Midwife-led Care
Midwife-led Care

What is a Midwife?

It’s not just the making of babies, but the making of mothers that midwives see as the miracle of birth.

With the medicalised model of birth that dominates today, we sometimes lose our perspective on this incredible milestone in the life of a woman and her family. It is possible to ensure the safe delivery of a child into this world while remaining respectful of the powerful emotional and spiritual aspects of childbirth.

Every woman has the right to have her fears alleviated and both her physical and emotional needs met during childbirth. Every woman has the right to be treated with love and respect at this pivotal moment in her life.

An active birth is a normal, natural birth, without (some, depending) medical intervention, in which a woman follows her own instinctive responses working with her body to enable her baby to be born. If women were to labour in a relaxing, secure environment with good support and the freedom to move around, most would know instinctively what to do. Active birth enables a labouring woman to respond naturally to her birthing process and to make appropriate choices. Women are encouraged to remain mobile and upright and to adopt the position of their choice during labour and birth and unnecessary restrictions and procedures are minimised. Fundamentally it is an attitude of respect and support for the labouring woman and her family. 

Benefits of Midwife-led Care

The modern midwife is a healthcare professional who undergoes extensive training and specialises in natural normal birth. They work with women and their families throughout pregnancy, childbirth and in the weeks following birth. A midwife provides personal, more intimate care than generally associated with a physician and respects the natural process of pregnancy, labour and birth. They have the expertise and skills necessary to care for healthy women with low risk pregnancies and at the same time maintain associations with other healthcare providers. Midwives consider birth a natural event in women’s lives. Midwifery is based on the belief that childbirth is (and should be), a natural, healthy process and that most women are fully capable of giving birth. Midwives see pregnancy as part of the full spectrum of life’s experiences, and they believe women have the right to a fulfilling, as well as a safe, childbirth experience.

Evidence based research has shown that midwives achieve the same outcomes as physicians without disrupting the natural birth process as often. In fact, care from midwives has significantly lower rates of induced labour, episiotomies, and forcep births. Midwives are most actively involved in a woman’s preparation for childbirth and their support and education reduces the length of labour, avoiding unnecessary medical interventions and improves birth outcomes. Midwifery care is proven to be safe. “Most women are healthy and have straightforward pregnancies and births. Over the years, evidence has emerged which shows that, for this group of women, giving birth in a midwife-led unit instead of a traditional labour ward is a safe option,” says Professor Mark Baker, NICE’s (National Institute for Health and Care Excellence) Clinical Practice Director. 

Women who give birth under the care of a midwife are more likely to have: [2]

 Lower rates of birth by caesarean section.

 Lower rates of induced labour.

 Significantly lower rates of third and fourth degree tears from delivery and less episiotomy rates.

 Higher success of breastfeeding.

If the need for a Caesarean Section arises, we have all the back-up in place. This is why your antenatal consultations with one of the affiliated ObGyn’s, will give you the final ‘go-ahead’ for a natural, low-risk birth. If you need a Caesarean Section, your gynaecologist and medical team will be on call immediately. You and your baby’s safety is our main concern and therefore we all have the essential medical back-up in place. We encourage our mothers to draw on their support systems during pregnancy, labour and birth and the postnatal period, therefore we have a family-centred approach to maternity care, ensuring that baby stays with mom all the time, unless there is a medical indication and baby needs specialised care.

Consultations are scheduled with substantial time to address questions and concerns. Midwives provide care that focuses on health promotion, education and shared decision making.

 

Their actions are guided by the Midwifery Model of Care which includes:

 1.Monitoring the physical, physiological and social well-being of the mother throughout her antenatal, labour, birth and postnatal period.

2.Providing the mother and partner with individualised education, counselling and antenatal care, continuous hands-on assistance during labour, birth and postnatal support.

3.Minimising unnecessary technological or medical interventions. Identifying and referring women who require gynaecological intervention.

Midwives respect that clients are individuals and because of their personal, cultural, and religious beliefs, every birth experience is different. Midwifery care involves education, health awareness, social support, and clinical assessment. Midwifery encourages mind-body connections, recognising the spiritual and emotional aspects of birth, allowing women to birth with strength and dignity. Midwives encourage women and their families to make informed choices, creating an atmosphere in which they can celebrate the miracle of birth, wherever they choose to be.

