rights will be extended to all children under 16 in April 2009. Your boss has to consider your request and can’t refuse outright.  She has to base a refusal on one of the following grounds:

• Burden of additional costs 
• Detrimental effect on ability to meet customer demands
• Inability to reorganise work among existing staff
• Detrimental impact on quality
• Detrimental impact on performance
• Insufficiency of work during the periods the employee proposes to work
• Planned structural changes

Making a change?

Once you are armed with the facts, decide whether you want to make a change. You should notify your employer 8 weeks before you want to return to work, and should allow plenty of time for negotiations if you want to return part time. If you decide not to return, tell your boss as soon as possible too.

What else might you do?

If you decide not to return to your current job, there are lots of other flexible options. Visit www.familyfriendlyworking.co.uk for ideas and resources for home working, self employment, franchises and direct selling.

What to do before you GO GO!

Rather like those last few days before you go on holiday, the last few weeks before your maternity leave starts, is full on. There are so many questions to answer: who will be dealing with my work, how will I hand over whats outstanding, when will I be back, what will happen when something important happens and many more. The temptation is to say ‘don’t worry I am only at the end of a phone/computer’ forgetting that a little friend will also be there with you and only too happy to make their presence felt as soon as you switch on that work button. Employers are also extremely hesitant to contact you during maternity leave, and rightly so, though new legislation has outlined reasonable contact is good practice for both parties.

So how can leave without worry, or feeling you have a half packed suitcase and you’ve forgotten your passport?

Agree your communication plan with at least 2 people Nine months is a long time in business. There are usually many changes; just think who’s new in organization and whats changed on the last year? Many women say the person who they have a ‘relationship’, with who understands what they want, how they work, is often doing something else when they are looking to discuss their return. So maintain flexibility and to ensure your wishes are followed through. Agree a plan with at least 2 people. Asking someone in management and HR may also be a useful place to start.

What type of communicationdo you want do you want while you are away. All emails, asked to all ‘important’ meetings or just catch up on the phone once a month. Think about what level makes you feel part of the team but not ‘at work’. Sometimes it can feel they don’t care when you have no communication and its easy to forget how focused on you can become when at work. its not personal its just that they might know who and how to involve you and need to get with their own work load. how will your 10 in touch days be used? Having some idea will really help them know what level of communication to keep up. It also means you can think about childcare and whether you’ll be paid for this well in advance.

whats going to happen to my job if you work on commission and your contacts are handed over to someone else, then this is a really important question. It is also a way some employers change jobs while women are on mat leave ie put someone in who is full time, higher grade or merge it with another role. It can make the return daunting so have these conversations now while you are clear on what you think is best for the business longer term.

what can I do if I am the company?When you are self employed many of these conversations are internal and even harder tie down because you can make up the rules as you go along and justify it. talking to someone external is really helpful here. either a coach who will help you uncover whats best for you and your family or someone who is self employed and been through the process. have a look at the many networking groups online which Antonia recommends in the next article.

In essence having a flexible plan will leave you less to think about and when things do come up, which they will, you’ll know what to do to keep all relationships sweet.

Birthing Hypnobabes

Do you want to be in control of your birth? Are you looking for an easy, comfortable, and yet drug-free method of birthing your baby?  Then HypnoBirthing® is the answer.  Now in its nineteenth year, HypnoBirthing® is a complete antenatal education programme.  It is a unique method of relaxed, natural childbirth education, enhanced by self-hypnosis techniques that allows women to use their natural instincts to bring about a safer, easier, and more comfortable birthing.  Emphasis is placed on pregnancy and childbirth, as well as on pre-birth parenting and the consciousness of the pre-born baby.  The course is a series of five two and a half hour classes taught in small groups or privately.  I am the longest established HypnoBirthing® practitioner in Edinburgh and aim to support women in having the best pregnancy and birth possible.  I have had many, many, amazing births and there is no reason why you should not be one of them.

The relaxation and self-hypnosis techniques which you will learn will give you confidence to birth your baby calmly, and comfortably.  Other techniques you will learn can produce a more comfortable and often shorter labour.  You will learn how the body’s own natural anaesthesia works and how to harness.  Over 80% of my mothers have normal childbirth using little or no chemical anaesthesia which leads to easier bonding with their babies and much quicker recovery from their labours.  Mothers say this leads to their babies being “happy”, “contented”, “chilled”, and “laid back”. They also feed and sleep well.   

Please take a look at my website www.hypnobirthing-edinburgh.co.uk where you will find much more information on the course.  Also on the site are birthing stories from my mothers and testimonials from couples who have attended the course – I hope you enjoy reading them.  If you have any questions about the course please call me on 0131 620 1080 for an informal chat.

Contact; Pauline Taylor BSc (Soc. Sc.) MNSPH HBCE

Clinical Hypnotherapist/HypnoBirthing Practitioner/HypnoFertility Therapist

If you do not live in Edinburgh and want to find a HypnoBirthing® practitioner near you have a look at the national HypnoBirthing® website at www.hypnobirthing.co.uk.  You will find a national list of therapists listed on the site and you can also find references for scientific research which has been done that proves the benefits derived by pregnant women who learn to use self-hypnosis during their labours.