MOTHERWISE: Pregnancy, Birth, Babies & Real Birth Stories with midwife Kathy Fray

“Karmen” (Pseudonym) – G2P0: Second Pregnancy, First Birth

Following a previous miscarriage, Karmen was pregnant for the second time and preparing for her first birth. With borderline advanced maternal age (AMA) at 39yrs of age, and mild obesity, her First Trimester Screening returned an “increased risk” result - not a diagnosis - for possible fetal chromosomal anomalies, as well as indicating increased risk for some potential pregnancy complications.

After considering their options, Karmen and her partner decided against diagnostic amniocentesis. As they knew they would not terminate the pregnancy regardless of the result, they did not wish to accept the small procedure-related risk of miscarriage.

At term, with suspected pyelonephritis (kidney UTI), Karmen went spontaneously into labor. (Infection can trigger the onset of labor.)

During labor, baby remained in a posterior position. Despite proactive maternal positioning, mobilisation and other techniques aimed at encouraging fetal rotation, the baby remained persistently posterior (which some women's pelvises can birth - but certainly not all). 

Ultimately, Karmen's baby was born vaginally, with the assistance of ventouse (vacuum-assisted instrumental delivery) to rotate the baby - and mother and baby went on to do beautifully. ❤️


ABOUT MIDWIFE KATHY FRAY

Kathy Fray is a retired senior New Zealand midwife, bestselling maternity author since 2005, and creator of the MotherWise MasterClass.

Drawing on decades of maternity experience, Kathy is passionate about helping parents navigate pregnancy, labour, birth and the newborn weeks with confident knowledge rather than anxious fear.

Her Real Birth Stories are told from both the parents' experience and the midwife's clinical perspective — helping you understand not simply what happened, but also why.

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WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

Meet “Susie & Dean” - pseudonyms, with personal details disguised to protect their identities.

For Susie, this is her first birth. For Dean, it isn't. He has previously experienced the birth of a child by Caesarean section - an experience he found traumatic and still really doesn't want to talk about.

And Dean is ANXIOUS+++ by nature.

So while Susie is approaching birth for the first time, her partner is approaching it carrying memories, fears and expectations from a difficult previous experience. Supporting the birthing woman sometimes also means recognising just how much her partner may be bringing into that birth room.

Late in pregnancy, Susie makes the significant decision to change Birth Practitioner and transfer into my care. She has been preparing for birth using hypnobirthing, but doesn't feel sufficiently supported in those plans and wants a birth professional who will work with her towards the physiological birth she is hoping for.

There is another important element to Susie's story. She has a history of Chronic Fatigue Syndrome and anorexia nervosa - factors that make me particularly mindful of her emotional well-being and potential vulnerability to postnatal depression.

Then comes the birth itself.

Susie goes spontaneously into labor and has a beautiful 4-hour active first labor+birth - a wonderfully common sort of childbirth length among the first-time mothers in my caseload.

Her baby is petite, but when assessed using a Customized Growth Chart, is not actually small for gestational age.

And then this little baby absolutely THRIVES.

Fully and exclusively breastfed, Susie's baby gains an extraordinary 1,225 g - nearly 3 lb - in the first 30 days of life. THRIVING!!!

It's another wonderful example of something I saw repeatedly throughout my midwifery caseload: with good lactation education and skilled, hands-on breastfeeding support, exclusive breastfeeding is achievable for the great majority of women.

A lovely spontaneous first birth, a mother determined to find maternity care that supports her plans, an extremely anxious partner carrying his own previous birth trauma - and a petite newborn who goes on to thrive spectacularly.

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

Meet “Lucy” — a pseudonym, with personal details disguised to protect her identity.

Lucy is in her late 20s, an immigrant with good conversational English (who chooses not to use an interpreter). She is expecting her second baby - but the first baby she will raise herself in her new homeland. Her first child lives in her original country in Southeast Asia, being raised by family. 
This creates a fascinating and unusual maternity journey: Lucy knows more than most first-time mothers-to-be, but considerably less than most second-time mothers-to-be.

Lucy describes her first birth as completely natural, but around 16 hours long. This time I'm particularly conscious of something every experienced midwife knows: second babies can come much, much faster - especially, typically, once the waters break.

But Lucy doesn't initially follow the typical pattern. Her waters break well before established labour begins - a prolonged pre-labour rupture of membranes, which is less common with a second or subsequent baby.

And then... things change quickly.

Once labour finally establishes, Lucy experiences a precipitous (very rapid) labor and birth — quite a contrast to her 16-hour first birth.

Her baby is small for gestational age, but not diagnosed as growth-restricted (IUGR). And what happens over the following month is wonderful: exclusively breastfed, Lucy's baby gains more than 1,100 g - well over 2 lb - in just 30 days. THRIVING!

For me, Lucy's story is also a lovely example of something I saw repeatedly throughout my midwifery caseload: successful breastfeeding is enormously influenced by the education and practical support a mother receives. With good preparation and skilled support after birth, exclusive breastfeeding was the norm for the vast majority of the mothers in my care.

A fascinating story of a woman who has given birth before - yet, in so many ways, is navigating motherhood for the very first time.

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

Meet “Jaqui” - a pseudonym, with personal details disguised to protect her identity.

Welcome to one of those wonderfully “textbook perfect” birth journeys very common to my caseload.

Jaqui is in her late 20s and having her first baby. Labor begins spontaneously right on her Estimated Due Date - something that actually happens to only a minority of babies, despite our obsession with that magical 40-week date!

Her labour unfolds beautifully: around 4½ hours of first-stage (cervix dilatation) followed by 1½ hours of second stage (pushing), culminating in a lovely natural birth.

But Jaqui’s story also has an important clinical element: she is Hepatitis B positive. I talk through the routine precautions and post-birth care used to protect her newborn, including Hepatitis B vaccination and immunoglobulin, along with the chlorhexidine bathing protocol.

And then there is breastfeeding. Jaqui exclusively breastfeeds her baby, who gains an impressive 1 kg - a couple of pounds - in the first 30 days of life ...such a usual journey for my ladies - it's all just about receiving enough education and support. 

A beautifully straightforward birth story, with some fascinating clinical lessons woven through it - and a wonderful example of just how well normal physiological birth and breastfeeding can unfold.

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories. 

WANT TO FEEL GENUINELY PREPARED FOR BIRTH & BABY?
Explore my premium MotherWise MasterClass - an extraordinarily comprehensive pregnancy, labour, birth, postpartum & newborn education program at www.MotherWise.app

WANT TO LEARN MORE ABOUT ME?
I'm a retired senior midwife and best-selling maternity author. Discover my books, articles and other pregnancy, birth & baby resources at www.KathyFray.com

You can also check out my mostly-daily posts:
TikTok: @prenatalwisdom
Instagram: @kathyfray

Enjoying MotherWise? Please follow the podcast and share your favourite episodes - it helps more parents-to-be discover practical, evidence-informed pregnancy, birth & baby wisdom and Real Birth Stories.