Blog

17 April 2018

Breathing during labour

During pregnancy yoga, we do several exercises to stretch the sides of your body to give more space for your lungs. We also do breathing exercises to help focus the mind and body, and to regulate our breathing rate and ensure we are getting enough oxygen to your lungs and to your baby.

Generally, the breathing techniques that I teach places emphasis on your exhale. I do this by getting you to visualise a white feather floating in front of your face or a golden thread coming out of your slightly-parted lips. The aim is to blow away the white feather or gold thread further and further away from you during a contraction/surge/wave.

Perhaps you have heard of Ina May Gaskin and her sphincter theory. She explains how the more the jaw is relaxed the more the cervix can dilate. Therefore, by keeping your focus on your exhale and making it longer than your inhale you can help to speed up your labour progress.

This reminded me of a conversation I had with one of my friends. She commented on how her labour was helped by whistling throughout her contractions. I thought that was fascinating at the time and did some research. I found that some hypnobirthing techniques encourage women to make a noise during the exhale which could be a “sshhh” noise or a deep exhale. Indeed, my friend used a whistling technique. I think that having this added sound can help you to focus your mind on something other than the intensity of the labour sensations. Making a noise during the exhale can also work to lengthen it and relax the muscles in the face and jaw.

If you are a practiced yogi you may find it useful to use your Ujjayi breathing. This is another way to create sound during the exhale. This breathing technique is sometimes called "the ocean breath". It works by slightly narrowing the back of the throat which constricts the passage of air. It’s important never to hold your breath during labour (or in pregnancy) as your body and your baby needs oxygenated blood.

Another breathing technique to lengthen the out breath is by counting. Inhale to the count of 3 and exhale to the count of 3 initially, but then gradually lengthen the exhale to the count of 5. You can count in your head or get your birth partner to help you count out loud. Alternatively, instead of counting perhaps focus on the sensation of cold air coming in through the nostrils and warm air leaving your nose and mouth.

If you’d like to sign up to my Yoga for Labour and Birth workshop (28th April) where I show you different breathing techniques to go along with each stage of labour please email me or book the workshop on the Yoga West workshop website

 

10 April 2018

The Importance of Making a Caesarean Plan

You might be thinking: ‘what’s the point of making a caesarean birth plan?’ Perhaps you know you definitely don't want one and are preparing for a vaginal birth. However, by making this plan it doesn't mean you are going to have a caesarean - you might not! And by making this plan it doesn't mean that you will thoroughly enjoy the theatre experience – you may not. It just means that you are better prepared and feel actively involved to cover this eventuality should it arise. 

Caesarean sections can be planned:

  • due to baby being in a transverse position (lying in a horizontal line across your uterus)
  • placenta covering the cervix
  • your choice

Or they can be unplanned, as a situation arises during labour (what you might call an emergency section):

  • if circumstances deviate from normal
  • if there are concerns for your health or your baby's health during pregnancy

An emergency c-section's name is a little misleading because it is not always an urgent/life-threatening situation. If this is so, then it is called a crash section.

There are many different reasons why a caesarean might be necessary or wanted, but I’m not going to go into them now. However, here are some useful tips to ensure you regain some control over a situation where you might feel you have no control over.

The Gentle, Natural or Woman-centred caesarean

This is a new type of caesarean that puts the woman back at the centre of her birth experience. Circumstances may dictate that this is the way your baby needs to be born, however, you can still make some choices around the environment and what happens to your baby immediately after birth. What constitutes a Gentle Caesarean?

  • the room is kept calm and quiet
  • all theatre staff are asked to stand at your head end while your urinary catheter is inserted to maintain your dignity and privacy
  • music of your choice is played (using your own headphones as one of my yoga student’s did, or ask the theatre staff to tune in the theatre’s radio to your preferred music station)

“when we were in theatre a radio was playing so I asked for it to be turned off and I put on my headphones and listened to your labour and birth playlist which I had downloaded. My son was pulled out of me to the ‘breathing ripples track which I think is what you often play at the end of your classes during shavasana” – Lucy, Acton

  • the screen is lowered during the birth so that you and your partner can watch your baby being born
  • you can still choose delayed cord clamping (as long as all is well with baby)
  • the ECG dots are attached to your back so as not to interfere with immediate skin-to-skin
  • your IV line to be placed in your non-dominant hand so it is easier for you to touch and hold your baby
  • ask the theatre staff not to tell you the sex of the baby, if you want to discover it or yourself

The above 8 points are not the ‘standard’ method of caesareans, so you will have to have a discussion with your care providers to see whether they can accommodate your wishes. Because it is not the ‘usual way’ of doing things you may be met with some disgruntled care providers. Don’t be afraid to consult different obstetricians or go to a different hospital, if your first obstetrician does not do certain elements of your gentle caesarean plan.

