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Thread: Welcome to Ask a Midwife
19th June 2012 02:29 AM #46
- Join Date
- Jun 2012
Hi everyone and to the on-duty midwife ,
I would like to know what are the differences between giving birth at a midwife clinic and at a hospital. My sister who is going to give birth for the first time with her baby girl and who is in her 30th week of pregnancy is still unsure where she wants to give birth in? I gave her advices and ideas how it feels giving birth to a hospital, yet she prefers in a midwife clinic.Please do enlighten us both.
Thanks in advance.
19th June 2012 10:38 PM #47
Whilst you are waiting for Jane (our wonderful midwife) to reply I thought I would share my experiences/knowledge with you on this.
I had my son in a midwife-led unit (it was called a 'birth centre') rather than the hospital ward and the main idea of this is to provide an environment where you could have as natural a birth as possible with minimal interventions. There were not doctors available at the birth centre but there were very experienced and skilled midwives. There were plenty of birthing pools - having a water birth can help a lady to relax so that the contractions are more effective and the labour is quicker. You could not have a an epidural or the use of forceps or the ventouse at the birth centre I attended as these are medical interventions. If you wanted or needed these during the labour you had to be transferred to the hospital (this would obviously also be the case if an emergency caesarian was necessary- although these rates are a lot lower if you have had midwife-led care in the birth centre).
If a lady has not had any complications during the pregnancy and it is not considered to be a high risk birth, then the midwife-led birth centre is a good choice to have a low-intervention labour where you are supported by midwives. If any unexpected complications did arise the midwives would arrange for a hospital transfer (but this is not common).
I hope this has been helpful.
Best wishes to you and your sister,
Last edited by ljmarsden; 19th June 2012 at 10:42 PM.
20th June 2012 03:00 AM #48
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- Jun 2012
A pleasant hello to you Ms LJ,
The information you gave is very much appreciated. Actually, I did remember that one of the reasons why I preferred to give birth to a hospital was because I was a high-risk patient. That was way ten years ago so I almost forgot the reason why I was brought in. I preferred to give birth to a birthing home or centre yet was advised to better be admitted to the nearest hospital. Anyhow, my little sister did prefer natural birth in a midwife-led unit because she was sure enough that full attention to her and her baby would be given. She has no history of having medical problems and that is one of the many reasons why giving birth in a center is what she wishes.
Once again, thank you for the information Ms LJ.
21st June 2012 12:43 AM #49
LJ has given you some very good information on why a birthing centre attended by midwives is often a better choice for mums. I've had 5 homebirths, and I've attended 2 homebirths and a hospital birth so I have a good idea of the differences between midwife led care and doctor/nurse led care.
One of my midwives attended births in the hospital, and she also attended births in a birthing centre. One of the many benefits of a birthing center is that you can labour and deliver in whatever position your body needs to. Sometimes this may mean that you need to lunge during labour to bring baby into a good position or you may want to squat to give birth (a great position that allows gravity to bring baby down and out).
In a home or birthing clinic setting, often times you will be able to use comfort measures much more effectively. We know that when we are relaxed and not feeling stressed, the labour progresses faster and pain is less. In a hospital you can use some comfort measures, but all too often, the woman is placed on a "protocol" that they use for each and every labouring mum. The problem with this is that every woman is different, and every birth is different, so every mum should not be placed on the same "protocol".
One of the things that often happen to mums in the hospital is that they have fetal monitors strapped to their belly and/or inserted through their vagina and screwed into the top of the baby's scalp. Once this happens, many women are confined to bed and it makes it more difficult for labour to progress normally, without intervention.
In a birthing center, often times the midwife will monitor the baby's heart tones with a doppler. This is what the doctor or midwife uses at all of the prenatal visits to listen to baby's heart tones. The benefit of using the doppler is that it never interferes with the natural progression of labour. The drawback is only for the attending midwife or doctor in that that the she would need to be in attendance during many hours of labour. This means it takes a lot of her time and in a hospital setting, the staff finds that they can sleep longer or attend more patients if they just run in for the "catch" and nurses can monitor more patients if they strap a monitor on to each mom and then sit at their nurse's station and monitor more than one woman from there. My personal opinion is that in a hospital setting, everything is about convenience to the doctors and nurses, rather than comfort for mum. It's much more convenient for the doctor to sit on a stool and catch a baby at arm's level, but poor mum, has to lay on her back, pull her knees to her chest, hold her breath and push as long as she can before gasping for another breath. Most of the time this is not the most effective way to bring a baby down the birth canal. Squatting or giving birth on hands and knees can be more effective for mum, but it's not as convenient for the doctor or midwife.