Birth options after previous caesarean section:

A VBAC; Vaginal Birth after a Caesarean can be a safe and healthy option for most women. Women who would like to enquire whether they are suitable candidates for a VBAC, must have an antenatal consultation with the Midwife to assess if they are a suitable candidate for a VBAC.

 

Is a VBAC Right For Me?

Of course, this is a discussion for you to have with your healthcare practitioner. But generally speaking, if you are a low-risk pregnancy, you are a great candidate for a natural VBAC birth. Moms with few complications or conditions during their pregnancy can successfully birth their babies vaginally and reap the many benefits. Some other considerations when thinking about a VBAC include the following:

 Type of surgical incision from the previous caesarean.

 Reason for the past Caesarean.

 Whether or not a previous vaginal birth was ever achieved.

 How many previous caesareans one has had.

 The gestational age of the baby.

 Whether or not there was ever a previous uterine rupture.

 The mother’s health issues, if any.

 The age of the mother.

 The shape of her uterus.

 The presentation of baby.

Birthing with a midwife will improve your odds for a successful VBAC. Giving birth in a birthing center is an excellent and safe option.

You will need to know if you are a suitable candidate for a VBAC by making an appointment with us first, as per our contact details.

Labour and Birth with a midwife

“Keeping active during labour and adopting natural, upright or crouching birth positions is the safest, most enjoyable, most economical and sensible way for the majority of women to give birth.” ~ Janet Balaskas

Labour & Birth

During an active birth, women are encouraged to move around freely and choose positions that feel comfortable to them. Mothers who choose an active birth are unlikely to lie on their backs to birth their babies which are the standard approach in traditional hospital birth wards. 

Historically, women have given birth in an upright position where they are free to move around. The traditional supine (on your back) position is a relatively recent development which is falling out of favour because this painful, physiologically dysfunctional way of giving birth, can result in the pelvis losing up to 30% of its capacity to be utilised for birth. This discovery has led to the active birth movement. 

In a world where labour was controlled by medical professionals, the active birth movement encourages women to take back control of giving birth. Instead of being told what position to adopt during labour, women are encouraged to do whatever feels the most comfortable for them. 

The term active birth was created by antenatal teacher and author, Janet Balaskas in the 1980’s. World-renowned and respected, Janet was born in South Africa is currently is the Director of the Active Birth Centre in London, UK. 

Through intensive research, Janet discovered that women in other cultures didn’t lie on their backs to give birth. In fact they squatted, knelt or stood, surrounded by supportive women. The active birth movement is now gaining in popularity, and many healthcare professionals are now aware of the benefits of giving birth in upright positions.

We advocate for active birth and women can use birthing stools, balls and cushions to allow comfortable sitting, kneeling and squatting positions during the birth, We also provide birth tubs which allow women to go through labour and give birth in water. The water provides support and buoyancy which allows the mother to change position easily in the pool.

 

 A shorter, more efficient labour: During labour your baby’s head moves slowly into the pelvic canal as it emerges from the dilating cervix. By adopting an active birth position your pelvis is at the best possible angle for gravity to help the birthing process. Numerous studies have shown that this is likely to make labour shorter and more efficient.

 Less pain: Being free to move and choose your own position has other advantages as well. It’s easier for your uterus to do its work naturally and the contractions tend to be less painful than if you were lying on your back. Freedom of movement, free expression of sound and the natural forward tilting of the uterus helps modify the pain and this is likely to reduce the need for medical pain relief.

 Less risk of foetal distress: Active birth also allows a better blood flow to the placenta since the mother is upright and breathing deeply. The baby receives plenty of oxygen and there is less risk of ‘foetal distress’ developing. Foetal distress is a common cause for a caesarean section or the use of forceps or vantoux to deliver the baby quickly. Another benefit is that there is no compression of the internal blood vessels which is not the case if the mother lies on her back for an extended period or in the semi-reclining position.