If your caesarean is done under general anaesthetic, you can include some other points for your plan:

  • ask for a film/photo of the birth to be taken of your baby being born. Being able to see the film/pictures afterwards can help it seem more real to you
  • ask for the baby to be placed for skin-to-skin with your birth partner

Remember that your birth experience will remain with you for the rest of your life and so it is important that you feel happy and your choices are respected. Studies have shown that feeling in control and respected during the birth experience have a huge impact on you and your family. Be prepared to negotiate with your care providers and find ones that will support you in your choices. Furthermore, you may never have to use your Caesarean birth plan, but I think it is good to have it for ‘just in case’.

 

Hayley and baby Indy
Hayley and baby Indy

 

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Birth Story: Becs and Marley

Becs begins by telling me how the events unfolded on a Sunday afternoon when she felt her waters break. What follows is her birth story as told by her to me. I have full consent to share her story.

There was a lot of expectation of having the birth at the birth centre... And everything I’d been studying, reading, and working towards was going to be encompassed at the birth centre.

Becs went to the birth centre where the midwives confirmed her waters had broken. However, since she was not having any contractions/surges, she was told she couldn’t use the birth centre.

That was the first moment I realised that everything was going to go very differently to plan. People keep telling you to stay open to things not going your way, and in that moment, my whole world came crashing down.

After reviewing her options, she chose to opt for expectant management – waiting for labour to start naturally. Most women (90%) will go into labour naturally within 48 hours of the waters breaking.

She decided to wait for things to start naturally and in the meantime monitor for signs of infection. Throughout Monday she tried all sorts of things to kick-start the labour – from eating pineapple, long walks, yoga, raspberry leaf tea. Becs had already started to feel sporadic tightenings and felt like mentally retreating inwards. By Tuesday morning, her surges had ramped up and she felt the need to use a TENS machine to help. By midday, the surges came every 2 minutes, and she started to feel intense pressure down below. So she got ready to go to hospital.

It was quite hard to get into the car, and to try and find a comfortable position … I had my pregnancy pillow and was lying on my left side with my head out the window. So, the looks people were giving us when we stopped at traffic lights and I was surging hard! We had one guy roll down his window, clapped and said, “go on, go on, you can do it!”

Once in hospital, Becs was examined and found to be 6cm dilated! In the labour ward she was looked after by one midwife and her student. Becs chose to use a birth pool and experienced a huge relief from the warm water – “pure feelings of surrender, and floating felt incredible”. She used her breathing techniques to help ride through the surges. The midwives attending her encouraged her to listen to her body and push if she needed to. After 1 hour of being in the water, Marley was born and brought up to her chest.

What a feeling! Your attention is diverted to something so much greater and what you have in your arms. I first sniffed his head – that beautiful baby smell!

One aspect that Becs found she was not prepared for is the checks that happen after the baby is born, ie checking for perineal tears, which felt very invasive. The gas and air really helped during this part. Both Becs and Sam (partner) are huge Bob Marley fans.

Bob Marley playing in background really helped. The midwives were singing along whilst doing the check-ups.

All in all, it was an amazing experience not only for the new parents but also for the midwives. This was the first water birth that the student had witnessed! Both the student and the experienced midwife felt privileged and commented how it gave them hope that birth doesn’t always have to be completely medicalised.

Rebecca: Was there any part that was challenging?

Becs: I think the challenging part for me was just keeping my focus. As the surges start to intensify, as your body starts to open, it gets more and more challenging to maintain the focus to your breath and to work through those surges. I felt like I had to drop a lot of my own ego and drop a lot of my own layers to reach that point, to get really deep into the intuitive side of myself.

Rebecca: How did you overcome this?

Becs: You have to trust the process. You have to trust that you do have it within you to dig deeper. You have to trust your baby and you have to trust your birth partner. It was really important for Sam to understand the breathing techniques. Find what anchors you, find what grounds you and make sure your partner knows what that is.

An important factor is having control over the birth environment you create. For Becs this was her birth playlist, muslin cloths with lavender oil, her breathing techniques, and having a wonderful birth partner in Sam who encouraged her when she felt like giving up. Having someone you trust is imperative.

Rebecca: Name 3 things that you learnt about in pregnancy that you found really useful and helped in your labour.

Becs:

  1. Breathing technique– During pregnancy and anytime I felt overwhelmed or needed a breather I would use these techniques: in-breath for 4 and an out-breath for 6, and also relaxing every single part of your body. On a few occasions, Sam helped count me in if I lost the focus, but it was mainly an internal thing.
  2. Mantraof “trust”– Trust became an important mantra for me to have. Having faith in yourself is important, having faith in the baby and the midwife.
  3. Yoga– I would be absolutely nowhere without yoga. Being able to move your body is a beautiful thing. No matter how small the movements are or how big, whatever it is you need to do on that day, just make the time to move your body – it definitely needs it and definitely helps you tune in.

Rebecca: and you practiced right up until the birth?

Becs: Yes I was practising all through the labour. I was doing all fours, hip circles, cat cows – really helped with the spine.

Rebecca: Any tips that you’d give to other women who are expecting their first baby?

Becs: One thing that we have done, which seems like such a trivial thing, is cook food and freeze it. He [Marley] came early so we still had another week on our schedule to do cooking and freezing but we managed to get a good 20 meals in the freezer.