Membrane sweeping or membrane stripping is often mentioned at the end of pregnancy as a way of starting labour. It certainly sounds rather uncomfortable but what does it really involve and does it actually make any difference? Here are the facts to help you decide whether membrane sweeping is the right choice for you.
First, the physiology of membrane sweeping.
The very bottom of
your uterus is called the cervix. The cervix sticks out slightly into the top
of your vagina. When you aren’t in labour the cervix is pointing around towards
your back rather than forwards directly towards the exit. This is good, because
it reduces the risk of infections and damage to the cervix from anything
entering the vagina.
The cervix is about
3cm long and has a firm consistency rather like the end of your nose. As it is
3cm long, it is like a tube with one entrance in your vagina and the other one
opening into the uterus where the baby is.
The body is really
clever and protects the baby from infection by filling this tiny tube with a
mucousy jelly which catches any nasty bacteria trying to enter the uterus and
cause an infection.
The baby is also
surrounded by a bag of waters which sits against the lining of the uterus and
protects the baby from infection, small bumps and jolts or pressure changes due
The purpose of membrane sweeps
Although we don’t
know lots about what starts labour, we do know that levels of natural
prostaglandins rise in your body when labour begins. We also know that putting
artificial prostaglandins up into the top part of your vagina can soften the
cervix and start opening it up. These artificial prostaglandins are used as
part of the induction of labour process at most hospitals when we want to start
labour for any reason.
prostaglandins can also be released by peeling the bottom part of the bag of
waters gently away from the wall of the uterus. This is known as membrane
sweeping or membrane stripping.
Research currently suggests that membrane sweeping can reduce the length of a pregnancy by about one week. This means women who have sweeps often go into labour earlier than they might have done without a sweep. If a sweep is successful, you are likely to go into labour within 48-72 hours of the process.
Policies differ between hospitals and care providers about when sweeps are offered and how many can be done for each woman. Please check with your midwife or health care provider for your local information.
The process of sweeping the membranes
membranes involves a vaginal examination. You will need to take off your
underwear and lie down on the bed, covered with a sheet. Partners are welcome
to stay with you, sitting at the head end of the bed and holding your hand if
The midwife or
doctor will ask you to bring your ankles together and your heels up towards
your bottom so that your knees bend. You will then be asked to let your knees
flop open to either side.
The midwife will
then insert two fingers of her gloved hand into your vagina using lubricating
jelly to reduce the discomfort. She will need to reach the cervix, so if it is
still pointing towards your back, she may ask you to put your hands into fists
and put them under your bottom. This tilts your pelvis and makes it easier to
reach a cervix that is pointing backwards.
When the midwife reaches the cervix with her fingers, she will try to put her finger through the tube of the cervix and into the uterus, where she will be able to feel the baby’s head through the bag of waters! She will then move her finger in a circular motion between the bag of waters and the wall of your uterus. When she does this, she peels the bag away from the wall which makes the body release natural prostaglandins.
What happens if membrane sweeping isn’t possible?
Sometimes, the midwife may not be able to reach the cervix. In other cases, the cervix may be so tightly closed that she can not reach through it to get to the bag of waters and sweep it away from the wall of the uterus. Unfortunately, we don’t know what we will find until we try. However, if the midwife can’t reach the cervix or through it to the uterus, giving the cervix and the area around it a gentle massage with her fingers may be helpful in softening and stretching the fibres of the cervix. This may make it more responsive to any tightenings or contractions you may have. It may also start the cervix softening so that in another few days the cervix is open enough to sweep the membranes.
After the membrane sweep
Once the examination is over, you may notice some heavier vaginal discharge, so it’s worth bringing a maternity pad with you to your appointment to wear home. You may also note a tinge of blood in the discharge. This is very common as when the midwife puts her fingers through the cervix it opens slightly more and small blood vessels called capillaries break. This bloody discharge should only be a small amount, so please contact your care provider if it seems heavy to you or you are worried.
It’s important to stay as upright and as active as possible after a membrane sweep. This pushes baby’s head down onto your cervix, which will already have been stimulated by the sweep. More stimulation will help your body produce more prostaglandins and start the hormone oxytocin flowing. Oxytocin causes contractions, which is exactly what we want! Perhaps try a good long walk, or bounce around the house on a birthing ball.
While you wait for the membrane sweep to work, why not read some of my other posts? You can find out my top tips for early labour here. The NHS website also has great information on induction of labour and choices when labour reaches 41 weeks. Read that here.
I want to let you in on a secret. It’s one that the press and social media and even your friends don’t want to tell you.
Sometimes pregnancy sucks.
You might be looking at all these stylised photos and posts telling you how wonderful women are finding their pregnancy. They describe how they feel as if they are glowing and finding fulfilment and a new purpose.
If you read those posts and feel inadequate or upset by them, you are not alone! I can’t tell you the number of women who come into my clinic each week feeling tired and exhausted and fed up and very unglamorous!
They have aches and pains in very private places, they can’t sleep and can’t eat and are too exhausted to do more than crash on the sofa after work. Some of them are physically sick every day well beyond the expected 12 weeks. For some, migraines sometimes get better during pregnancy but sometimes they get much much worse. Other women develop crippling pelvic pain which leaves them on crutches for weeks until the baby is born. Still others suffer with heightened levels of anxiety and fear over the what if’s and unknowns of pregnancy, labour, birth and parenthood.
The problem these women face is that society expects them to be glowing. It expects them to be radiant and smiling and excited. Society might make you think that any other reaction to pregnancy makes you a bad mother.
Things to remember
A miserable pregnancy does not automatically lead to a miserable life as a new parent. You will probably feel a whole lot better once you aren’t carrying 8 to 15 pounds of extra baby and placenta around inside you.
Any feelings of frustration or dread don’t mean that you don’t or won’t love your baby. It simply means that pregnancy is hard for you, and that’s ok to admit.
There are things your midwife or health professional can do to help you. Don’t suffer in silence for fear of judgement. What you feel is valid and won’t be the first time they’ve heard someone struggling with pregnancy.
