Hi Bernie. 
I had my beautiful baby girl this morning at 8.54am. Labour only 4 hours!! Contractions were more or less 5 mins apart from the get go. After barely an hour labouring at home I was 6 cm by the time I got to hospital which I had actually envisaged in my mind movie!  Didn't feel it though as was totally managing, completely drug free. Didn't even manage to use the gas and air! That's not to say that the pain wasn't intense near the end but I knew if I went with my body all would be well. Natural 3rd stage too. Didn't fight any of the labour sensations  and still can't believe it worked out so well.
Thanks so much for your help.  ​

PART 1: Nutrition & Nourishment for Pregnancy


Have you noticed that when you’re pregnant, everyone has advice for you?! And everyone seems to have an opinion on what you should be putting into your body.

But nutrition during pregnancy is not just about staying away from blue cheese and raw fish. When you pay attention to what you put into your body while pregnant, you can really make a difference to your own health and the health of your baby now and into the future.

I’ve put together a handy summary of all you need to know to create your healthiest possible baby.


Your Five Nutrient BFF’s

This is the science bit! There are five nutrients every pregnant woman needs to make a special effort to include in her diet.

1. Folic Acid
   - You can’t miss hearing about folic acid when pregnant. It’s important to take folic acid supplements in the months running up to conception, but it’s also essential to continue taking it throughout the first trimester. Adequate levels of folic acid in your diet before and during pregnancy reduce the risk your baby will have neural tube defects, such as spina bifida, by 70%.

Food Sources of Folate:

• avocado


• dark green leafy vegetables 
• asparagus


• papaya
• oranges


• seeds and nuts
• brussels sprouts


• bran flakes
• brown rice


• broccoli and cauliflower
  
  2.   Iron
  - Iron is important throughout your pregnancy, but especially in the third trimester, when there is a marked increase in the the volume of blood in your body. 

It’s worth investing in a good pregnancy vitamin and mineral supplement, which will look after your iron needs, in addition to eating iron-rich foods.

Food Sources of Iron:

- red meat
- chicken and turkey (especially the dark meat)
- pumpkin seeds
- fortified breakfast cereals
- lentils, chickpeas and edamame beans
- whole grains like quinoa and oats
- dark green leafy vegetables
- prune juice 


3.     Zinc
- When pregnant, your zinc needs increase by 50%. Zinc is not just important for your immunity but is also the building block for our DNA, helping us produce and repair every cell in our body. So it’s especially important for our growing babies! 

Food Sources of Zinc: There is no food higher in zinc than oysters - but you may prefer to stay away from shellfish while pregnant.


Other options include:

- beef and lamb
- chicken and turkey
- wheatgerm
- pumpkin seeds
- cashew nuts
- cocoa powder, dark chocolate or raw cacao


4.    Calcium
- Your baby will require calcium to form its bones and teeth. Ensuring your calcium stocks are high will help you maintain your own bone mass and strong, healthy teeth.

Sources of Calcium:

- Dairy products, such as cheese and yoghurt
- Green leafy vegetables, such as spinach, kale and bok choy
- Almonds
- Dried figs
- Canned salmon and sardines (with bones)
- Seaweed


5.  Omega 3 Fats
- These are a little secret ingredient to your own happiness and your baby’s healthy development. 

We’ve been hearing (incorrectly) for years that a low-fat diet is the key to health and weight loss. But healthy fats help keep your hormones in check and combat depression as well as boosting your baby’s eyesight, memory and language comprehension.  


Sources of Omega 3 fats:

• Oily fish - aim to have 3 portions each week of oily fish, like salmon, sardines, anchovies, herring and mackerel. Go for wild, rather than farm-raised fish where possible.
  
  

Pregnant women are advised to stay away from fish which may be high in mercury, such as albacore tuna, swordfish and shark (but you probably weren’t going to be tucking into shark anytime soon!)

• Walnuts, olive oil, flaxseeds and chia seeds
  
  

Eat a Rainbow

Once you’ve looked after your top 5 nutrients, you don’t need to get too scientific if you just stick to one very simple rule:


Eat 5-7 helpings of fruit and vegetables every single day and make sure they are a mix of all the colours of the rainbow.


The deeper the colour of your fruits and veggies, the greater the concentration of nutrients and antioxidants. (Hence why vibrantly coloured foods like kale, blueberries, beetroot and tomatoes have been labelled ‘superfoods’.)


Eating a wide variety of foods also has the added benefit of exposing your baby to new tastes via the amniotic fluid, hopefully resulting in a more adventurous palate when they’re ready to be weaned!



Get Things Moving!

You may already have experience with the pregnant woman’s sworn enemy: constipation.

An increase in the hormone progesterone during pregnancy means that muscles throughout the body, including your bowel, will relax. So food will likely move more slowly than usual through your intestines. In your third trimester, the weight of the expanded womb pressing against the bowel can cause even further difficulties, including haemorrhoids.

