Monday, January 25, 2010

What should we eat in pregnancy?

or the other question, what should we not eat?

I often counsel women to eat well. Eat the best food you can access.

Here's a blog with some good advice. (BTW I have no idea what link there is between phlebotomy - taking blood from veins - with a healthy diet in pregnancy.)

It's a good list. You'd have to be a pretty fussy eater not to be able to satisfy yourself from this.

Have a look at the list, and let me know if your favourite is not included. One I would add is dates. They are good, and take care of sluggish bowels at the same time. Anyone watching sugar intake would need to limit the number of dates you eat: they are very sweet.

You may also enjoy checking out the Food Standards Australia and New Zealand (FSANZ) website page Thinking about getting pregnant in 2010 – vital information about what's good to eat and drink.

Also the brochure
and the web videos
and translations

Monday, January 11, 2010

Babies who need to be born at night

I was heading West along Burwood Highway in the morning traffic at about 8am, coming up to Springvale Road about 5 minutes from home when the dreadful realisation hit me in slow motion. I was heading for a post.

A near miss, I am thankful to report.

But this is an experience which is an integral part of the life of any midwife who accepts the need of women in her care to come into spontaneous labour, at any time of the day or night. The small number of midwives who practise privately in my part of the world, and the small number of women who plan homebirth, adds distance to the midwife's work terrain. A midwife has to accept travel: our 'village' is a virtual space that links the homes and lives of our clients with our own.

Those micro-second sleeps can kill. The risk potential is increased by the fact that I have a bottle of oxygen in the boot of the car, and other road users could also be at risk of fire in a collision.

The scenario about which I am reflecting now had several points of increased risk that were specific to this particular birth: I had been called out before midnight, and the mother had given birth around 5 am. The home was about 50 minutes' drive from my home. I followed my usual precautions for driving after a night's work: slowly eating an apple to keep some energy going into my body; listening to the radio; having the fan blow on my face ... After the 'scare' I phoned Noel and we talked until I drove into our yard.

I have no way of predicting which mothers will labour and give birth at night, and I discourage my clients from trying to 'know' this. One mother told me her five children had all been born in daylight hours. Her sixth was not!

This risk of falling asleep at the wheel is not about private practice or home birth. I remember a similar near miss about 25 years ago, when I was driving home after a night shift at the Women's hospital. That experience prompted me to explore ways of keeping my mind active and functioning when driving home after a 'night out'.

What have I learnt from this experience?

When I encounter combined risk factors of distance and sleep deprivation after a birth, I will consider other ways of getting home. This could include a taxi, or another person (who has slept the night) driving, or finding a place to sleep for a few hours before heading home.

I hope this post supports other midwives in their own understanding of our work, and planning for our own safety as well as that of mothers and babies in our care.

Sunday, January 03, 2010

"We are dealing with human biology, so ...

... inevitably things will not always go to plan."

This statement is attributed to Professor Euan Wallace, head of obstetric services at Southern Health (Melbourne) in a recent special report, 'Birth Pains' in the Age.

This seemingly innocuous comment by a respected obstetrician is in fact a significant example of a major difference in the philosophy of obstetric/medical maternity care, compared with midwife led maternity care.

It's an interesting perspective.
"inevitably" - there's nothing you can do about the inevitable
"things will not always go to plan" - nothing specific to human biology there!

My comment would be, "We are dealing with human biology (in birth), so our skills and systems need to be finely tuned to working with, and not against, the natural physiological process."

Medically managed maternity care treats the birthing woman+child as a potential disaster area. Strict surveillance is relied upon, using technology rather than 'fallible' human feelings. As the woman was told in Monty Python's classic 'The Meaning of Life', she can't do anything, because "You're not qualified."

It is no wonder, under these conditions, that human biology in childbearing can not be trusted.

The midwife who is skilled in promoting and protecting normal physiological (biological) processes in the birthing continuum engages in a partnership with the woman+child/ mother+baby, and seeks to work in harmony with human biology. This midwife knows that on occasion "things will not always go to plan-A", and has plan-B within reach. But the midwife does not have a defeatist attitude: there is nothing inevitable at all about the change of plans from A to B. That's just the way it works.

In childbearing we are dealing with human life, at its most basic and most rewarding.