Induction For A Large Baby… if it’s not recommended by guidelines then why are so many women being offered inductions??
So, a bit of background… NICE guidelines state that women shouldn’t be advised to have an induction of labour for a predicted large baby, where there are no other factors to consider (such as diabetes).
Let me bust some myths for you about birthing a predicted big baby… ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
Your baby’s bones in its head aren’t fused. Baby’s heads are more like plates of the earth rather than one large bone. They are soft and can move to fit through your pelvis, called “moulding.” They can even overlap so that their heads are a smaller diameter.⠀
Your pelvis when pregnant can expand in diameter by up to 28%. Relaxin is a hormone that increases as you get towards your due date and is a right pain in the peach 🍑 for when you’re pregnant but, it’s very useful for birth. It’s like the WD40 for your joints and makes your screws loosen in your pelvis so they can accommodate your baby travelling through. See photo evidence of this below in the Rhombus of Michaelis (sounds super geeky right 🤓)
Scans are notoriously inaccurate for measuring size. They are beneficial for trends in growth rather than a one-off measurement. ⠀⠀⠀⠀⠀⠀
The next time a relative says “How you gonna push out that massive baby??”, you can reply, “🙄 Have you not heard of the Rhombus of Michaelis” followed by your best smug face 😏 ( or you can just think about these above points.) Either way, you’ll feel much better.⠀
So why do so many women with predicted large baby’s get offered inductions….?
There was a Cochrane Review that was published, (a Cochrane Review being a tip top piece of evidence as it looks at several pieces of evidence to find results) that found that for women who were predicted a baby over 4kg (women who didn’t have diabetes) were less likely to have shoulder dystocias if they had an induction compared to women who waited for labour to start spontaneously. (By approx 27 per 1000 births)
Percentage of women to have a shoulder dystocia when there baby was predicted over 4kg….
4.1% in the Induction Group
6.8% in the Waiting Group
So you can see that in both groups, it is a relatively rare thing to occur. The large majority of babies measuring big are birthed with no complications.
The reason why we want to reduce shoulder dystocias are because they can cause injury to baby in the form of injury to the nerves and lack of oxygen, both of these complications can lead to life long disability. And also fractures- an awful thing to happen to a baby but fractures heal, so don’t hold the same long term impact to a baby than the above nerve damage and lack of oxygen.
What was interesting about this Cochrane Review was although there were less shoulder dystocias in the group that were induced. There wasn’t a clear difference in the group between nerve damage or baby’s Apgar score or blood gases. Meaning that induction of labour didn’t appear to have any positive impact when looking at nerve damage and baby’s health at birth.
Induction of labour did though reduce fractures caused by shoulder dystocias by approx 16 per 1000 babies.
Percentage of fractures…
0.4% in the Induction Group
2% in the Waiting Group
On average, baby’s weighed 178g less in the induction group.
So what did the research say about the effects of induction of labour vs. Spontaneous labour for women.
There was no clear difference between the two groups of the amount of cesarean births or instrumental births. Both groups had a similar amount of both cesarean births and instrumental births.
Perineal tears were suggested to be more likely in the induction group.
The research didn’t look at Mums experiences or compare effects on mental health.
So, even though the guidelines don’t suggest to advise induction of labour for a large baby. A Dr, is bound by her duty to tell you about risks if you fall into a category (Montgomery Ruling) and then give you an option to have an induction if you’d like.
Remember, this information here is to help you have more informed conversations with your obstetrician about the choices you’d like to make in your birth. It’s not to replace medical advice.
MANY of your fears about birth can be squashed with some myth busting and change of your mindset/perception. Or you can grab the reigns and feel more in control and informed with stats like above. I can help you do both these things with The Bump to Baby Chapters Online Antenatal and Hypnobirthing Course. This course will CHANGE THE WAY YOU BIRTH for the better.
If you’d like to know ways to feel calm and in control in all birth situations then take a look at The Birth Chapter. An antenatal and hypnobirthing online course with midwife, Beth. Giving you the tools to stack the odds in your favour to get the birth you want and techniques to cope with contractions and keep you feeling calm in all births.
