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P E R I N E A L M A S S A G E This technique can be started between 34 and 36 weeks gestation. There have been studies to show that practicing perineal massage antenatally can help reduce the chance of severe tears (3rd and 4th degree) and also the need for an episiotomy. e.g.(Ugwu et al., 2018) You need somewhere comfortable and private, clean hands, short nails, lubricant and it works best after a bath (tissue is relaxed). Begin by pressing down on the lower part of the vaginal opening, inside the perineum. Gentle downward pressure should not be sore, but you should feel a stretch. After 30seconds - move in a U-shape (see video for demo). Do this movement for 30seconds. Go back to downward pressure for 30seconds, U-shaped movement for 30 seconds and continue this pattern for a total of 3-4 times. You can practice this 3-4 times a week in the lead up to labour. Have you tried it? Will you? Any questions - let me know⬇️ #todandb #todeliveryandbeyond #pregnant #pregnancy #labour #labor #birth #postnatal #newmums #newborn #antenatal #antenataleducation #hypnobirth #hypnobirthing #hynobirthingclass #perinealmassage #antenatalinformation #pregnancytips #labourtips #due2021 #pregnant2021 #onlineantenatalclass #onlinehypnobirthing #irishmidwife #34weekspregnant #36weekspregnant #40weekspregnant (at County Mayo) https://www.instagram.com/p/CQlHOqjnEiM/?utm_medium=tumblr

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P E R I N E A L M A S S A G E A technique that research has shown may help reduce the chance of experiencing a tear during birth. You will need - somewhere comfortable and private, clean hands, short nails, lubricant, a comfortable position (reclined is good). Your partner can also do this with you. From 34 - 36 weeks is a good time to start. Doing this for 3-4 minutes, 3-4 times a week is recommended. Sitting comfortably, press biking thumbs down inside the vaginal opening. Apply pressure for 30 seconds and then start moving thumbs in U - shape (shown in video) for 30 seconds. Repeat. This should not be painful, but you should feel some stretching. Have you tried it before? Will you try it now? Let me know in the comments⬇️ #todandb #todeliveryandbeyond #pregnant #pregnancy #labour #labor #birth #postnatal #newmums #newborn #antenatal #antenataleducation #hypnobirth #hypnobirthing #hynobirthingclass #perinealmassage #antenatalinformation #pregnancytips #labourtips #due2021 #pregnant2021 #onlineantenatalclass #onlinehypnobirthing #irishmidwife #37weekspregnant #40weekspregnant (at County Mayo) https://www.instagram.com/p/CQjsW5eHQuZ/?utm_medium=tumblr

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#MOVEMENTSMATTER ➡️swipe to see info I like to call baby’s movements a communication tool between us and them, letting you know they’re okay in there. This is why it’s so important to know what’s normal and what’s not. If ever in doubt, especially about their movements, go and get checked out. Don’t leave it until later in the evening or until the next morning. Save this post and refer back to it as you need 🤍 *All info from the RCOG Greentoo Guidelines 57 Reduced Fetal Movements * 📸: @foxvalleybirthandbaby #todandb #todeliverybeyond #antenatal #labour #labor #labouranddelivery #laboranddelivery #postnatal #antenataleducation #antenatalonlineclass #antenatalclass #hypnobirthing #hypnobirthingclass #hypnobirthingonlinecourse #hypnobirthingonlineclass #due2021 #newmums #newmoms #labourtips #newborn #birth #pregnancybump #pregnant #pregnancy #36weekspregnant #37weekspregnant #38weekspregnant (at Ireland (country)) https://www.instagram.com/p/COoAJsNHjhs/?igshid=ymjeq11npnt9