Comfort measures are so important, and as LJ mentioned, you can labour in the water (or even give birth there, as I did with two of mine) and you can have an active birth with slow dancing.
Here's a wonderful little video that shows some of the comfort measures that can be used to manage pain and encourage a shorter labour and birth.
9th July 2012 12:03 PM #50
- Join Date
- Mar 2012
Is it ok to use pacifier early age
Its me raish its been a while i have successfully born my 1st baby now i'm having a problem since my baby is almost 2months is it ok for her to use pacifier? Because most of the time even she is not hungry she wants me to stay by her side and suck my nipples for her to be able to sleep but i cant stay always beside her i have work need to be done so i just wondering if its ok for her to use a pacifier because someone told me that its not ok...so i will be happy if you can help me
Looking forward for your reply
11th July 2012 09:13 PM #51
I'm sure our midwife will reply to you shortly but I just wanted to give you some information on using pacifiers and breastfeeding. The main disadvantage of this is that using a pacifier can lead to decreased milk supply (which could then lead to you giving your baby formula and missing out on the benefits of exclusive breastfeeding). This is because milk is produced on a supply and demand basis and if your baby is not sucking on your nipples for milk then your body will not produce enough. There is a useful forum post explaining the advantages and disadvantages of pacifier use here.
Another potential disadvantage of using a pacifier is that it can lead to 'nipple confusion' and affect how well a baby latches onto the breast. Some healthcare professionals advice waiting until you have been breastfeeding for 12 weeks in order to minimise this risk.
I would recommend baby wearing as a gentle parenting method of staying close to your young baby but still getting some jobs done (if you have the energy!). At this age, it is important for a baby's social and emotional development and well-being that they are close to you and baby wearing allows you to bond in this way. It is also possible (with a little practice) to breastfeed whilst the baby is in the carrier - I found the ring sling easiest for this although I sometimes breastfed with my baby in a soft wrap sling (Kari Me or Moby sling).
Finally, I would say be kind to yourself! Your baby is still very young and you are adapting to having a new baby. Rest when you can and try not to worry if the household jobs slip for a bit. Try and eat a healthy balanced diet and drink plenty of water and fruit juices.
I hope this is helpful for you but please post back if you need any further suggestions.
Last edited by ljmarsden; 11th July 2012 at 09:15 PM.
12th July 2012 02:18 AM #52
Congratulations on the birth of your daughter! I'd love to hear how your birth went.
When you fully breastfeed your baby there will be times when baby seems like she's always at the breast, and all you do is sit on the couch. Those times would be when she's going through a growth spurt and increasing your milk supply to keep up with her growth, or when she is sick and not feeling well, and if she has fever, she would need more fluids, so suckling at the breast would not only soothe her but would also increase milk supply so she has more fluids during her fever.
But other than that, if you truly feel like your baby is constantly at the breast, even while she sleeps, she may not be getting a good, full feed.
You can use breast compressions to help baby feed faster and become full without "nibbling" at the breast all day. By using compressions you can even give a baby a full feed on one breast at one feeding, and then offer the other breast at the next. This can give painful nipples a break so they can heal too (I had very painful nipples with my first baby).
Here's a video by Dr. Jack Newman that shows you how to keep a baby awake during a feed. It also shows how mum uses compressions to help move milk down into the baby's milk so the baby gets a good mouthful rather than just "nibbling".
If your baby's desire to nibble at the breast is not due to being hungry, but is more about wanting the breast to simply pacify, then you could offer a dummy (pacifier) only in a very limited capacity. You really need to keep in mind what LJ shared about. Using a dummy can cause nipple confusion and it can also cause you to have less milk for your baby. But if needed, you can use it a little, and the way I would do this would be to give your baby a really good, full feed (using breast compressions if needed). This shouldn't take more than 10-20 minutes.