 A more powerful, easier way to push: During the second stage, when you are ready to give birth, choosing a kneeling, supported squatting or standing position will help you use your energy in the best way while you are pushing. It is much more effective and powerful to push with the help of gravity and the rotation and descent of the baby’s head is easier. There is no ideal position for giving birth and this varies from woman to woman. You may use several upright positions during this phase of the birth and can give birth in any one of them. The supine or reclining position is by far the least advantageous – working against gravity and reducing the space within the pelvis. When you are upright the pelvic joints are not constricted and this allows a greater degree of movement and expansion of the pelvic diameters so that the internal shape of your pelvis has more space to accommodate the baby’s head as it descends. During the final stages of the birthing process, the back wall of the pelvis (sacrum and coccyx) are free to move back to increase the diameters of the pelvic outlet to make plenty of space for your baby to be born.

 Skin to skin and breast contact: After your baby is born and you are enjoying the pleasure of holding him or her in your arms for the first time, it’s a good idea to sit upright so that you can hold your baby ‘skin-to-skin’ and position your baby well for the first contact with the breast. Then, while you are welcoming your baby and the first breastfeed begins, gravity will be helping your placenta to separate and your uterus to contract efficiently to prevent excessive blood loss.

 Partners can get more involved: In an active birth partners are often actively involved in giving both emotional and physical support. This active sharing of the birth experience can be very fulfilling and memorable, providing a good start to a new relationship as parents.

 Less trauma: An active birth usually results in minimal trauma for the baby during the birth process. Generally the baby is likely to be born in optimal condition, bonding after birth and the first breast feeding are facilitated and the mother generally feels good and recovers well from the birth. This makes caring for the new born baby easier.

 Birth hormones: From beginning to end, the entire birth process is stimulated by hormones that are produced by the hypothalamus. We share this trait with all other mammals, and like them, we need to feel safe and protected to release birth hormones effectively. Two important elements in an active birth are the quiet, reassuring presence of a supportive midwife and the right ambience in the labour room. The labour room should be comfortable, warm, calm and peaceful so that you have enough privacy and security to let yourself go, to be noisy if you need to be and to relax and rest in between the contractions without distractions. When the lights are turned down, the curtains are drawn and it is quiet, your body produces high levels of a hormone called oxytocin which stimulates good strong contractions. Your body also produces hormones called endorphins which are natural painkillers and relaxants. Combined with the benefits of being upright, these hormones help you shut out everything else, to immerse yourself in your labour and concentrate on the contractions. Once you relax, labour usually progresses well leading to an efficient second stage and a successful birth. It’s important to understand that labour and birth are involuntary. The uterus contracts spontaneously, firstly to open the womb and then to give birth to the baby. All of this happens without your conscious control. You do not need to do anything other than relax and let it all happen naturally.

 With the help of water: An important innovation in creating the ideal birthing environment for an active birth is the introduction of water birth pools.  In addition to gravity, water is another natural element which has enormous power to support your instinctive resources during labour. 

 After the birth: There is no denying that going through an active birth and experiencing labour is a challenge that may stretch you to your limits. The moment you are holding your baby in your arms for the first time you are likely to forget what you have been through almost instantly. Instead it is likely to be replaced by a feeling of enormous exhilaration. Giving birth is an achievement you can be very proud of. Having an Active Birth is an empowering and life transforming experience for many women. Starting from the basic wisdom that it’s best to keep upright and with a few simple modifications to the environment, I have seen over the years that most women can have a much better experience of birth than they might otherwise have done.

Content adapted from an article by Janet Balaskas, founder of the Active Birth Movement ~ “Active Birth and Why It Can Make a Difference for Your Birth.” [5]

RESEARCH BASED EVIDENCE FOR ACTIVE BIRTH:

  1. US National Library of Medicine National Institutes of Health, May, 2012.
  2. US National Library of Medicine National Institutes of Health, Maternal positions and mobility during first stage labour. [Cochrane Database Syst Rev. 2013].
  3. American College of Midwives and Nurses, ACNM Releases Research Showing Significant Midwifery Care Benefits, Press Release, May 15, 2012.
  4. Sci Flo, Brazil, The vertical position during labour,  December, 2009.
  5. Active Birth Manifesto Janet Balaskas, 1982. Revised, 2001.