What you can do
Talk to someone you trust. It might be a close friend or family member you know had a difficult pregnancy themselves. Sharing your feelings enables people to encourage and reassure you that everything will be alright.
Speak to your GP or midwife. If you have sickness, pelvic pain, migraines or some other physical symptoms, they may be able to suggest treatments for you. If you are struggling with anxiety around your pregnancy, birth or parenthood, they can refer you to local counselling services where trained professionals can guide you through the anxiety to find your calming and coping strategies.
Take time to rest and give yourself some grace. You don’t have to live up to society’s expectations and post a glowing selfie every day! Just getting out of bed might be a major success for you, so celebrate it!
Keep your eyes on the prize! However hard this pregnancy might be, focus on the baby and your parenthood to come. It will be worth it. They say parenthood is the hardest job in the world, which I definitely agree with, but it is also the most rewarding. There are so many stages to look forward to. If you aren’t keen on newborn babies, that’s ok. You might feel more confident looking after children when they reach the toddler stage. I promise that time will fly and that favourite age you like most will be here in no time!
It’s time to talk about leaving the house! For many new mums, this seems like a massive step which takes military precision to accomplish. It’s not unusual to make it out of the house several hours after your originally intended time. As part of my ultimate baby checklist series, here are my equipment ‘must haves’ to make getting out and about easier.
Unless you live in central London you’re probably going to need a car seat. Even if you do live in central London and don’t have a car, car seats can still be useful. They are helpful for transporting baby between venues, including on the tube or train or other public transport.
There is plenty of guidance available on car seats and ways to keep your baby safe. Read the brilliant Royal Society for the Prevention of Accidents website here for all you need to know about current UK laws and regulations.
Unfortunately, I don’t think this is an area where you should buy second-hand. You may be told that the seat you are buying has never been in an accident or had a fault, but you don’t have a guarantee of that. By buying a new seat, you know that it is structurally sound and have a manufacturer’s guarantee.
However, there are a lot of fancy seats and travel systems out there that are more bells and whistles than substance. You don’t need to buy something that costs more than your first car!
My favourite car seat on the market is the Doona. Visit their website here.
These gifted and brilliant people have figured out a way to integrate wheels into your car seat. It makes travelling with baby so much easier! You lift baby’s seat out of the car and don’t have to spend hours unpacking the boot to get out a separate wheeled base.
The integrated wheels means a quick conversion from car seat to stroller when you get out of the car, then another quick change from stroller to car seat if you have to climb stairs. It also frees up lots of space in the boot of your car for those trips to relatives you have to make or the normal supermarket shopping trip.
The price is pretty fantastic too and you can get extra add on’s like storage accessories, insect nets and rain covers. Everything you need in one neat little well-priced package! Yes, you will need to buy a car seat base as well as the seat itself. This is about £130, which still makes the whole package extremely good value for the flexibility of the product. It is a category O+ seat, so is suitable from birth to 13kgs, which is about 12-15 months old.
Having mentioned my love of the Dooma car seat, which transforms into a stroller, I have to admit that I don’t think a pram is necessarily essential. If you decide to buy one, I would still recommend buying new to avoid any worries over undeclared damage or faults. It’s also really important to check how easily it folds and make sure that it and it’s wheeled base will fit in your car. For that reason, you may want to go in store to check these things first, then you can either haggle for a great deal or walk away and buy online to save yourself some pennies.
Sling / Carrier
Baby wearing is a contentious issue for some mums. I believe it can be a wonderful way to bond with your baby and make life that little bit easier to maintain when your little one wants to be close to you. Please make sure that you read the safety guidelines below and apply them every time you put your baby in a sling or carrier.
Getting out and about is so much easier if you have a hand or two free. This is where slings and baby carriers can come in very handy! There are lots of different styles to choose from. You can make your own with fabric or buy ready made fabric or more fitted, shaped designs.
Simple fabric ones can be easier to store and transport when not in use, but sometime require a bit of origami style fabric folding to get the baby in to them! Others have easier clips and belts that make getting baby in and out easier, but they can end up being bulky.
If you get a chance, try and find a local sling group before you buy. These groups allow mums to swap slings and try out different ones to find out what works for them and their child at whatever stage of life they’ve reached. It’s also a great way to meet new friends!
Car Window Sun Shade
Travelling in sunny climes with little ones can be wonderful. However, if the sun gets into children’s eyes they can find it uncomfortable and they may wake if they were previously asleep. Adding a window shade to the car can reduce the glaring sun as well as protect little one from any harmful UV rays.
For many years, parents have been using suction cups to attach shades to windows, which is really straightforward. These kinds of shades come in all sorts of sizes and shapes to fit various window sizes. They can also have pictures of cartoon characters or cute animals for your child to look at.
However, we now have alternatives which can make life even better. There are some newer styles of shades which fit over the door itself. This enables you to open the window with the shade still in place. It also prevents any tiny fingers from pulling the shade off over and over again as part of a new and apparently exciting game!
Car Seat Mirrors
Driving with children in the car can be stressful for everyone. It’s sometimes hard to concentrate on the road, when world war seven is breaking out in the back seat! Luckily, someone has figured out how to help you monitor those back seat brawls without having to turn around and take your eyes off the road.
Buying a rear seat mirror is a very good investment. For rear facing baby car seats there are lots of inexpensive mirrors which tie around a back seat headrest to show you little one’s face. There are also mirrors you can fit under the main rear view mirror which enable you to see the full back seat and all those sibling squabbles!
Having a new baby always means more travelling. Family and friends can be many miles away and having maternity leave often helps make travelling to see them more feasible. If it has been many years since those friends or family have had small children of their own, you will probably need to take a travel cot along with you.
Usefully, travel cots can be playpens too, if you aren’t confident letting baby loose in a strange house. They can be pretty reasonably priced if you would like the flexibility of having your own. However, if you aren’t expecting to do a lot of travelling, it might be worth just borrowing one from a friend if and when you need it.
