Welcome to my new Birth Preparation and Parenthood course! 

Please read through the slides to understand what this course is about and whether it is right for you. 

If you are planning to book one of my birth packages such as the Comprehensive Package or the Traditional Package, this course is included in your sessions. 

Hello! My name is Irene Vine and I am an independent midwife  covering Suffolk, Essex, Cambridge and East London. I provide full antenatal, postnatal and birth care including homebirths and outside of guidelines care. I am passionate about supporting women achieve a birth experience where they feel empowered, heard and understood. If you would like to experience the best possible care with unrushed appointments and a midwife who is always at the other end of the phone, give me a call! I cover most cities and villages in East Anglia, such as Chelmsford, Colchester, Ipswich, Cambridge, Harlow, London or Southend.

Course Summary (Same content as in the slides)

Welcome to your birth preparation and parenthood personalised course!

We will spend the next few weeks talking all things birth, babies and bumps!

Buckle up because you are in for a ride!

The course is structured in 7 sessions of 2 hours each. But the learning doesn’t stop after the sessions.

Throughout the course you will generally receive emails with content before and after the sessions. That way you can invest as much or as little extra time as you want. I am confident that with the face to face sessions themselves and the print outs you will learn plenty, but if you want a dive dive I strongly recommend engaging with the extra content. Some of this content would have been personalised to your questions and interests and it will consist of a mixture of articles, research, guidelines, videos and podcasts. I draw on my experience as a university lecturer to prepare all this. But do not worry, there will be NO test or exam at the end!

There will also be some suggested questions for you to work through at home before the session to help you become more self aware and reflect on the given topic. And these apply to your partner too!

On most sessions I will bring things to show and a little or big gift (depending on your plan). These can go from a magazine, teas, a massage oil, books, to a rebozo or aromatherapy kit.

In the next few pages I introduce what to expect on each session of the course so have a read through and let me know if there is anything that you want to change 🙂 The sessions order may change depending on your circumstances.

 

SESSION 1: The brain and birth physiology

26 weeks

In the session we will learn about what happens in your body during birth, the role of hormones, how labour progresses and how fear interferes with the process. We will explore your fears and expectations of giving birth, becoming a mother, your body, anything that comes to mind.

This is a fun first day where we will use play dough to work out how the cervix dilates in labour and watch an animated birth video. No need to shock anyone with explicit birth videos on the first day! I will also show you some birth preparation books.

You will receive the following print outs:

Breathing techniques

Labour physiology

Visualisations

Balanced statement worksheet

Birth environment

 

SESSION 2: Birth Plan Drafting 1

28 weeks

On the second session we start discussing topics that are important for your birth plan such as pain relief options, vaginal examinations, fetal monitoring, the placenta, vitamin K, skin to skin, delayed cord clamping, etc. You will not be expected to fill up your birth plan this early but you will begin to think about it. As I enjoy interactive sessions where we use our hands I will bring a big A3 paper with print out dots form the Naked Doula birth plan that we can stick on the paper to make a draft of a birth plan. We will also use the Naked Doulas flashcards as conversation starters, she has wonderful resources.

After this session you will get lots of links in your email to follow up on the questions above unless you have purchased one of the birth preparation books I recommend.

 

SESSION 3: Biomechanics workshop and birth partners

30 weeks

This is an exclusive biomechanics workshop where you will learn movements and positions that can help your baby get in the best position in the uterus while you are pregnant and in early labour. I will show your partner how to use a rebozo to help you relax and, depending on your package you will get your own rebozo! On this day we will also give your birth partner tricks and tips to support you in labour, this includes massage techniques he can practice in pregnancy. I will bring my doll and pelvis for this session so we can see the movements the baby does to be born. We will touch on movement and voice as coping mechanisms for birth and we will comment of the real birth videos I will send you that focus on birth partner support and movement.

Print outs:

Biomechanics workbook

Birth partner support strategies

Words of affirmation

Massage techniques

Belly mapping

Labour positions

Latent phase tricks

 

SESSION 4: Interventions and birth plan drafting 2

32 weeks

This is a heavy session with a lot of optional content sent before or after. After all, preparing for and understanding the consequences of and reasons for an instrumental delivery, a cesarean section, labour augmentation or continuous monitoring, is not easy. I would say that, even for those preparing a homebirth, it is important to know what would happened during interventions. They will come as less of a shock and adjustments can be made to your birth plan beforehand to accommodate for them. Sadly 42% of UK women have a CS nowadays, so it is worth understanding the cascade of interventions and how to avoid having unnecessary interventions. I will bring a forceps, kiwi, amnihook, and FSE, episcissors. Depending on your interests we can also talk about gentla CS, vaginal seedling and microbiome.

Print outs:

CS birth

Slow labour

Epidural info used in hospital

Pre labour warning signs

 

SESSION 5: The postnatal period and parenthood

34 weeks

This session tends to come at a time when parents are thinking of what they need to buy for baby and realising how unprepared they may feel. Don’t worry we will go over bathing baby, skin care, safe sleeping, changing nappies, cloth nappies and how to use a baby carrier/sling with your baby. We will also talk about how to make a postnatal plan, your mental health in the postnatal period and recovery. With regards to pregnancy this is usually a good point to start perineal massage and we will talk about tearing in labour.

Print outs:

Postnatal plan activity

Postnatal mood

Postpartum recovery

Postpartum warning signs

Posnatal 5-5-5 rule

Baby care guidelines

Pevic floor excersises

Perineal massages

Baby checks information

 

SESSION 6: Breastfeeding and bottle feeding

36 weeks

On this session we will go over everything you need to know about breastfeeding including some complications. We will also talk about bottle feeding, expressing and storing milk. I will bring my doll and boob and we will have a practice with common breastfeeding positions.