Featured photo of baby 📷 @patriesblogger & @jessica_vi_photography
#MeetTheTeam This is Vic…. she is the newest member of TBTBC squad and has been doing lots of behind the scenes bits and bobs. Here is her story ❤️
I thought it was about time I removed my head from the sand and came to say hello!
My name is Vic and for the last 8 weeks I have had the pleasure of working with this amazing business (and Beth) behind the scenes.
And I’ll tell you why I took the job…
Late in 2019 I reluctantly took this course thinking it probably wasn’t going to be for me! I thought, F*ck it… it’s only £34, I’d actually spent more on a (totally useless) decorative teepee for my unborn baby!
As I started bingeing the videos I realised that it was not AT ALL what I was expecting.
I thought there would definitely be guided meditation, I was almost certain the woman doing the course would be smoking crack and wearing a poncho, but I couldn’t have been more wrong, I had absolutely no idea just how valuable I would find this course.
At 34 weeks my waters broke (in Homesense of all places!) but I wasn’t afraid, not even a little bit. I felt ready, excited and totally at ease with what was happening to my body.
After a little wait, I delivered at 36weeks in 1hour 11mins and it was the most incredible experience of my life. And not a tear in sight… knowledge really is power!
Now, maybe it’s coincidence, or maybe that was actually the best £34 I had ever spent?! Who knows. But what I do know is, that I was lucky enough to fall pregnant in July 2020 and my first port of call was my Bump to Baby Chapter login!
⚠️Sensitive content ⚠️
The scans I had at 10 and 12 weeks had me super pumped to embark on this “two under two” journey. We were very excited and felt overjoyed at our happy plans ahead.
However, on 30th October 2020 at a private gender screening, we were delivered the shattering news of our baby’s death.
At 16 weeks and 3 days my world stopped as I saw my lifeless baby on the screen. That’s it, we were part of that life altering 1 in 4 statistic and victims of a rare late, missed miscarriage.
I’ll cut to the chase.
After this day and many harrowing ones that followed, I decided that I wanted to make a difference. It was cathartic to go over and over this ground, it was like therapy and helping people made me so happy.
Call it fate or whatever, but Beth was looking for some help growing this amazing business and I had what she needed skill wise, it was the perfect storm.
I’ll fill you in with more about what I actually do in the next update and a bit more about my birth experiences delivering my (almost) term baby in an hour!
But for now, I just want you to know that if you’re on the fence… don’t buy that crappy teepee, take the course! It will be the best £34 you’ve ever spent. I promise 💪🏻
I will set a scene for you…. A walk across the countryside holding hands admiring the wonderful views, followed by your favourite curry, maybe some candle light, your favourite songs playing in the background. You may then watch a funny film followed by a massage with some essential oils and then an ‘early night’ hem hem. Lots of you may see the scene as a relaxing and chilled date night, where as mothers approaching their due dates will be sure to recognise these umm.. activities as ways to induce birth. All fun ways to try when you are term to encourage those first contractions. But have you ever considered using some of these date night activities for coping strategies in labour too? Now I am certainly not recommending a spicy curry as a way to deal with tightenings, as that will surely not end well. But how about using this Valentines Day evening as a mock up for what you’ll use for coping strategies for early labour? If there is any a time where we deserve that date night it would be in early labour…
Let me break it down so this strategy makes total sense…
The hormone oxytocin is produced from anything that makes us feel loved, happy and relaxed. Which would be everything included in a date night at home. Just as a reminder, oxytocin is the hormone that will encourage our uterus to tighten in labour. It also encourages our bodies to release endorphins, which is our own naturual morphine. So anything that means we will have more oxytocin in our body is a good thing, right? A Valentines Day night in with the other half is the perfect way to do this.
I’m not the biggest fan of Valentines Day. However, I do think it gives us a reminder to take some time together as a couple. In our busy lives we forget how to do this. We forget how to relax with each other, yet when we start labour we want our minds to relax to allow our bodies to get on with what it knows.