Current research and reported experiences tell us water birth has many benefits: 

 Pain relief

 Relaxation

 Buoyancy to helping women feel lighter

 Facilitating position changes

 Helping reduce stress hormones that increase pain

 Immersion in water can help reduce anxiety

 Reduced risk of episiotomy and tearing

 Can facilitate the fetal ejection reflex rather than interfere with it

 Encourages relaxation of the pelvic floor

 Reduces inhibition and anxiety by creating a feeling of privacy to allow a mother to follow her natural birthing instincts and work with her body

 Encourages a gentler arrival and transition for baby

 By facilitating movement, privacy, and both emotional and physical relaxation water birthing can reduce the length of labour by encouraging the release of labour hormones

 Reduces the risk of medical interventions.

 How will my baby breathe during a water birth? When we observe a birth out of the water, we often notice baby quickly breathes and cries. However, simply exiting the womb does not trigger breathing. Babies are triggered to breathe when they feel the change in temperature. When the birthing pool is kept at a safe temperature, (between 36 and 38 degrees Celsius ~ body temperature) the baby will continue to receive oxygen through the umbilical cord. Once brought swiftly out of the tub, the change in temperature will trigger baby to take the first breath. The method most commonly used term for baby to be birthed is, “through” the water as opposed to “into” the water. By this method, the baby is birthed and brought to the surface within one minute of birth. Once a mother has birthed her baby, she will want her baby in her arms immediately!

 Is there a risk of infection? The birth tub is thoroughly cleaned before and after the birth and the water is clean (if it is clean enough to drink then it is clean enough to birth in) and there is no significant increased risk of infection to either the mother or the baby. Salt is also added to the water to act as a natural antiseptic and to make the water more like body fluid so the baby is birthed from fluid in the uterus into a similar saline fluid. It is important to ensure that both the mother and the baby are healthy before choosing a water birth. During a study on water birth, French obstetrician and a world-renowned water birth Dr Michel Oden, reported no infections, regardless of whether membranes (waters) were intact or ruptured. 

 When should a woman get in the water? Experience has shown that it is best to use water in mid labour – when the mother is about 5 to 6cms dilated. Labour is usually very intense at this stage and the mother may feel she needs help and this is the ideal time to enter the birth pool. After about half an hour of being in the warm water the mother is likely to enter a very relaxed state where she can enter a deeper level inside herself and surrender to the power of the more active phase of labour. This is the time to allow the body to take over, to trust in nature and to surrender to the involuntary forces that are opening your body and bringing your baby into the world. The warm sensations of water on skin will help to modify the pain and the buoyancy of the water will relieve the body’s weight. This helps enormously to make the mother more comfortable in upright positions and to conserve strength and energy. It’s much easier, for example to move or to squat in water. Your partner can sit right beside the birth tub or even get in with you to massage and hold you. Once in the water, the mother is unlikely to notice the world outside the rim of the pool or how much time has passed. It helps her stop thinking and to be “in” her body. The increased secretion of oxytocin when the mother enters the water peaks after about two hours. Oxytocin, an important labour hormone is more easily secreted when the mother feels safe, comfortable and loved.  This aids the secretion of birth hormones which stimulate contractions and aid the body’s natural pain relief mechanisms. When you feel you are ready to push and give birth to your baby you may decide to leave the pool and have your feet firmly planted on the ground or you may decide to remain in the water for the second stage.  Provided there is good progress and no sign of any complication, birth in water can be easier for the mother and gentler for the baby.  

 Is a water birth right for me? Until you’re in labour it can be hard to know for certain what will best to help you cope with contractions. However, many women do plan for a water birth, and take steps to keep it as a viable option should they find it helpful. 

 What benefits does water birth have for babies? Midwives who attend water births report that babies tend to be calm and the transition to life outside the womb more easily. Women who labour in water respond by feeling more relaxed, which in turn facilitates more effective labour and less stress on their babies. Babies who have been surrounding by warm water for nine months are eased into a warm, watery environment, reducing the sudden temperature changes and bright lights. The transition to breathing is gentle, as the baby is brought to the air and the umbilical cord is left intact.

