During the First Trimester, the expectant mum can sleep in any position of their choice. So whatever makes you comfortable is good seeing as you are more or less the same size. I always prefer sleeping on my tummy but if you have backache as part of your early pregnancy symptoms, this position and lying on your back might make it worse.

During the Second Trimester, you are probably a bit bigger. The “SOS” ( Sleep on Side) Position is one you want to start getting used to. It is the best as it does not provoke heart burn, back pain or frequency of passing urine as sleeping on the back would.

During the Third Trimester, the baby is probably “ruling” as far as your sleeping position is concerned. If you had not learnt to use the “SOS” position, you have to now. Sleeping on the left side is even better. The great vessel that carries blood back to the heart lies more on the right side of the chest. When you lye on the right side, the baby’s weight compresses it and this may reduce your blood circulation and that of the baby.

5 Tips to help you sleep especially for the last trimester1.      

1. Go to bed relaxed:
   Take a warm bath, take a hot drink or read a book before sleeping. Make sure you are emotionally calm before going to bed
2.  Do not get into bed till you are ready to sleep:
   Being in bed and not asleep might make you tired. If you lose sleep in the middle of the night, get up and out of bed for a short while, stretch your muscles then go back to bed.
3.  Use Pillows:
   Pillows are a great help, use them on any part of your body that needs them. If you have heart burn, use two or more pillows on your head. Use a pillow under your bump especially if you have pressure symptoms. When on the “SOS” position, use a pillow in between your knees as this helps relieve pressure off your back. If you can purchase the Pregnancy pillow, the better as it helps you adopt a much comfortable sleeping posture.
4. Exercise:
   Exercising  helps give you some equilibrium and this helps you sleep better. Pelvic tilts and kegel exercises done just before sleeping help reduce the frequent “journey” to the bathroom.
5. Sleep Robbers:
   Getting into bed right after a meal, too many naps during the day, watching a high action movie before getting in bed, sleeping late are some sleep robbers that you can avoid.

 Sleep well

The Role and Importance of Doulas

            A doula is a female birthing companion who provides physical, emotional, and informational support to the expectant, laboring, or new mother.  She “typically provide[s] some form of prenatal preparation and stay[s] at [the mother’s] side once labor begins until [her] baby is born” (Gaskin 237).  Additionally, she aids and encourages the mother’s birth partner.  Although one woman may function in multiple areas, there are three primary types of doulas: antepartum doulas, who assist the mother before the birth; labor doulas, who aid the mother during the birth; and postpartum doulas, who help the mother after the birth (Gurevich 6).  In her book The Birth Partner, Penny Simkin states that doulas are “[o]ne of the most positive developments in maternal care” (8) because they significantly reduce the need for major medical intervention during the labor process and help the mother to feel good about her birthing experience (10).

DONA International is one of the world’s largest and most well-known organizations for doula certification.  Their high standards and code of ethics are both universally acknowledged and accepted by the international doula community.  Within the DONA code of ethics, it is made very clear what a doula does and does not do.  A doula supports the mother emotionally, reassuring her and providing her with the necessary information she needs to make an informed decision about her own care.  With this information, a doula also helps the mother and her birth partner to devise a birth plan, which outlines the general course the client wants the birth to take and answers questions such as, does the mother want to have a home birth or a hospital birth, and does she want any medication during labor.  The doula’s main goal is to ensure that the mother is comfortable, secure, and happy.  A doula knows that it is not always possible to follow this predetermined course of action, however, and is prepared for any unforeseen circumstances that might arise.  With the birthing plan in mind, it is then the doula’s task to ensure that her client’s wishes are made known to her birth partners\ and/or other caregivers.  A doula also encourages the mother to speak up for herself to her caregiver when she has a need or when a change needs to be made to her birth plan (sec. I., pt. A.; C.).  In addition, when the mother (client) has a need that goes beyond the scope of duties permissible for a doula to perform, it is the doula’s duty to make referrals of other professional sources from whom her client could obtain further assistance (sec. I., pt. D.).

It is important to note that all advice and support given by a doula is strictly nonmedical.  By definition a doula is not permitted to perform any medical procedures or prescribe any medical advice, unless she is acting in a dual role as an obstetrics nurse or a midwife.  In such a case, her dual role must be established beforehand, for if she is hired only as a doula, she is not allowed to do anything outside a doula’s scope of services even if she is capable of doing so.  Though a doula is the one to clearly reiterate the mother’s wishes, she does not make decisions on behalf of her client nor speak in her place.  Her main focus is to provide the mother with necessary support and information.  A doula is not a primary caregiver and does not take the place of a doctor or midwife; this includes both prenatal and postnatal care.  A doula encourages the mother to seek the medical advice and attention she needs to support herself and her child (sec. I., pt. A.; B.).