So let’s look at what you have planned for Valentines Day tonight and how you can also use the same for your coping strategies for labour.
When you plan your date night appeal to all of your sense:
Smell – Smelly candles are often a must when creating a date night. In labour you can light a nice pregnancy candle, or use a pillow spray or your favourite (pregnancy safe) essential oils. You won’t be able to take a candle (other than LED ones) into hospital but a pregnancy candle will be a great help to your birth environment at home. In hospital there are essential oils for your use.
Sight- Look at your environment. Turn the lights to dim. Dim lighting always makes us feel more romantic, whilst in labour dim lights encourage melatonin which again acts up on our uterine muscles to cause tightenings. When you go into your hospital setting take some home, familiar comforts with you. Your own pillow or a nice photo/picture, a scan photo or a birth vision board.
Feel- Massage and touch are great ways that directly encourage oxytocin. I am sure you will agree that this is ESSENTIAL to practice this with your partner in pregnancy.. maybe once a week, actually twice a week…. Every day…?
Sound- ‘If music be the sound of love, play on’ Music is incredibly powerful for our emotions. Who else plays Beyonce loud in their headphones when you want to feel like a strong, powerful woman… guilty! Likewise who puts on Ray LaMontague when you’re feeling romantic. Yes my music choices may not be on point but you get the idea. It’s amazing how many people discover their birth soundtrack months after birth and are left in floods of emotional, happy tears whilst sitting on the kitchen floor. Build yourself a soundtrack, there are docking stations at the hospital or if in doubt get your own mini stereo or some headphones ready to go when the time comes.
Lastly taste… Food again can hold us so emotionally. I bet all of you who are planning something romantic for Valentines have involved food. A romantic meal, a special brownie, a glass of bubbles. Who reaches for the biggest bar of Galaxy when needing a little pick me up? I’m not saying during childbirth you will be able to scoff your favourite takeaway and the largest bar of chocolate but having some of your favourite snacks with you will help keep your energy levels up. Your uterus is a muscle and needs energy to contract. Most importantly keep hydrated.
All these scene setters I have listed you’ve probably done without much thought. We seem to know how to make a room look romantic for a date. We know that this will make us feel more in love and more relaxed. Yet this simple thing is often over looked in labour. Your body already associates all these Valentines (or date night) smells, sights, tastes and sounds with those feelings of calm and relaxed. Therefore just playing that soundtrack or smelling that smell in labour will be enough for your body to start to release the oxytocin and give you effective tightenings and lots of endorphins. Use this to your advantage!
And if you want to really nail down that relaxation, then book in some more date nights with your partner during pregnancy. Practice is the key to perfecting this strategy for coping with early labour. Yes that’s right? Tell your partner that weekly date nights have been prescribed to you… Midwifes orders. The more you put into this the more you get out so try and get in as much as possible.
So for all those who are partial to a ‘to-do’ list here is a short one I have put together for you…
Get together with your partner and schedule in some regular night-in date nights.
Find your favourite smell/ essential oil/ pregnancy candle.
Find a good picture/photo. Holiday picture, happy place, family, scan photo, birth mood board.
Create a soundtrack.
Get some massage oil (again a nice smelling one.)
Compile a list of your favourite snacks for the hospital bag
Keep the format the same and appeal to all (or as many) of your senses.
Schedule in some more regular relaxing time on your own. Using a similar routine (ie. Bath, dim lighting, smell, music, hypnobirthing cd)
Most importantly… Enjoy it!
Want to know what you can do to stack the odds in your favour for the birth that you want? Access videos, checklists, audios & a support group all created by a midwife to get you feeling excited, prepared and confident for birth. Click the link for more information about The Bump to Baby Chapter’s Hypnobirthing and Antenatal Online Course.
