***November Sparklers 2012***(101)babies(14)angels**33 babies here

[Alandsa]

NICE guidelines still put a time limit on the second stage (when you start pushing to when the baby is born) but the Royal College of Midwives doesn't recommend directed pushing. I saw a good article recently, will try to find it x

oh really? that is interesting! i would be really interested to read the article if you find it, i shall do some searching myself too thanks

 

[lovealittle1]

There is a December group now!!

1 week until my 1st mw appt this pregnancy is going by so fast so far!

Hope everyone is well!

 

[gaiagirl]

Awesome! The existence of a December group makes me feel like we are really making progress!

 

[Coleey]

I think it's flying by! xx

 

[skweek35]

Oh my!! A Dec group already - makes me feel like one of the veterans! hehe

I, too, would be interested to read that article.

 

[Fish&Chips]

I'm hoping to have a nice MW this pregnancy. With James I had loads of different ones. I'd just found one I liked and I had James 2 weeks later

Wow how amazing! I had an epidural pretty early so I wasn't able to move etc and was told when to push. X

 

[skweek35]

I just spent the day with 2 of my closest cousins and told them the good news.
My one cousin, who seems to think she is the expert at babies and birth, gave my a 2 hour 'chat' on everything babies - from buggies to nappies, oh and don't forget labour, birth and breastfeeding!!
She has told me that she thinks I will be fine in labout and wont need an epidural! Its apparently really bad as they cause really bad back ache and make the baby really sleepy. She says that I definitely dont want a sleepy baby straight after birth as I will need to get baby to latch on straight away! As if it is the bee and end all of breast feeding - bear in mind that she has only had one baby!! and he is now 6 years old!
I will definitely only take the info I want and make up my own mind!!

 

[Fish&Chips]

Yowzer Skweet, she sounds a little full on. I'm still bfeeding my son and I had an epidural. I had lots of info before my labour, knew the risks but decided to just decide then and there. Every labour is different so what's right for one isn't necessarily right for the other. I think it's hard if we feel we're expected to do things a certain way as it can lead to disappointment. Xx

 

[booflebump]

Morphine makes the baby very sleepy sometimes, but it's not a common side effect of an epidural. Having an epidural can increase the risk of a slowed labour/needing a drip/instrumental delivery, but they can be incredibly useful as well for some women

Can't find the direct link for the valsalva pushing studies, but here is base of it with references for further reading

The Channel 4 television show One Born Every Minute won a BAFTA in 2010 under the category of Best Factual Series. A definition of the word factual is:



"The available body of facts or information indicating whether a belief or proposition is true or valid".



Whilst it may be assumed that the audience knows that editing has taken place, especially those who are aware of the time involved in the labour/birth of a baby, there is no doubt that what is being seen, said, and done is fact for it is happening as we are witnessing it. What is questionable is whether or not these “facts” or the actions and words of the professionals involved are true or valid? Turn that into professional speak and it could be asked if the words and actions are evidence based. Are they in line with the rules and codes of the governing bodies of the professionals involved? If the answer is no then surely there are further issues to be considered and questions to be asked.



During the 29th February and 14th March episode, Zoe Leonard and Anna Cookerham were encouraging long sustained breath-holding whilst caring for women who were pushing in the second stage of labour. This practice is known as the Valsalva Manoeuvre which involves prolonged breath-holding.



With prolonged breath-holding there is an increase of the maternal intrathoracic pressure by forcible exhalation against the closed glottis, which causes a trapping of blood in veins preventing it from entering the heart. When the breath is released, the intrathoracic pressure drops, the trapped blood is quickly propelled through the heart producing an increase in the heart rate and blood pressure and followed by a slowing of the heart rate. All of this disrupts the blood flow to the uterus and ultimately to the baby which then shows up or is interpreted on the fetal heart monitor as fetal distress.



There is no evidence that the Valsalva Manoeuvre shortens the second stage, decreases fatigue or minimizes pain. The evidence suggests that it alters the contractile pattern of uterine smooth muscle, leading to inefficient contractions and failure to progress. Studies suggest that encouraging women to believe in their ability to push the baby out may be as important as the type of breathing.



