Category Archives for Midwifery

9 Reasons to Exercise in Pregnancy

Exercise and nutrition play an essential role in our general health and wellness.  So why is it that many women stop exercising when they become pregnant?  Is it because they fear that it may harm the baby or cause miscarriage?  Alternatively, is it because their doctor advises against it – particularly in the first trimester?  There are many reasons why following a safe exercise programme can play a big part in having a healthy pregnancy.  Here are 9 of the many Health Benefits of Prenatal Exercise.

  1. 1
    Reduce and Ease Backache -  Lower back pain is one of the most common complaints in pregnancy and can lead to discomfort that is so severe that carrying out simple tasks such as walking around the supermarket or standing for any amount of time become distressing activities.  Backache is caused when the ligaments relax and the joints loosen as a result of the pregnancy hormone relaxin.  The same hormone also causes the ligaments around the spine to loosen, leading to instability and pain.  Exercise to strengthen core muscles and address your changing posture can lead to a significant reduction in pain and discomfort.
  2. 2
    Manage Weight Gain – It goes without saying that exercise and healthy nutrition will help you to avoid excessive weight gain.  Women who maintain a healthy weight gain have fewer pregnancy complications and lose weight easier following the birth of their baby.
  3. 3
    Reduce Stress and Improve Mood – Exercise releases the body’s natural happy hormone called endorphin.  It is natural to feel stressed during pregnancy because your body is changing, the impact on your regular routine and family life so if you exercise you can take advantage of endorphins released and lift your mood and reduce your stress levels.
  4. 4
    Improve Sleep – It is vital to get plenty of sleep as this will help with the growth of the baby and your overall well-being.  As your pregnancy advances, it can become increasingly difficult to get comfortable in bed, and this can affect the quality and quantity of sleep.  Exercising regularly during pregnancy will improve your sleep by maximising your energy output, working your muscles and clearing your mind, all of which will promote a peaceful night’s sleep.
  5. 5
    Reduce Risk or Manage Gestational Diabetes – Gestational Diabetes is caused by reduced insulin sensitivity, which results in an increase in blood sugar levels in the body.  Gestational diabetes can lead to severe complications during pregnancy,  labour and delivery. There is much evidence to show that exercising regularly improves blood sugar control and reduces the need to maintain healthy blood sugar levels with medication.  Studies have also shown that baby’s of mums who exercised regularly during pregnancy had improved insulin sensitivity into adulthood and less incidence of obesity.
  6. 6
    Reduces Constipation, Water Retention and Swollen Ankles – Again uncomfortable and irritating effects of pregnancy and extremely common, which can be caused by rising blood pressure.  If unmanaged, this can lead to serious complications such as pregnancy-induced hypertension (high blood pressure) and pre-eclampsia.  Regular safe aerobic exercise can help to regulate blood pressure as well as exercising joints and reducing discomfort.
  7. 7
    Improve Stamina and Strength and Prepare you for Labour – It is generally said that an average labour uses the same amount of energy as running a marathon.  Most people wouldn’t consider running a marathon without undergoing months of training for the big day.  So, it goes without saying that “training” for labour and delivery will significantly improve your experience and possibly even reduce the length of labour.  Training your core muscles, posterior chain (legs and back), as well as regular aerobic exercise for cardiac health, will significantly affect your energy and strength and ability to cope with the demands on your body during labour and delivery.
  8. 8
    Increase Chances of a Natural Birth – the position your baby is lying in when you go into labour can have a significant impact on the length of labour, pain experienced, and type of birth.  For example, babies lying in the posterior position (baby’s back adjacent to your back) will result in a longer labour and a potentially obstructed labour leading to an increased risk of forceps delivery or caesarean section.  Exercising and remaining upright and mobile encourages the baby to adopt an anterior position, which is the optimum position for the baby during labour.
  9. 9
    Quicker Recovery and Longer-Term Benefits – whether you have a natural birth or your baby is born by caesarean section, being fit and healthy will help your body to recover more quickly.  In addition to aiding physical recovery, exercise boosts your immune system, which means that you’ll have additional protection from infection and any incisions will heal quicker.  Moreover, the final icing on the cake is that many studies have shown that babies born to healthy mums are healthier and more intelligent!

There are many more reasons why exercising in pregnancy is so beneficial to you and your baby – hopefully you are now convinced!

For more information about MamaBFit’s prenatal exercise programme, visit their website https://www.smartfitness.ae/mamabfit/

THE FIRST 48-HOURS AFTER BIRTH

With our new midwife service launching in July 2019, Emirates Home Nursing will now be available to help you before, during and after your pregnancy.

As your due date is drawing near, you might be wondering what exactly happens after birth. Our in-house midwife has put together an overview of the specifics of your first 48-hours after giving birth.