This story made me ball like a baby 😭 What a tribute to his wife & new baby girl. Thanks for sharing your story with us Matt 🦸🏻♂️🦸🏻♀️
A birth story……..From a first time Father 💥
After my partner had started having contractions on Friday night she gave birth to our beautiful daughter Sunday afternoon.
After her waters broke at 12:30am on Sunday morning we called up the hospital and was asked to go in to be checked. After being checked she was told that she wasn’t having full contractions yet. So my partner came back out to the corridor, (where I have to wait) and told me that she had to either walk around for a few hours, go home or go onto the ward without me until she was 4cm dilated. She was a little worried because she felt like she was having full contractions. We decided it was best for me to go grab a couple of hours sleep in the car on the car park while she went to the ward to be fully examined. At this time she was told she was only 3cm dilated which after 2 days of contractions was a bit demoralising, especially after them being so painful.
After just over an hour I got the message I was waiting for. As the ward had a private room empty and hardly anyone else there, they agreed to let me in early so that I could be there with my partner. Because of this I only missed an hour of the whole labour process at the hospital. And for that I will be eternally grateful to University Hospital Burton. After 9 months of no dads to be at scans or midwife appointments and no antenatal classes to visit which was making me feel like I was missing out on my father to be journey. I could finally be there for my partner and my little girl when they needed me the most.
So……. Our birth plan……. It was amazing. Candles, music, birth balls, birth pools, essential oils and minimum pain medication. Well that went out the window!
After 10 hours of my partner having really intense contractions and having to use gas and air and Pethidine injection to manage the pain we were moved to a delivery room in case she needed more pain relief. After the Pethidine kicked in we moved to the delivery room and just like that within 30 minutes she was at 6cms and it was nearly time to rock and roll.
At this point she was offered a epidural. After going over our EBRAN and talking to the amazing midwives we decided to not have it and to go with just gas and air moving forward. It was like that decision gave the little one a nudge and within the hour it was time to push! We were so glad that we didn’t go ahead with the epidural, as it would have taken around a hour to set up and kick in etc to only work for the very end of the labour experience.
As she started to push they realised there was something wrong. Our little one was getting distressed and not making an entrance (or an exit) when she pushed. A doctor was called and the decision was made to have an assisted birth using forceps. The little one had got the cord trapped around her neck and she needed to make her grand entrance (or exit depending on how you look at it) quickly. I won’t go into all the details but after a few jiggles, a cut, a slight pull, 4 midwives and a doctor the head was out and it was up to my absolute trooper of a partner to finish what she started and pushed the rest of our little diamond out. She needed a little help to get her first cry but after a minute she was laying on my partners chest looking absolutely gorgeous.
From the midwives point of view it was their time to clean up, stitch up, and give us some time to our self. From our point of view it was time to cry, rest, and adore our new family member and feel what I can only describe as the most moving, thought provoking and absolutely breathtaking feeling that I have ever felt.
So to summarise. Burton hospital midwifes and doctors are incredible. Not only did they look after my partner and daughter to be. They made sure that I was there, helping as much as I could and helping make important decisions when my partner needed me too.
My partner Kyla (and yes I know I’m biased) is the most incredible, strong, amazing and frankly breathtaken person I have ever known and she has given me a little girl that has absolutely taken my breath away and will do for years and years to come .
To the people in this group (TBTBC Online) and the amazing Bump to Baby ladies. From a first time father. What you have shown me on your video course, Q&A’s and posts made such a difference in not just my experience but Kylas. We stayed calm, used EBRAN and adapted to our new birth plan using what you guys have shown us. So all I can say is a huge thank you. Especially from a dad who has felt left out a lot of my families journey. This group has been a breath of fresh air and I really think more FTFs need to check you guys out!
Sorry for this massive story but I wanted to let you know that even with some antenatal experience, you guys and a couple of books you helped we managed to bring the most amazing little girl into our world.
Stay strong mother’s and farther to be. You all got this!!!!
And without further a do. Please may I introduce you to Indi Aurora. Born at 13:56 at Burton University Hospital weighing 6lbs 14oz.