Apparently the latest fashion accessory, this will be your lifeline when getting out and about with baby. You can keep all the essentials in it so you can handle any surprises your baby has in store for you. I’ll spend another post discussing what to put into your bag. For now, why not explore the various options out there. They range from short handled handbag styles, to backpack types. There is something for everyone.
Options to consider: a fold up changing mat included – to make nappy changes on the move easier; waterproof or removable lining – there will be spills!; lots of compartments to keep things organised; fewer compartments to keep things simple; shoulder straps or backpack styles to keep your hands free; pram or stroller clips to attach the bag to the stroller.
So there you have it. My equipment suggestions for your new baby’s travelling comfort. Don’t forget to comment if there is something you think I should have included or if you have any tips on great products out there.
Here we go. You’ve read my Ultimate Baby Equipment Checklist, but don’t quite understand why I’ve included some things and not others. Perhaps you’re intrigued by my promise that all this stuff doesn’t have to cost the earth or could be done using stuff you already have. Well let me explain myself more thoroughly.
This is the first of several posts where I break down my ultimate checklist into smaller chunks. I’ll add the links to the others as I’ve written them. We’ll start here with the nursery.
Read the post on equipment to help you when you are out of the house here.
**This post contains affiliate links. If you make a purchase from one of my links, I may receive a commission or credit at no additional cost to you. For more info, please read my disclosure policy.**
A Moses basket or crib is simply a smaller version of a cot. It’s a safe flat bed to place baby in when they need a nap. It is a lot more portable than a full sized cot, so you can move it around the house. It is great if you want to put baby down to sleep while you do some housework or have a coffee, but don’t want them far away in their cot in your bedroom.
There are lots of different styles of Moses basket. Some have stands so they are off the ground. Some have rocking stands which might be useful if your baby likes movement to settle them. Just be careful with the rocking style as older siblings or pets might get their feet, fingers or paws trapped. They might also start rocking the baby by mistake which could wake them when you’ve just got them settled!
Whichever design you decide to go for, I wouldn’t recommend spending a really big amount on this. Babies often outgrow their Moses basket very quickly so it isn’t a long term investment. You could even try finding a second hand basket on Ebay, which will save you some pennies. If you decide to do this, please do buy a brand new mattress for the Moses basket even if the second hand one comes with it. There are certain stains and things you don’t want to share with a previous owner!
A cot is an essential item and here I do recommend buying new if you can. That is because you know that every new cot sold has to meet the current safety standards. If you buy a second hand cot, you might not know when it was manufactured or if it has a fault. More information on cot and sleep safety can be found here at the Infant Sleep Information Source.
The recommendations to reduce the risk of Sudden Infant Death Syndrome (SIDS) include the baby sleeping in their parent’s room for their first six months. It is worth buying one which is height adjustable. That means that as little one gets bigger, you can drop the base of the cot to reduce the likelihood that they can climb out. It also means that in those early days, you don’t have to strain your back lifting little one up or down quite as far. You can even buy cots that can be converted into beds for toddlers. That saves you the expense of replacing it with a separate new bed.
You may want to consider a co-sleeping style cot for the early days. These are designed to attach to the side of your bed, making it easier for you to reach baby when they need you at night.
Whether you decide to buy a second-hand cot, or you are reusing the cot your older child had, please buy a new cot mattress for each new baby. Make sure that the size of the mattress fits your cot, leaving no gaps around the edges which could trap or hurt the baby. Also, makes sure it meets all current safety standards. This should be stated in the seller’s paperwork or website.
Don’t believe what your local department store baby section says. You don’t need a specific baby furniture suite with fancy wardrobes and drawers and cabinets etc. A standard set of drawers or a dresser is really all you’ll need to start with.
I promise that your baby won’t mind if it isn’t white with pictures of cartoon animals on it. You can buy second hand and upcycle it if you prefer.
When getting heavy furniture for the nursery, please make sure you buy and fit some wall anchors. This prevents the drawers falling onto baby if they pull on them. Our favourite Swedish furniture store has some tips on anchoring furniture here.
To start with I would go for something with plenty of drawers. That way you can have one drawer for vests, one for babygrows, one for hats and socks, one for cardigans and jackets etc. You won’t be folding stuff neatly and even if you do, a middle of the night scramble for a new babygrow will undo all that hard work!
I’m a bit of a sucker for the Ikea Kallax range, as you can be quite unique and inventive in the style of drawer inserts you choose. The drawers are also deep, which is good for all those extra clothes you’ll get as gifts!
Changing areas can be fancy or simple. You can have a specific changing station which has a place to hold your bowl of water and drawers to hold your nappies and wipes.
You can manage just as well with a simple changing mat that you can place on the floor or on top of your bed or dresser.
I would recommend a changing mat as a minimum. Some mums like to simply change their baby’s nappy whilst the baby is lying on their bed. Unfortunately, a projectile poo can mean you have to change your entire duvet set at 2 am. I wouldn’t want to risk it!
The great thing about using a changing mat rather than having just one changing station, is that you can have multiple mats around the house. One will easily slide under the bed or beside the sofa. That means you can change nappies anywhere in the house rather than having to go upstairs every time.
It’s also worth having a nappy changing kit close by. I’ll write more on that in the post on equipment for changing (coming soon). Suffice to say for now, get a small basket or box which can hold some nappies, nappy bags, nappy cream, wipes or cotton wool pads and hand sanitiser. One basket per changing mat, and one changing mat per floor of the house makes everything a little easier.
To be honest, I’m not totally convinced that this is really essential. Feeding chairs do support you in an upright position and can enable soothing movement for an unsettled baby. However, you can also just stand and move or sit in a fixed chair and rock your torso yourself.
Some nursing chairs come with foot rests, which can definitely be helpful for those times when all you seem to do is feed your baby. Others are just really comfy for long feeding sessions. There is no right or wrong answer here. See what your budget can stretch too or make do with your favourite armchair.
Really, you’ll need one. A lot. Babies are messy little people. They will get poo and urine and milk and vomit over themselves and their clothes frequently. Having somewhere to throw the clothes needing a wash means you don’t have to go back and forth to the machine hundreds of times a day.
