Common Pregnancy Questions, Part 1

Nina Sebastiane: Pregnant women have thousands upon thousands of questions about their pregnancy. Will it hurt? How much will I scream, what if get to the hospital and I am too late, I have had the baby. Here at the baby channel, we've teamed up with some top midwives to answer all of your pregnancy questions and concerns that Claire Wood from the Queen Charlotte hospital, London has joined me in the studio. Welcome Claire. Claire Wood: Okay. Nina Sebastiane: Now you've been a midwife a few years now. What's the sort of biggest fear do you think that most pregnant women have about having a baby? Claire Wood: I think it is almost always how much it's going to hurt. I think that's their biggest fear, putting aside every pregnant woman's desire to have a normal healthy baby, which is almost taken as red. I think after that they worry about how much labor will hurt. Nina Sebastiane: And what you tell them? Claire Wood: Well, I think that's the big challenge for the midwife to reassure women about labor and their own ability to cope with labor. And that's not something that you can do overnight. I think that's a process that goes on throughout antenatal care in terms of preparing women for what is undoubtedly and enormously stressful physical and physiological event. But reassuring them that, it is something that they are equipped to do. Nina Sebastiane: Yes we have been doing it for millions of years that for don't worry about it will be fine. Claire Wood: Yes, absolutely. But at the same time not trying to hoodwink, I mean to thinking that, well, you're not and feel the thing because clearly that's not the case - it's important to manage their expectation realistically. Nina Sebastiane: Well, I remember with my first birth, I have this list as long as my arm of stuff I needed to take to the labor ward with me. And now with the second pregnancy, I've gone through the old list printed of the computer. I just laughed to all the things that I can ignore. What would you say to somebody getting that list ready? Claire Wood: I think very much what you've said, don't take too much in because you won't need that much. Nina Sebastiane: I had books, hot chocolate, little stereo to listen some music, some candles and I thought, when on earth would I have had any chance to use any of these stuff. Claire Wood: Yes, I think it very much depends what sort of birth you are planning and clearly, you might be making different preparations depending on whether you are hoping to have a water birth or whether you for another reason brought to an electric caesarean section. So it will depend from women to women but I think it's better to aeromassage if less is more. Nina Sebastiane: Now you are coming from a midwifery-led background. You know, how important do you think if you are going to that environment, is it to have a birthing plan? Claire Wood: I think a birthing plan is very useful for everybody concerned, not only for the women but also for her partner. I think it is very important for the women and her partner to have a clear understanding between them or what their expectation are from this event and particularly, for the partner who can feel quite just enfranchise from what's going on because he is not experiencing the pain and he can't do anything about it and he is not having the baby. It can fell quite left out to the process. It's also very important for the midwives or the caregivers who ever they are, to understand what the woman's feelings are about different scenarios that might arise in Labor. So I think a birthing plan is very useful. What I'd say is that there is enormous potential for disappointment with birthing plans if they are too prescriptive because labor is an unpredictable event and if women are very wedded to certain aspects of their birthing plan, there is always a potential for disappointment. Nina Sebastiane: I mean I remember going in as you are saying into my labor, thinking -- I am fairly flexible if I do - one of the things that came up. I had my child at the Royal Free and they had a birthing pool there. And I was thinking, well, I would like have a water birth if it works, hope that would be great. But if it doesn't, I am not going to built my hopes upon it and actually, within that whole labor experience, I was in the pool and then out and then in again and then it all worked out fine. But for me it was kind of the not been completely fixed upon one idea, I am just running with whatever the midwife was guiding me towards. Claire Wood: Yes I think having an open minded approach like that is very sensible. It's a good idea I think in constructing a birthing plan, probably to talk to your midwife during pregnancy, so that you can discuss some of the options and some of the scenarios that might arise and why certain things might not be possible or advisable or why things may change on the day. I think you always worry when you see women coming in with a birthing plan that is specific down to the kind of drug they would like to use, if they feel sick or something. Nina Sebastiane: But then you'll start worrying. Claire Wood: Yes, well, it's just that I think then they are perhaps expending too much mental energy, worrying about very small details rather than focusing on their own ability to get through the labor. Nina Sebastiane: Well, let's talk on that because that's a very interesting thing. We do get so wrapped up with kind of what's going on around us and so on, you know. Is that something that passes a good piece of advice for somebody about to have a baby or going through labor, which is probably should be focusing internally. I don't know I mean - in hospitals, for example, there is so much else going on, there's machinery, there's doctors, there's nurses, is that something that perhaps we