For more information about The Bump to Baby Chapter’s Hypnobirthing and Antenatal Online Course. Videos, checklists, audios & a support group all created by a midwife to get you feeling excited and confident for birth.
💥Home Dopplers are dangerous. Period. If you listen in to baby’s heart rate and you hear a nice normal heart rate sound because you’ve googled a normal heart rate for a baby, you may get false reassurance from this. There are many things that we look for on a baby’s heart rate and the number is just a small part of this. Don’t get false reassurance from a home Doppler.
💥 Don’t drink a cold drink to make baby move… if you are ill with an infection in bed, you move less because you are conserving your energy. If someone makes you cold by pouring coldness onto you, you will move. It doesn’t make you well, but you will move.
💥The risk of catching the Coronavirus from going into your hospital/unit should not outweigh your need to go into get checked. Remember, a maternity unit is filled with women who, like you have been self isolating for the last 2months. It is a safe place to be.
💥 It is usual for movements to be felt between 16 and 24 weeks. As you first start to feel baby move you may not notice movements all the time as you start to realise what they feel like. This is really normal. This is why if you report reduced movements before this time, you may be invited in for reassurance or given advice over the phone.
💥 From when you start to feel movements regularly, about 24weeks, they should increase over the weeks till about 32 weeks when from this time they stay about the same every day. They don’t reduce as you get closer to your due date.
💕Baby’s don’t run out of space to move. 💕It is not a sign that labour is starting. 💕 It is not what baby’s do as they get closer to their due date.
💥Please remember, if you ever are worried about baby’s movements, always call your local triage/assessment unit or maternity advice line. You should all have a number to ring on the front of your notes that is a number to call for things like reduced movements and any concerns that you have.
💥When you get reduced movements or a change in your movements , your Triage/assessment unit/local midwife unit is the place to call usually. Your community midwife is not usually the person to call as they will advise you to call triage as with reduced movements, at a hospital unit they can assess you properly with a CTG/CEFM machine to pick up a trace of baby’s heart rate (these machines are used from 28weeks). These CTG machines show a longer recording of baby’s heart rate and are much more helpful to determine the well being of a baby compared to a snap shot that a Doppler provides.
Good websites to go on for questions about movements are Kicks Count and Tommy’s.
What is hypnobirthing? If you’ve landed on this page then I’m sure you’ve heard the term ‘hypnobirthing’ term thrown around many times … I’m sure you have heard it talked about amongst those positive birth stories but wonder whether it is all too good to be true. A good birth is something that only happens in your imagination right? So let’s look at the facts on what actually is hypnobirthing….
Clock swaying and Derren Brown type voodoo is definitely what it’s not, even though the name suggests. Without dumbing down it’s marvellousnous…it’s just science. So let’s throw it back to secondary school biology.
Fight or flight? Neither possible for birth.
So you hear a buzz of a bee, or see a spider, or you have to do a presentation at work. All these things create a reaction in our body, our heart rate increases, palms get sweaty and we get that sticky feeling in our tummy. This is a programmed response that would have served us well in the Stone Age times. Blood shunts away from our major organs to the arms and legs, our breathing increases and heart rate increases as we prepare to fight or run from a sabre tooth tiger or woolly mammoths. It would have helped us survive tricky situations.
The same would have happened for women giving birth in the Stone Age times. Imagine they’d be in their birth cave, doing their birth thing and in walks a sabre tooth tiger. That birthing Mum would have seen that tiger, thought, “Oh crap. I’m not safe” and triggered the fight or flight response. Her heart rate would increase, her blood would shunt away from her uterus causing her contractions to slow and her labour to stop and this would give her some more time to move away from the tiger and find another safe place to have her baby. As you can see, this bodily response is a great thing, it helped her body stop labour so that she could give birth in a safe birth cave. Us women, are like lionesses when it comes to their baby’s and giving birth when feeling safe is a massive priority in our thoughts. But, the difference in this situation to that of now, is that we are not cavegirls. We do not have sabre tooth tigers coming into our environments. We do not have to deal with these kind of threats …. so why does this response still happen?