A study published in the Journal of Midwifery & Women’s Health looked at midwife attended water births in the United States over a five year period. [4] The researchers analysed data collected by the Midwives Alliance of North America Statistics Project (known as MANA Stats).  More than 6,500 women in the database gave birth in water, either at home or in a freestanding birthing centre; the study didn’t include women birthing in hospitals.  The outcomes in these water births were compared with the outcomes for births not in water. The results speak for themselves. Babies born in water are no more likely to require transfer to hospital after birth, or require admission to a neonatal intensive care unit (NICU) in the first six weeks following birth, than babies who aren’t born in water. Water birth babies are also no more likely to have a low Apgar score after birth than babies born out of water. The Apgar score assesses your baby’s wellbeing at 1 and 5 minutes after birth, to determine if any treatment or assistance is needed. Factors that are assessed in the Apgar score are skin colour, heart rate, reflex response, muscle tone and breathing. Babies with an Apgar score of 7 or higher are not likely to require any assistance and are considered to be in excellent condition.  This concurs with another study from Australia, which analysed birth outcomes over 12 years in a large Sydney birth centre. The researchers found babies born in a semi-reclined position were more likely to have lower Apgar scores than babies born in water.  Water birth is increasingly popular as a method of pain relief and relaxation during labour. You might be undecided about whether you will just labour in water, or choose to birth there as well. If access to a water birth during labour is important to you, make sure you choose a birth setting with care providers who are supportive and experienced in water birth. RESEARCH BASED EVIDENCE FOR WATERBIRTHS:
  1. The Evidence on Water Birth, The Journal of Perinatal Education, 2014 Summer; 23(3): 124–134.
  2. Water Labour & Water Birth, International Childbirth Education Association Paper, 2015.
  3. Water Births: A Comparative Study, Fetal Diagnosis Therapy ,2000.
  4. Journal of Midwifery & Women’s Health, Maternal and Newborn Outcomes Following Waterbirth: The Midwives Alliance of North America Statistics Project, 2004 to 2009.

The Golden Hour

Skin-to-skin contact is when a naked baby is placed tummy-down on the mother’s (or father’s) bare chest. When this is done immediately after the baby is born, there are many benefits for both mother/father and baby. Mom’s bare chest is the perfect place for a new baby to recover from the stress of being born. It is a warm, comforting and peaceful place to begin life in the outside world. Unless there’s a need for immediate medical intervention, the majority of babies should be able to rest on their mother’s chest for at least an hour after their birth.  At this time, the midwife will not  immediately cut the umbilical cord. This is known as delayed cord clamping. This is the practice of waiting to clamp the newly born baby’s umbilical cord until it stops pulsating. This allows the blood that is in the cord to travel back to baby. 

These studies show that mothers and babies should be together, skin-to-skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby’s temperature is more stable and normal, the baby’s heart and breathing rates are more stable and normal and the baby’s blood sugar level is more elevated. Though simple, this practice has so many proven benefits that it is recommended by the World Health Organisation, the American Academy of Paediatrics and the Academy of Breastfeeding Medicine. 

Not only that but skin-to-skin contact immediately after birth allows the baby to be colonised by the same bacteria as the mother. This, together with breastfeeding, is thought to be important in the prevention of allergic diseases. When a baby is placed into an incubator, his skin and gut are often colonized by bacteria that differ from the mother’s. 

We promote skin-to-skin contact immediately after the birth and partners are encouraged to continue skin-to-skin contact with their new-borns while the mother is being attended to by the midwife after birthing the placenta.

Skin-to-skin will help the mother learn baby’s cues and increase the level of prolactin produced – prolactin is the hormone responsible for helping the body to produce milk. Many mothers find that latching their babies is easier when they are held skin-to-skin. Skin-to-skin contact also calms a fussy baby and helps the mother’s body to produce more milk.

 Baby cries 10 times less and for shorter periods than infants in cribs.

 Increased maternal affectionate/nurturing behaviour.

 Enhances effective breastfeeding.

 Sleep is synchronised with the new-born.

Skin-to-skin helps regulate the baby’s temperature, breathing, heart rate and sugar levels. It also calms the baby so he or she does not get stressed or cry excessively. It is easier for many babies to latch on to the breast when held skin-to-skin and it is beneficial for both full term and premature babies. 

 Apnoea reduction.

 Less initial weight loss.

 Positively influences state organisation (moving from sleep to awake and back) and motor system modulation (smoothness of movement).

 More restful natural sleep cycles and more quiet sleep.

 Reduced stress reaction to painful procedures.