Then, if baby has not fallen asleep yet you notice she is tired, you could offer the pacifier, swaddle her tightly, put her in a swing or in a front pack and start running the vacuum or a hair dryer.
When you do all of these things, you are replicating the environment in the womb, which she was used to for 9 months. The swing or front pack gives her movement, similar to the movement she experienced when you moved around and she was in the womb. The sound of the vacuum or hairdryer or running water is similar to the sounds she heard when she was in the womb "white noise", the tight swaddling is similar to the confines of the womb, and the dummy allows her to suck, which is similar to the sucking of her thumb that she may have done in the womb.
Take a look at this video to see a 21 week baby in the womb who was caught on tape (ultrasound) sucking her thumb. Amazing!
Please write back and let us know what you think. We're here to make mothering life much easier on you so let me know what it is you want to be able to accomplish, and if you need more ideas.
8th September 2013 07:16 PM #53
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- Sep 2013
Hello. I'm hoping to ask for some advice.
I am 31 and pregnant for the first time. I had a scan mid my 7th week and the doctor couldn't see a heartbeat, just a sac. I know the date of my last period so I don't think my dates could be very out of whack.
He said to come back late this week to scan again but was quick to jump to the possibility of it not being an 'ongoing pregnancy'.
I went and got my HCG levels tested afterwards and they are in the right range for week 7 and doubling as they should every few days - plus I still have morning sickness and the other usual symptoms. But my GP said sometimes the hormones go up and symptoms continue because a placenta is growing but no baby.
I always assumed that if you miscarry it just happens, the idea of having to get a D&C really upsets me.
I just wanted to know whether I should start preparing myself for the worst?
8th September 2013 08:13 PM #54
Hi Jane - sometimes you ovulate at different times in your cycle - so it could be that the pregnancy is not as advanced as first thought. The only way to know is to repeat the ultrasound. I will cross my fingers that everything is okay at your ultrasound.
Sometimes a pregnancy will continue without the baby developing - this is sometimes called a blighted ovum. In these pregnancies when the women reaches approximately 12 to 13 weeks bleeding starts to occur. At this point the placenta is supposed to take over to maintain the pregnancy but because the baby and placenta are not developing the pregnancy miscarries.
16th September 2013 02:03 PM #55
- Join Date
- Sep 2013
hello good day,
I just want to ask about Implanon,is this safe?or have side effects?
Thank you for the response
17th September 2013 05:49 AM #56
Implanon is registered as a safe means of contraceptive. It is inserted under the skin in the top of a woman's arm and contains the hormone progesterone.
However, this implant does have possible side effects, as does any medical treatment. The possible side effects include vaginal bleeding or a change in your period (there is a 1 in 10 chance of this happening). There are also more rare side effects (with a chance of 1 in 100 of occurring) including: flu like symptoms, nausea, pain at the site of the implant and ovarian cysts.
There is some further information about other contraceptive options here.
29th September 2013 10:46 PM #57
- Join Date
- Sep 2013
Hi there! have just joined the site looking some advice if thats ok? firstly lovely to meet you all! its so nice to see everyone helping each other out!
