Amy’s questions about episiotomy and foetal dopplers

Amy, 31, is pregnant for the first time and has never changed a nappy. She asks Sarah Denning her questions about her birth choices.

Sarah Denning is a midwife at The Birth Team, The Spires Hospital, Bushey

Q: Can I Choose Not To Have An Episiotomy?

A: Of course you can choose not to have an episiotomy, just bear in mind that no midwife or doctor will routinely perform one unless they feel that by NOT doing it you will have a tear that would be more damaging. What we try to do is avoid a woman having a tear that extends down to or involves the rectum and the muscles around it. This is more likely with assisted vaginal birth (forceps or ventouse) and very large babies but can happen with normal birth and average babies too. Usually, the decision is made just at the time the baby’s head is being born, as it isn’t until then that we could see there may be a potentially bad tear. Your midwife or doctor should explain and get your consent. It’s good to discuss your thoughts around episiotomy with your professional before the birth and include your preferences in your birth plan – but also try to keep an open mind, as it is only ever done to prevent possible damage and with good pain relief to the area beforehand.

More information here

Q: Are Home Foetal Doppler Machines OK? There’s Such Conflicting Information Online

Most healthcare professionals do not advise using home doppler machines unless you are professionally trained in how to listen to the baby’s heartbeat and how to interpret it. It isn’t an accurate way to tell if your baby is doing well. Sometimes you may be listening to your own heartbeat instead of the baby’s, you may not be able to find the heartbeat, which will cause unnecessary panic and you may give yourself false reassurance if there is a problem. Also, it makes sense to avoid exposing babies to ultrasound unnecessarily. Hearing a heartbeat for a minute or two is not a reliable way to tell that he or she is well; after 24 weeks, baby’s movements are the best way to tell if your baby is doing well. If you have any concerns about your babys movements, contact your midwife, doctor or hospital straight away. Don’t rely on a home doppler!

More at Count The Kicks

I Get Acid Reflux in the evenings, What Can I Do To Ease The Pain?

This is usually worsened by acidic or spicy foods. Often seen as a minor problem, acid reflux or heartburn can be painful and miserable. Try to avoid it by not eating spiced or acidic food in the evenings, and eat little and often. This ensures you aren’t going a long time with no food, which in itself can cause nausea and heartburn. A milky drink in the evening can help and Gaviscon is a safe formula that can really help. Also, talk to your pharmacist.

I Have Been Sleeping On My Back – Is This Bad For My Baby?

Try not to worry too much at this stage. In later pregnancy, lying on your back compresses the large blood vessels that run behind your womb, slightly reducing blood flow from the lower body to the heart (and therefore to the baby via the placenta); that’s why pregnant women are advised to lie on the left side.

Hypnobirthing: Helpful Or Mumbo Jumbo?

Very helpful! There is a very sound basis for hypnobirthing, as it is rooted in positive thought; we know that calm, relaxed breathing reduces the amount of pain hormones you produce and will make labour feel easier. It is an intense form of self relaxation and a way of looking at contractions as positive, forward-moving surges that bring the baby closer to being born, instead of painful intervals to be endured. However, it is a technique that needs practice, preferably with your birth partner or friend and doesn’t work for everyone. It can be expensive. Best results usually result from a course with a qualified hypnobirthing practitioner.

Find a hynobirthing professional one our Resources page.

I’ve Read About Stem Cell Collection: Is It Worth The Money?

I think it is a very personal decision for parents to make. Stem cell collection is relatively new and is evolving all the time. There is a National Stem Cell bank, like a blood bank, used nationally and internationally to help people that need stem cells. For more about Stem Cell collection online, see our Issue One feature.

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