Should you delay cord clamping with a c-section?

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Remember life before pregnancy?

Sure, you had choices to make, big ones like whether or not to change job or whether or not to move flat, and smaller ones like where to grab dinner or whether or not to get those jeans.

And some of those choices were tough, I know. But most often, the only person impacted by your choices was you. And maybe your partner.

Enter pregnancy – and everything changes, right?

Suddenly it feels like you are making difficult choices daily; choices that will impact you and your beautiful baby. So I want to help you out with one of them.

When should you cut or ‘clamp’ the umbilical cord once your baby is born?

This is a choice you don’t want to make whilst you are lying in theatre – it’s a choice you want to make and discuss with your caregivers way before the day of your c-section.

So why should you even care about this?

Historically, the practice of clamping baby’s cord has taken place within seconds of baby being born and evidence shows that this might not be great for baby. This is because a whopping one third of baby’s blood is still outside of their body at the moment baby is born. The blood needs time to make its sweet way from the placenta to baby.

Yikes – that’s a lot of blood left in the placenta, I know, and once the cord is clamped, that blood is blocked from moving to your baby, where it is supposed to be.

Modern practice is moving towards ‘optimal’ cord clamping. This is the practice of leaving the cord unclamped for the most time possible, based on a medical assessment of you and baby. Usually this would mean waiting at least a minute. But whilst practice is moving that way, it’s still a discussion you will want to have with your caregivers. You want to be sure you’ve got all the facts and you are happy with how the cord clamping goes down on the big day. It’s your birth experience and it is super precious, after all.

What does the evidence show?

Evidence shows that optimal cord clamping has advantages for your baby including higher birth weight, early haemoglobin concentration and increased iron reserves for up to six months after birth. Some sources report benefits reaching even further into childhood. High fives to all of that!

Small studies have reported that delaying the cord clamping can lead to a slightly higher risk of jaundice, but there is strong evidence that shows that the benefits of optimal cord clamping outweigh the small risk of higher levels of jaundice.

As with every birth choice, it is so important to talk with your caregivers about the pros and cons of ‘optimal’ cord clamping in the context of your specific pregnancy.

Here are some questions you might want to ask:
  • Can you talk me through the benefits and risks of optimal cord clamping?
  • What can you offer to support me in waiting to clamp my baby’s cord at the optimal time?
  • How will you assess when the cord needs to be clamped?
  • What kind of situation would mean that the cord would get clamped immediately after birth?
  • Where will my baby be placed whilst the blood is moving from the placenta to the baby?

You might also want to ask about ‘milking the cord’. That sounds gross, I know. Milking, or stripping, the cord is the practice of manually moving the baby’s blood along the cord to speed up its journey to the baby. There is little evidence available around the pros and cons of doing this, so open up the conversation with your caregivers and decide what is right for you.

Asking questions like these upfront during your antenatal care is a great tool to get you to a place of knowledge and power.

I have a vision of a world where every mother and birth partner come away from their birth experience feeling heard, cared for, respected and valued. ‘Healthy mum, healthy baby’ is not all that matters. Those are the minimum outcomes we should be striving for. We should be aiming much higher and I believe this starts with making informed choices about birth.

I want to support you in making the birth of your baby the most empowering experience you can ever imagine. Please check out the next Birthsure course dates to jump onboard.

The simple way to keep calm for your c-section

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I recently subscribed to one of those food recipe subscription boxes. I needed inspiration in the kitchen. Nine weeks into lockdown and there was only so far I could stretch my culinary repertoire. It had the tagline ‘’Healthy meals in under 30 mins – all ingredients delivered to your door’’ – It sounded like just what I needed.

I’m not going to bore you with a step by step account of what happened in the kitchen that evening – but just know that 30 mins turned into 90 and I was cursing each and every one of those damn tiny sauce sachets I had to open. And the worst part? The food wasn’t even nice. All that effort and drama for a mediocre outcome.

