baby hand in adult hand Melbourne doula melbourne birth

About the epidural

Epidurals are brilliant pain relief, but they’re not without drawbacks. There are subtle differences to the epidural and spinal blocks, and each has different instances where they’re used, but for the purpose of this blog I have lumped them in same basket.

Firstly let me say that the decision on whether to have an epidural is a personal one. If you’re not planning on one going in to labour but then up having one, for whatever reason, you have not ‘failed’. If you’re set on having one from the first contraction, then that is absolutely your choice. No-one should be judged on what happens during their birth. But I do strongly believe that parents need to have all the information about any pain relief option they choose so that they can make fully informed decisions. I also strongly advocate for people to learn this information during pregnancy, not be hearing it for the first time in the birth suite (which is why I’m such a strong believer that every pregnant family should receive independent childbirth education!)

If you’re on the fence about what comfort measures and pain relief options to use, then you’re best to work up to the epidural, since it’s a final decision – not typically reversable. I explain this by referring to the epidural as the ‘ten’ of the labour coping/pain relief world, with other comfort measures and pharmaceutical options appearing at different points of the scale from 1-10. Alternative methods of coping and pain relief to consider having first include:

  • Use of warm water (shower/bath)
  • TENS machines
  • Sterile water injections
  • Counter pressure and massage on the lower back/pelvis
  • Rebozo application
  • Movement (walking/swaying/rocking on a yoga ball)
  • Pethidine injections
  • Nitrous oxide (gas and air/laughing gas)
  • Birth doula – studies have shown that having a birth doula at your birth results in a 30% reduction the use of analgesia and specifically a 60% reduction in epidural use. Check out my blog on how to budget for a doula.

One other thing to keep in mind is potential problems with the application of the epidural. It may take multiple attempts by the anaesthesiologist to get correct placement, it may provide incomplete coverage (only getting relief on one side of the body or having ‘holes’ where contractions are still felt) or severe headaches during the early postpartum period as a result of a dural puncture.

Epidurals can be very beneficial if a birthing parent is approaching exhaustion, or are holding conscious or subconscious tension in the pelvis/pelvic floor which may be stopping labour from progressing.

To download infographic, click here

The infographic above lists some of the main ‘cons’ of having an epidural. But by asking questions and discussing epidurals during pregnancy with your care providers some of the cons can be mitigated by:

  • Having an ‘upright epidural’ – eg kneeling facing the back of an upright bed
  • Having assistance to change positions periodically – eg lying on your side, rather than your back, and changing sides every 30-45 minutes.
  • Using a peanut ball to assist in leg positions to keep the pelvis open – check out the Lamaze blog Peanut balls for labour

The upright epidural utilizes gravity to assist with baby’s decent through the pelvis. The assisted position changes and open pelvis may help mitigate the problem of being stationary with an epidural. Movement helps baby descend into and navigate through the pelvis. Without movement, a baby may descend very slowly or not at all, resulting in a longer labour, a fatigued baby which may show signs of foetal distress, and need for further intervention like assisted vaginal delivery or an emergency caesarean surgery.

As always, ask the BRAIN questions (see my blog Have you got your BRAIN?) about any interventions you’re considering or are offered. With careful considerations as to what other comfort you’ll use, it is absolutely possible to get through labour without an epidural. But if you choose to have one they can be of great benefit and with planning and discussion with our care provider, some of the drawbacks can be mitigated. 

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Rachel Angelone is the founder of Your Birth Your Baby and is a Lamaze Certified Childbirth Educator, Postpartum Doula and NurtureLife Pregnancy Massage Practitioner based in Melbourne. Rachel offers independent childbirth and early parenting education to pregnant families before baby arrives. Once your baby is Earth-side, she offers practical and emotional in-home support as you adjust to your new life as parents. Along both journeys she can provide relaxing and restorative massage treatments. She is also a loving wife and mother to two young girls.

Cover photo by Seif Eddin Khayat on Unsplash

Why massage during pregnancy and early postpartum?

Pregnancy is never static. Every day your baby and body grow, organs shift position and ligaments stretch to accommodate the changes. Aches and pains can come hand in hand with pregnancy, but that doesn’t mean you have to ‘put up with it’. Seeing someone who specialises in pregnancy massage can help reduce those discomforts, can increase your capacity to cope with the changes, and help you connect with your growing baby and body.