The number one thing you can do to help is ensure you have lots of fibre in your diet. The best sources of fibre are fresh fruit and vegetables, legumes (beans, nuts, peas and lentils) and whole grains (porridge oats, quinoa, whole grain brown rice).

Prune juice worked a treat during my own pregnancy (as much as I hated the taste!), as did adding whole linseeds to my breakfast. Linseeds soak up fluids to form a gel which helps push food waste through the digestive tract.


Drink Lots of Water

If you’re going to be eating more fibre than usual, then it’s important you keep your water intake up throughout each day too (fibre without water will actually make things worse!).

Keeping hydrated also helps prevent pre-term labour, headaches, exhaustion, dizziness and kidney stones.

Keep sipping water throughout the day and limit caffeinated drinks. If you’re unsure as to whether you’re drinking enough, a quick check of your urine will tell you. Urine which is light yellow in colour is a sign you are on track. If your urine is dark and concentrated in colour, you are probably dehydrated.


One word of caution: drinking lots of fruit juice in pregnancy is not a good idea. Juice is low in fibre but very high in sugar, so it will spike your blood sugar and likely cause unnecessary weight gain.


It’s best to stick to water or herbal teas for your drinks and satisfy your fruit cravings with whole, fresh fruit, which is full of fibre.


Don’t Eat for Two!

I’m sure you’ve been told this before, but it’s worth noting that you actually only need an extra 300-500 calories each day while pregnant - mostly during the last trimester - no matter what your body tells you!

Sometimes when you’re pregnant you can feel ravenous for no good reason. (I remember feeling the need for two helpings of every dinner during my second trimester!) It’s those hormones playing tricks on you.


At these times, it’s best to ensure you snack on healthy, nutritious foods, like fruit, veggies, hummus, avocado, nuts and seeds.

Another good option is to ensure you include a mix of protein (meat, fish, eggs and legumes) and complex carbohydrates (whole grains) in every meal to ensure you feel full longer and keep those cravings at bay.


Processed carbohydrates are not your friends right now. Your body has no use for processed white bread, pastries, biscuits and cakes. It will be treated by your body as junk - clogging up your digestive tract and causing weight gain.



Eat Whole, Organic Food


At any time of your life, it is best to stay away from too many pre-packaged and processed foods. When food manufacturers prepare your food, they don’t have your best interests at heart. Too many ready meals contain high levels of sugar, salt and fat - not to mention additives and preservatives that you and your baby could really do without.


This means moving from ready meals to fresh, home-cooked food. If you have been used to eating out or on the go, then you could see pregnancy as the perfect opportunity for you and your loved ones to slow down and begin to cook from scratch. There are plenty of great, easy meals that can be prepared in half an hour, or so.


Why Organic?


You may be questioning whether organic food is really worth the investment. But did you know that the average supermarket apple will have been sprayed with up to 48 different kinds of pesticides by the time you bite into it?


We now know that pesticides do get stored in our bodies and can even be passed through the placenta into our developing babies. It is still unclear what the long-term effects of this will be, but you may wish to err on the side of caution, where you can.


To receive an organic certification, food needs to be produced without using chemicals, pesticides or artificial fertilisers. In addition, organic meats will be from animals treated humanely and not given antibiotics (unless absolutely necessary) or genetically modified feed.


If you have a local farmers’ market, get yourself there and stock up on all the gorgeous organic produce. This is the least expensive way of getting your organic food - and it also helps support local producers, rather than big supermarket chains.


If you’re anxious to make savings, then just choose to buy organic for those items that are most heavily sprayed. Check out the list of the Dirty Dozen and the Clean Fifteen. This will give you an idea of where best to spend your euro to make a difference, as some fruits and veg are more heavily sprayed than others.



I hope you found this checklist of use. The very best of luck for your healthy, happy pregnancy!


Niamh -  A Whole New You

 “Hi Bernie I have been meaning to e-mail you, N arrived at 8pm exactly, 36 weeks 4lbs 2oz.  I went into spontaneous labour, I thought I had indigestion when I woke up that morning.  I spent a few hours at home having brekkie and chatting with my parents, decided to go to hospital and check if all was ok about 1pm.  Had trace and heartbeat was fine.  Then they performed VE and I was fully effaced so they admitted me.  My sister went and got us lunch and I asked for a ball as I didn’t have anything like that with me.  I sat on ball and chatted to my sister and my husband came in around 3.30.  I used the shower a few times, I had my birth preferences in a folder but had never discussed these with anyone.  So talked them through with midwife.  About 5.30 midwife asked if I would like to be examined again to consider moving to delivery room. I said ok, after the examination we walked to the delivery room and on the way midwife asked was I doing hypnobirthing.  I used my breathing all the time and honestly felt relaxed and calm throughout.  My waters went in the delivery room (naturally) and there was meconium so I had CTG.  I delivered our little girl vaginally, tried gas and air in delivery room but didn’t like it.  Labour couldn’t have gone better!  .... …. N was discharged last week so we are finally enjoying time at home and I’m delighted.  Thanks for the class and for staying in touch.  I found the last few weeks of pregnancy very stressful and the whole programme really helped me to stay calm and focus on the positive.  I’m so thrilled to have my gorgeous little girl here now.