I thought to myself – the simple things in life really are the best. You just can’t beat a beautiful Italian spaghetti with simple tomato sauce. 

And when it comes to tools to calm your mind for birth, the best tool of all is by far the simplest. So simple that it sounds like it could never make a difference. But it does. A massive one.

Which tool is it? Breathing, my friend. 

The simple act of breathing releases the hormone Oxytocin, the feel-good hormone that has got your back when you need to feel calm. You want to get that good stuff flowing in every single vein all over your beautiful body.

Let’s try this…

A long, slow, breath in through the nose and an even slower, long breath out through the mouth. Just in and out, naturally, calmly. Take as long as you need – there’s no right or wrong amount of time the breath should take.

Just slowly breathing in and out. Close your eyes and let the breath take you to a gorgeous world of calm. If you want to, try saying a word to yourself as you breathe out. Maybe say ‘calm’, ‘peace’ or ‘relax’. Whichever word works for you.

Just as a simple spaghetti works so well paired with a delicious tomato sauce, breathing pairs so nicely with visualisation. Close your eyes, breathe in and out slowly, and picture in your mind a place of calm and peace. Somewhere you feel really safe and at ease. 

I guarantee that after 15 or so breaths, you will feel the benefit. So… when should you use it?

Literally whenever and wherever – during pregnancy, giving birth, being a parent, returning to work, losing your mind during lockdown  – this tool is yours for life! Here are some ideas. 

Before an antenatal appointment – couple it with the word ‘confidence’.

When you’re about to have your anaesthetic before your caesarean – couple it with the word ‘calm’.

When you’re feeding your baby – couple it with the word ‘capable’.

If your baby won’t sleep  – couple it with the word ‘patience’.

Before meeting your boss during maternity leave – couple it with the word ‘strength’.

So here’s a high five to ditching the recipe boxes and celebrating the simple. Let me know in the comments if this breath works for you and remember to join the conversation on Instagram @birthsure

Sending love as always for the week ahead.

Do I really have to plan for a c-section?

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I heard a Mary J. Blige song on the radio the other day – No More Drama. Remember that one? What a tune!

It’s one of those tracks that takes you right back to the moment you first heard it and gets you thinking about what you were doing that year.

Well back in 2002, around the time that song came out, I was packing for my upcoming girls’ holiday to a place where the bodies are bronzed, the parties are loud and the vibes are good. Yep, you guessed it – Ibiza.

My thought process went something like this…

What should I take – I mean, I need at least three pairs of stilettos. Actually probably four. Then maybe some wedges. And also a couple of pairs of platform boots (they were still a thing in 2002!). I need a short black dress for the clubs, a mid-length for dinner and probably a long-length for the café scene. Maybe I should take white ones too. Just to be sure. You never know how you will feel on the day, right?

And I’ll need a cute jacket in case it’s chilly and maybe some jeans. I’ll just pack all of my swimwear – I’m pretty sure I will want all of it. I need all the sun creams – factor 30 to start, factor 50 in case I burn, factor 15 for a week in and some oil to finish (oh how I wish I could tell my younger self not to take the oil!!).

You see, I liked to plan out the outfits and take into consideration all eventualities. Taking so many pairs of shoes was just prudent planning in my opinion.

So what really gets me is this. How can someone who has 15 back-up outfits organised for a girls’ trip (me!) be the same person who doesn’t plan for a c-section when pregnant? (also me!). And I know this applies to a lot of ladies out there.

Just as I wasn’t expecting cold weather during an Ibizan summer, I took the jeans anyway. I was prepared for anything. 

But when it came to my birth planning, probably the most important planning you can do in your life, I didn’t plan for what I would like to happen if I needed a c-section. And guess what, friend. I did end up needing a c-section.

Without having done the prior thought and preparation, the experience was less than peachy, I’ll be honest. Kind of like arriving in Ibiza without any suitcase at all.