The problem that we have is our thoughts. The thoughts of bad things happening. We are basically always thinking about sabre tooth tigers coming into our birth caves- but the modern day equivalent.
We think about that episode of one born every minute when the woman was screaming in pain.
We think of the story that our Mum or Auntie told us about what giving birth was like when we were 11 years old.
We think of the story that our bestie told us, about how nothing went to plan, and she had a tear and it was all very dramatic.
And when we haven’t done birth ourself, we only have our imagination and snippets of what we have seen from the TV and heard from stories, to piece together what may happen. And often it is on the dramatic side, as one born every minute wouldn’t be on its 6th series without a bit of drama to feed our drama craving minds, and a story wouldn’t be a good story without that shock factor.
So what happens when we go into labour and we feel those contractions? Our mind says,
“Ah ha… I know what happens here, I’ve seen this lots on the TV, this is when the drama happens, there’s going to be pain.”
Then our other part of the brain says,
“Did someone say PAIN? Holy crap, let’s get out of this situation. Now!”
Cue the fight or flight response…
So your feeling more pain, because that’s what you’re telling yourself is happening. You feel more fear, because you’re mind is telling you that what is happening is exactly the drama that you expected. Then because of the fight or flight response, your labour stalls, intervention is recommended so it reinforces your initial thoughts that something is in fact going wrong. You then feel more fear, more pain, more tension and more intervention…. And the cycle continues.
So now, to answer the ‘What is Hypnobirthing?’ question.
Well, it’s actually just a different type of birth prep with the focus on having a positive birth. It’s main focus is reducing the fight or flight and increasing oxytocin. And here is how, as a midwife, I teach it over here at The Bump to Baby Chapter.
1. Change your thoughts and rewrite the way you think about birth. This isn’t done by doing anything wacky… just watching positive birth stories, birth affirmations, some relaxations and a whole lot of understanding. Lots of birth stories often come with wrong information. When in fact, the more you know, the less that is unknown. This goes for what contractions are actually like, what vaginal tears are like (not as scary as how you’ve read it on MumsNet), what cesareans are like… etc? All the things that you might be pushing far down now, are only going to come to full surface if that happens bringing fear. Knowledge is power 🙌🏼🙌🏼 Always.
2. Learn ways that will help you stop the trigger of the fight or flight. How to keep yourself calm, how to cope with contractions etc. Learn what to do when you think you might be losing it. You know when you breathe out for a long time ( for example in for 4 seconds, out for 7 seconds), you actually trigger the calming response in your body that will stop the fight or flight response. Meaning that oxytocin will increase, endorphins will increase (your body’s natural pain relief) , you feel happy with oxytocin, calm, you bond with your baby more when she’s arrived, your breastfeeding is encouraged. Learning ways that will help increase your oxytocin and reduce your fight or flight is the key to a positive birth. This section of Hypnobirthing is great for birth partners too as it gives them tips on how they can help too.
3. Extra things you need to know. This is practical things that can help your birth go smoother. Things like positions that help labour go quicker, eating and drinking because your uterus is in fact a muscle that won’t work as effectively if it’s not being watered and sugared- think lucozade, jelly babies, water etc.
I think the main thing that can be learnt from Hypnobirthing is that the more you know, the more things you can do to increase that oxytocin. Oxytocin isn’t just important to help your birth go smoothly. But it’s the hormone that will encourage bonding between you and baby, it will encourage your breast milk production, but most of all it will mean that in years to come it will be a time that you look back on with fondness, love and happiness, rather than experience tainted with fear.
So what do you think? Not as whacky as you once thought!
If you want to learn ways to have a positive birth, know how to stack the odds in your favour to get the birth you want & feel more prepared and confident in your pregnancy, then come and enrol in The Bump to Baby Chapter’s Antenatal and Hypnobirthing online course, it is only £34 to give everyone the opportunity to have a great birth. This course is led by a midwife, includes antenatal education birth prep and Hypnobirthing.