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In UK, for women with a pregnancy at term (37-42 weeks pregnant), you can choose to give birth at home, at a Birth centre or in Hospital.

All Trusts have a Homebirth Service run by midwives and Trusts are expected to run this service. Sadly this service is commonly restricted due to inadequate staffing levels.

Birth Centres are run by midwives, as part of a Maternity Service. Some are integrated into the Maternity Unit within a Hospital, whereas others are standalone community units.

Obstetric led Hospital Birth Units are run by Midwives as well as Obstetricians ( Drs trained in higher risk pregnancy, birthing & postnatal care).

The placenta is the “source of life” for pregnancy. It is an incredible organ, linking the growing baby to its Mum!

It embeds deeply into the maternal uterus soon after conception, and maintains pregnancy in so many differing ways. It is essential for the baby for survival in utero.

To highlight just a few….It nourishes and feeds the baby with nutrients to facilitate growth, and is the point of gas exchange to deliver oxygen & remove carbon dioxide. It facilitates the hormones needed to maintain and grow the pregnancy, as well as the vital role of protecting baby form nasty bugs or “pathogens”.

Aside from the membranes sealing the baby in a “bag” to create that vital safe sterile environment, the waters or amniotic fluid around the baby, allow baby freedom of movement in utero as well as keeping baby at right temperature warm inside the Mum!

Delivery of the placenta is the 3rd & final stage of labour and it is often called the “afterbirth”.

It is crazy that such an organ is considered “medical waste” after it is birthed; its function is complete once the baby and the placenta itself is delivered. Of course many cultures around the world have a differing opinion on the placenta and they perform all sorts of rituals and ceremonies, amounting to a sign of respect for such an incredulous organ!

For me as an experienced midwife, when checking the placenta after birth to ensure it has been delivered complete, it fascinates me enormously. The intricacies & the detail of the human body never fail to astonish me!

Anaemia in pregnancy can commonly develop due to the demands of the growing pregnancy, and can be caused by a deficiency of iron in the diet.

Pregnant mothers are tested (blood test) usually at booking and again around 28 weeks of pregnancy, and these levels are used to shape care and advice.

Symptoms of anaemia can include tiredness and paleness of colour – breathlessness too on exercise – but essentially it can be common to feel tired in pregnancy due to the demands on the body so a chat with your midwife or GP to talk through any concerns you have is important.

Diet plays a key part – that saying “we are what we eat” is oh so true!

For my clients I always take a thorough history as well as review of blood tests results, and take the time to discuss in detail their diet – such as number of meals a day, home cooked meals from ingredients as fresh/ close to the source, food restrictions or avoidances, choices and intolerances.

If you eat very healthily and enjoy a full range of foods then supplements may not be necessary. I counsel women too regarding maximising the absorbency of iron from their diet/supplements if they are required. One simple trick is to increase vitamin C intake as this has been shown to improve the absorbency of iron.

If iron supplements are required it is important to have a repeat blood test 2 weeks after commencing the supplement, to ensure that the iron levels are improving.

I also counsel women regarding the unpleasant side effects of iron as these can come as a surprise, and deter women from continuing with the iron. It is important to find an iron supplement that “suits you” so if clients struggle with one type, I recommend another to try until one is found that is tolerable.

“It is impossible to explain how much Helen has helped us. I credit her with my positive pregnancy, birth and parenting experience to date. Her support has made a phenomenal difference for our family. She helped us make informed choices as pregnancy progressed – everyone commented how calm I seemed and I think this contributed hugely to a relaxed straightforward labour. Having a relationship with your midwife helps immensely and it is a real shame this isn’t the normal procedure.
Helen was a mentor, a friend and when necessary ensured i got the old-fashioned straight talking I needed to get through labour! When we had early issues with breastfeeding Helen was fantastic and without her support I’m sure I wouldn’t have been able to continue. We were also impressed she supported us as a family and included my husband. I would not have another child without her support and recommend her services to everyone.” Jan 2019

This is a very helpful update from RCOG – Royal College of Obstetricians.

A recent article in the Sunday Telegraph (https://www.telegraph.co.uk/news/2020/01/25/women-labour-denied-epidurals-nhs-amid-concern-cult-natural/) suggested that women are being denied an epidural in labour.

As an experienced midwife, I can only see that comments such as these will scare monger women, who after carefully researching all methods of pain, have made an informed decision to choose an epidural for pain relief in labour.

When I support clients for their births, yes I see the NHS is stretched and staff are over challenged by sheer volume of work, but I see staff – midwives, obstetricians and anaesthetists, listening to women and their requests and choices for pain relief, and providing that care within a safe framework. Yes sometimes client’s have had to “wait” for their epidural as there is an emergency on Labour Ward – but I witness good support in the meantime whilst they have to wait etc. So I seek to reassure that it is unlikely that you will be refused or denied an epidural, if requested. All pregnant women need to be mindful that of course sometimes all the best laid birth plans can be over ruled by Mother Nature though!

This is a balanced article written by an Anaesthetist you may find helpful to read!

https://www.rcoa.ac.uk/blog/epidural-denial-thoughts-frontline

Dr Bill Franklin recently celebrated his 107th birthday and as an expert in allergies, was asked what practical steps parents could take to protect their children from allergies.

He highlighted that genetics plays a part in around 30% of allergies but that 70% are due to the environment.

He talked about parents smoking and whether the family live near a road and therefore the children breath in pollution.

But he also highlighted the importance of breast feeding as well as vaginal birthing, where clinically possible. There is increasing research into the importance of the newborn baby passing through the vagina/birth canal, and picking up on important bacteria – we call this the seeding of the newborn microbiome.

Both breast feeding and vaginal birth helps to properly prime the newborn baby’s immune system.

I am often asked about this!

It really is a good idea to keep moving, even at term of pregnancy! It is very tempting to sit back and “rest” when you feel heavy and uncomfortable, but a gentle walk every day for around 45 minutes will help you, and your general wellbeing – both mentally and physically!

Pregnancy hormones can cause your  joints to relax a little (in preparation for labouring), especially towards the end of pregnancy, so go easy – no crazy workouts!

Swimming is an ideal exercise, as the water supports you well.

It is quite common to get a little increased breathlessness when exercising, due to the weight of pregnancy etc. If you have any concerns do speak with your midwife or GP.