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P E A N U T B A L L This tool is a MUST HAVE if you want to lie down and rest or if you have an epidural in labour. Did you use one? Let me know⬇️ Don’t forget to save this video to remind yourself of all these tips for labour ❤️ #todandb #todeliveryandbeyond #birthplan #downbreathing #upbreathing #pregnant #pregnancy #due2021 #pregnancyprep #antenatal #antenataltips #antenataleducation #antenatalclass #onlineantenatalclasses #hypnobirth #hypnobirthing #hypnobirthingclass #onlinehypnobirthing #onlinehypnobirthclass #postnatal #labour #labor #labouranddelivery #babyprep (at County Mayo) https://www.instagram.com/p/COkxBWbnbHn/?igshid=yseeo6omv7u

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Happy International Day of the Midwife 🤗 They say if you love your job you’ll never work a day - midwifery isn’t my job it’s my passion. I think true midwifery isn’t just a profession, it’s a calling. It comes from the heart ❤️ Midwives are known for catching babies, but there is so much more to it than that. From pregnancy through to the postnatal period, we support, educate, encourage, and guide women and families through one of the most special and sometimes vulnerable times in their life. To be allowed take part in that journey is never something I would or will take for granted. Cheers 🥂 to the amazing midwives and student midwives who I have learned from, worked with and am inspired by. #todandb #todeliveryandbeyond #internationaldayofthemidwife #midwife #irishmidwife #midwifelife #midwifery #midwiferyismycalling (at The Farm Midwifery Center) https://www.instagram.com/p/COgPyPdnooh/?igshid=z6ht13c2du3h

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H O B B S L I N E Otherwise known as ‘the purple line’. It is know as Hobbs line due to the Midwife Lesley Hobbs who wrote about it in 1998. Swipe right ➡️ (I had to cover some of it because of Instagrams rules) and you’ll see a purple line running along the top of the bum and up the back. It grows longer and deeper in its purple/reddish colour as labour progresses. In darker skin the line can have a deeper colour or silvery look, but it can be harder to see than with lighter skin tones. It can be a very useful tool for care providers to help decrease the amount of vaginal examinations. A study by Shepard et al (2010) published in the BMC Pregnancy and Childbirth found that it was visible in 79% of labouring women with a medium positive correlation between the length of the purple line and cervical dilation plus the station of the fetal head. That's a fancy way of saying usually the line grew as the cervix dilated and the head went deeper in the pelvis. It was also seen to be more common in spontaneous labours. When we stand back and take in the complete picture of a labouring woman there are lots of signs the body gives us to judge progression. Discussing these with your care provider may help you avoid unnecessary Vaginal examinations and other interventions 📸 : @blackcherryphotography #todandb #todeliveryandbeyond #pregnant #pregnancy #labour #labor #birth #postnatal #newmums #newborn #antenatal #antenataleducation #hypnobirth #hypnobirthing #hynobirthingclass #hobbsline #antenatalinformation #pregnancytips #labourtips #due2021 #pregnant2021 #onlineantenatalclass #onlinehypnobirthing #irishmidwife #37weekspregnant #40weekspregnant (at Ireland (country)) https://www.instagram.com/p/COdXj-WnUzJ/?igshid=1xw40500polfx

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S H O U L D E R T I P P A I N This is a common complaint after having a c-section. Caused by the disturbances inside your body during the operation, your bowels can slow down, creating excess gas. This presses on the diaphraghm triggering referred pain in your shoulder. The pain is usually describes as a deep pain and can vary in severity. Some people may be concerned if they experience it, but there are ways to help. Generally analgesia, like paracetamol, is not as effective as something that will treat the production of the gas -like peppermint. You might be offered peppermint cordial, peppermint tea or Colperin (a tablet form) to ease this. Peppermint has been known to impact milk supply if you are breastfeeding and because I get asked about this I consulted with a lactation consultant to weigh up benefits/risks. The advice was that you would need to be drinking buckets of tea fo it to become an issue, so should be considered to help if you experience this discomfort. Have you felt this after a c-section? Let m know ⬇️⬇️ 📸: @thefirsthello #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant #shouldertippain (at Ireland (country)) https://www.instagram.com/p/COPnGjnHTnS/?igshid=iczahjt8nkd4