The term doula is derived from the Greek and refers to a woman servant (Gurevich 6).  Despite the fact that this terminology is not particularly well-known to the world at large, the concept of having female attendants present during childbirth is prevalent throughout world history. In various cultures women who practice as doulas take on different titles.  For instance, in Minnesota the Native American women prefer to be called “Turtle Women” because “the turtle symbolizes creation,” while ladies in British Columbia like to be called “aunties.”  Cheyenne women might be called a name meaning “Holding Women,” and a respected grandmother-doula in Quebec even held a title meaning “she who helps the mother” (qtd. in Celebrating Birth 9).  Historically, Queen Victoria of England was known for assisting women during birth, “…providing for the mother and observing the birth and keeping medical and emotional notes of the confinements she attended” (“Queen Victoria”).

An antepartum doula can be especially beneficial to the expectant mother and her birth partner, preparing them for the birth experience and helping them in all manner of ways.  The doula can assist the mother by explaining the changes that will be occurring in the mother’s body and emotions during both pregnancy and labor, as well as afterwards.  Many antepartum doulas are available to accompany expectant mothers to childbirth classes and obstetric appointments.  This preparation is important in helping the mother to cope emotionally and physically, and to feel empowered to do well.  This information is also helpful those who plan to be birth partners so that they can feel that they are able to assist the mother and comfort her at this time when she most needs their support.  If the mother has no birth partner, friends or family nearby to help her, the antepartum doula is practically a necessity to the mother’s well-being.  Her presence can make the mother feel that she is not alone during her pregnancy, and that she has someone who is caring and informed to speak with.  Whether or not the mother has other support, an antepartum doula can help her client in other, more physical ways.  She may do housework such as cleaning or laundry, cooking, watching other siblings, or running errands.  She might also help the mother bathe or, if she is trained to do so, give the mother a prenatal massage.  Additionally, it is the antepartum doula who helps the client to create a birth plan.

Whether a mother decides to give birth in a hospital, a birthing center, or her own home, a labor doula can play the role of comforter, both in a physical and an emotional sense, and provider of pertinent information and advice.  In her book Ina May’s Guide to Childbirth, Ina May Gaskin, one of the modern world’s most respected midwives, points out several benefits of having a doula present during labor, including the fact that: “Doulas are not usually employees of the hospital and so are answerable only to the mother, not to the hospital.  Unlike nurses, they stay around when shifts change” (238).  In The Doula Advantage, Rachel Gurevich states that, according to numerous studies, “[D]oulas help women avoid drugs during a normal birth” (27) or “can help [the mother] avoid medication until [she] really need[s] it” (28).  The doula may soothe the mother by doing things that comfort her.  This may include anything – talking to the mother, listening to the mother, playing familiar music, brushing the mother’s hair, bringing her cool cloths, or rubbing the mother’s back – whatever the mother finds relaxing or diverting is what the doula will do.  The labor doula’s support does not merely extend to the laboring mother, however; she also encourages and aids the birth partner by, for example, taking their place at the mother’s side when they need a break, helping them cope with their own emotions and understand what is happening, and incorporating them into the birth process as supporters (Simkin 8-9).  The doula may remind both her client and any birth partners of breathing and massage techniques or of gentle stretches and exercises to boost labor or relieve the mother’s discomfort.  For those who have a desire to know details, the doula can explain the different “stages” of labor, even pointing them out as labor progresses.  The doula will remain at the mother’s side during the birth and for whatever amount of time the new mother feels necessary.  Most labor doulas stay with the mother after delivery until breastfeeding has been established on one or two occasions.

After the birth, a postpartum doula can provide the new family with a great deal of assistance by, again, giving advice and support.  Depending on what course the mother has chosen to take in regard to feeding the child, the doula may give her tips on breastfeeding, help her to pump milk, or assist in bottle-feeding the infant.  She may also demonstrate, if needed, such things as proper handling techniques, swaddling, or diaper changing.  The doula may also do things similar to that of an antepartum doula: cooking, cleaning, babysitting, running errands, and giving physical assistance to the new mother.  She encourages both the mother and any others who are aiding the mother and tries to promote the growth of a happy, healthy family.

