Valerie Gommon Midwife’s Blog

Archive for the ‘shiatsu’ Category

What is the definition of Natural Childbirth?  A hospital might say that a woman whose labour was induced and who had an epidural was a normal birth; others might say that induction, augmentation, analgesia, episiotomies etc do not constitute a normal birth!

A more radical definition of a natural birth might be a labour that starts spontaneously between 37 and 42 weeks gestation, and progresses to a vaginal birth without any intervention or pharmacological drugs.

Natural childbirth has been given a bad press – women choosing natural childbirth have been described as “hippy types” and indeed there has been an item in the press this week about a midwife who suggested that women would do better to avoid epidurals that has caused considerable outrage!

Pregnancy and childbirth are normal life events, not medical condition; a woman’s body is perfectly designed to give birth.

Of course some pregnancies and labours will need medical help – but the vast majority of women will go through their pregnancy and birth without problems and this process works best when interference is kept to a minimum.

For example anything we do to interfere with this natural processes has consequences – if mother and baby are well I am suggesting that we (the medical profession) should not interfere!

One example of this is the huge number of women whose labours are induced – why?  In some areas women are induced at 41 weeks (interestingly in France a normal pregnancy is defined as 41 weeks!).

Induction is not an easy option.  It is usually quite a lengthy process which makes the mother tired.  It is also usually more painful and the mother is therefore more likely to need pain relief, possibly an epidural … the mother is then less mobile … making it harder for the baby to find a way through the pelvis and consequently she is more likely to need the help of a ventouse or forceps, or even a caesarean section.

We all know that although caesareans are very safe in this country, it is still far safer for both mother and baby if the baby is born vaginally.  A caesarean section is major abdominal surgery which will take weeks and months to fully recover from – and the mother will have a demanding baby to care for too!  Babies born by caesarean also have many more problems, and are far more likely to need to receive Special Care.  There are also implications for future pregnancies – so, although fantastic if needed, caesarean sections are far from ideal.  The World Health Organisation recommends a 5 – 10% caesarean section rate, but our rate is approaching 30%, and I believe 90% at The Portland private maternity hospital!

This interference in birth has been called a “cascade of intervention”, because we do a) we have to do b) and because we do c) d) is also necessary this is also described as “iatrogenic” or hospital induced.  Whatever we do has consequences, for example a woman with an epidural will need more careful monitoring, she will need an IV drip and also a catheter – so you can see this spiral effect, because we do this, we have to do that and so on …

I believe there are several factors that lead to this escalation of intervention in childbirth:

Our cultural conditioning, fear, poor health habits and medical intervention in normal birth (perhaps because of fear of litigation) that make birth difficult often requiring more intervention, including surgery.

With good preparation, much intervention can be avoided – women who have a midwife they know and trust are less likely to need analgesia.  With good preparation they should be in optimal health for the birth – complementary therapies they may have experienced acupuncture, homoepathy, osteopathy or any number of helpful treatments during their pregnancy which will help align their body and prepare them for birth.  They may also have practised relaxation or hypnosis techniques all of which can be hugely beneficial.  There is also much a woman can do to help herself: mobilization, relaxation, support, the use of water …

The satisfaction that a woman feels when she has successfully given birth is amazing – it is empowering and is a fantastic start to the parenting journey, and of course breastfeeding is so much easier when you haven’t got a caesarean section wound on your abdomen.

If things didn’t work out this way for you, remember that you did the very best you could at the time.  Some labours do need help and some mothers and babies wouldn’t survive without the help of our medical colleagues.  If this has raised questions or distress for you I am more than happy to speak to you please do feel free to email me

A difficult or traumatic birth experience has long-lasting implications for both the mother and sometimes her child.  We don’t have many babies in our lifetime and it is important to get things as right as we possibly can!

Piles or haemorrhoids

Often the butt of jokes, but not a joke if you are suffering!

Of course not everyone gets piles, but they tend to occur from around the middle of pregnancy, they will probably remain throughout the pregnancy and may take several weeks to disappear after the birth.

Haemorrhoids are varicose veins in your anus or back passage and because of the hormonal influences in pregnancy the walls and valves in the veins around your anus can relax and stretch; also the weight of your growing uterus and baby put pressure and slows the blood flow and if you get constipated this exacerbates the effect even more.

You may experience a feeling of fullness in your back passage, itching, soreness, pain when you open your bowels and, sometimes, a small amount of fresh bleeding afterwards.

How can you help?

Try to avoid constipation by eating a high fibre diet and drinking lot of fluids.  Some sources suggest that eating raw garlic, onions, and parsley to increase the elasticity of your veins, and avoid constipation.  Sunflower seeds and wheatgerm are rich in vitamin E, a deficiency of which is linked with varicosities.  A daily vitamin E supplement of up to 600 IU is recommended to help repair broken capillaries. Rutin supplements will build up the walls of the veins, but should not be taken until the fourth month of pregnancy. Buckwheat is a good source of rutin that you can include in your diet.  Increasing your intake of vitamin-C-rich foods will promote healing and strengthen blood vessels, and raw beetroot/beets, either grated or as a juice, will fortify the liver and aid elimination. It is best to avoid spicy foods and aloe vera products.  When opening your bowels, try to relax and avoid straining.

Regular pelvic floor exercises may help to boost the circulation of blood in the area and gentle exercise such as walking and swimming may also help.

Ask your pharmacist, midwife or doctor to recommend a suitable haemorrhoid cream.

Take regular warm baths as this will ease the itching and pain. Some women find comfort with an ice pack, while others swear by warmth. Alternate between warm baths and cold icepacks to find which brings you the most relief.

Gently but thoroughly clean the affected area after each bowel movement. Some women find wiping with medicated pads more comfortable than using toilet tissue.

Try a herbal “sitz” bath which is a bidet or bowl with the following ingredients:

120g (4oz) dried witchhazel
60g (2oz) comfrey root
2.25l (4pt) water

Steep the witchhazel and comfrey root in the water and simmer for 8 hours. Strain into a shallow bowl and discard the herbs. Sit in the solution for 15 minutes at least twice a day. Dry the genital area thoroughly after use. The solution can be re-used and is soothing even when haemorrhoids are severe.

Take the pressure off your rectal veins to reduce the chance of developing haemorrhoids or to relieve the pain if you already have them. Avoid sitting or standing for long stretches of time, and sleep on your side, not your back.  Try lying on the left side for 20 minutes 4 to 6 times a day.

Analgesia such as paracetamol during pregnancy and ibuprofen (after the baby is born, if you are not asthmatic) can be helpful.

A special “Valley” cushion, which takes the pressure of the affected area can also be hired from the NCT

Complementary therapies may also be helpful; acupuncture, aromatherapy, shiatsu, herbalism and homoeopathy are all suggested as being beneficial but it is always wise to consult a practitioner who will advise you directly.

Try raising the foot of your bed a little with books or bricks, or even put books under your mattress or sleep with a pillow under your ankles.  Support stocking may also be beneficial.

Make up a potato poultice (a layer of hot mashed potato between two layers of muslin) and sit on it as soon as the heat is bearable; this encourages the piles to shrink back in.  Another suggestion is to use grated raw potato.