Studies published between 1992 and 2009 show that the physiological effects of Valsalva Manoeuvre can include: impeded venous return; decreased cardiac filling and output; increased intrathoracic pressure; affected flow velocity in middle cerebral artery; raised intraocular pressure; changed heart action potential/repolarization; increased arterial pressure; increased peripheral venous pressure; altered body fluid pH, which contributes to inefficient uterine contractions; decreased fetal cerebral oxygenation. The World Health Organisation, (WHO) concluded that it is a dangerous practice and should cease.



Later in the same programme when interviewed, Midwife Zoe said that babies can, if left too long in labour, "get tired" (labour ward talk for become hypoxic) if the 2nd stage goes on too long. There is no evidence to support better outcomes when time limits are imposed on any stage of labour. More importantly, Zoe is obviously not aware of the evidence around her practice with efforts to encourage Vicky to birth her baby quickly. Is Zoe disregarding them the evidence in favour of dangerous practice? Either way she is in breach of her Nursing and Midwifery Council Code, (NMC) as according to Rule 6- Responsibility and sphere of practice, the guidance indicates that practice should be based on the best available evidence and that a midwife must make sure that the needs of the woman and baby are her primary focus. The NMC code of professional conduct: Standards for conduct, performance and ethics (2010) states that a midwife must keep her knowledge and skills up to date.



This programme needs more editing in order to stop showing bad or dangerous practice. Whilst the programme makers must be delighted in their ability to pull in large audiences, the success of other birth programmes has demonstrated it does not always need sensationalism and car crash births in order to do so. It must not be forgotten that the viewers may include new and impressionable midwives who may get the message that it is fine to copy what they see and for women to accept as normal what they too may be exposed to or ask to do when they face childbirth. Questions needs to be asked and they include; why are awards being given for dangerous practice?







REFERENCEs



Martin C 2009, Effects of Valsalva manoeuvre on maternal and fetal wellbeing, British Journal of Midwifery, vol. 17, no. 5, pp. 279-85



Nursing Times 95:15, April 15, 1999.



WHO (1996) Care in Normal Birth: a Practice Guide.



Royal College of Midwives: Campaign for Normal Birth online 2012

 

[Fish&Chips]

That's really interesting, thanks. X

 

[skweek35]

Thanks for that reading. Its really interesting and begs the question that ends the article - why are awards being given for dangerous practice?

I will defo be reading more around that to make sure I dont put my baby at risk.
Thanks again Boofle!

 

[Alandsa]

Thanks for sharing that article. I too will certainly be doing a little more reading around on the matter also

 

[SpringerS]

There is a December group now!!

It's amazing isn't it? We're officially old hands now! Not to jinx things, but once the January group appears some of us will be scraping into the 2nd trimester!

 

[gaiagirl]

Yes...8 weeks tomorrow and I keep telling myself...4 more weeks!!!!! Some say (and here in Canada all say) that 14 weeks is second tri. But still, I will feel GREAT at 12 weeks to have made it that far.

Hopefully the nausea has eased up by then too

 

[ashleywalton]

Yes...8 weeks tomorrow and I keep telling myself...4 more weeks!!!!! Some say (and here in Canada all say) that 14 weeks is second tri. But still, I will feel GREAT at 12 weeks to have made it that far.

Hopefully the nausea has eased up by then too

I am with you! I am 8 weeks today and I cannot wait until I hit 12 weeks. I am hoping the nausea eases up by then. I'm just hoping it doesn't stick around as long as it did with my 2nd daughter....
Hang in there!!

 

[Sal85]

8 weeks today. Just had scan, saw little bean and cord with a gd heartbeat. Also measuring exactly 8weeks. So so relieved, was getting myself in a right state in the waiting room as 3 poor ladies before me had bad news hugs to them.

 

[auntylolo]

So pleased you had good news Sal

 

[bethanchloe]

Oooh all you lucky ladies with your scans! I wanna scream haha. Patience is not my strongest point!
Oh well, 8 days til I see a midwife at least x

 

[booflebump]

Yay Sal, do you have piccies? xxx

 

[sallyhansen76]

My first appointment is schedualed!! Soo excited, the 13 of april.