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C A R E A F T E R A C-S E C T I O N Having a c-section means you are left with a wound on your skin, but there is also tissue and muscle healing deeper than that. Your doctor goes through 6 layers of skin, tissue and muscle during this surgery and all of this needs to heal aswel. So taking care of the wound is important but resting and taking care of yourself is just as important. Say yes to help. Eat well. Stay hydrated. See a Women’s Health Physio Think of how long you would allow yourself for recover after any other major surgery. This should be no different. 📸: @belleverdiglione #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at County Mayo) https://www.instagram.com/p/CN7isn7H1dc/?igshid=1mggqjn1fjzzt

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R E A S O N S F O R A C-S E C T I O N There are lots of different reasons why someone may need to have a c-section. Here are a few: Prolonged labour (the true definition of prolonged labour and the cut off point in the hospital can vary by A LOT. We cover this in my class) Fetal distress - baby not managing well in labour. This can be caused by a variety of reasons. Baby’s are made for labour so quite often it happens when we intervene. Birth Defects - it may be decided that it would be safer for you and/or baby to have a c-section rather than a vaginal birth. Some health conditions may mean a c-section is safer. Obstetric Emergency’s - e.g cord prolapse, placental abruption Multiple births - this depends on how many babies and the position they are in. Repeat c-section - if you had a previous c-section and choose not to have a VBAC Placenta Issues - this can be anything from a low lying placenta to one that is embedded deep into the uterine tissue or a placental abruption. Breech birth - the majority of people with baby in a breech position choose to have a planned c-section. This list is not exhaustive and everyone’s journey is different. Would you like to share why you had one below?⬇️ 📸: @thefirsthello #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at Ireland (country)) https://www.instagram.com/p/CN7IMScHTGY/?igshid=1hiz1tavh0gdy

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WHAT HAPPENS DURING A C-SECTION Join me on Thursday at 11am over on @lactationtalkwithorla where I’ll be going through what to expect during a c-section and any questions that you may have (she has a question box up). 📸: @memories_by_mckenzie #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at Ireland (country)) https://www.instagram.com/p/CN7FqIPH0aq/?igshid=1ncnbjamh7dwz

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R E C O V E R I N G A F T E R A C/S Take it easy on yourself - you have just had major abdominal surgery Keep the wound clean and dry. Depending on the dressing, you may have a dressing in place for about 24 hours, sometimes longer. Keep this clean and dry. Watch for signs of infection e.g redness, swelling, discharge, fever, chills, feeling unwell. Also if you have any unusual vaginal discharge or heavy bleeding, swelling or pain in your lower leg, shortness of breath. Contact your midwife/doctor with ANY concerns and do not delay Wear loose comfortable clothing, big knickers that don’t sit on the wound and some people use a clean sanitary pad as padding between their knickers and the wound Use a rolled up towel to hole against the wound when you cough, sneeze or laugh to help more comfortable Stay on top of pain medications and take the regularly for the first 3-7 days Do not lift or carry anything heavier than your new baby - that includes other children You will probably be sent home on blood thinners - make sure you or your partner are confident in administering them. Rest as much as possible and accept help from family if you can Drink plenty of water and eat high fibre foods. Take a stool softener if you need to What was your top tip for recovering after a c/s? 📸: @myfamilyhomebyclaire #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at Ireland (country)) https://www.instagram.com/p/CNzzmr9nzcg/?igshid=1kbvk9g20hk3

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T I P S T O R E D U C E C/S 1️⃣Avoid an epidural, or at least delay it, if possible 2️⃣Remain in an upright position in labour and for birth (see my highlights - you can do this with an epidural too) 3️⃣Hire a doula - you decrease the chance of having a c/s by up to 25% 4️⃣Choose midwife-led care instead of private care 5️⃣If it is available and you are comfortable with it - choose to have a homebirth 6️⃣Do an independent antenatal education class like the one offered here at To Delivery And Beyond 7️⃣Try and stay at home until active labour 8️⃣Request Intermittent Auscultation of baby’s heartbeat rather than continuous monitoring 9️⃣If it’s a time issue and both you and baby are okay, request more time 🔟Avoid artificial rupture of membranes (when the doctor/midwife breaks your waters) unless indicated for a reason such as to monitor the heart-rate via the baby’s head (not common but sometimes used) 📸: @elliana_allon #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at London, Unιted Kingdom) https://www.instagram.com/p/CNvNeY1nZey/?igshid=u4ngjkatx0qo