It also provides an opportunity for ‘me’ time, when so much of the focus can shift to your baby, or is already on existing children.

The top four potential benefits of massage in pregnancy include:

  • Improvement in sleep
  • Boosted immune system
  • Lowered stress levels
  • Reduction in pain and discomfort

Other potential benefits may include:

  • Increased connection with baby
  • Improved posture & reduced postural tension
  • Reduction in oedema
  • Improved circulation
  • Stimulation of cell nutrition
  • Increased acceptance of your changing body
  • Improved mood
  • Boosts to your immune system
  • Boosts of feel-good hormones, which boosts your mood and reduces anxiety

Postpartum massage can also be hugely beneficial as you recover from pregnancy and birth, and shift into this exciting but often exhausting phase of parenting a newborn. A postpartum massage can achieve all the same benefits as listed above, as well as giving you a boost of oxycontin – the feel-good love hormone that’s vital for bonding and milk production.

Rachel Angelone is the founder of Your Birth Your Baby and is a Lamaze Certified Childbirth Educator, Postpartum Doula and NurtureLife Pregnancy Massage Practitioner based in Melbourne. Rachel offers independent childbirth and early parenting education to pregnant families before baby arrives. Once your baby is Earth-side, she offers practical and emotional in-home support as you adjust to your new life as parents. Along both journeys she can provide relaxing and restorative massage treatments. She is also a loving wife and mother to two young girls.

Why should you keep using my services, despite COVID 19

*Edited to add: Due to Government restrictions, my massage service is on hold from late March to further notice. Doula services are classed as ‘care giving services’ and are still available.*

There’s much discussion about close personal contact at the moment. Two thirds of the services I offer rely on this type of interaction. So, should you keep engaging in these services?

Short answer, is yes.

Massage

Massage has many benefits, for any person. I exclusively offer pregnancy and postpartum massage. The main two that will be relevant at this time are:

  • Boosting your immune system
  • Boosting feel good hormones, which boosts your mood and reduces anxiety

The following are the measures that mean you’re as safe as possible in having me come to you to provide a beautiful relaxation massage:

  • I only do a max of 2 massages a day, and never back to back.
  • Every piece of linen I or a client touches during my time at their house goes in the washing machine as soon as I get home, washed on the hottest, longest cycle with sufficient detergent.
  • Linen is dried in the sun when possible, or in a dryer. Not left on clothes wracks for days to dry.
  • I wash my hands thoroughly when I arrive, and of course when I’m finished because I have oil all over my hands!
  • My massage table gets wiped down at the end of each massage with disinfectant wipes, and again when I get it out of the case at the next appointment.
  • I would never come to an appointment if I felt unwell, or had had contact with a person who is positive for Covid 19.
  • I contact all clients on the morning of their massage to check they’re feeling well. I’ve temporarily suspended my $30 cancellation fee.

Postpartum doula services

This virus may have seriously disrupted the support plans you had in place for your first few weeks home with bub. You may have had planned to have family come in from overseas or interstate – plans which may now be in disarray. Postpartum doulas can help restore a calm confidence to your postpartum care plans. Please get in contact if you have any questions about this service.

When it comes to hygiene when visiting for postpartum support, again, the upmost care is taken.  

I would never come to an appointment if I felt unwell in any way, or knowingly had contact with a person who is positive for COVID 19. I have a back-up doula so that you will still receive the support you need if I am unable to attend.

I wash my hands thoroughly when I arrive, follow the most stringent personal hygiene for coughing and sneezing at all times, and have an existing policy of only supporting one family at a time.

Online sessions now available: Childbirth education classes, & Birth and/or Postpartum planning sessions.

These services I am able to move to a virtual format to reduce face-to-face interactions.

I’ve tweaked my content and delivery to be suitable for conducting sessions via Zoom.

Pricing for the virtual services sessions will also be reduced, because I wouldn’t incur car petrol/servicing costs:

  • Face to face Childbirth education (7 hours-min 2 sessions): $350
  • Virtual Childbirth education (7 hours-min 2 sessions): $275
  • Face to face Birth and/or postpartum planning sessions (minimum 3 hours): $50/hour
  • Virtual Birth and/or postpartum planning sessions (minimum 3 hours): $40/hour

If you have any questions about any of my services, or any of the measures I’m taking in order to protect clients, please get in contact via the Contact Me page. I’d love to chat to you.