The power of first impressions is well known. None may be more significant than the first experiences of a new-born baby exiting mother’s womb. Our first impression of life outside the womb and the welcome reception we receive immediately after birth may colour our perceptions of life as being difficult or easy, hostile or safe, painful or comforting, frightening or reassuring, cold and lonely or warm and welcoming. 

The events surrounding birth have the potential to set the stage for patterns of subconscious thought processes and behaviours that persist for a lifetime. Because the first hour after birth is so momentous, it is named “The Golden Hour”. 

Every culture has occasions and ceremonies it holds sacred that are honoured, cherished and protected. In most cultures, for example, a wedding ceremony is considered a sacred occasion. 

Birth is an equally sacred event. It is a time when a new member of the family arrives, is greeted for the first time and welcomed by his or her parents. Yet, in many hospital settings, this once-in-a-lifetime process is routinely interrupted for details that can easily wait until after the new baby has had time to adjust to life outside the womb in the loving arms of the mother and after the baby and parents have had time to meet each other as a new family.

Skin-to-skin contact improves physiologic stability for both mother and baby in the vulnerable period immediately after birth. It also increases maternal attachment behaviours, protects against the negative effects of maternal–infant separation, supports optimal infant brain development, and promotes initiation of the first breast feeding resulting in increased breastfeeding initiation and duration rates.

The first hours after birth are a developmentally distinct time for a baby and there are well documented short and long term physical and psychological advantages when a baby is held skin- to-skin during this time.

 Babies are warmer.

 Babies are calmer.

 Babies can hear their mother’s heartbeat.

 Heart and breathing rates are normalised.

 The release of hormones is stimulated to support breastfeeding and mothering.

 Other family members can hold and bond with babies through skin-to-skin holding too.

 Allows colonisation of baby’s skin with mother’s-friendly bacteria – providing protection against infection.

 Baby’s digestion is stimulated.

Carry on cuddling baby skin-to-skin after the birth. Your baby will stay warm and comfortable on your chest and the benefits of bonding, soothing and breastfeeding are likely to continue. 

If your baby is sleepy, skin-to-skin contact can help keep your baby interested in breastfeeding. Fathers and mothers who hold babies skin-to-skin help keep them calm and cosy. Babies are comforted by skin-to-skin contact during procedures. 

Fathers and mothers who hold babies skin-to-skin are also thought to have increased confidence and are more relaxed. 

Carry on cuddling baby skin-to-skin after the birth. Your baby will stay warm and comfortable on your chest and the benefits of bonding, soothing and breastfeeding are likely to continue. 

If your baby is sleepy, skin-to-skin contact can help keep your baby interested in breastfeeding. Fathers and mothers who hold babies skin-to-skin help keep them calm and cosy. Babies are comforted by skin-to-skin contact during procedures. 

Fathers and mothers who hold babies skin-to-skin are also thought to have increased confidence and are more relaxed. 

RESEARCH BASED EVIDENCE FOR SKIN TO SKIN CARE:

  1. World Health Organisation, Handbook for Guideline Development. Geneva, WHO, 2012.
  2. American Academy of Paediatrics, Hospital Breastfeeding Policy for Newborns, 2006.
  3. The Academy of Breastfeeding Medicine Protocol Committee, ABM Clinical Protocol #7: Model Breastfeeding Policy (Revision 2010).
  4. International Childbirth Association,  ICEA Position Paper, 10/2015.
  5. Benefits Of Skin Contact – Review, Anderson 2003, Rojas 2003.
  6. World Health Organisation, Handbook for Guideline Development. Geneva, WHO, 2012.

Breastfeeding

Every woman’s journey to motherhood is different, but one of the first decisions a new mother makes is how to feed her child. When you choose to breastfeed, you make an investment in your baby’s future.

 

Breastfeeding allows you to make the food that is perfect for your baby. Your milk gives your baby the healthy start that will last a lifetime.

 

The evidence is well-established, for both the benefits to mother and baby of breastfeeding. Human milk is designed perfectly for human babies. It provides the perfect nutrition for our little ones and creates a beautiful way to bond. Breastfeeding has some of the most wide-reaching and long lasting effects on your baby’s health and development, more than anything else you can do for her.

 

Keep in mind that the early days are a learning period for both mother and baby, but with the right support and information at this time, most women breastfeed successfully.

