Wednesday, January 5, 2011

Birth scene in Riyadh

Labour and delivery in Riyadh is nothing short of arcahic because they lean towards the American Model of care, which funnily enough is in the massive period of transition back to natural, low to non intervention and high support in the form of fathers and doulas being recognised. For me coming from a midwife lead maternity system, into a OB directed care system, its been tough. Tough as a parent and as a professional. Midwives are trained in normal birth, they can handle everything until it steps out of normal realm. OBs on the other hand are trained in the abnormal labours, babies with medical issues etc etc Yet we have these highly trained doctors incharge of our 99% totally problem free pregnancies. WHY?


My advice for mums and dads in Riyadh.
  • Educate yourself. Attend antenatal classes. There is a few around. Read books, read research, take control of your pregnancy.
  • Hire a doula. Doulas need to be a minimum care requirement. There is a few around, you can check out my website for more details or simply google doulas in riyadh. Doulas are experts labour and delivery. They really do make a difference.
  • Develop a indepth birth plan together and with your doula. Note those things that are NON negiotable and share with your doctor. If they cannot adhere to your wishes then they probably arent right for you
  • Interview doctors. You are hiring them, not you allowing them to help you birth your baby. Do you research, visit, ask around, evaluate after each meeting. Dont hire someone because you feel you have to, go with your instinct. This will be the most amazing day in your life, who do you want to share it with?
  • Stay at home for as long as you can. Walk, dance, watch movies. When it gets intense and the surges are regular say 3 in 15 mins then make your way to your hospital on preplanned route.
  • Research rezbo, spinning babies, birth balls, hypnobirthing and use.
  • DONT TAKE NO FOR AN ANSWER. Your planned this, this is how it will be.
  • DO NOT consent to anything you do not want. They will do things as matter of routine. Everything is consentable. This includes Vit K, Vaccinations and eye infection ointment.
  • Babys can be checked with you, there is no need to clamp the cord or take baby away for its routine observations to be made. If you decide to cut cord immediately, someone should stay with the baby at all times if you do not choose hopsital policy.
  • Babies who are pink, feeding, passing meconium and urine, breathing comfortabley do NOT require observation in a nursery.
  • If you choose to breastfeed, let the hospital know. If you do not wish the baby to have any artifical teat, make that clear. They will give the baby a bottle in the nursery unless you either stand guard or not allow baby to go to nursery.
  • You are not bound to the hospital for any length of time. You can discharge yourself at any time but you will have to sign a refusal to treat most likely.
  • Educate yourself and choose if you are going to vaccinate or not before hand. Make this clear.
  • Enjoy your baby, take lots of photos, have quiet time - ask nurses to leave. They are only tiny for such a short time.
Own your gentle birth
xx

Sunday, January 2, 2011

New mum health

While pregnant mothers often get plenty of attention, after the birth, most of this attention can be focused on the baby. Gifts, cooing, visits and 'hows the baby' all occur in the first few days yet mums are often left out of thoughts and their own. Mums tend to present themselves as super mums. Up and about, making tea for visitors, doing the grocery run, feeding, changing, burping the new baby but it doesnt take long for the sleepless nights to take hold.

It takes a while for a new mums body to adjust to the change. From a increase in blood while pregnant to the obvious decrease. Drops in hormones cause 'blue' days where the mark on the carpet makes a mum cry or a ad on television for a McDonalds happy meal. The changes are completely normal and expected. A mums breasts become tender, hot, full, leaking at a squeak from the baby and the swelling can be painful. If you have had a caesarean section you will need extra time to let yourself recover.