My second pregnancy was different. I had discovered c-section birth preparation and knew that I had an entire ‘suitcase’ of tools to help me stay cool, calm and collected. The birth, this time a planned c-section, was a positive, joyful experience and I have the right c-section preparation to thank for that.

So don’t be that girl who has a burn mark in the shape of a t-shirt at the airport. Don’t be that girl who has blisters all over her feet from that one pair of stilettos. Get yourself prepped right!

Please hop on over to the BirthSure Courses page to sign up to our next c-section prep course. I’ll see you there!.

What will my c-section feel like? Will it hurt?

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What does a c-section feel like? Does it hurt?

I’m a big fan of the TV show, First Dates. I lap up that feeling of anticipation as the lady sits at the bar waiting for the guy to arrive. Will he be funny? Will he be smartly dressed or maybe more low-key? Will he talk about his ex the entire time?? 

Her high heels tap nervously on the bar stool. She glances towards a reassuring Fred. (Fred is the best, isn’t he?)

Imagining what your c-section will be like, is kind of like that, only 1000 times more. The anticipation! The unknowns!

How will it feel?? Will it hurt??

Well, my dearest, I’ll tell you. 

I hadn’t planned for my first c-section, and so most of the wondering about how it would feel happened as they wheeled me into theatre. That was a lot of wondering to cram into 30 mins. 

By the time I was there, I was already numb to levels I didn’t know were even possible (I had had a lot of epidural, like, really a lot!). I could feel very little aside from my face.

(Epidural numbness even on its own is a strange sensation – like when the dentist numbed your gums that time, except now it’s all over your body). Weird, yes, but numbness is what you want before a surgery! You will definitely have anaesthetic too, don’t worry.

Even though I was numb everywhere, I remember lying there and a feeling almost like someone drawing on my tummy with a pencil and then, as my son was born, a strong feeling of pulling and tugging on my abdomen – strong enough to shift my body back and forth a little on the bed. Think of it like someone has tied a rope to your tummy and is yanking it this way then the other. Not painful, just a very surreal tug-o-war on your tum.

The room was pretty cold also. To be honest, I’m one of those people that feels cold during an Italian summer, but that draughty hospital gown is another level of ‘not at all cosy’.

It was also pretty uncomfortable in general. There were wires here, there, everywhere. I was hooked up to a few different monitors and fluids. The bed itself was hard and the lights and sounds were harsh. There were a lot of people checking, monitoring, operating, checking again! Let’s face it, it was no night at the Ritz.

Then, there were the emotions. So many feelings all pulsing through me at once. Overwhelm – yep! Worry – yep! Excitement – yep! Tearfulness – yep! Fear – yep! Gratitude – yep! Tiredness – yep! Anticipation – yep, yep, yep!

They say ‘a healthy baby is all that matters’ and of course, a healthy baby is crucial. But even though my son was born healthy and I was super grateful for that, the whole experience took me some time to process. I simply wasn’t prepared for it. I had no tools to help me deal with the physical or emotional side of the birth or the recovery and neither did my birth partner. 

Fast forward to my second birth, this time a planned c-section. This time I was prepared. Not just because I had had a c-section before – that experience alone wasn’t going to help me navigate an entirely different pregnancy and birth.

I had discovered hypnobirthing and positive birth prep and the amazing tools they offer in making c-sections positive, empowering and yes, actually enjoyable! I had done my research on whether a c-section or vaginal birth was right for my unique pregnancy, I had had meeting after meeting with my care providers, using all of the hypnobirthing tools to get the right information.

As with everything in life, the right prep pays off, my friend. You wouldn’t rock up to a client presentation without having prepared, and it wouldn’t be the smartest idea to do that with birth either. Take it from me – I learnt the hard way!

The experience of my second c-section was a world away from my first. All that prep under my belt, I felt confident and reassured. I knew my rights, my choices and the impact of my decisions. I had a ginormous tool box at my disposal for decision-making, keeping calm, keeping comfortable, keeping informed and keeping in control. I was in my happy place for this birth and so was my birth partner.

