Letter of the week: 

Dear Karen and Charlene, 

I have just finished your course - and I loved it by the way, but I have a few questions about pain relief. 

I have been thinking about about how labour will be - and if i will cope. I have heard that epidurals are amazing for pain relief - but have also heard that they can have an adverse effect on the baby. Is this true? What options do i have for pain relief - and should i opt for an epidural? 

From the course I learnt about having a doula present to help with natural forms of pain relief. How do they compare to the big guns of epidural and pethedine? What other options do I have? 

I think i have a high pain threshhold, but my husband thinks I will be begging for an epidural from the get go. I am hoping to prove him wrong - but I also have no idea what to expect. 

Thanks for your help - and for the course, I learnt so much! 

Elle in Cape Town.

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Our weekly listener email 

Dear Charlene and Karen I actually found your podcast when I was doing a google search to know the difference between a midwife and a doula so it would be great if you could talk about that in one of your shows. I listened to your episode last week about which gyn to choose but recently I have been considering working with a midwife. When I posted in the Facebook group I belong, I had lots of recommendations but many of them were for doulas and now I am a bit confused. Is a doula able to do  my prenatal care and deliver my baby? Can I hire a doula instead of a midwife? If I have a midwife will I automatically have a doula? And if I choose to have a hospital birth can I still have my midwife or maybe even my doula....as you can see I am totally confused and befuddled and hoping you can help me understand. Thanks so much,  Annamarie. 18 weeks pregnant with my first baby.

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Every week, we cover topics of pregnancy, birth and motherhood – and we read your letters and interview relevant folk to bring you the most up to date info in every podcast. We do our research – thoroughly… In this episode, we answer a letter from 20-week pregnant mama Jennifer, asking us for advice on how to best choose a doctor and hospital for her gynae-led birth. We offer advice and tips to cover all bases, including info on home birth vs hospital birth and midwife-lead vs ob-gyn-lead birth.

Charlene and Karen share their recommendations and some anecdotes – both funny and serious. If you love what you hear and you want more then drop by and download our FREE 40 page pregnancy playbook and journal packed with loads of fun stuff and tons of “must know prego info”. Grab it here

All about Karen here

All about Charlene here

Relax into Birth PLUS course here

Each week you are invited to send us your big birth question and we'll give you every angle of the dangle. This week a listener, Fran, shares her concerns about whether her midwife or OBGYN will know if she has had sex when she is examined - if sex was the activity that induced her labour? Also, she is feeling mighty frisky - and we assure her this is normal too - Frisky Fran!  

Charlene and Karen share their recommendations and some anecdotes - both funny and serious. If you love what you hear and you want more then drop by and download our FREE 40 page pregnancy playbook and journal packed with loads of fun stuff and tons of "must know prego info". 

Grab it here

More about Charlene here

More about Karen here

Each week you are invited to send us your big birth question and we'll give you every angle of the dangle.

This week a listener shares her concerns about how her partner might react during birth. Will he still find her desirable afterwards and will her body change? 

Charlene and Karen share their recommendations and some anecdotes - both funny and serious. 

If you love what you hear and you want more then drop by and download our FREE 40 page pregnancy playbook and journal packed with loads of fun stuff and tons of "must know prego info". Grab it here

All about Karen here

All about Charlene here 

Relax into Birth PLUS course here

I've partnered up with the best doula in South Africa Charlene Yared West, founder of Relax into Birth. We have been working together for the last few months bringing our collective knowledge and expertise into a course that highlights "the doula and the midwife" perspective and we had such fun doing it that we decided to share it on our podcast. 

We've also been getting tons of questions in our whatsapp group so this is the perfect platform to share them with you (with permission of course!)

Each week you are invited to send us your big birth question and we'll give you every angle of the dangle. 

This week is the big poop question....