Co-sleeper e.g. Sleepyhead
A big cot can be very disconcerting for a baby. They’ve spent nine months inside mum, where they can only stretch a little before they meet the resistance of mum’s body. When they then get placed in a cold flat cot where they stretch and stretch and find nothing within their reach, they don’t like it!
Recent trends include the emergence of co-sleepers like the sleepyhead. These can be really useful as they seem to reassure the baby by fitting around him or her. You can have a look at them on Amazon here. If you decide to get one, it’s worth getting a couple of extra covers at the same time, as middle of the night accidents happen, and that’s not the time to run a fast wash and dry cycle on your washing machine!
However, before Sleepyhead arrived on the market and started pulling hundreds of pounds from new parents, midwives had other tricks which use items you already have in your house! Grab one of your big bath sheets or towels. Roll it into a long sausage shape and place that sausage in a U shape around the sides and head of the baby. Magic! Your baby reaches out and feels reassured by the towel being close, and you’ve not had to spend any pennies!
Many babies sleep better if there is a little light in the room. It also saves you from stumbling around the nursery in the dark as you answer their cries at 3 am. No more stubbed toes as you search for the new pack of wipes or nappy bags!
You can use any light for a night light. Just adjust the bulb wattage so that it isn’t too bright for you, and you’re all set. However, if you want to get a specific baby night light it might be worth looking at this one by The Gro Company.
I like this type of night light because it actually has another function, so saves you money! Two products for the price of one is definitely a bargain. It also serves as a room thermometer….
Now, as I’ve recommended a night light which doubles as a room thermometer, you might think this is an essential. If you feel unsure about the temperature of your room, or your house as a whole, a thermometer can give you concrete measurements of heat. This might be really reassuring for you, in which case, buy one and rest easy trusting that little LCD screen to guide you about open vs closed windows and one blanket or two.
A thermometer is not completely essential though. Every house I visit as a midwife has a different ambient temperature. Some people like their houses cooler and fresher. Others (like me!) want to be wrapped in warmth as soon as they cross the threshold. Babies learn to adapt to their environment. They can be dressed in extra or fewer layers depending on the air temperature.
If you want to keep a cooler house, just add an extra cardigan, babygrow or blanket to what baby is wearing. The general rule is one extra layer than you have. If you are wearing a shirt and jumper, baby will need a vest, babygrow and cardigan or jacket. When you are feeling really warm and just wearing a camisole top, baby might just need a vest on.
If you feel comfortable being guided by your own temperature and clothing levels, that’s brilliant. Just make sure you check a baby’s temperature by putting your hand on their chest or the back of the neck between their shoulder blades. Their hands and feet are always cold so don’t be guided by that.
If you feel too unsure about that way of checking, then use a room thermometer to keep the temperature within the recommended range so that you have one less thing to worry about. It’s entirely up to you!
Checking on baby is a natural instinct, so most parents like to have a baby monitor of some kind set up. This means they can check that little one is ok, even if they’re in a different room. It can be really useful if you have a big house, where you wouldn’t necessarily hear the baby crying in the nursery if you were in the living room.
It can also be useful if you are having a night in with friends, because being a parent doesn’t mean you can’t be sociable! As sociable and fun as the night gets, you’ll still be able to hear baby from the monitor even if someone is in the middle of a funny anecdote.
Sound and/or vision monitors
The type of monitor you buy is entirely up to you. You may want to just be able to hear when your baby stirs or cries. In that case a simple sound monitor is for you. You can go a little fancier by getting one with a camera. This enables you to see your baby from another room if you prefer.
If you and your partner have the same type of smart phone, you can set them up together as a baby monitor. A simple app will turn one phone into the transmitter that you leave in the nursery. The other phone stays with you and receives any sounds signals the first phone picks up. This certainly works wonders except for those of us who might be a little addicted to our phones. The idea of leaving it in the nursery or by the cot all evening might not be something you can contemplate!
Some parents prefer a little more functionality in their baby monitors. You can get some which have a pressure pad which lies underneath the cot sheet. This picks up on the breathing movements of the baby and can sound an alarm if these movements stop. You can even get monitors which clip onto your baby’s nappy or foot. These provide a continuous assessment of their breathing or blood oxygen levels.
*the Owlet baby blood oxygen monitor seems to only be available via Amazon.com at the moment. You would need to add in import charges if you decide you want one and live in the UK.
One great recommendation for helping babies to settle and sleep is white noise. This sort of background noise helps to mask any other household noises. Therefore that means baby won’t be woken by you flushing the toilet or watching the latest episode of your favourite TV show. It also helps to cover the noise of older siblings or even just adult conversations.
You can get really clever, and expensive, with noise machines. Some will play heartbeat sounds, so your baby thinks it is back in the womb. You can even get ones which upload your own baby’s heartbeat recorded from an antenatal scan! Some noise machines play nursery rhymes, whilst others go for nature sounds like rivers and rain.
There are quite a few white noise apps for smart phones too. Some of them are free, which also makes sense for any budget conscious parents out there. Unfortunately, as with the baby monitor apps, you do need to leave your phone with the baby. Those parents who like to check on social media or news or communication apps might find that hard.
The alternative is a tablet or laptop and a good wifi signal. Youtube has some great videos with white noise. I like this channel and use it when I’m writing. You can find rain falling on a car, or on a tin roof. Similarly, there are river sounds and thunderstorms. Lots of them have black screens too, if you don’t want to damage your device by playing it for 10 hours straight!
There we have it. My guide to what a nursery really needs, and a few tips to make it less of a strain on the purse strings. I hope you found it helpful. Above all, I hope you can see that babies don’t need extra special stuff although if you do feel more comfortable and reassured by having it that’s fine too.
Let me know what you think and any stuff you think I’ve missed by leaving a comment below.
You know how it goes. You want to be organised in time for baby’s arrival and the world wide web must be full of great ideas on what you need. Unfortunately, you discover exactly that! The internet is bulging with baby registry lists and new mum lists and equipment lists. Some seem incredibly short so you worry that they’re missing things. Others consider a baby bouncy chair that looks like a space rocket and has 273 modes to be essential!