The more natural your birth and post-birth experience with lots of skin-to-skin contact, and the more your baby nurses, the quicker your milk will come in. The first few days after birth, before your milk comes in, the yellow liquid your new baby receives from nursing at your breasts is called colostrum. 

Colostrum is the first secretion rich in antibodies which help protect your new-born from diseases. The amount ingested is so small, just teaspoons, not ounces. It is like liquid health, or liquid gold, if you will, for your baby. Also worth noting is that this “liquid gold” colostrum has a laxative effect that clears the meconium from their bodies (which is a good thing!)

 Nutrients and Protection: Breast milk is the best food to help your baby to grow and develop. It is custom-made by each mother for her own baby, and contains the perfect amount of protein, carbohydrate, fat, vitamins and minerals. Remarkably, as your baby grows, your milk will also change to keep up with your baby’s needs.[1]  Human milk is also easier than formula for your baby to digest, which means less mess and fuss! Breastmilk contains valuable antibodies that help prevent disease and may reduce the risk of your baby developing allergies. After birth, your first milk, called Colostrum, offers vital early protection and helps to prevent the growth of harmful bacteria by coating your baby’s digestive system. 

 Brain Power: There is strong evidence that children who were breastfed score higher on IQ tests, as well as on teacher ratings of their academic performance. 

 Convenient and Portable: Breast milk is always safe, fresh and exactly the right temperature. It is ready for baby at a moment’s notice, and you don’t have to heat it, boil water, or sterilize bottles. This makes night time feedings a lot easier. Since breast milk is always with you, travelling and shopping with your baby is simpler, with no equipment to carry or refrigeration needed.

 Size Doesn’t Matter: The size of your breasts doesn’t matter. Big or small, they will produce milk for your baby. Breasts begin to prepare for baby very early in pregnancy and are able to produce Colostrum (the first milk) from about 24 weeks of pregnancy. As soon as your baby is born, hormones begin to activate the breasts to make more milk for your baby. You will continue to produce milk through the wonderful partnership of supply and demand, the more your baby breastfeeds the more milk you will produce!

 Benefits Mothers Too: Research suggests that breastfeeding provides a measure of protection against breast cancer, ovarian cancer and weak bones later in life. [2] Your body uses calories to produce milk, so breastfeeding can help you to gradually lose weight gained during pregnancy. Exclusive breastfeeding may also delay the return of menstruation for at least a little while.

 Bonding: The closeness and comfort of breastfeeding strengthens the bond with your baby, as one part of all the things you can do to build a secure, loving relationship. Dads and moms can’t spoil a baby, so give your baby all the cuddling she or he wants. Dads can be involved with breastfeeding by helping to wind your baby after a feed.

 Benefits Don’t Stop: Research shows that breast milk is so important that it is the only food or drink your baby needs for the first 6 months of life. Beginning at 6 months of age babies need a variety of foods in addition to breast milk, which continues to provide nutrition and protection. Many mothers continue to breastfeed until their babies are two years old or more, any amount of breast milk is always good for babies.

 Breastfeeding is Free: Breastfeeding saves you money! Without question, breastfeeding saves a lot of money.

 Works for Working Mothers: Your baby can have all the benefits of your milk even if you plan to go back to work. You can express milk by hand or with a breast pump and leave it with your caregiver to feed the baby. Breast milk can also be frozen for future use. Some mothers have childcare facilities at their place of work, school, or nearby, so they can breastfeed during their breaks.

 Good for Environment: Breastfeeding is good for your baby, for you and the environment! Human milk is produced and delivered to your baby without any pollution, unnecessary packaging or waste!

Breastfeeding provides unique nutrition for unique humans and the health benefits of breastfeeding extend far beyond weaning the child. Even babies who continue to nurse into toddlerhood benefit from the many immune factors contained in their mother’s milk.  As researchers look at the various factors associated with different diseases, they often find that children and adults who were breastfed as infants are less likely to experience problems with chronic diseases. 

 

In some cases, even minimal amounts of breastfeeding may provide some protection against disease in later life. However, the rule of thumb is that the longer a baby is breastfed the greater the protective effect. Breast milk is so much more than food – it is potent medicine and, simultaneously, a powerful medium of communication between mothers and their babies. It is astonishing and it should be – the recipe for mother’s milk is one that female bodies have been developing for 300 million years.