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This is ✨ M A G I C ✨ Following on from last nights post where we looked at what is involved in a Gentle C-Section (and so many of you loved it so hopefully more will be able to have them) - here is an example of a mum assisting the birth of her baby at a c/s Okay, this gowning up and putting on gloves might not be possible with every c-section, but it would be for a lot of them. Who would love to get their hands stuck in? 🙋🏻‍♀️ I know I would 😁 #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at The Farm Midwifery Center) https://www.instagram.com/p/CNumGkwnvuW/?igshid=9mhpwc7uf92h

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G E N T L E C-S E C T I O N A gentle approach to having your baby by Caesarean section. There are a few things that can be done to help make the experience more calm and relaxed, more gentle for baby and still have some benefits that you would get after a vaginal birth. All of these suggestions can be done in almost any situation. Even during the most emergent type of c-section (Category 1 - see previous posts) if your baby is born, and is well, then optimal cord clamping, skin to skin etc should still be facilitated. If you are planning an elective c-section it is definitely a good idea to discuss this during your antenatal appointments. If you are not planning a c-section, it is still good to have a discussion so you can add it into your birth plan. This is not a crazy idea that is strange to ask about. These things are widely done in some maternity units by some doctors, and if it’s not common in your unit - nothing will change without asking. The main points that can be included are: ➡️The leads for monitoring your heartrate can be placed on your back instead of your front so you can have baby on your chest easily. ➡️Clear screens used for the drape or the drape can be dropped so you can see baby being born (really helpful for making the connection with what’s happening). ➡️Some doctors have even put a sterile gown and gloves on mums and let them participate in helping baby to be born 🥰 Either way allowing a slow delivery of baby, sometimes they wiggle their way out, kind of like in this video. This can even be done while still in the amniotic sac, which can then be then be broken after they are outside the abdomen. ➡️Optimal cord clamping which is so beneficial for baby and I will cover in-depth in a future post. ➡️Skin-to-skin after delivery and ideally all through the time in recovery. ➡️Quiet in the theatre and even having your own play list in the background. ➡️Dim lights after the initial setting up. ➡️If you plan on breastfeeding it can also be initiated during this time. Now imagine that environment compared to what you might have previously thought about. Pretty nice? Have you experienced this? What are your thoughts?⬇️ 📹: @fertuligo (at Ireland (country)) https://www.instagram.com/p/CNsqHLRn53Q/?igshid=10v0d164tehog

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✨ C-S E C T I O N T I P ✨ Sometimes it can be a calm experience, other times it can be chaotic. One thing I try to make clear in my classes when we cover c/s is that what’s happening in the room can help, or hinder, how you feel. (See my previous post for a breakdown of the different categories of c/s). If you are having an unplanned c/s (so category 1-3) the room can fill with people. Midwives, doctors, porters...all of this can be very overwhelming. What I like to point out is that - if the decision has been made for you to go to theatre for an emergency c/s - a category 2 (no immediate risk to mum or baby) is the most common type of emergency c/s. However, when the decision has been made, the staff usually kick into action and get you ready to go to theatre just as fast regardless of the situation. It’s very likely you’ll have someone telling you to: Drink something that helps settle your stomach contents Someone else is putting compression stockings on Someone may be putting a cannula in your arm and taking bloods A doctor could be gaining your consent A midwife could be going through a pre-op checklist An anaesthetist could be checking you to see what kind of pain relief you need. ‘All this happening at once!?’ I hear you say. Yes 🙃 So it’s no wonder the room and the experience can be a blur and chaotic. So my tip is: Don’t let the pace of what’s happening let you jump to a conclusion about the extent of the emergency. Bring yourself back to your breathing. Talk to your baby. Partners - it can be hard to know what to do but reminding you of the last 2 points is helpful. I hope you find these tips useful! Let me know in the comments⬇️ 📸 : @kendalblackerphoto #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #csection #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 (at Dublin, Ireland) https://www.instagram.com/p/CNpr3p1HhHU/?igshid=ypt9u84ggxgr