Don’t panic! In my ongoing efforts to simplify the whole ‘having a baby’ thing for you, I’ve scoured those lists and created my own. I’ve taken lots of great ideas and left out the weird and wacky ones. Check it out below and let me know what you think in the comments section.
I’m going to be creating several blog posts over the next few weeks which will split this list down. I’ll discuss my reasons for adding and excluding certain items. I’ll also give hints and tips on how to save money by using cheaper alternatives or repurposing items you already own! Having a baby doesn’t have to ruin your bank account. I will help you find those great equipment deals and cost savings. Check back at the blog page to catch all my tips as I post them.
The first few posts are up! I cover the equipment for baby’s nursery here. For the ‘out and about’ equipment, read this. You’ll find health supplies here and bath-time equipment here.
You might have heard of it, you might have seen a Facebook post about it or read a poster somewhere. Group B Strep is becoming more widely known about and talked about in pregnancy. So what is it and what impact can it have on your pregnancy, your labour and birth and your baby?
What is Group B Strep?
Simply put, Group B Strep is a bacteria which is found in about 30% of women. That’s one in three of you and your friends. Most of the time, this bacteria causes no problems whatsoever. It’s like those bacteria in your digestive system which help you to break down your food. Group B Strep bacteria (GBS) are most often found in your vagina or rectum, although occasionally they can transfer to your urine. This can cause a urine infection, which should be treated with antibiotics as soon as it is found.
How do I know if I’ve got Group B Strep?
Most women discover they have Group B Strep because it appears in their urine during pregnancy. They may or may not have any symptoms of a urine infection. Your midwife may find it in the urine sample you provide at your booking appointment. Alternatively, you may be aware of a urine infection and Group B Strep is identified as the cause.
With the increase in awareness of Group B Strep and the implications it has on pregnancy, some women ask to be tested. This testing is best done between 35 and 37 weeks of pregnancy. Your own midwife can usually do this at your GP surgery. You will need to sweep a long-handled cotton bud around the inside of your vagina. You put the cotton bud into a tube with a tiny amount of solution in it and the tube and cotton bud are sent to the laboratory. In a day or two, the laboratory can tell you if the sample has grown Group B Strep.
The newest type of test for Group B Strep is the enriched culture medium test which may or may not be available within your local area. Please ask your own midwife for details.
Implications of Group B Strep on Pregnancy
Finding out that you have Group B Strep during your pregnancy does not have a large impact on your care during the pregnancy itself. If the bacteria is found in your vagina or rectum, you will not need any antenatal treatment. If it is found in your urine, we recommend that you have some antibiotics to treat the urine infection.
Implications of Group B Strep on Labour and Birth
You will be advised to have antibiotics in labour if you have been identified as carrying the Group B Strep bacteria, whether that is during the current pregnancy or at any point in the past. These will be given via a drip in the back of your hand or in your arm. You will get a dose every 4 hours for as long as labour lasts. It’s really important to mention to the hospital that you’ve had Group B Strep when you phone them in labour. The midwife takes into account the time it takes for you to get to the hospital as well as the time it takes to provide the antibiotics when they invite you in to be assessed.
Providing antibiotics in labour has been shown to reduce the risk of the baby getting Group B Strep. It is a pretty simple procedure which can keep your baby safe. That is why it is recommended practice in the UK. Please discuss this further with your midwife or Obstetrician if you have any other concerns.
Implications of Group B Strep on Your Baby
Whilst most babies are fine even with exposure to Group B Strep, a small minority can get an infection from it. An even smaller minority can have serious consequences from that infection.
For that reason, if we know that you have carried Group B Strep in the past or in the current pregnancy, we recommend the use of antibiotics in labour. We also recommend that you stay in hospital for at least 12-24 hours after the birth. This enables us to monitor your baby’s heart rate, breathing, temperature and general condition every couple of hours and ensure no infection occurs.
If any signs of infection occur, such as an increase or decrease in temperature, breathing rate or heart rate, your baby will be referred to a neonatal doctor to assess what treatment may be required. Sometimes the baby will need a course of IV antibiotics, which usually lasts between 5 and 7 days. In most cases, you will still be able to care for your baby yourself while the antibiotics are given. A small number of cases may need extra support from a Special Care Baby Unit to help them fight the infection.
Please try not to read every internet story on Group B Strep. There are very heartbreaking cases out there and the internet would have you believe they are the most common kind. The reality as seen in the midwifery, obstetric and neonatal world is that most cases of Group B Strep infection will respond quickly to a course of antibiotics with no long-term effects.
You can read more in the Royal College of Obstetricians and Gynaecologists patient information leaflet, available here.
Are you worried about your supply of breast milk? Are you anxious because your baby doesn’t seem to want to do anything except eat? Does he or she never seem to settle fully between feeds or only settle for short periods? This can all be normal behaviour for very new babies, but no matter how old your baby is, there are some things you can do to increase your milk supply. That way you’ll know that if there is a problem, it doesn’t lie with your breast milk supply.
**This post may contain affiliate links. If you make a purchase from one of my links, I may receive a commission or credit at no additional cost to you. For more info, please read my disclosure policy.**
Supply and Demand
Your body produces milk on a very simple supply and demand system. If all of your milk is removed, hopefully by a baby, your body produces even more for the next feed. This enables us to strategically increase demand artificially to increase your supply.
You may have thought or heard about expressing or pumping milk. This is an excellent way to increase the amount of milk your body produces and can produce results fast.
There are many ways to express milk. Some people like to hand express, others will use a hand pump, others prefer an electric pump. You can even get a double electric pump. Yes, you can feel a bit like a milking machine, but let’s be honest, pregnancy isn’t all that great for dignity or glamour. This is for your baby, right? You’ll do anything to keep them well fed. That includes attaching yourself to an electric pump several times a day. For suggestions of good quality double pumps, trying this search on Amazon.