 

RESEARCH BASED EVIDENCE FOR BREASTFEEDING:

  1. The evidence and rationale for the UNICEF UK Baby Friendly Initiative standards, 2013.
  2. Womenhealth.gov. Breastfeeding, July 21, 2014.
  3. Cochrane, Moore ER, Anderson GC, Bergman N, Dowswell T, 16 May 2012.
  4. National Institute of Child Health and Human Development, Research on Breastfeeding & Breast Milk at the NICHD, August 6, 2012

POSTNATAL CARE WITH A MIDWIFE

“Birth is not only about making babies. It’s about making mothers; strong, competent, capable mothers who trust themselves and believe in their inner strength.” ~Barbara Katz Rothman

After the Birth

“There is a secret in our culture, and it’s not that birth is painful. It’s that women are strong.” ~ Laura Stavoe Harm

Following the birth of your baby, regardless of method of delivery, Protea Midwifery will do a postnatal follow up with you and your new family. Postnatal care is offered in both the home and clinical care settings. Should you wish to do a home based follow up, we will attend to you in the comfort of your own home. Should you prefer to attend postnatal visits at the clinic, you may attend at the individual clinics where Protea Midwifery Services are consulting on that day. During these visits we will attend to the needs of the mother, baby and surrounding family. They are individualised and suited to the needs of the new family.

Reading resources

“Whenever and however you intend to give birth, your experience will impact your emotions, your mind, your body, and your spirit for the rest of your life.” ~Ina May Gaskin

Resources

“If you don’t know your options, you don’t have any.”

Choosing the right childbirth books to read is so very important. Not only can the books you choose provide you with factual information, but they can influence crucial decisions you make about birth. 

 

The next nine months is all new territory. Even if you’ve already brought tiny humans into the world, no two pregnancies are alike. While the thought of food may have turned your stomach during your first pregnancy, your second baby may have you eating everything in sight. And if you’ve never experienced pregnancy before, you are sure to wonder what is normal and what is not.

 

There are many websites and apps dedicated to pregnancy and birth topics, but there’s something comforting about having a stack of physical pregnancy books to flip through and reread during your nine-month adventure. These are our recommended resources and books to read during your pregnancy.

  • Birthing from Within: by Pam England
  • Ina May’s Guide to Childbirth
  • Spiritual Midwifery by Ina May Gaskin
  • Birth Matters: A Midwife’s Manifesta by Ina May Gaskin
  • Ina May’s Guide to Breastfeeding
  • Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood by Erica Chidi Cohen
  • What Does a Doula Do? by Kim Turton
  • Birth Reborn by Michel Odent
  • The Womanly Art of Breastfeeding by Diana West
  • Supernatural Childbirth by Jackie Mize
  • HypnoBirthing by Marie F. Mongan
  • Gentle Birth Choices by Barbara Harper
  • The Thinking Woman’s Guide to a Better Birth by Henci Goer
  • Childbirth without Fear : The Principles and Practice of Natural Childbirth by Grantly Dick-Read 
  • The Mama Bamba Way: The power and pleasure of natural childbirth by Robyn Sheldon
  • The Basic Needs of a Woman in Labour by Ruth Ehrhardt
  • New Active Birth by Janet Balaskas
  • The Waterbirth Book by Janet Balaskas

Natural Childbirth

  • Comfort Measures for Childbirth (DVD)

  • The Face of Birth (documentary)

  • The Business of Being Born (DVD)

  • The Essential Ingredient: Doula (documentary)

  • Gentle Birth Choices (Harper) (DVD—also book)

  • Giving Birth in America (documentary)

  • It’s My Body, My Baby, My Birth (DVD)

  • Laboring Under an Illusion (DVD)

  • More Business of Being Born(DVDs)

  • Orgasmic Birth: The Best Kept Secret (DVD)

  • Pregnant in America (documentary)

  • Spinning Babies Parent Class (DVD — also taught by The Doula Experience)

  • These Are My Hours (documentary)

  • What Babies Want (DVD)

  • Why Not Home? (documentary)

VBAC / Cesarean Prevention

  • The VBAC Dilemma (More Business of Being Born DVD 4)