PREPARING FOR BIRTH

A lot happens during the first hour of birth, and it is important that you create a birth plan with your doctor or midwife. Each hospital delivers differently, which is why you need to communicate with doctors beforehand. Delivering a baby into the world is a special moment and each person will want to experience this differently. This overview is a guide for what happens in the hospital room when labour has happened, but mothers can choose to change certain aspects.

RIGHT AFTER DELIVERY

When your baby is delivered, the nurse will place them skin-to-skin as soon as possible and perform delayed cord clamping. The cord will be clamped between one to three minutes after birth. The skin-to-skin contact will last about an hour, depending on the well-being of your baby. A Vitamin K injection will be given soon after birth to assist with blood clotting and prevent a bleeding disorder. Within the first hour, breastfeeding will be attempted, even if you are tired, as your baby needs to start feeding to let the body know to start producing milk. Babies only need a few drops for their first feed, so do not worry if you think you will not produce enough milk. 

Baby-friendly hospital initiatives do not allow nurses, midwives or doctors to give the baby supplemental feeds unless the baby has low blood sugar or the breastfeeding was not adequate to raise the blood sugar levels.

THE FIRST TWO HOURS

Whilst all this is happening you will also need to deliver the placenta, this can happen a few minutes after the baby is born, or it can take anywhere between 30 minutes to an hour. The placenta is soft and much smaller than the baby; however, some mothers have felt intense cramps when the placenta was delivered. You will then receive medication to help your uterus contract and stop the bleeding or have your uterus massaged from the outside. Your midwife or doctor will perform a full inspection to make sure nothing has been torn or will stitch necessary areas.

AFTER 2 HOURS

Once everything is in order, you will be cleaned, given fresh robes, and covered with a warm blanket. This is the time mothers can rest and eat, as you may be very hungry.

You will also be tired but still expected to feed the baby every 2 to 4 hours. Each time you breastfeed, your uterus will contact (due to oxytocin being secreted), and painful contractions will occur. The contractions will not be as severe as before, but you will still have bleeding. This is normal, but you can always ask your midwife if you are unsure.

While still in the hospital, you can ask for help and demonstrations on all first time activities, such as cord care or nappy changing. However, some hospitals do not demonstrate these well; in this case, midwives are happy to help. Call your midwife and they will be able to show you a full baby care demonstration.

Furthermore, some hospitals will only bath the baby 24 hours after delivery, as research has shown that the white matter which babies are born with on their skin, called vernix, is very good for the baby's protection of their skin and gives them that soft feeling. Newer baby-friendly hospital initiatives have the baby in the same room as the mother to allow maximum bonding time. However, you can always ask to have the baby moved to the nursery if you wish to sleep for a few hours. But, be prepared to be woken up to feed the baby.

Finally, babies will receive their first immunizations in hospital, BCG and HepB.

24 HOURS OR MORE

Depending on the hospital and the type of delivery, the time of stay can range from 24 hours to 5 days. When getting ready to go home, there are essential factors to keep in mind when preparing to leave. A paediatrician will examine your baby will you will also be examined by the hospital staff to make sure your uterus is healing correctly. A skill check will be completed, which means the baby can breast and bottle feed and that you and your partners understand the necessary baby care. You will also need to fill out and sign the birth certificate. Finally, make sure you have a car seat to take the baby home; most hospitals do not allow discharge without a car seat.

ONCE AT HOME

When you have settled down, the baby might start cluster feeding (feeding with minimal intervals between feeds), which can be very tiring but normal. You need to understand that you are doing nothing wrong if the baby wants to latch often and proper latching is essential to prevent your nipples from becoming painful and raw. If you need any help with feeding or are uncertain if you are feeding correctly, do not hesitate to call your midwife.

There's a saying "sleep when the baby sleeps". You need your rest to make milk for the baby but do not be afraid to ask for help; you do not have to be a supermom.

Finally, your hormones will be all over the place, if you feel sad or detached, talk to someone about it, there is nothing wrong with you. Your body is trying to figure out how to get back to normal, and it might need some help. Drink plenty of fluids, to replenish your stores which are being used to make breastmilk. If you are unsure of your diet, there are many resources to help you out – or - give your midwife a call.

Welcoming baby: planning for birth and beyond

Whether you’re a first-time mum or adding to a growing family, giving birth is a big deal. We asked Ana Piera, a Dubai based childbirth, hypnobirthing, doula and breastfeeding counsellor, and our resident midwife Anoesjka Myburg, for their expert tips on how to plan for this life-changing experience.

Women have been doing it for 1,000s of years but that doesn’t make giving birth any less daunting and the benefits of having a well thought-our birthing plan in place and surrounding yourself with a great team of experts – and your birth partner! – is the way to go.

An Emirates Home Nursing trusted partner, Ana Piera is a champion of positive birthing and works with mums-to-be to create an empowering experience from start to finish, irrespective of what path the original plan followed in reality.