The key to expressing or pumping to bring in more milk is to do it after the baby has fed. That way you know that the baby is getting everything they want before you collect the remainder or put in the order for more.
Try expressing or pumping for 10 minutes on each side after every other feed to begin with. Obviously, a double electric pump will be finished in 10 minutes, whereas hand expressing or a single pump will take 20 minutes to do the same. However, some people may get a better let down reflex from hand expressing and end up collecting more milk than they would using a pump. That might be because they feel more comfortable hand expressing – the milking machine analogy can certainly make some women feel uncomfortable enough to slow production. There is no right or wrong way to express and sometimes only trial and error will show you what your body prefers.
You may not collect a lot for the first couple of sessions but this is very normal. It simply means your body will be getting clear signals that the supply needs to increase. Just keep going and over the next 24-48 hours you will find the amount you collect increasing.
If you don’t want to spend extra time expressing after you’ve fed your baby, you can get your baby to make the demand for more milk. Sometimes babies will get so very comfortable and relaxed during a feed that they don’t eat everything they could before they fall off to sleep.
If your baby seems to fall asleep after only a short time at the breast, why not try switch feeding?
Start feeding the baby on one breast. When you notice the baby slowing down take them off and put them onto the other breast. You need to switch breasts before baby gets sleepy if possible. This means they may only feed for 2 minutes before the sucking and swallowing rhythm slows down. That is the time to switch breasts. Do this 3 times over the feed if possible so that both breasts have been fed from twice. This will definitely remind your body that there is a big demand for milk!
When you take the baby off the breast to switch onto the other one, try talking to them before you put them on the second breast. Lift them so that they are facing you vertically and try to catch their attention with soft encouraging words. This may help them wake up a little more.
Another classic midwife trick for waking up a rather sleepy baby in order to put them on the breast is letting them hang. Holding the baby securely with both hands under their armpits, lift them up into the air so that their legs are no longer supported by the bed or your lap. Although the baby is perfectly safe, they don’t like the sensation of having their bottom half unsupported, so it may wake them or even make them a little upset. I don’t recommend doing it for long periods! Just use it as a 2-second thing to wake them up enough to put them back on the breast. And tell them it was the nasty midwife’s idea if they complain!
Passive milk collection
Have you noticed that your breasts are leaking milk? Does that feel like a waste of the good stuff? There are ways to collect this leaking milk so that it can be used to feed your little one, rather than getting lost in a muslin cloth or your favourite nursing top.
Try using a silicone breast pump. This is a pre-formed silicone cone which is shaped to fit onto your breast and collect the dripping milk without any pumping action, manual or electric, required!
I like this one at Amazon:
Nipple shells can also collect the dripping milk if you don’t feel you have such great quantities. Shells are also great for wearing even when you aren’t wanting to collect the milk. If your nipples are really sore, nipple shells can help reduce the pressure on them from your bra or top.
Amazon has this twin pack with great reviews:
Keep to a schedule
The easiest way to boost your milk supply requires no extra money to be spent, which is great news since babies are very expensive little creatures! It’s such a good job they’re so cute!
The simplest technique is simply putting the baby to the breast more often. Babies are definitely the most efficient at removing milk from a breast. You may find you get nothing when you use a pump or hand express but your baby is getting plenty of milk when they feed at the breast. That’s absolutely fine!
Keep sleep periods short if you want to increase your milk supply. For healthy babies, demand or baby led feeding is recommended. That means as long as the baby gets at least 8 – 10 feeds of 10 minutes or more in 24 hours, we don’t mind how long the gap between feeds is.
However, if you think you need to increase your milk supply, try planning for a feed every 2.5 – 3 hours maximum. Gaps of 4 hours or longer might be normal in healthy babies who feed 8 – 10 times in 24 hours, but they won’t stimulate an increase in milk supply.
You can be kind to yourself and try waking the baby more frequently for feeds during the day. Let him or her have longer sleeps during the night. Don’t make your sleepless nights even harder by waking yourself and baby every 2.5 hours overnight!
Keep watching for hunger cues
Sometimes we miss an opportunity to put the baby on the breast because we haven’t noticed that they are hungry.
Keep your baby close to you, preferably in the same room. You can then notice the signs of hunger which come before crying, such as licking their licks, searching with their mouths open and sticking out their tongues. If you have left your baby in a safe place in another room you may want to consider bringing them back to your side when the 2.5 hour point comes, as they may already be beginning to stir.
Don’t use a pacifier all the time. Pacifiers can be really useful as a baby gets older or if your newborn just seems to be a very sucky baby who wants to suck even though they’ve fed well.
However, if you want to increase your milk supply, then the baby needs to be using your breast as its pacifier instead. You can still use the pacifier overnight if you would rather have that help for settling the baby to sleep. Just consider avoiding using it during the day.
IF YOU THINK YOUR BABY IS UNWELL BECAUSE THEY ARE NOT GETTING ENOUGH MILK, SEEK ASSISTANCE FROM YOUR DOCTOR, MIDWIFE OR HEALTH VISITOR AS SOON AS POSSIBLE. DO NOT WAIT TO TRY THESE TECHNIQUES AND SEE WHAT HAPPENS.
THE TECHNIQUES ON THIS PAGE SHOULD ONLY BE USED BY MUMS WITH HEALTHY BABIES WHO WANT TO INCREASE SUPPLY FOR CONVENIENCE OR PRACTICAL REASONS.
Burning, stinging, smelly urine? Yeah, pregnancy is all about the glamour! Unfortunately, women are more likely to get urine infections when they are pregnant. Find out more about what causes them, what you can do to prevent them and what treatments are available.
Why urine infections are common in pregnancy
During pregnancy, you have many different hormones at different levels in your body. These hormones help your body to nurture and develop your baby. They also help prepare your body for birth. One of the hormones involved is called Relaxin. This hormone is brilliant at relaxing (yes, really) the small vessels in your body. These vessels might be blood vessels or the tubes which carry your urine from your kidneys to your bladder or from your bladder to the exit! Relaxed blood vessels make it easier to send more blood flow to the baby to help them grow. Relaxed tubes for urine make it easier for bacteria to enter these tubes and cause urine infections. You can also find more information on the effects of Relaxin in my article on pelvic pain in pregnancy.