Being a mum is fantastic but babies can be very demanding in the first few weeks and this can make life very tiring and stressful. These ideas may help:
  • Try not to expect too much from yourself. If you are in your jammies at 4 in the afternoon, who cares!
  • Dont worry about your house on a basic level. The baby needs your attention, not you scrubbing the floors.
  • Get help. Whether it be husband, postnatal doula, mother or mother in law, take all the help offered. Even if its just so you can go for a walk and get perspective on life, do it. People like to be needed and it will make life easier for you.
  • Take time to play with your other children or pet.
  • Do rest while baby is sleeping. It might only be for 10mins if its a bad day so SIT DOWN. The world over we hear rest when baby rests and alot of mums take that time to do the dishes or put a load of laundry on. Dont. Put your feet up with a cuppa and watch bad television or lie down on the sofa.
  • Borrow a grandmothers time and go for a walk with your husband, catch a movie, get a massage... Anything to feel like you are in the real world for a hour.
  • Do some journalling or blogging. Get those feelings out on paper, some will be rational, many not.
  • Find parent groups in your area and make use of them.
It can be a very surreal feeling sitting at home with a newborn when your friends are out at the weekends or at work during the day. After the inital 'welcome home' people stop ringing and emailing asking how the baby is. You may feel lonely and isolated. Take note when you dont feel so good and meet your friends for lunch or at the park for a picnic. You will find friends at parent groups and even the playground. Having a baby doesnt mean you have to leave the real world, it just means you need empathatic people to talk to during the day.

EATING
Some say you need to eat for 2 while breastfeeding, some say you only need a extra 1000kilojoules... Whatever it is, you do need to watch what you eat. Its a falicy that everyone looses weight, some do but many put it on THINKING they will loose weight. It depends on genes, establishment of breastfeeding and types of food you are eating.
Dont schedule eating, eat when you want. 6 small meals are better for your body with 3 a day. Drink as much water as you can stomach. Water is an essential ingrediant in breastmilk so you do need to up that. Using small bottles is great, you can always grab one when you are up. Drink when thirsty. Many mums find while feeding they are thirsty so always have your phone, tv remote and water bottle handy when feeding baby.
Good snacks include:
bananas
yogurt
sandwiches
fruit smoothies

Some old wives tales but also work for some...
Grapes give baby wind
peas and most green veges increase babies gas and therefore sore tummies
Google the recipe for Tiger Milk... Tastes terrible but apparently good for increasing milk supply (as a lactation consultant in training I have different views)

Skin and Hair
Stretch marks, typically the red ones, can begin to fade. Those creams DONT work so dont bother. Stretch marks are, sorry ladies, in your genes. Not much to be done except accept they are the war wounds of pregnancy.
Your stomach will be flabby and squishy to start with but tones in time. Your stomach muscles are stretched and some people can actually damage those muscles. Its part of it all, sorry :)
Your hair can be dry and look like straw. Alot of mums comment on the changes in thickness. It happened to me but I could loose alot more. Your hair will come right in time. Hormones are very powerful characters!

Vaginal Bleeding/discharge
After the birth of your baby it is normal to have vaginal discharge for a number of weeks. It is just your uterus healing so it will change colour from bright red to pink to brown as the surface heals up. It is called lochia. It may increase for a short time if you go for a fast walk, be up and down stairs all day and even laughing. After around 6 weeks it will cease and if you are breastfeeding it will stop faster as your uterus shrinks down quicker with nursing.
Its not recommended to use tampons with a raw uterus. You need to keep an eye on the smell for any signs of infection that could mean retained placenta. By all means use tampons after a few weeks but initally you will be tender and the last thing you will feel like doing is putting something back in there!
Do see your doctor if there are clots or it suddenly becomes bright red afte a few weeks or there is a smell, unpleasant smell.
If you are feeding 2-3 hours over a 24 hour period consistantly your periods are more than likely not going to return. Usually around 4-6 weeks your first normal period will return. They could be longer or shorter or mixed. Usually the flow is increased after a baby as uterus's cant shrink back down to the size they once were. Once your hormones have leveled out so should the regularity and amount of your monthly visitor. Some ladies like to get smears at around 6 weeks and some even do a pregnancy test and OMG its positive. It happens so dont think you cannot get pregnant in that inital phase.... Use protection always. You can go on a minipill from around 6 weeks if you are breastfeeding.