So if you’re reading this and are wondering what your planned – or even unplanned – c-section will feel like, check out the BirthSure FREE GUIDE to cesaerean birth ’10 things no-one tells you about your planned (or unplanned!) c-section’. Download it for free now!

Anxiety, overwhelm, guilt? Mood swings and meltdowns? Why postnatal emotions and the pandemic lockdown have more in common than you think…

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Yesterday was not a great day for me, I admit. It was week five of lockdown, gone midday and I wasn’t even dressed. I wasn’t even thinking about getting dressed. Rock bottom levels of motivation, sky high levels of anxiety and a complete absence of ‘me’ time creating a perfect storm for a mini ‘self-isolation meltdown’. Still too early for wine, even by my standards, so an entire pack of kitkats would have to do. Not a pretty sight.

It’s hardly news that self-isolation is putting a huge strain on everyone, but who knew how dramatically my emotions would swing from

‘I’ve got this! I’m a superwoman!’

to

‘aagghh help me; I literally cannot cope!’. 

It’s a vast and unpredictable daily spectrum at the moment; overwhelm, anxiety, guilt, joy, gratitude and hope – and it’s anyone’s guess which emotion will arise at any point. A supersize emotional lottery, right? Exhausting.

I feel pretty bad to make the comparison, but it actually reminded me of how I felt when our first son was born by emergency c-section (in the time before I’d discovered hypnobirthing or knew about positive caesarean birth prep).

Those first few weeks at home brought a range of feelings. 

I remember the overwhelm of clumsily grappling with the demands of a new baby (I’ve always been a 10 hours sleep kinda gal!) and the anxiety that he wasn’t putting on weight (no one told me that motherhood brings with it a life-long obsession about what your kids eat).

I remember the sadness I felt that the situation wasn’t as perfect as I had planned and then I piled a whole load of guilt on top – just for good measure. 

A bunch of pretty rubbish feelings – and mostly I told no one about them.

And then, mixed in with all of the blues were the absolute highs – so much joy and gratitude to have our little man safely at home and so much love for that tiny new person. Like, insane amounts of love.

Also, a hope that every day would get easier.

And you know what, my friend, it did. Every day was a small but mighty step forward in the right direction.

It did get easier, and it absolutely will for you too.

The days of new motherhood can sometimes seem longer and tougher than that 10k run you did absolutely no training for. So with a pandemic turning up the volume on all of these emotions, new parents everywhere are doing an extraordinary job and I want you to all high-five yourselves immediately. You absolutely rule and I have so much respect for every single one of you. 

Today, 12 kitkats down, I’m feeling hopeful, just like I did when my first son was born six years ago.

I’m know that better days for everyone are right around the corner. One day at a time we will all get there and I’m here right beside you, cheering you on.

So, tell me, how about you? How are you feeling? I’d love to know how you are and what have been your highs and lows of new motherhood during a pandemic. Comment below or join the conversation on Instagram @birthsure.

**RESOURCES**

Here are some resources that can help if you do feel it’s all getting too much or if you feel you might be suffering from postnatal depression.  It can feel incredibly daunting to raise your hand and ask for your help, I know, but early support is really important. Know you are not alone.

GP, Obstetrician, Midwifery and Health Visitor Services: they can organise the right support for you and your family.

Perinatal Positivity: https://perinatalpositivity.org/

Best Beginnings: https://www.bestbeginnings.org.uk/out-of-the-blue

PANDAS Foundation: http://www.pandasfoundation.org.uk/

Action on Post-Partum Psychosis – https://www.app-network.org/

Association for Postnatal Illness: https://apni.org/leaflets/post-natal-depression/

PND and Me on Twitter: #PNDHour

How to feel calm during labour…and what the Real Housewives have to do with it…..