If you love what you hear and you want more then drop by and download our FREE 40 page pregnancy playbook and journal packed with loads of fun stuff and tons of "must know prego info". Grab it here 

All about Karen here 

All about Charlene here 

Relax into Birth PLUS course here

Teresa LW and Inderjeet Kaur, Fernandez Foundation, India

The World Health Organization (WHO) recommends Delayed umbilical cord clamping (not earlier than 1 min after birth) for improved maternal and infant health and nutrition outcomes. The aim of this paper is to investigate the effect of delayed vs early cord clamping on breast feeding and skin to skin contact rates. Retrospective data collection of six-month data from 1741 mothers who birthed at Fernandez hospital is analysed from July 2020 to December 2020. The analysis shows that 292(17%) mothers had early cord clamping soon after birth of the baby followed by 1449(83%) had delayed Cord Clamping. The breast feeding and skin-to-skin contact rates were high among the mothers who had delayed cord clamping. We recommend delayed cord clamping for all births irrespective of the mode of delivery unless there is an indication to separate the mother and baby.

In Indian health care settings Midwifery-led care is in its infancy. In public maternity settings, practice of prophylactic episiotomy is implemented for all primigravidae and for those with diagnosis of meconium-stained liquor or LGA baby. From December 2020 to January 2021, 55 mothers were supported during birth by the midwifery mentors and trainees of the Telangana State Nurse Practitioner in Midwifery [NPM] program. 

The group we studied had 24(44%) primigravidae, 52(95%) with term gestation and 3(5%) with MSL. Perineal protective measures like intrapartum mobilization, warm perineal compresses during active second stage, birth positions of choice along with perineal support and helping mothers breathe out their baby slowly were used. Results revealed only 3(5%) mothers needed an episiotomy, 22(40%) had intact perineum post-birth .

None had extensive tears. Twenty one (38%) babies had birth weight of 3kgs and greater while 53(96%) enjoyed the first golden hour with skin-to-skin contact.

Acupressure for induction and augmentation of labour

Loredana Zordan, Independent midwife, Italy

Acupressure is an ancient Chinese technique based on the principle of acupuncture which involves the use of finger pressure (without the needle) on specific points along the body. Chinese culture believes the points to the junction of the meridian pathway that carry energy called QI, Acupressure stimulates the bodies own energies to help fight illness and restore harmony. Acupressure has also been used to stimulate contractions, helping to induce labour. Induction of labour is common as Post maturity can pose risks for the pregnant women and the unborn child, increasing the risk of stillbirth. Acupressure helps to establish contraction and promote cervical dilation. The acupressure points commonly used for induction of labour, have a very strong effect on the energy of the uterus, causing uterine activity and promoting a downward expulsion of the foetus. We have chosen to focus on acupressure rather than acupuncture as acupressure is a less invasive procedure and has the advantage that the woman or her partner can administer it themselves. The case presentation here reports a case of successful use of acupressure for induction and augmentation of labour for post maturity in a home birth situation.

Reviewing evidence and revisiting the option of caesarean sections in breech mothers by offering physiological breech as a choice of birth

Kalavathi Mudili and Inderjeet Kaur, Fernandez Foundation

Introduction: At Fernandez Foundation, the Breech clinic was introduced weekly in June 2019 after multidisciplinary breech training by Shawn Walker. Method: Retrospective data collection of 68 low risk mothers with breech presentation between 32-38 weeks attended breech clinic from June 2019 to March 2020. Results: Spinning baby exercises explained at the initial visit. 27 babies (45%) turned cephalic when checked for presentation between 36-37 weeks. 8 notes were misplaced, 33 mothers (55%) offered ECV. 14 (42%) mothers accepted ECV and 7(50%)were successful. Out of 19 (68%) mothers 5(26%) accepted the choice of a Vaginal Breech Birth and 3 (60%) mothers had physiological Breech Birth. There were no maternal or fetal morbidities in Vaginal Breech Births. Conclusion: The breech team and midwifery consultations offered mothers who were eligible, the choice of physiological breech birth. This will also impact on the caesarean section rates for breech presentation.