“It is very important that both mum and her birth partner feel in control, informed and respected, even when special circumstances demand that control is handed over to the experts, but with all the decisions still theirs,” she says.

Anoesjka Myburg adds: “There isn’t a one size fits all definition for positive birthing.

Catering for the individual is important and the information I share with different groups empowers each mum-to-be in different, and positive ways.”

Growing demand for hypnobirthing services in the UAE is thanks to increased awareness of how empowering and effective it can be for both expecting couples and healthcare professionals.

“A hypnobirthing course will teach you how to take control of your body and manage its reaction to fear and anxiety so as to create internal equilibrium,” explains Anoesjka.

“There is an assumption that women only attend a hypnobirthing course because they want a natural birth without drugs. However, hypnobirthing techniques are beneficial for any type of birth, even when women decide to use pain relief or in the case of a C-section. The techniques are even more valuable when there is increased fear and anxiety,” points out Ana.

Al Zahra hospital in Dubai has a hypnobirthing room as well as a birthing pool. Mediclinic City Hospital, Saudi German Hospital and Mediclinic Parkview Hospital also have birthing pools.

Another option is to engage the services of a doula. Also known as a birth companion, a doula is a non-medical person who assists a woman before, during, and after childbirth and who acts as an advocate throughout the journey, helping her

fulfill specific desires she might have for her birth and beyond.

“Demand for doula services is also growing and, with improved education, more people will be able to understand the positive effect a doula can have on a mother’s experience during pregnancy, labour and delivery,” says Anoesjka.

BEFORE

Think of the word hospital and it doesn’t necessarily engender warm, positive feelings, and Ana is keen to address this early on, as she explains: “It is important that expecting couples visit several hospitals and choose the one where they feel most comfortable, safe and positive. It’s a good idea to visit several times, to get familiar with the environment, find out what they offer and get to know the medical team.”

“Find a doctor who puts you at ease and who supports your labour and delivery views. Your midwife is your personal advocate and cheerleader and someone who  can answer all the questions a doctor perhaps doesn’t have time for, especially the more difficult questions, such as what to truly expect,” adds Anoesjka.

Ana makes sure to share as much evidence-based information and techniques as possible that will help expectant mums remain positive, calm and confident. This extends to birthing partners too, with a ‘toolbox’ of relaxing techniques to boost their confidence and enable them to more effectively support the mum-to-be during birth.

This is also important if there is a history of complications or if a pregnancy hasn’t been textbook plain sailing.

“You will both be more aligned if you talk about the birth preferences plan, about your fears or limitations, and how you can work as a team. This involves lots of home practise and at hypnobirthing classes, for example,” she notes.

Anoesjka also reinforces the importance of partner involvement. “Most midwives enjoy having the father as part of the experience and appreciate it. Discuss how you want your partner to participate with him. It can be anything from him holding your hand to having him cut the cord after delivery.

“Make sure he also knows where your hospital bag is, so when it is time to go, he will feel like your knight in shining armour. The most difficult part for him is seeing you in pain and not being able to make it better; so making them feel needed is a sure way to include them in the whole experience!”

DURING

“At the birth, one of the key things we do as a team is to breathe slowly and deeply throughout the whole process in order to remain calm, relaxed and in control. When we are calm, our breathing slows and creates more inner peace, bringing us into the present moment,” says Ana.

This kind of breathwork helps women stop fixating on what is about to happen and reduces the possibility of slipping into a negative shallow breathing cycle.

Birth partners play a vital role, as Ana explains: “They can support mum by breathing with them, listening to relaxing music together, providing a massage and some pressure point relief, practising pregnancy and birthing positions, providing positive talk, plus emotional support.

You also shouldn’t be afraid to ask for what you want, as Anoesjka explains: “Allow staff to do their job but if you want to get up and move around, use a yoga ball or take a shower to help relieve the pain, then just ask.”

AFTER

The physical work done, what comes post-partum is a whole new world.

“Skin to skin contact immediately post-delivery is the first physical connection and the midwife and doula, if you have one, will be on hand to help with the initial breastfeeding,” says Anoesjka.

“You can also ask for help and demonstrations of all those important first-time activities from cord care to nappy changing and most baby-friendly hospitals insist on your newborn remaining in the room with you during your stay,” she adds.

Says Ana: “Mums need to be aware that it may be challenging, especially in the first three weeks. It’s a new experience for everyone and is particularly emotional for new mums, as well as being a learning time for the rest of the family. Depending on the birth experience, mum may need more time for recovery and it’s important that she rests as much as possible, eats healthy and drinks lots of water.

“It’s a good idea to also have a post-partum plan, to have someone take care of the housework and cooking in those early days. Breastfeeding may be challenging at the beginning and the key is to be prepared and patient. Professional breastfeeding support may also be an option worth considering.”

Emirates Home Nursing host a number of free sessions on calm and positive birthing. For more information or to register for a session, contact us on 800 687 7464.