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T Y P E S O F C-S E C T I O N There are 2 types of c/s - planned (also called elective) and Emergency. They are broken into 4 categories and we’ll start from Category 4, working our way back. Category 4 - this is an elective section. These are planned ahead of time and would be used for reasons such as : having had a previous c/s and deciding to have a repeat, breech babies are commonly delivered by c/s, having a multiple pregnancy, some medical conditions may mean a c/s is safer (e.g. placenta praevia) or if for personal reasons you choose that a c/s is the right method of delivery for you. The other 3 are considered as emergency, with varying degrees of urgency. Category 3 - this is considered an emergency because it is not planned ahead of labour. This type of c/s is done when there is NOT an immediate risk to mum or baby e.g. You have already booked an elective c/s but go into labour before that time. The time between deciding on a Category 3 c/s and delivery varies because there is no immediate risk, but delivery is necessary. Category 2 - This is required when there is a risk to mum or baby but is not immediately life threatening e.g. infection, malpresentation (baby coming into the pelvis in an unusual position). From the decision being made to have a c/s to baby being born, NICE (2021) recommend delivery asap, and in most situations, within 75 mins of making the decision. Category 1 - this is the one with the most urgency for early delivery of baby. This is the category of c/s when there IS immediate threat to mum and/or baby. There are different reasons why this type of c/s may be required e.g. placental abruption, uterine rupture, cord prolapse (where the cord comes in from of the head). The delivery should be carried out asap and in most situations within 30mins. The RCOG recommend that ‘the delivery should be carried out with an urgency appropriate to the risk of the baby and safety of the mother.’ Hope this helps ❤️ 📸: @helloworld_birth #todandb #todeliveryandbeyond #gentlecaesarean #caesarean #caesareansection #csection #antenatal #birth #labour #hypnobirthing #onlineantenatalclasses #hypnobirthingclass #onlinehypnobirthing (at The Farm Midwifery Center) https://www.instagram.com/p/CNphCCcHzRj/?igshid=1g5messvls7o2

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C L A S S I C I N C I S I O N This is another way of performing a Caesarean Section that is still sometimes used today, but is not as common as the incision seen in my previous post. There are a few times where your doctor may have to use this type of incision: ➡️ If the placenta has implanted over where the regular site is. ➡️ Sometimes if your baby is in an abnormal position it may be indicated. ➡️ If you have a preterm c/s (before 30 weeks) depending on position and size of baby ➡️if there are adhesions, that are difficult to navigate, from a previous surgery ➡️ Abnormal uterine shape There are benefits and risks to each type of incision. The lower transverse incision does seem to carry less risk and is the most commonly used, but your doctor will weigh up the best way for you to safely deliver your baby. Anyone here have this type of scar? Let me know? ⬇️ #todandb #todeliveryandbeyond #caesarean #caesareansection #csectionawarenessmonth #antenatal #postnatal #labour #labor #birth #labouranddelivery #laboranddelivery #antenataleducation #antenatalclass #onlineantenatalclass #midwife #midwifeled #midwifeledantenatalclasses #hypnobirth #hypnobirthing #onlinehypnobirthingclass #hypnobirthingmidwife #newmum #newbaby #newborn #birthisbirth #bellybirth #due2021 #pregnant2021 #pregnant (at Ireland (country)) https://www.instagram.com/p/CNnktCFHbQ6/?igshid=16520j0brvres