should really don't worry about. Claire Wood: No, I think it's important to remember where your surrounding are going to be and prepare yourself for the kinds of things that you have described to which is doctors and technology, and people buzzing about and so and so. Yes, you need to have a realistic sense of what the birthing environment is going to be. It doesn't need to be a very stressful birthing environment and in the unit, where I work, we don't have machinery and we don't have medical staff present unless we need them. So, it doesn't necessarily have to follow the sort of course you have described. But I forgot what the question was, sorry. Nina Sebastiane: No, but don't worry because I have got tons more to ask you. I have got a few here that basically are the kind of questions that a lot of moms, you know, moms to be that are going to be worried about and we have collected the most. I am going to run through a couple with you. Claire Wood: Oh, is about focusing on yourself, wasn't it? Nina Sebastiane: Well, yes, but I think the more important is the kind of questions that I think a lot of women who are about to go through the whole labor process is I have got one here, I am embarrassed that I might go to the loo when I pushing my baby out. That's a genuine concern, I know I have that concern. What would you say to somebody with that kind of worry. Claire Wood: Yeah, a lot of women do express that anxiety, it tends to be in labor that it dawns on them, or somebody has told them and they remember in labor that there is a possibility. And yes, lots of women, almost majority of women to some extent will empty their balance a little during labor -- at the end of labor as more as the baby has been born, it doesn't happen that you are in Labor. I can understand why that is the most terrifying prospect for some women who see that as a sort of complete loss of their dignity at that moment. Particularly, with their partner present. From the midwife's point of view, no problem, we are well use to that. Nina Sebastiane: No problem - you know what there is progress something is happening. Claire Wood: Well, yes, and I always remember a colleague of mine who use to say, oh, well, I always like that smoke because it means that the baby is coming. Nina Sebastiane: Really. Claire Wood: She just says that in quite a graphic ways of reassuring you that is a sort of normal and natural thing that is suppose to be happening. Nina Sebastiane: Yeah. Claire Wood: But that doesn't necessarily make any easier for the women to come to terms with what's happening and perhaps what she sees as a sort of lots of control, over her bodily functions that she is not used to. Nina Sebastiane: But isn't it almost the lost of control that is at her final stages of having a baby? Isn't it almost kind of almost giving in and just letting things take over? Claire Wood: Yes, I think so, I mean, I think it's important to the women to listen to their body if that's not a terrible clay shaped but to really try tuning to what their body is telling them and the more we interfere with that communication between a woman's body and her brain if you like, the more we interfere with that then I think the more you see labor going off the rails. Now occasionally, interventions are necessary some times they are necessary for different reasons, but on the whole when we allow labor to progress in a way that a woman is able to know what her body is telling her. Even if it's her first baby, then the better be results really and more satisfying for her. Nina Sebastiane: I've got another one that I am sure that's a common concern which is I am worried about tearing and having to have an Episiotomy, is there anything I can do to prevent it? Claire Wood: Ultimately, I don't think there is anything that you can do to absolutely guarantee that you either will not need an Episiotomy or won't tear. I think probably nowadays it's fair to say most midwives will view Episiotomy as a last result and only perform it if it's absolutely necessary. Tearing is a little more difficult to predict because it's very dependant on the woman herself. There are different ethnic groups that are more predisposed to perennial tear. Nina Sebastiane: Is that so? Claire Wood: Yes, the nutritional status of the woman may have a bearing on how like she is to tear different positions can influence perineal trauma, the size of the baby, how fast the head comes so its multifactorial. So there is nothing you can do it to say, well I am going to prevent all of that. There are things that you can do to minimize the risk, antenatally perineal massage is thought to have some influence on the state of perineum at the time of birth. Nina Sebastiane: Perineal massage for those who aren't sure is essentially moisturizing all of the perineum and the area within. Claire Wood: Yes, I think more towards the end of pregnancy is probably more value. Then during labor particularly, during the second set of labor as the baby's head is crowning, listen to the midwife. So that the moment where it's going to be helpful to not push any more really listen to the midwife and give the perineum time to stretch over the baby's head. But with all the best advice and support and management, if you like at that stage of labor, you can never say that can guarantee a woman but I think every midwife would do her very, very best to try and achieve an intact perineum folk for the women. Nina Sebastiane: Well Claire, we are running out of time there is just hundreds of other questions that we have got for you. So I am kind of hoping that we can bring you back to answer a few more them for us another time. But thank you so much for coming in. Claire Wood: Thank you. Nina Sebastiane: And you know, it's fascinating this to me, to what you have to say. Claire Wood: Thanks.