This is generally a good point to start colostrum harvesting if you are interested and I will give you a kit.

We will also go over your hospital birth bag or alternatively, what you need for a homebirth. Finally we will make sure your birth plan is finalised and that you know what to do if you go into labour (who to call, when, what to expect with contractions, biomechanics revision, etc)

Print outs:

Breastfeeding guide

Colostrum harvesting guide

Hospital bag checks list

Homebirth check list

 

SESSION 7: Emergencies and recap

38 weeks

I believe it is important to be prepared for any eventuality and if you are planning a homebirth it is important for us midwives attending your birth that you know how we work and what we may ask of you in case of an emergency. The algorithms we follow to guide our actions are very standardised and you can expect the same approach in hospitals. This is why this session is useful regardless of where you are planning to have your baby.

Emergencies we will discuss: PPH, APH, newborn resuscitation, shoulder dystocia, undiagnosed breech, Cord prolapse, Eclamptic fit.

We will also go over other common last minute change of plans like your waters going before labour, meconium in the waters, abnormal fetal heart rate and other reasons for transfer from a homebirth such as retained placenta, third-fourth degree tear, abnormal observations, no progress in labour, etc.

 

SESSION 8: Postdates Induction of labour and recap

40 weeks

If you get to 40 weeks usually the pressure starts ramping up about when you are going to have your baby. We will go over the risks and benefits of going overdue and plan if or when you would consider an induction. We will explore what happens during an induction and review the cascade of interventions.

As this is the last session we will review what we have learnt around early labour, when to call your midwife, what to look out for and any last minute questions you may have.

 

Resources For Fetal Heart Monitoring

1.When did we start monitoring babies in labour?

For more high quality evidence around fetal monitoring please visit Kirsten website here, an obstetrician with a PHD in CTGs. https://birthsmalltalk.com/

In this post she discusses intermittent auscultation: https://birthsmalltalk.com/2023/08/23/what-is-intermittent-auscultation/

Hear her talk about the lack of evidence behind CTGs in this podcast: https://open.spotify.com/episode/1eXZY973Oxbs1ducavpSAk?si=872f8c4077be4ba5

Post on the history of fetal heart monitoring: https://birthsmalltalk.com/2023/08/09/listening-to-the-fetus-the-history-of-fetal-heart-rate-monitoring/

Cochrane review comparing CTG to intermittent ausculation (CTG increases interventions
): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006066.pub3/full

Does CTG use improve outcomes for high risk women? https://birthsmalltalk.com/2024/10/16/the-story-behind-our-paper/

2. How should we use intermittent auscultation in labour?

These are the NICE guidelines for fetal monitoring in labour: https://www.nice.org.uk/guidance/ng229/chapter/Recommendations

Midwife researcher and lecturer Rachel Reed has a brilliant article and podcast about this where she unpicks the evidence around the recommendations for intermittent auscultation protocols here https://www.rachelreed.website/blog/listening-to-baby-during-labour

and podcast here: https://open.spotify.com/episode/3sJeIR3xUOr20EBRGilHxl?si=818537594dd04457

The WHO recommendations for intrapartum care: https://iris.who.int/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1

3. How does intermittent auscultation detect fetal distress?

For more on normal and abnormal heart rate monitoring watch this explanatory video: https://www.youtube.com/watch?v=Ni48bbtiZgs

4. What happens if there are concerns with the fetal heart rate at a homebirth?

NICE guidelines for fetal monitoring in labour: https://www.nice.org.uk/guidance/ng229/chapter/Recommendations

5.What is better for fetal monitoring in labour: a Doppler or a Pinard/fetoscope?

To read about the research and the experiences of midwives using a fetoscope/pinard antenatally and in labour check these links out.

Short facebook comments compiled in this magazine here: https://www.midwiferytoday.com/mt-articles/wisdom-of-the-midwives-issue-131/

Midwives perceptions of fetoscope vrs Doppler Tanzania https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1736-y

Midwives experiences of Pinard use Norway https://www.sciencedirect.com/science/article/pii/S0266613822000407

Defense of fetoscope article by American midwives

https://hearthandhomemidwifery.com/blog/fetoscope-a-tool-of-the-midwifery-trade#:~:text=Fetoscope%20uses%20go%20beyond%20just,birthing%20person%20and%20the%20baby.

A Cochrane review that compares Doppler and Pinard use in low income countries: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008680.pub2/full

For a compilation of research that compares the use of Doppler to Pinard check this link: https://www.cochranelibrary.com/content?templateType=related&urlTitle=%2Fcentral%2Fdoi%2F10.1002%2Fcentral%2FCN-01110791&doi=10.1002%2Fcentral%2FCN-01110791&p_p_id=scolariscontentdisplay_WAR_scolariscontentdisplay&_scolariscontentdisplay_WAR_scolariscontentdisplay_action=related-content&p_p_lifecycle=0&p_p_mode=view&type=central&contentLanguage=

6. What if you decline some or all fetal auscultations?

Is fetal monitoring essential?: https://birthsmalltalk.com/2024/11/06/myth-busting-3-fetal-monitoring-is-essential/

7. What to bear in mind about intermittent auscultation in labour?

Examples of womens experiences of fetal auscultation in labour: https://www.sciencedirect.com/science/article/pii/S1871519224002658#bib14