Rachel Angelone is the founder of Your Birth Your Baby and is a Lamaze Certified Childbirth Educator, Postpartum Doula and NurtureLife Pregnancy Massage Practitioner based in Melbourne. Rachel offers independent childbirth and early parenting education to pregnant families before baby arrives. Once your baby is Earth-side, she offers practical and emotional in-home support as you adjust to your new life as parents. Along both journeys she can provide relaxing and restorative massage treatments. She is also a loving wife and mother to two young girls.

pregnant tummy with question mark post-it notes childbirth education melbourne

The mine-field of the Due Date

Due date: estimate of when a baby will probably not arrive.

Due dates. Family, friends and strangers alike will all be asking during your pregnancy: ‘what’s your due date?’ But did you know that only about 4% of babies are born on their due date? Some babies come a little earlier, some come a little later, but they all eventually come out!

Did you know that a 19th century ‘rule’ is used to estimate your due date?

It’s called Naegele’s rule: Take the first day of an expectant person’s last menstrual period, add a year, subtract three months, and add seven days. Crazy huh? But there is one massive assumption made when using this rule; that the birthing person has a 28-day menstrual cycle, with ovulation on day 14. But in reality, cycles range anywhere between 21 and 35 days. Add on top of this that babies don’t know about months and days, and ultimately, it’s a very inaccurate way of estimating when a baby will arrive.

On a related note, do you know the difference between pre-term, term and post-term gestational ages?

Pre-term: Born on or before 36+6 weeks
Term: Born anytime from 37+0 weeks to 41+6 (that’s a 5 week swing!)
Post term: Born after 42+0 weeks

But, due to the inaccuracy of the due date estimation, you can have a baby born at 37 weeks who looks skinny and premature, and another baby born at 36 weeks could looks fat, healthy and full term.

When it comes to inductions, if you do not have a medical reason to be induced, it’s best for your baby’s development that you wait for labour to being spontaneously until you are 42+0 weeks (and even then, you can choose to decline). If your care provider is pushing to induce you earlier without a medical indication, ask the BRAIN questions, ask for a second opinion, and be confident enough in your body to say ‘no’ if needed. You can say no to any procedure or intervention offered to you at any time if it doesn’t feel right for you. It’s called informed consent/refusal. 

If you’d like to know more about your rights as a birthing person, understand more about where the pros and cons start with and end with any labour option, and so much more, consider doing a Lamaze Childbirth Education class. I hold mine privately with each couple/family, at a time and location that suits. Contact me to find out more.

Rachel Angelone is the founder of Your Birth Your Baby and is a Lamaze Certified Childbirth Educator, Postpartum Doula and NurtureLife Pregnancy Massage Practitioner based in Melbourne. Rachel offers independent childbirth and early parenting education to pregnant families before baby arrives. Once your baby is Earth-side, she offers practical and emotional in-home support as you adjust to your new life as parents. Along both journeys she can provide relaxing and restorative massage treatments. She is also a loving wife and mother to two young girls.

woman having a dentist checkup

How to Take Care of Your Gums During Pregnancy and Why It’s Important

This month I’ve got another guest blog for you – Dr Amanda Tavoularis has written a post on oral health during pregnancy, and why it’s important not to neglect this area of your body!

Dr. Amanda Tavoularis (dentably.com)

When you become pregnant, it can be a very special time as your body changes and prepares to bring a new life into the world. While it’s important that you remain as healthy as possible for yourself and for your baby, many women can develop inflammation of their gums, or gingivitis during their pregnancy. This is often referred to as pregnancy gingivitis and happens because of the changes in hormone levels.

Gum disease can result in premature births, so it’s important to be aware of this disease and take care of your gums to help prevent this disease. In a study conducted in the postnatal ward at the Women’s and Children’s Hospital in Adelaide, most women were aware of dental disease, but over 80% of women surveyed were not aware of periodontal disease!

I have been practicing dentistry for nearly 20 years and have worked with women on prioritizing their dental health during pregnancy so they can carry their baby to term. Oral health issues can worsen quickly, especially if women are unaware so, it’s important to take proper measures in preventing and treating them for the safety of you and your baby.

