| 12.2°C Dublin

What to expect

WOMEN have been having babies since the world first started turning but that doesn't mean that every single birth isn't a hugely important event.

Most would-be-mums have feelings of anxiety regarding their pregnancy, delivery and the first few months of their baby's life. But for first-time mothers, the whole experience can be very daunting and the realisation of a new life being formed can be overshadowed by fear of the unknown.

Tricia Nugent has three children, giving birth to her third just last week. She says it is understandable for women to be nervous about the months ahead but if they have done their research, all should be fine.

"My advice to mums would be to research their options in relation to hospital care and home birth," she advises. "Look at it a little like getting married, you don't just choose the nearest hotel, instead you make sure it fits with your needs and wishes."

Nugent says it is important to have a birth plan and the support of your loved-ones during pregnancy and labour.

"One huge thing for me was having my husband on board," she says, "He knows exactly what I want so that he can be my advocate. I have one job on the big day and that is birthing my baby. So my husband will communicate my wishes to my midwife."

The Dublin woman had her first child in hospital. Her second arrived unexpectedly and her third was born at home, so she is only too aware that every birth is different.

"Pregnancy and delivery can be wonderful for some but really tough for others," she says. "But support is the key. I used the Gentle Birth programme on all three pregnancies and found listening to my CDs made me relaxed and I always slept very well.

"I felt amazing right up to my due date but the first few months were very tough. I have a daughter of three and a half and a son of two and I work part-time, so I have been very tired.

"Emotionally I found the first 18 weeks very hard but then something changed and I got very attached to the life growing inside me. I decided to go for my first home birth, having given birth in hospital and in the back of the car."

Nugent says while it is important to get as much advice as possible during pregnancy, it would be wise to choose your sources carefully.

"Turn off programmes like One Born Every Minute as they are way too dramatic," she says. "Normal birth is amazing but pretty boring to watch and these programmes are edited to keep in the drama. I would ignore advice from anyone who relishes horrific labour stories and in this sense am very lucky to be part of the Gentle Birth community.

"Also, my mum is my best friend and my sounding board for everything. She is so open, non-judgemental, kind and supportive," adds Nugent.

"In order to stay healthy emotionally I have kept a journal and I talk a lot. And I have kept myself physically well by running around after my other two. I love to cook and use local, organic produce as much as possible. I am no saint though and do enjoy a McDonalds and a cream bun from time to time. I guess it's all about balance and moderation."

Conflicting

Mim Moran is a doula, antenatal teacher and breastfeeding counsellor. She says there is a lot of conflicting advice given to pregnant women about how to look after their bodies, but the most important thing is to eat well and get moderate exercise.

"Weight gain during pregnancy is a can of worms as it has an awful lot to do with mums' original birth weight," she explains. "For example, 25 to 35lbs would be a normal gain for someone with an average BMI, while underweight mums need to gain more, and overweight mums less.

"So basically, eating a generally healthy diet and maintaining normal exercise is fine. If someone is an avid gym goer they can continue this with adaptations to suit their pregnancy and only take on new exercise routines if the body can easily adapt to it. Pregnancy yoga or relax, stretch and breathe classes would be ideal."

Moran says fear is one of the biggest hurdles pregnant women need to overcome, as without it, they will have a much more enriching experience.

"Our society tends to fuel the fear of labour," she says. "If women can stay calm and focussed, decreasing adrenaline and tuning into the primal physiological part of their brain, they can build confidence, encouraging their bodies to do what they are meant to do without becoming anxious.

"Every labour and birth is different, and antenatal education helps women to make informed decisions about their care, and prepare for postnatal life."

Caring for a newborn

Margaret Hanahoe is the assistant director of midwifery and nursing at the National Maternity Hospital. She has some words of wisdom regarding looking after your new baby.

"Midwives in hospital often bathe babies daily," she says. "This is more for observation or to teach parents, but at home a top and tail wash is good enough for small babies, and a bath once a week is more than adequate."

Many parenting books advise a strict routine for feeding but Hanahoe says a more relaxed approach is preferable.

"Babies should be fed on demand," she says.

"But for the mother's sake, I feel it is important to develop a routine so her life is not completely dictated by the baby. However if a baby is hungry there is no point in denying them food as they will continue to complain until you feed them.

"When feeding has been established, the baby should not be left to sleep more than four daylight hours at a time in order to preserve the six-hour stretch for the night-time hours."

Most new mothers have been warned about the danger of babies sleeping on their front, and Hanahoe says this should be taken very seriously.

"Babies should always sleep on their backs, and research has shown that they should never sleep in the parents' bed where there is a risk of overheating, suffocation or being squashed.

"Having the baby too hot, smoking in the baby's surroundings and sleeping on the tummy are the three main causes of cot death."

AT A GLANCE - Advice from the experts

Pregnancy

•Common signs include sensitivity of nipples, darkening of the areolae and a feeling of something being different

•Nausea or morning sickness can start before any other signs and can vary massively from feelings of sickness to the more extreme hyperemesis gravidarum

•During pregnancy it is advisable to maintain a healthy weight and take gentle exercise

•Maintaining your sex life is fine during pregnancy and when the cervix is 'ripe' and ready for delivery, it may help to prepare the body for birth

•Braxton Hicks are irregular pains, which can happen at any time and last for minutes

•Contractions or surges build to a pattern, increasing in strength, length and frequency. As they become closer, longer and stronger, they become more effective in moving the baby gently down

•Hospital guidelines for first-time mums in labour are generally to consider heading in when contractions are three to five minutes apart, lasting about a minute and increasing in strength - for approximately one hour. However, instincts should override this and those guidelines do not apply to subsequent babies.

Pain relief during labour

•Pain thresholds vary depending on how women perceive the sensations in labour. Some mothers say that with the absence of fear, labour sensations may not be perceived as 'pain'. Remember, labour is different for everybody.

•Natural methods during labour include Gentle Birth, hypnobirthing, water, movement, focussed calm breathing, and immersion (to breast level) in body temperature

•Alternative therapies include homeopathy, acupressure, aromatherapy, reflexology and Tens machine

•Medicinal pain relief includes entonox (gas and air) which takes the edge off the contractions (but can cause nausea and light headedness)

•Pethidine is an intramuscular injection which, when used in early labour, may help mums rest, however it does cross the placenta and is not recommended within three hours of the birth

•Epidural is administered by injection and numbs the area from the waist down. It can relieve the pain of contractions. Side effects include anti-gravity, which may slow down labour and indicate the use of syntocinon to speed labour up again. A bladder catheter may be needed and the epidural also lowers blood pressure causing a need for IV fluids.

Looking after your new baby

•Breastfeeding is the biological norm and what the baby seeks both emotionally and physically after birth

•Attend breastfeeding support talks while pregnant, see babies being fed, ask new mums for their tips, and get to know your breastfeeding counsellors, so that if you do feel you need that support you are comfortable calling them

•Bathing your baby once a week is sufficient. Top and tail washing can be done on a daily basis

•To reduce the risk of cot death always put your baby on his or her back to sleep in a face up, face clear position with feet touching the end of the cot

•Baby-feeding times are based on each baby's needs

•It is recommended that babies do not start solids until six months of age.

For further advice visit:

gentlebirth.ie

bumptobabe.ie

bumptobirthtobaby.com

cuidiu-ict.ie

doula.ie

antenatalireland.ie

Irish Independent