All-in-all, the doula’s job is to support, advise, and encourage.  A doula’s ultimate goal is to do everything within her scope of practice to promote a positive birth experience for the mother and birth partner, and to help the family become comfortable with the new baby.

Let’s start by putting out what a birth plan is not; It is not a script for how you want your labor to progress, neither is it an agreement with your doctor, midwife or doula about what they will do during your labor. It is not to determine the outcome of your labor either.

A birth plan is for you. It helps you know what may happen during labor, what options you have so that you settle for what you would like and express your ideas and expectations. It helps you inform your birth team what options you have chosen and would like to try during labor and those you would like to avoid. They get to understand what type of support you are looking for leaving you to focus on the amazing birthing process. A birth plan may also help you determine if the caregiver you have chosen is the best match for you. If a situation arises during labor and a decision must be made, it is easy for your birth team to check your birth plan and see how you wanted the scenario handled.

In a nutshell, the purpose for a birth plan is to help you determine how to react during labor; and to help those attending to you understand your decisions about how to handle both the normal and the unexpected situations.

Here are four steps to getting your birth plan to work for you.

1.  Know Your Options
   Different doctors, midwives, doulas and hospitals will give you different options for handling the same situation. As you talk to the different birth team members, find out what their birth policy and philosophy is. Get to know the different options that are provided.
2. Make Your Choice
   Now that you know what options are available to you, genuinely ask yourself what you feel about the options. What you strongly feel about is important to you and is definitely your choice, so stick to it.
3. Write Down Your Plan
   You can keep the plan in mind but putting it down on paper helps communicate it to your birth team. Write the options you would like to try and those you would like to avoid. Start by planning how the normal labor is to be handled, then how you prefer the unexpected to be handled. Some areas you may want to think about include:
   • Support: husband, friend, doula?
   • Environment: music, TV, quiet, lighting
   • Equipment: Birth ball, pool/tub, stool, bed
   • Examinations and monitoring: Which and how often
   • Coping techniques: positions, massage, hypnosis etc
   • Birthing: positions, pushing, episiotomy
   • Yours or your spouse’s participation during the actual birth
   • After birth: holding your baby, breastfeed, placenta
   • The baby: stays with you throughout, vaccines
   • Interventions you are open to at all stages
4. The Reality Check
   Determine if what you have decided can be offered by your caregiver and hospital. Be assertive remembering that it is your choice and birth but also pay attention to the thoughts and rationales of your birth team as this may influence your decision to change your plan or your team.
5. Share your Plan With Your Birth Team
   Get to discuss the plan with each member of your team. Ensure that each of them understands your preferences, expectations and are willing and ready to support you. Ensure they also understand how you would like the unexpected handled. Give a copy to each team member and keep a copy with you.

Finally, when interventions are recommended, the mnemonic BRAIN will help you remember what to ask;

Benefits: What is the advantage of the intervention
Risks: What are the risks the intervention is preventing?
Alternatives: Is there another way?
Intuition: What do you feel about the situation, recommendations?
Need time: If possible, take some time to make your decision

Remember, your dream may sometimes be realized and sometimes it might not. Your birth team may also keep you so comfy, you forget you had a birth plan!
So, be flexible and don’t use your birth plan as a benchmark for how well or not your birth went.

This is a question I hear so often, the answer to which I am always so glad to give!

No pain, no gain is not just a saying for the Gym-goers….It is true to any gain I guess. Pain is a natural and important part of labor. If you have ever asked a woman to describe to you what labor pain is like, you get varied expression most of which do not give you a real description of this kind of pain. My theory, it is a kind of pain that is unique to the gain, hence the reason why most women cannot describe it. One can only experience it in child bearing. I continue to theorize, because you do not need to register it, it is stored in your subconscious mind…so no clear memories…

There are several good approaches to pain relief that are effective throughout labor that everyone in labor should try. Any of the following approaches with which you feel comfortable can be used during your labor:

• Walking does help
• Water therapy (shower or tub) helps relax your muscles. Be careful though, it could slow down labor
• Sitting or leaning on a birthing ball or rocking chair
• Keeping a restful environment in your labor room (quiet, low lighting, soothing music). Carefully select support people for a calm environment
• Using various positions (all fours, sitting on toilet, kneeling, squatting, pelvic rock) and supporting with pillows if necessary
• Massage/back rubs by support person, watch the muscles though, the need for a massage may change in the course of labor.
• Abdominal breathing could be deep and slow combined with shallow and fast at the peak of a contraction
• Effleurage (light massage of abdomen), very soothing. Can be combined with the rhythmic breathing
• Having your partner or a support person rub a tennis ball over your lower back
• Applying warm or cold compresses
• Using relaxation techniques
• Prayers or religious ceremonies
• Guided meditation using calming imagery

Utilizing several comfort techniques is an excellent way to involve first-time partners in supporting and working with you in the childbirth process.

