Why It’s Important You Book Antenatal Classes

The pregnancy and perinatal period is one of immense change for a person as they gets to grips with becoming a parent, both physically and emotionally. In many regards, particularly for first-time mothers, pregnancy is a threshold which separates the known world from one that will be radically different. In this context, emotional balance is likely to be disturbed readily and substantially. Antenatal classes provide a safe space for women to explore this change and empower themselves with knowledge and confidence, while reflecting in an informed manner on the change that awaits them. As will be elucidated here, this provision of balance is achieved through the careful consideration of and respect for the relevant social, hormonal and bonding factors, as well as each mother’s own belief structures and anxieties.

A big consideration when thinking about a woman’s changing emotional state while pregnant is that of her adaptation to her new role, either as a first-time mother or when changing the family dynamic to include more children. Both parents are understandably nervous about that which they don’t yet know and this can cause extreme challenges within the family unit and for the parent’s mental health. Cowan and Cowan argue that there is a “conspiracy of silence[1]” around the pregnancy and newborn period that can make parents feel that they’re the only ones that are struggling. One only needs to take a quick glance at the multitude of mother forums online to see a glut of ‘am I the only one…’ and ‘is this normal…’ postings by mothers who suffer from a lack of support around them. One of the big reasons that women seek out antenatal classes is to make friends with other like-minded people in a similar situation to them, and a key role for the antenatal teacher is to help facilitate friendships within the groups they teach. Having a support network of people going through similar experiences will help de-mystify their journey and ease many worries of each woman.

Classes where a woman can take some time to focus and centre herself will be beneficial to those who are dealing with pregnancy difficulties bigger than those ‘normal’ feelings and worries. Helping mothers to use techniques to have control of their own labour can help to counteract the negative impacts of health concerns that the mother may have about her own body or that of the baby. Antenatal classes help to empower women to make genuine change over their pregnancy and to benefit from the confidence this gives them. Antenatal teachers help a woman take charge of her body, filling her with self-belief by empowering her with knowledge and therefore control of her pregnancy and birth, the definition of antenatal classes according to Dick-Read who champion antenatal education to remove anxiety and dread, inhibiting fear and replacing it with confidence and increase normal labours and pregnancies[2].

There have been studies which link the level of a mother’s bonding with her child after birth to the amount of engagement with her pregnancy and the thoughts she has around it and what the baby will be like once born[3]. Benoit, Parker and Zeanah[4] linked this to the security of attachment the baby has to its parents in the first year of life. Antenatal classes encourage the mother to focus on her baby, creating a peaceful bond between them and soothing anxieties that they may not develop a strong bond. Antenatal teachers aim to anchor these bonding moments through techniques used in pregnancy which baby will recognise and be soothed by once born. Classes are spaces within which mothers can reflect on their pregnancy and learn to prepare for the future; this has substantial benefits for her emotional balance.

It is not unusual for a pregnant woman to experience feelings of stress, anxiety or depression; often this is from the usual worries and concerns a woman has when embarking on a pregnancy as seen previously, and it is important that we encourage women to let these worries go. Creating balance and harmony in her mind has a knock-on effect on her body; there are a number of studies which show various physical responses to anxiety and stress hormones in the pregnant body including reducing oxygen and calorie intake to the baby, maternal cortisol crossing the placenta and restricting foetal brain growth, growth delays, reduced levels of serotonin, reduced ‘quiet and active alert states’ when born and increased risk of hyperactivity in the long-term[7]. As Gaskin alludes to, when the mind is steadied the body can open for birth[8] and it is our aim to equip each mother with the tools to help balance her mind as well as her body.

[1] Cowan, C.P.P. and Cowan, P.A. (1993) When partners become parents: The big life change for couples. New York: Basic Books.

[2] Grantly, D.-R. (2006) Childbirth without fear the principles and practice of natural childbirth. London: Pollinger in Print, United Kingdom.

[3] http://www.refuge.org.uk/get-help-now/what-is-domestic-violence/domestic-violence-and-pregnancy/

[4] Dex, S and Joshi, H (2005) Children of the 21st Century: From Birth to Nine Months. Bristol: Policy Press

[5] Stern D (1985) The Interpersonal World of the Infant. London: Karnac Books

[6] Benoit D, Parker K and Zeanah C (1997) Mother’s representations of their infants assessed pre-natally: Stability and association with infants’ attachment classifications. Journal of Child Psychology, Psychiatry, and Allied Disciplines

[7]https://www.rc.org.uk/sites/default/files/Emotional%Wellbeng_Guide_WEB.pdf

[8] Gaskin, I.M. (2003) Ina May’s guide to childbirth. New York: Random House Publishing Group.

What Should I Pack In My Hospital Bag?

