Month nine Have the best birth you can

The 24-step guide to the best birth experience possible, according to Tracey Hawthorne

IGNORE THE HORROR stories. Birth is safer today than it’s ever been, and the risks to both mother and baby are small. But a successful birth isn’t just about delivering a physically healthy baby – it’s about having the best possible experience you can. Follow our 24-point guide to give your baby a great start, and yourself memories to cherish. 1GET INDIVIDUALISED ANTENATAL CHECK-UPS Even if you’re feeling well, regular check-ups will identify and reduce risks to you and your baby. “A normal, uncomplicated pregnancy should be seen for eight to 10 visits,” says Johannesburg gynaecologist Dr Kiran Kalian. 2AT YOUR FIRST APPOINTMENT with your medical practitioner or midwife, discuss your birth plan based on your risks, including birthing options and pain relief. Reassess (and either adapt or confirm) your plan at 36 to 38 weeks, Dr Kalian says. 3 THINK ABOUT YOUR BIRTH PLAN IN DETAIL and especially if you’ll want a doula. A doula does not deliver the baby, but offers emotional and physical support during pregnancy and labour. A doula stays with you during all the stages of labour, and afterwards for as long as you need her. “Research has shown that doulas are good for supporting Dad too, as it’s really hard to be a loving husband and a labour coach at the same time,” says Irene Bourquin, nurse, midwife and author of The Very Practical Pregnancy Handbook. If you can’t afford a doula, just having a good support system that will be there with you on the day will help. Ask your partner to be by your side, and if he can’t, a family member can be a good alternative.

4 READ, READ, READ Suck up all the knowledge you can from reputable books, magazines and websites. Sign up for newsletters – visit parent24.co.za to register. 5KEEP A LIST OF QUESTIONS to ask your medical practitioner or midwife at your next visit. Keep this list with you, and add to it every time you think of something you want to ask. 6SIGN UP FOR A CHILDBIRTH AND PARENTING COURSE (good medical aids cover part of the cost for this). “This is important for parents to get the right information to make informed decisions, and to be able to ask questions, no matter how silly they may seem,” says Irene. 7IF YOU’RE KEEN FOR A NATURAL CHILDBIRTH (without medical pain relief or intervention), you’ll need plenty of energy and stamina, so stay fit. “If you can, go to pregnancy exercise classes; if not, walk, swim, and concentrate on keeping your posture correct to avoid backache,” Irene advises. If you weren’t fit before you got pregnant, speak to your doctor before embarking on any exercise programme. Walking is however a safe and suitable exercise for most pregnant women. 8PRACTISE SQUATTING This is a great position for natural childbirth and to build up your thigh muscles. 9 PRACTISE THE RELAXATION, visualisation and breathing techniques you’ll use in labour. 10IF YOU’RE GIVING BIRTH AT A MEDICAL CENTRE or in a hospital, visit the birthing suite and meet with the staff in the labour ward. “A helpful doctor will assist your understanding of labour by showing you illustrated diagrams and photos of common items used in the labour ward,” adds Dr Kalian. 11READ UP ON YOUR PAIN RELIEF OPTIONS If you are giving birth at a government clinic, make sure to find out what pain relief options will be available to you. “Pain relief options may include nothing (natural birth), pethidine, an epidural or nitrous oxide,” says Dr Kalian. 12STAY CALM AND TRUST YOURSELF Remember that your body was designed to give birth – it knows exactly what to do. 13TREAT MIDWIVES AND DOCTORS WITH RESPECT In return, expect to be treated with dignity (it’s your right), and to be allowed to move around, eat and drink if you want or need to, be provided with pain relief, and be given full and correct information about what’s happening during the labour. “Women in labour are no longer restricted to their beds, or shaved, or given an enema [to release poo before labour] or subjected to routine episiotomies [a cut from the vagina to the anus],” says Irene. But you have to follow the hospital rules. 14 IF YOUR BIRTH PLAN HAS TO CHANGE BECAUSE OF CIRCUMSTANCES, don’t sweat it. While your medical practitioner or midwife will try to honour your wishes, your and your baby’s safety come first, and your doctor may strongly recommend medical or surgical interventions. “Remember, a good experience lasts a lifetime, but so does a bad one – so give your baby the best chance to come into the world and thank you for a great start,” says Irene. 15 MENTALLY PREPARE YOURSELF FOR THE TRANSITION PHASE, when the cervix is dilating from 7 to 10cm and most moms-to-be want to call it quits. This is when you need additional coaching – when your birth partner or doula should remind you that it’s almost time to push and then it will all be over. 16PRACTISE SKIN TO SKIN Healthy babies, including those born by caesarean section, don’t have to be taken away from their parents for any routine procedures. All these can be done at the bedside while the baby is skin to skin (baby on mom’s bare chest). “This encourages bonding, and promotes early suckling and successful breastfeeding,” says Dr Kalian. Discuss this with your doctor before the birth. 17SKIN- TO-SKIN CONTACT WITH THE DAD IS EVERY BIT AS IMPORTANT not only for bonding, but also because good bacteria from the dad’s skin will enter and colonise the baby’s gut, strengthening the baby’s immune system, says Irene. 18DON’T RUSH BONDING You’ve spent nine months bonding with your baby in your tummy, and now your baby is in your arms. The best predictor of a child’s future wellbeing, health and happiness is the quality of the bond formed in the hours and days after birth. Don’t rush this step, both directly after birth and in the first few days. Spend as much time as you can staring into your baby’s eyes, touching and smelling his skin, and allowing him to cuddle up to you (preferably skin to skin) to experience your breathing and heartbeat. 19GET PLENTY OF FLUIDS and resume your normal healthy diet as soon as possible after the birth. “This assists in breastfeeding and ensures a happy baby,” says Dr Kalian. 20LET THE HOSPITAL STAFF HELP YOU with birth registration and information about vaccinations and follow up visits. 21ASK QUESTIONS ABOUT BABY CARE including breastfeeding, bathing and changing nappies. “This may be new to you, so get answers before you go at it alone,” says Irene. 22TAKE IT EASY You’ll be tired after the birth, and walking and moving about may seem like hard work. Speak to your doctor about medical issues such as bleeding or stitches if you had them. 23TAKE LOTS OF PICTURES including special family pictures that include both parents – get a nurse or someone else to take them. 24GET SUPPORT NUMBERS before leaving the place of birth, for example, for postnatal depression, lactation consultants and postnatal exercises.

REMEMBER THAT YOUR BODY WAS DESIGNED TO GIVE BIRTH – IT KNOWS EXACTLY WHAT TO DO