The Virtual Midwife

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.

Midwifery postpartum clinical guideline following a term stillbirth

Barbora Snuggs, University of North Georgia, Vanderbilt University, USA

Many pregnancies and births bring joy and excitement while some end with the death of the baby prior to labor and delivery, also known as an intrauterine fetal demise (IUFD) or a stillbirth. Midwives are closely involved in care for these women during labor and delivery, but evidence-based care guidelines related to midwifery care during the postpartum period following a term stillbirth are limited in the literature published in the United States. A midwifery guideline was developed based on 1) a needs assessment, 2) a literature synthesis, and 3) current guidelines to care for women following a term stillbirth in the initial 6-week postpartum period with input from obstetrician-liaison and the midwives working in a practice setting. Midwives can care for patients utilizing their clinical knowledge with skill, empathy, and compassion by following an established term stillbirth postpartum clinical guideline.

Signs of a healthy birth / Zeichenlehre der gesunden Geburt

Rafaela Joos

Signs of a healthy birth. Observation of the healthy birth process by midwives. Background: «Unique normality», that each person’s uniqueness is normal for them, has been recently postulated in the literature as a new paradigm in midwifery practice. Midwifery skills should include a holistic, woman-centered care during a healthy birth. Instead of a linear approach where, birth should be considered as a circular process. Method: Within the setting of action research, four semi-structured interviews with midwives with expertise in the field of birth centre or homebirth were conducted and an observation chart for the healthy birth was developed. The qualitative interview analysis was carried out with the Mayring method. Results: The multi-faceted knowledge of midwives is demonstrated. A comprehensive observation chart for the observation of a healthy birth could be provided. Conclusions: Each birth is unique and requires continuous individual observation by the supervising midwife.

Pregnant women during the COVID-19 pandemic in Indonesia: Knowledge, anxiety and motivation

Niken Bayu Argaheni, Universitas Sebelas Maret, Indonesia

Background: The COVID-19 pandemic threatens such as pregnant women who are predicted to be at higher risk and more susceptible to exposure. The purpose of this study was to find out the knowledge about COVID-19 among pregnant women and how their motivation to continue pregnancy.

Methods: Researchers collaborated with SEKOCI (Sekolah Komplementer Cinta Ibu) to provide bold counseling to its members consisting of 69 pregnant women from various cities once every 7 days for 1 month, then an online questionnaire was evaluated the knowledge, the feelings and motivation for pregnancy during the COVID-19 pandemic.

Results: This study shows that respondents who have good knowledge about COVID-19 (76%), experience moderate levels (69%), and have motivation to do pregnancy (93%).

Conclusion: Pregnant women in Indonesia have good knowledge about COVID-19, and still have the motivation to come to health workers.