 1.    Feeling Calm, Confident and in Control!  

GentleBirth Mums know all about the 3 Cs!

• Mums who choose their own position during labour, will rarely lie on their backs and have reported more feelings of confidence and being in control.  
• Stress hormones are lowered when adopting an upright position, allowing oxytocin and endorphins (birth hormones) to flow.  
• Women feel part of their birth team and less like a patient when they’re not lying in bed.

You can imagine it could be difficult to feel confident being the only person in the room on your back with no underwear on. ​

3.  Less chance of Distress to your Baby 

Getting off your back allows maximum circulation between you and your baby, maximum blood flow and oxygen to your baby.

• Your baby is 54% less likely to have abnormal fetal heart rate patterns.
• It reduces the risk of aorto-caval compression  -  

You know how you’ve been told not to lie on your back during pregnancy, it usually gets quite uncomfortable from somewhere in your second trimester anyway.   The reason is that the main abdominal artery and vein can be compressed by the uterus and the weight of the baby limiting blood flow.  This can result in low maternal blood pressure, feeling faint, sweating and dizziness and may also affect baby’s heart rate.  It doesn’t sound like a good idea at the best of times never mind when you’re in labour.  This does not occur when a woman is in a side lying or upright position.

 

4.    More Comfortable Labour!

Movement into comfortable positions will help you to manage your sensations.  Think about what you did the last time you had a cramp in your leg – you probably got up wiggled your foot until the cramp eased…

• Women tend to move and sway during their surges.  Standing, leaning on your partner, squatting, hip circles on your birthing ball and rocking on all fours can all be comfortable positions for labour.  
• Mums who use movement in labour find their labour sensations more manageable and have less need for the epidural and other pain relief. 
• Birth partners can easily support mums and use comfort measures like massage and counter pressure.

 

5.    More Room for Baby!

Standing, squatting, kneeling, all fours and sitting facing forward in a chair all increase space in the pelvis.

• Squatting can increase the space in the pelvis by up to 30%!
• More room makes it is easier for baby to get into the perfect position for birth.  (point 2 – shorter labours!)
• Babies who start out in the OP (back to back) position have more room to turn and surges help baby turn in the uterus when the mum is supported.  Helping the baby to turn increases mum’s comfort level as well.

6.         Decrease Chance of Assisted Delivery by 23%!

• In  2012 Cochrane Review of 22 studies including over 7,200 women, those who were in an upright position for labour were 23% less likely to have a forceps or vacuum-assisted delivery.
• An assisted delivery may be necessary if baby is in distress or if the mum is exhausted after a long labour or long pushing phase.
• An assisted delivery can be prevented by avoiding birthing on your back and common interventions such as the epidural or amniotomy   (artificial rupture of membranes).
• The benefits of avoiding assisted deliveries are less damage to the pelvic floor and a gentler birth for baby.

7.    Decrease Chance of Episiotomy by 21%

• In the same review it was found that women who were upright in birth were 21% less like to have an episiotomy.
•  An Episiotomy is a surgical cut to the perineum as baby crowns.
• Disadvantages are increased pain after birth, more likely to cause 3rd / 4th degree tears, infection and longer healing times. 
• To avoid an episiotomy, birth off the bed, no purple pushing – slow controlled “pushing” phase, labour in water, practice perineal massage and pelvic floor exercises during pregnancy.

 
Reasons NOT to Lie Down in Labour:

·         Because there’s a bed in the room!

·         Because you’ve seen it on TV and in the movies!

·         Because “Everyone” gives birth like that!

·         Because “insert name” told you to! 


To sum it all up choose whatever position you feel comfortable in.  

·         Lie down if you need to rest or you’ve had the epidural

·         Choose a side lying position

·         Use pillows / peanut ball to create space in your pelvis

·         Get your partner & midwife to help you change sides every half hour.

 

To learn more about comfort measures for labour, having an upright epidural birth and navigating the system consider doing a GentleBirth workshop. 

Contact bernie@blissfulbumpsnbabes.ie for more info

Further Reading: 

Whole, Healthy and Intact - Avoiding Perineal Trauma by Tracy Donegan -

http://www.gentlebirth.ie/index.php?route=ac_cms/article&b_id=3

http://evidencebasedbirth.com/what-is-the-evidence-for-pushing-positions/

 

References:  2012 Cochrane review, Gupta et al. , de Jonge and Lagro-Jansenn 2004; Green and Baston 2003; Green et al. 1990. Lawrence et al 2013