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The Real Housewives of... Labour and Birth

Say what? Oh yes, your guilty pleasure TV is going to change your birthing game…for the better

How often do you think about your brain? That beautiful brain of yours does so much, and yet you pretty much never think about it. Maybe aside from the times you thought it was literally going to explode from a hangover (remember those days?).

But here’s the thing – your brain is SO important during childbirth, whatever type of birth you have – vaginal, instrumental, c-section – all of them. And this is why, my friend…

Think of your brain as having two states, like, two ‘ways of being’. The first one is your cool, calm, collected state. Your every day, happy state. Think about how you feel when you are sitting on your sofa, eating popcorn, watching Real Housewives. In fact, let’s call this your ‘Real Housewives’ state. When your brain is in the Real Housewives state, it produces Oxytocin – the happy hormone. The hormone of love, fun and feels.

Now think back to that time you were running late for that mega meeting with your boss, the printer was jammed and you spilt coffee all over your notes. Gahhhh! Think stressed, jumpy, anxious as hell. Let’s call this your ‘spilt coffee’ state. In this state, your friend Oxytocin is nowhere to be seen. She is outta there! Instead now your brain is sending adrenaline all over the shop. 

So why should you even care about this? Well, it’s simple. Your birthing body needs Oxytocin. Oxytocin helps to make all the labour cogs turn more efficiently and comfortably. Adrenaline, on the other hand, messes with those birthing cogs like damp weather messes with your hair. No-one wants that.

OK then, jeez, Alex, just tell me what I need to do to get my Real Housewives state on, I hear you say.

Luckily, there is loads you can do and here is a quick-fire snapshot of just some of the ideas we go through on a BirthSure hypnobirthing course. It all boils down to you feeling safe, unobserved, comfortable and calm. Here are some top techniques for each…

I wanna feel safe!! 

Of course you do – that’s nature’s way. Feeling safe is a must. Asking your caregivers plenty of questions will help you make decisions you are happy with and boost your sense of security and confidence. And remember, lady, no-one has the right to perform any kind of procedure on you unless you give fully informed consent (more on this one in an up-coming blog). It’s your birth and you are in the driving seat.

I wanna feel unobserved!!

Have a little switch around of your birthing environment if you want to – dim the lights, move the bed out of the middle of the room, make it clear in your birth plan that you don’t want folks wandering in and out of your space and they defo shouldn’t be asking you 20 questions when you’re ‘in your birth zone’. 

I wanna feel comfortable!!

Work with your body during labour. Listen to it and move in whichever way feels natural. Keep gravity and an open pelvis on your side and have a play with a birthing ball or birthing mat. Use water if that makes you feel good – if you can’t get your hands on a birthing pool, try a bath, shower, foot bath or even good old hot water bottles. If you’re hooked up to a monitor, ask your caregiver if it’s even necessary and if there are alternatives, like wireless monitoring, for example.

And breathe!! You’ve gotta breathe to get that in the Real Housewives state. Slow breaths in, slow breaths out. Super important. More on breathing in an up-coming blog.

I wanna feel calm!!

Bring out all the feel-good vibes. Music, soppy movies, affirmations, hypnobirthing audios, gorgeous smells, your own pillow, meaningful photos. Surround yourself with lovely things that make you feel like the birthing goddess you are. If you’re having a c-section, ask your caregivers about ‘gentle’ or ‘mother centred’ cesareans and really make the environment your own special little place.

And my top tip – get your visualisation game on. Close your eyes and let your fabulous brain take you off on a journey somewhere amazing. Somewhere you feel safe, unobserved, comfortable and calm. It could be as fancy as laying on an exotic beach, or as familiar as a cappuccino in Gail’s. That’s the magic of it, you can be anywhere.

Check out the BirthSure guide to Giving Birth During a Pandemic for techniques to navigate birth during Covid-19. You can find it on the website pop up.

Keep subscribed for more pregnancy, birth and parenthood nuggets and follow @birthsure for my latest course dates, oh and pretty pics of babies!

I believe in you – you’ve got this, Momma!

Sending love,

Alex xx