1. Dental Visits Are Vital for Gum Health

It’s important to continue regularly visiting your dentist during pregnancy to try and prevent gum disease. Professional dental cleanings are more important during your pregnancy and are essential to preventing tooth decay and gum disease. Your dentist can also evaluate your periodontal health so you both can work together to decrease the chance of adverse pregnancy complications. Let your dentist know that you are expecting, and they will be able to accommodate to your needs.

2. Seek Treatment Immediately

If you’ve been diagnosed with gum disease or believe that you may have it, it’s important to seek treatment quickly to prevent potential preterm labour. Research has shown that there is an association between gum disease and adverse pregnancy outcomes such as low birth weight and premature births. According to the Australian Dental Journal, a recent study found that, “Women with prenatal loss due to extreme prematurity were more than four times as likely to have periodontal disease, compared to women with full term, live born infant.”

The cause is most likely because the bacteria from gum disease can attack the ligaments, gums, and bones surrounding your teeth to create infected pockets similar to large infected wounds in the oral cavity. These pockets can provide access to your bloodstream and allow bacteria to travel throughout your body, down to the uterus and placenta.

Visiting your regular dentist is the best way to treat your gingivitis or gum disease. Most doctors recommend waiting until your second trimester before receiving dental procedures. Your dentist will give you a deep cleaning to get rid of plaque and build-up that’s contributing to the disease. If your gum disease is severe your dentist or doctor may prescribe antibiotics to help combat the infection. Your doctor will know which medications are safe for you during your pregnancy but be sure to let them know of any allergies that you have.

3. Maintain a Healthy Dental Care Routine

Finally, be sure to continue an effective dental care routine during your pregnancy to help prevent gum disease and gingivitis. Good dental hygiene consists of brushing twice a day, flossing once a day, and using an antimicrobial mouth rinse. Another great way to keep your mouth healthy during this special time is to avoid sugary foods. Excessively eating foods high in sugar can lead to tooth decay and gum disease, so try incorporating more vegetables, lean proteins, and nuts and seeds into your diet to help prevent any disease. 

It’s important that you take precautionary measures to make sure your mouth is as healthy as possible for you and your baby because premature births are more common in mothers with poor dental health. Regular dental visits, seeking treatment, and continuing a good dental care routine the best ways to help prevent gum disease. Remember to enjoy this time in your life and embrace the changes happening to your body.

The toughest thing.

The toughest thing you’ve ever been through, is the TOUGHEST thing you’ve ever been through.

I remember hearing this in high school. It clearly stuck with me, as things that seem so obviously true often do, and I’ve thought of it often since then.

There is no point in comparing your own struggles with someone else’s. We all have different cards to play in life, and we all have different perspectives on those cards. But if the hardest thing you’ve ever faced is the not getting into the university you had your heart set on, and someone else’s is cancer, that doesn’t make your struggle less relevant, or less important. It’s the toughest thing YOU have ever faced. It’s your measuring stick. That’s not something to be embarrassed about or shamed for.

It may sound like what I’m saying is the old ‘don’t compare your life to others’, ‘the grass isn’t always greener on the other side’ etc. All that is true, but really what I’m really trying to get at is to not diminish your own experience just because it’s not as ‘big’ as someone else’s. If it’s the hardest thing you’ve ever faced, then it’s no small thing for you. And if anyone makes you feel like it is a small thing, you might want to consider pointing this out to them.

To bring all this back to pregnancy, babies and parenting, it doesn’t matter what ‘type’ of baby you have, what your birth experience was like, whether this is your first or third or sixth baby, it’s all hard. Just because someone’s baby doesn’t have silent reflux, or a tongue tie, or whatever, doesn’t mean a new parent has it easy. All babies are hard work. Learning new skills like parenting and breastfeeding are hard work. There are tough days. Some days might be the toughest you’ve ever experienced, and that’s ok. You don’t have to pretend to love every minute. You’re still a good parent.

Rachel Angelone is the founder of Your birth Your baby and is a Lamaze Certified Childbirth Educator and Postpartum Doula based in Melbourne. Rachel offers independent childbirth and early parenting education to pregnant families before baby arrives. Once your baby is Earth-side, she offers practical and emotional in-home support as you adjust to your new life as parents. She is also a loving wife and mother to two young girls.

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