How do I know if I have a urine infection?
The symptoms of urine infections include:
pain when passing urine;
lower back pain on one or both sides of your back;
feeling generally unwell;
and needing to pass urine urgently but only passing small amounts when you do.
That last one can simply be because your baby is bouncing about on your bladder and making you think it’s full. However, if you have any of the symptoms of a urine infection, you should get a urine sample checked by your midwife or doctor. You can also have a urine infection without any symptoms, which is why your midwife checks your urine sample at every appointment just in case.
When the midwife checks your urine, she is looking for things like proteins, nitrites and leucocytes. Proteins can show up because the bacteria are made of proteins, nitrites because some bacteria produce these, and leucocytes because your body is producing them to fight off the infection.
Treatment for urine infections in pregnancy
The standard treatment for a urine infection is antibiotics. You will be asked to provide a urine sample which will be sent to the hospital laboratory. They will check which antibiotics work best to kill the bacteria. However, you can be started on antibiotics before the results come back, as there are general groups of antibiotics we can start with. The doctor will contact you within a couple of days if we need to change the antibiotics or if your sample actually showed that you have no infection.
It is important to complete the whole course of the antibiotics and to provide a sample at the end of the antibiotics to confirm that the infection has gone. Untreated urine infections can occasionally spread up into your kidneys and make you very ill, even possibly needing hospital care, so please ask for help if you think you have an infection.
Ways to prevent urine infections
So how can you reduce your risk of a urine infection, even if you do have that troublesome Relaxin hormone floating around your body?
Make sure that you are keeping clean. When you go to the loo, wipe from front to back. You can even get wet wipes to use after you’ve used the toilet just to keep everything fresher.
Change any pad or liners regularly. You do tend to have a heavier discharge during pregnancy, so you may be using liners or pads to keep your underwear clean. Just remember to keep changing these if they become wet or soiled.
Drinking plenty of fluids is really important. It keeps you and baby hydrated, which regulates your own and the baby’s heartbeats. It also means that you are passing urine a lot. This might be inconvenient but passing lots of urine means you are flushing out any nasties before they can start an infection.
Good sexual health
Mother told you to wee after sex and she was right. Any sexual intercourse can introduce bacteria into the area, some of which might want to set up shop and cause you an infection. By passing urine, then perhaps using a wet wipe or two, you are going to help flush them out of the area before they do.
Other things to consider
Some women find out during their pregnancy that they have a bacteria called Group B Strep in their urine or around their vagina. If it is in the urine it should be treated as usual but this bacteria can also impact upon your labour, birth and baby. I will be writing another post on Group B Strep and will link to it as soon as I have, but in the meantime, here is the link to the Royal College of Obstetricians and Gynaecologists patient information on Group B Strep.
Maybe you’ve had a baby recently and want to express your thanks to the midwife who cared for you. Maybe you are a student midwife who has come to the end of a placement and wants to show appreciation to your midwife mentor. Perhaps you have a friend or family member who is a midwife. Whatever the occasion, here are some ideas for gifts for midwives that may help if your mind has gone blank.
General Gifts for Midwives
Midwives love getting ‘Thank You’ cards. It helps us to feel we are making a difference and helping people, which is definitely our ultimate aim. Even if it is just a small card with 3 lines written in it, it can make a difficult day seem not so hard and put a smile on a stressed face. We love to remember your birth or experience with you. Cards can also be used as part of the revalidation process. Revalidation is how midwives renew their professional registration with the Nursing and Midwifery Council. It requires us to provide evidence of feedback on our work, so your card can help us to do this.
Who can survive the day without a bit of caffeine? Midwives are no exception, so coffee cups or mugs are always a great idea. We may not get a chance for lunch or tea, but sometimes we do get to stop for a drink. Finding a suitable mug in the work kitchen can be a challenge, so a unique mug which is easy to find is a big plus. Some people like thin china mugs, while others prefer enormous chunky mugs. There are so many options in terms of designs such as pictures or slogans. Let your imagination run free.
Chocolates are always a good idea. When we have a busy shift and no time to stop for lunch, a quick scoff of a truffle or fudge can stop the hunger pains for a short time. There are also so many options, from biscuits to selection boxes and more. You’re bound to come up with some original choices.
Let’s be honest, we shouldn’t really survive on caffeine and chocolates. Most of us want to try something healthier so a basket of fresh fruit is a refreshing option and can be pretty quick too for those busy shifts.
Equipment Gifts for Midwives
Ever a practical person, a midwife is always happy to receive practical gifts.
I’m sure you’ve seen your midwife with a wheel in her pocket. These tiny plastic whirlygigs can help us figure out when your baby is due or what your Body Mass Index is. Because they are used so often, they do wear out or crack and break. Why not see if you can find a new one for your midwife? Try searching for a pregnancy calculator wheel or BMI calculator wheel on Amazon, the Goodies for Nurses website or the Funky Midwife website.
I have no idea where all the pens of the NHS go, but there seems to be an epidemic of disappearing writing utensils! We write a lot. Sometimes it feels like we write more than we provide care, which isn’t good at all. However, it does provide you with another gift option. We will always appreciate a lovely pen and if it is not just a standard biro, we’re more likely to chase it if the doctor tries to walk off with it! In order to meet our standards for record keeping, it needs to have black ink and a rollerball or ballpoint pen is less messy than a fountain pen.
Although Infection Control policies prevent us from wearing any wrist watches, we still need to be able to count seconds and minutes. You’ll probably have seen some midwives with fob watches, which are pinned to our uniforms. Most of the time we buy the cheapest as we have to provide these ourselves. However, there are so many amazing designs out there for fob watches! Having a unique one would always make putting on the uniform a little more fun. Watches need to have second hands on them so that we can measure you and your baby’s heartbeat if our other equipment isn’t available. If we work night shifts a glow in the dark or backlit watch might be really useful.