Try practicing the different comfort measures during early labor to determine your most preferred one

When in labor remember, you really are not in pain, you are just having painful contractions.

We’ve put together a weaning plan which we’ve tested over the years and which we think will work for just about any mother in Africa.

Download the Baby Weaning Plan here.

Refugee woman breastfeeding in a CAR camp, 2008.

Pregnancy, labor and delivery are now behind your back. Congratulations!
Truth be told, there are times you will probably feel like you have no idea what to do or how to do it. I know the feeling, it’s just like that new job when you have to go through orientation, trial and error until you are accustomed to your new role. Give it time, you will soon develop your own system around parenting. Here are a few tips to help you cope.

Tip 1: Get help:

Help is the one thing you need and must get.
Get dad to participate in caring for the baby. Parenting should be a team effort. You will gain a lot by being a tag team; it also draws you close and helps you create the family bond.
Experts like midwives, lactation specialists offer you support as you settle down, counsel and information that helps you learn faster.
Nannies are perhaps one of the most important people at this time. You may not agree but don’t dismiss their help and advice especially if they are experienced. Get one or two as per your needs, assign them duties and allow them to help you as you please.
Friends and family who come to visit you can be very helpful. Give them little chores around the house. Get them to baby sit while you take a nap or a walk out of the house.

Tip 2: Taking care of your baby:

New-born babies can be intimidating at first especially if you are a first time mum. Remember, they too are learning to be who they are…be patient with them and yourself.
Wash your hands before handling your baby. Make this a habit; it helps reduce the risk of passing an infection to your baby as their immunity is not fully built. Get your visitors and all others washing their hands too. A tip I learnt from my dad that, if asking relatives and friends to wash their hands is difficult , offer them a hand sanitizer, it will serve the purpose.
There is no harm in washing your baby if you feel confident about it. If you have not built the confidence, give them a sponge bath. Always ensure they are not exposed to a draught, cover them. The water should be at the right temperature, you can use your elbow to test that.
Handle your baby gently at the beginning as they are delicate. They may not break bones, but they are not strong enough to handle roughness. The head and neck are the most delicate so remember to put one of your hands at the back while lifting, carrying or putting your baby down.
When using a carrier or stroller, ensure your baby is strapped in and well padded.

Tip 3:  Bonding with your baby

As mothers, we are privileged to start bonding with our babies during the pregnancy. At birth, the first physical contact begins to create an emotional connection between the baby and the parents. Bonding goes on as we handle and care for the child and this contributes to their emotional growth and general development.
Stroking, cuddling and skin to skin contact are ways we can use to start a bonding process with the baby. The dad can use these ways to initiate and develop a bond with the baby. Gentle massages especially after a bath enhances bonding. This is especially helpful if your baby was born prematurely.

Four more tips coming up this Friday.

image: flickr.com (hdptcar)

Our One-day Birthing Classes provide a thorough overview of labor, birth and the first days with your baby. It defines the experience, and suggests ways in which you can go through labor with ease and comfort.

Click here to book your place

This article contributed by Muchiri Nyaggah

No idea what ‘baby blues’ are? Here’s Wikipedia to the rescue.

Postpartum depression (PPD), also called postnatal depression, is a form of clinical depression which can affect women, and less frequently men, after childbirth.

2 month old baby

If you’re expecting your first baby, it’s best to be prepared for the blues. They may be as mild as a little moodiness or serious enough to require medication and hospitalization. How deep the depression can get may be impossible to predict but there are ways of ensuring things don’t get too out of hand. Check out this link for more information on post partum depression. Try not to get too anxious from the all the information.

What can YOU do to make it less intense you and mummy?

1. Be Helpful
Yes it does mean getting off the couch and taking the baby off her hands for a little bit. Mummy needs ‘me’ time too. Making room for her to go get her hair and nails done, hang out with the girls or do some shopping can be very therapeutic.