If you’re anything like me, you’ll be obsessing about what goes in your hospital or birth centre labour bag for weeks. That’s why I’ve come up with this handy checklist. But…try not to worry too much about it, because if you forget something there’s always a way of getting it – maternity unit stock, 24 hour supermarkets, a friendly neighbour or Amazon Prime!

Many people leave packing their hospital bag til a week or two before their due date but remember that term is classed between 37-42 weeks so you may want to do it a little sooner than you had planned. And it’s not like you can’t add things to it once you’ve got the majority of it done. It’s also a good idea for those of you planning a home birth to have a think about what you might want to take with you if you transfer in, being able to put your hands on the items you want in a hurry will be helpful (especially for your birth partner who will likely be doing the packing!)

I always think that instead of a bag for you and a bag for baby, a bag for labour and the first hour or two and a bag for the rest of your stay is more useful. You don’t need going home outfits and car seats cluttering up your birthing space so they can stay in the car (assuming you’ve driven to hospital!) and your birth partner can pop out for them when you’ve given birth and are ready to think about clothes.

Don’t panic about packing too much. Yes it will feel like you’ve got enough stuff to last you’re a fortnight, no it doesn’t matter. You need to feel comfortable in your surroundings or the oxytocin won’t flow so pack what you need.

  • Maternity notes
  • Birth plan (1 for you, at least 1 more for your care team)
  • Something cool to wear in labour; a baggy tshirt or nightie can be good
  • Something to wear in the birth pool if you’re hoping for a water birth, unless you plan on being naked
  • Snacks and drinks, for you and birth partner
  • Your oxytocin boosters
  • A way of playing your labour playlist (if you have one). Make sure you download it as wifi is often rubbish
  • Downloaded programme/podcasts for distraction
  • Phone and charger
  • Pillow/blanket
  • TENS machine and other pain relieving methods not supplied by the hospital (eg comb)
  • Maternity pads (LOADS, at least 2 packs)
  • Giant or disposable knickers
  • Toiletries (don’t forget lip balm and bobbles!)
  • Socks or flip flops if you don’t want your feet touching the floors
  • Comfy clothing for after baby’s born; stretchy to help facilitate skin to skin and with boob access if you’re planning to breastfeed
  • Dressing gown or similar
  • Soft bras, with space to accommodate the breast growth you’ll likely have
  • Breast pads
  • The National Breastfeeding Helpline number (0300 100 0212)
  • Spare clothes for birth partner
  • Nappies
  • A few outfits for baby in case they poop all over themselves
  • Muslins for milk, spit, sick and all sorts of things that need mopping up
  • Car seat

Everyone’s different so you might have lots of other things that you want to pack, and that’s cool. You need what you need to be comfy. Enjoy the checklist!

What Do I Do If My Labour Slows Down?

Sometimes labour slows down. This might also be called stalling or “failure to progress” (bleurgh, nobody should be using that phrase if they’re giving proper personalised care). When labour slows down, contractions aren’t as effective and as efficient as they could be. Your body might need a little help increasing the frequency, duration and intensity of contractions in order for your labour to progress.

This is a checklist of things for you or your birth partner to consider if labour has slowed. Trying some or all of these might help ‘unstick’ whatever’s made labour get stuck and take a holistic view of what’s happening during the birth experience. Depending on what’s happening in your individual circumstances you may be offered medical augmentation of labour – all of these methods can be used before or as well as medical methods.

Progress Ps

Position: Are you in your preferred position? Is your position giving space for your pelvis to open, and is it using gravity to help your cervix to dilate and baby to come down the birth canal? Would moving help maximise your physiology? Do you need help and support to move?

Preferences: Has your birth plan been read and understood? Are your preferences being actively listened to? Are you being supported to work towards your preferences? Have your preferences changed?

Personal: Are your physical needs taken care of? Have you eaten and drunk to make sure your birthing muscles work effectively? Are you breathing to ensure your muscles are well oxygenated? Is your jaw (and therefore your pelvis) clenched? Have you had a wee recently – full bladders can impede baby’s progress.

Place: Is the room you’re in promoting oxytocin? Is it too hot, too cold, too cluttered to mobilise?

People: Who is present in the room with you? What are they doing? Do they make you feel safe? Do they need to be there if they’re not? Are they giving unbiased evidence based information for you to make your decisions? Are they asking consent?

Prohibitors: Are there any inhibiting factors that might be slowing your labour progress? Fear, stress, energy levels, mobility…?

Partner Potential: Is your birth partner/s doing everything they can to help labour progress? If not, what’s stopping them? Are they hungry, tired, in need of a pep talk? Do they understand what’s happening in the labour? Are they being respected in the birth room?