So about myself, Im 30 and ttc #4 our last little bundle of joy. I came off my pill cilest (im in uk hope this ok!) and waited the month as advised and did for my other princesses. wed 28th aug I had my first period (not withdrawal bleed) and as Im normally a 28 day cycle worked out ovulation around the week beginning 9th Sept.On the Sat, 7th I felt some cramping and my breasts became sore, an indicator ovulation was beginning so my husband and I dtd over a number of days that week to be sure lol! my next period was due wed 25th Sept. In or around the 16th I had a few wee symptoms like heightened smell, bouts of nausea, tiredness and not sore but uncomfortable breasts that came and went. I didnt want to get my hopes up as I knew this could be pms starting, I would suffer badly from pms even whilst on the pill, severe cramps and heavy periods. On Sunday 22nd I woke up with very bad cramps and back ache and thought here we go but nothing. Around 5 that evening it just all disappeared! That evening my husband and I were intimate and afterwards I had mild cramping for a few minutes and then nothing. Monday everything was good until early afternoon when I wiped and saw pinkish blood, then nothing. Tuesday morning I woke to a gush of blood, like a spurt, as the day went on I would get numerous 'spurts when active, no pain or cramps and no heavy feeling like Id normally get with my period. The blood always stayed watery pink. That evening after work I had a little lie down and a nap as so tired and when I got up to go to bed I had stopped bleeding. I woke up Wednesday and bleed the same as the day before, this continued until yesterday, Saturday, where it stopped as usual last night and didnt re start today. All through the week I had no pains cramps or heavy feeling except for a pinching feeling low in my uterus on thursday that last half an hour and a stabbing pain over my right ovary on friday that lasted a few seconds and i continued to have all the other pregnancy symptoms. some spurts where very heavy where after two or three I would bleed through my pad. there was no pattern in when they would come. Now today Sunday Im having mild cramp/heavy feeling almost like my period is about to start! no blood though! so totally confused! I tested at home yday and got a negative. When I had #1 I had a heavy bleed simlar in time but not appearance and later discovered I had been carrying twins. #2 got a postivie test 5 days after missed period and # 3 several neg until I was 11 days late. with #3 I was induced at 38 weeks as I wasnt well and suffered bleeding very similar to what Ive just detailed, came in bursts when I moved in bed (was on bed rest in hospital) then I passed a large clot the size of my fist and then continued to bleed in spurts during labour and even after. They had initally been concerned there was a tear but couldnt find one post delivery. then about day 4 after delivery it just stopped spurting and became the same as you would normally bleed post delivery. Sorry about all the info and long winded post but I felt I needed to give as much info to help as poss. One last thing in march this yr I fell pregnant on cilest and miscarried at 8 weeks. What I experienced then was very different. Thanks in advance for anyone who can offer any insight. At the I feel pregnant but dont believe that I am.
29th September 2013 11:51 PM #58
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- Sep 2013
forgot to say other pregnancy symptoms include a headache since the monday the bleeding started, sore legs, dizzy head and hot flushes from about 4 days post ovulation! thanks again
30th September 2013 06:43 AM #59
Welcome to our forum. It is good to have another new UK forum member on board.
As you probably know, bleeding in pregnancy occurs in around 1 in 4 pregnancies. In the majority of cases, the bleeding is 'normal'. However, bleeding can also sadly indicate a miscarriage. From what you describe, it sounds as though bleeding in pregnancy would not be unexpected for you based on your pregnancy history. However, this early on it is unfortunately difficult to say if you have successfully conceived or not.
Have you considered asking your doctor for a blood test to check for pregnancy? These can usually be performed from 8 days of the expected ovulation date. With coming off the pill quite recently it could take up to 3 months for your cycles to become fully regular again which again makes means a pregnancy test would be the best indicator as to what is going on. At the moment, it could still be too early to get a definitive pregnancy test result as you may have ovulated later than you predicted.
When you bled through your pad was the blood still a watery pink colour or had it become a brighter red?
I do wish you all the best in conceiving baby number four very soon.
30th September 2013 06:58 AM #60
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- Sep 2013
Thanks for getting back to me so quickly and for the warm welcome.
I think I may try and get an appointment with my GP this week unfort they all males in my practice but sure they have seen it all before so they say lol!
To answer you question it stayed quite pinkish and watery throughout. Certainly did not appear to be like anything Ive experience before except that of when I was being induced. it was quite watery and pink and at first put down to a watery show but then after passing the clot and it becoming a lot heavier it was established as it not being that and I was scanned to check it wasnt placenta which is wasnt and they thought prehaps some kind of a clot but unfort my care at the time wasnt great and they didnt keep me up to date with terms etc or even test results! I had to do a 24 urine collection and to this day dont know why or what the results where but thats a different story lol! I was wondering if it could maybe have been connected to what had happened before maybe? I suppose the only way to get an answer is to visit the dread GP lol!
Thanks again for your response and help!