2. Eat Better
Junk food, caffeine and alcohol should not be on your list of foods during the first 6 months after delivery. Avoid putting these into your shopping cart on your next visit to the supermarket or ordering them when you take mummy out to dinner. Encourage her to eat better and let her know you’re in it together.

3. Let Her Talk
And listen! Actively. Low grunts from behind a newspaper don’t quite count as active listening. Creating and protecting the space to talk helps her decompress when she begins to feel overwhelmed. Her timing may not always be great but she needs to know she counts more than the game on TV. This means you also need to talk. Find someone to talk to regularly so that you also get the opportunity to decompress. Remember, even fathers can suffer from baby blues.

Keep in mind that baby blues are triggered by a cocktail of factors ranging from the body’s hormonal changes to social pressure to be a great mom right ‘out of the box’. Daddy can’t fix everything so if it only starts to get worse, seek out psychiatric help immediately.

Come and learn all about it. Click here to book your place.

Source: Flickr.com

Sue:“You look so nice girl! What have you been up to?”
Ann: “Oh thanks my dear. It is this diet that I have been on! It has so worked!”
Sue: “Please fill me in on it, it sure will do me some good..”
This is a fairly common conversation among women.

Diets work well only as long as you don’t get your body into starving mode. Starving mode will reduce your metabolism (acquiring, processing, transporting, using and disposing of nutrients) for only a short time. Your body responds to starving as an environmental problem so it only exists until its able to block the reduced metabolism. As a result your metabolism then increases and a rebound appetite to correct the starvation is enhanced. This is why some diets cause weight lose but soon after you stop your body puts on a lot more weight than you had shed off.

Well, here are 5 tips to help you lose weight without necessarily going on a diet.

Tip 1: Increase your metabolism

1. Convert all fat into muscle by exercising regularly
   Muscle helps burn calories faster
2. Lots of water
3. Black coffee (not mocha or cappuccino but simple black coffee) does you some good. It keeps you alert. During your alert phase your metabolism increases to produce the energy needed for you to be alert…vicious cycle?
4. Take Green tea
   The caffeine remains at work
5. Eat frequently
   By doing this you keep your metabolism at work constantly. Getting a full meal slows down your metabolism. Just watch what goes in your mouth thou.

Tip 2: Fill up before you fill up

1. Curb your appetite
   Hot pepper is said to do this so well. Cinnamon (in your tea, coffee) tends to stabilize your sugar level so you do not feel hungry. Good idea for a sweetener too.
2. Spice your food
   Spices in your food help you fill up faster. I guess many people don’t eat much when the food is spicy. If you have tummy issues you will need to agree with your doctor on what spices to avoid.
3. Water, or water containing fruits and vegetables like water melon, lettuce, soups(broths) taken an hour before a meal give you a full feeling when eating so you do not eat much. Be careful with the salad dressings you choose, salsa is a good option, vinegar has been found to help break down fat so go for it.
4. Fiber
   Fiber takes longer to get fully digested thus keeping you full. Breakfast cereals oatmeal, vegetables, Beans should be part of your meals. Fiber helps you move your bowels better too.
5. Nuts and dried fruits
   These are a nice in between snack and are filling. Take them in moderation though.
   Popcorns (especially those popped openly) are a filling snack without many calories.

Tip 3: Have your food and beverages hot.

1. Hot food is eaten slowly, which is a good way of increasing metabolism.
2. The slow eating also reduces caloric intake

Tip 4: Eat Protein (Yes, I actually said that!)

• Proteins are harder to digest. That should explain why you get sleepy after a meal rich in protein; all the blood got sent to the stomach to digest this heavy stuff. The body does use more calories to digest proteins.
• As a result, proteins take longer to leave the stomach thus keep you feeling full. So, you can have your egg for breakfast but watch your cholesterol. Have your meat but get it lean. Remove the skin from your chicken as sweet as it may be. Eat lots of fish. Fish is actually best as it is more satisfying that most other meats and it fat ( omega 3) is helpful to the body. Beans are good to as they are a protein, vegetable and have fiber. A glass of milk especially skimmed is good during your meal.
• Don’t miss a protein

Tip 5: Substitute the Carbohydrate

• Whole grain bread, cereal, pasta and biscuits
• Replace a potato with a sweet potato
• Replace sugar with a natural sweetener, cinnamon or honey
• Avoid saturated fats, use little oil

Start by taking your weight today, if you are maintaining your weight then you should not lose. If you want to lose, hope you can lose half a kilo each week.

Let us know how this works for you and as usual if you need more help contact us.