Hopefully, you’ve seen us wash our hands. A lot. As an integral part of care and infection control, we wash our hands more often than you can count. This is good for you, but not great for our skin. It doesn’t have a chance to replenish those lovely nourishing oils between washes, so our skin is often dry and can even crack, peel and itch. Not so glamorous. This is why gifts of good quality hand creams can be a lifesaver for a midwife. Little bottles we can keep in our pockets or bags or larger ones we can leave by the sink are all very much appreciated.
Another thing you might see midwives use is alcohol-based hand gels. These are really useful for disinfecting our hands quickly if soap and water and a clean towel aren’t available. There are actually quite a number of different brands offering hand gels these days. Some have lovely scents, whilst others are said to be more gentle on skin, or even just a pretty colour. As a small but much-appreciated gift, they are definitely worth considering.
So there we are. Just a few suggestions for simple and inexpensive gifts for midwives. Thank you for thinking of your midwife and considering a gift for her. Please know that we really do love sharing the whole pregnancy experience with you and are very happy if we know you have had a good or great pregnancy and birth.
Any other gift ideas I’ve not mentioned? Why not write me a comment below?
Just when you thought pregnancy couldn’t get any more glamorous, you find yourself struggling with pelvic pain. You start walking with a John Wayne waddle and even the simplest of tasks is accompanied by sharp stabs of pain in your pelvis. What is going on, and how can you solve it or at least soothe it?
WHY PELVIC PAIN HAPPENS
Your pregnancy causes an increase in various hormone levels in your body, and the hormone responsible in this case is Relaxin. Relaxin does exactly what the name suggests. It relaxes things like your blood vessels and your ligaments.
Relaxed blood vessels are great as because they relax they can hold more blood and send that blood to the baby to help him or her grow. Relaxed ligaments is also a good thing when you consider the process of labour. You have to get a baby out of an area not used to dealing with things that size! By relaxing the ligaments which hold and stabilise your pelvis, the exit area gets wider and giving birth gets easier.
Unfortunately, the downside of relaxed ligaments is the reduction of stability in your pelvis. If this happens very early in pregnancy, it can bring a lot of pain and discomfort. This pain might be around the edges of your pelvis or at the back near your coccyx. Pelvic pain commonly occurs at the front of your pelvis, where the two bones are joined by a pad of cartilage called the pubic symphysis. The only cure is the end of the pregnancy when the Relaxin hormone levels drop back to normal.
HOW TO MANAGE PELVIC PAIN
If giving birth is the only cure for pelvic pain, then the key is learning to manage it while it lasts. Here are some tips and tricks I know women have found helpful.
Have you ever noticed how the Queen sits so elegantly? She is a great example of good pelvic alignment. Since the focus of pelvic pain for many women is the pubic symphysis, keeping your hips aligned and stable is really key.
Try to keep your knees together and your hips at the same level. This is something most of us forget to do on a daily basis. We put one leg into the car, then sit then pull the other leg in, or get out of bed one leg first then the other. We sit on the sofa with our knees curled under us.
Instead, try to sit sideways on the car seat with both legs outside. Then once you are seated, swing your legs in together. When getting out of bed start by keeping your knees together and rolling onto your side. Drop both ankles over the side of the bed and push yourself up using your arms. Sit on the sofa with your feet both touching the floor or out on a footrest in front of you.
Speak to the Professionals
Physiotherapists are the experts in healthy movement and support of joints and ligaments. There are always local specialist physiotherapists who have a great deal of experience in treating and helping pregnant women. They have great advice for back and pelvic pain, separated abdominal muscles and pelvic floor exercises as well as so much more. Please speak to your Midwife or GP and get a referral to the physio service in your area. Even if the pain isn’t too bad at the moment, sometimes the referral can take a couple of weeks and things may be worse by then.
Heat can be very soothing for pelvic pain. Use it as an excuse for an extra long shower or an extra daily long bath. You can also use heat packs or hot water bottles. These are good for positioning directly over the painful points. However, please be careful not to burn yourself and give yourself short breaks without the heat packs so you don’t overheat the area.
There are lots of options for extra support to help reduce pelvic pain. These include tubigrips, support belts and taping. All of these offer different levels of support and none will cause any harm to the baby.
Tubigrips and support belts can be supplied by a physiotherapist or sourced online. Tape can also be bought online and applied by yourself or a partner.
Tubigrips can help you feel like your hips are being held in and comfortably surround your whole tummy and back.
Support belts can be found on Amazon in various styles. Some will sit just underneath your bump and give the feeling of lifting it up off the pelvic bone. Others are adjustable with straps across or over your bump. Which style is best for you is a matter of personal preference.
Taping is another option for providing abdominal support. This involves using kinesiology tape in various lines across or around your abdomen. Kinesiology tape is used by sports people and physiotherapists to help provide flexible temporary support to joints, ligaments and muscles. The Rock Tape brand has suggestions for tape positions in pregnancy on its Youtube channel here. Try searching on Pinterest for kinesiology taping in pregnancy as this will also provide lots of great positioning suggestions. Have a look at Amazon for a selection of tape options to buy.
Although taking painkillers regularly throughout pregnancy is not ideal, you may need to consider this if the pain is very bad. ALWAYS discuss this with a pregnancy professional such as an Obstetrician, Midwife or GP.
Worst Case Scenarios
It is very uncommon for pelvic pain to be completely overwhelming. Usually, measures such as those outlined above will help you manage until the baby arrives. Unfortunately for a very small minority of women, the pain is so bad that they need to use crutches or a wheelchair to get around. If this is you then please keep in touch with your pregnancy professional and make sure you are linked in with the local physiotherapy service. For a small number of women, the obstetrician may be willing to discuss starting labour off early to stop the pain. This is always only done after long discussions regarding the health and well-being of both mum and baby.
Why not have a look at the helpful physiotherapist videos at Best Beginnings or on your Baby Buddy app?
You can also find more sources of information on the useful links page, including the NHS website and the Royal College of Obstetricians and Gynaecologists website which has guidance on many subjects.