We ask the midwife

"Savor each overtired, wonderful moment because they will grow up so fast"

-On preparing for birth, giving birth, and the pressious time with your newborn

Nara Crotty:

Australian registred Midwife

What made you become a midwife?

I have always been interested in women’s rights though I didn’t always know I wanted to be a midwife. I was studying and working as advocate for women within my university when a perceptive friend suggested I might be interested in midwifery. I attended my first lectures and placement and knew I had found a profession I was incredibly passionate about."

How can one prepare for giving birth?

Attend antenatal education classes with your birth partner. Educating yourself on what to expect is so important so you can make informed decisions about your birth and the care provided to you.

If possible have a known midwife or care provider throughout your pregnancy who will be present for your labour and birth. Midwifery continuity of care models are associated with improved clinical outcomes and greater feelings of satisfaction for women and their families. Having a known midwife who you trust and knows your story allows you to feel safe and supported throughout your labour and birth.

Discuss your birth preferences with your midwife/doctor and support persons. You don’t necessarily need a written birth plan (though for some women this is an important process) but rather have an extensive ‘birth talk’ with your midwife or care provider. Here you will discuss the signs of labour, coping strategies, when to call, when to come in and pain relief options (from non-pharmacological options such as massage, heat, shower and positional changes to the drugs available and their benefits and side effects).

Following this talk reflect on what your preferences might be and discuss these with your care provider and birth partner. It is important for your birth partner to know your preferences to effectively support and advocate for you.

What would you say is the most important thing for a newborn in their first hours/ days/ weeks?

Skin-to-skin contact

This is the act of placing your baby onto your chest immediately after birth in direct contact with your skin. The two of you should be in a comfortable position to relax and bond uninterrupted for at least an hour in this state or until your baby has fed. Skin to skin in the first hours after birth helps babies to better adapt to life outside the womb through regulating their temperature, heart rate and breathing. Skin to skin is also an important first step to encourage breastfeeding.

If you are unable to provide skin to skin immediately after delivery, fathers or partners can provide skin to skin.

If your baby is born very early or needs to be separated from you at birth the skin to skin contact and cuddles you have with them at the first available moment will still be special and extra beneficial to them.

Even in the days and weeks to come regular skin to skin contact is a lovely way to slow down and just be with your baby. Skin to skin cuddles after bath time can be a great night time activity for fathers to bond with their new baby.

Breastmilk

Breastmilk is designed for human infants and is the natural first food for babies. It provides your baby with everything they need (energy and nutrients, comfort and reassurance, increased resistance to infection and disease) for healthy growth and development. The World Health Organisation recommends “exclusive breastfeeding up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond”.

While breastfeeding is perfectly natural it is still a learned behaviour. Newborns breastfeed very frequently, every two to three hours is normal in the first weeks and this can be very exhausting for new mothers. Be kind on yourself as you and your baby are both learning the steps in this new dance. It will get easier but for many women active support from their partner, family, midwife or lactation consultant will be necessary to establish and support breastfeeding. You can work together as a team to provide your baby with the best start to life. Adjusting pillows so you can get into a comfortable position, getting you a glass of water and just sitting with you are small gestures from your partner that can go a long way as you work together as a new family.

If you have decided to breastfeed, discuss with your partner and family why this is important for both you and your baby. I would also recommend attending an antenatal breastfeeding class during your pregnancy. Once your baby has arrived seek out support from your midwife or lactation consultant if you are having difficulties. The sooner you seek help the sooner breastfeeding will improve for you and your baby.

Some women know from early pregnancy or shortly after birth that they don’t want to breastfeed. We all have our own personal and unique reasons that inform our decision making and it’s important to respect that. However for many women they are keen to “give it a go” and just need the appropriate advice and support. Breastfeeding can be so rewarding and it really is one of the most important things for a newborn is the first hours, days, weeks, months and even years.

“Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large.” - The World Health Organisation (2018)

Love

Early loving interactions with you and your baby are so important for their healthy development. Cuddle your baby, talk and sing to your baby. Respond to your baby’s cues, picking them up and comforting them when they cry. This is how your baby is learning that they are safe and loved in this world. You cannot spoil a newborn.

What does a day at work look like for a midwife?

Midwifery is a varied profession. You could work across the community, at a busy hospital birth suite, as an antenatal educator or an educator for students to list a few examples.

As a continuity of care midwife (looking after the same women throughout their pregnancy, labour and postnatal period) the day may consist of attending antenatal appointments, home visits to see how mother and baby are getting on at home in the early weeks, and getting a call in the middle of the night to come in for a labouring woman.

As a midwife working within a hospital setting the day may involve getting into work and spending the shift on the maternity ward or busy birth suite, caring for women in labour, delivering babies and providing immediate postnatal and breastfeeding support.

In your experience, are there some common mistakes people make as new parents that can easily be avoided?

Safe Sleeping

Beanies and hats sure look cute but make sure you take them off when your baby sleeps. Babies lose heat through the top of their head and can easily overheat when their head is covered. Research has shown overheating increases an infant’s risk of cot death. Other simple measures to ensure a safe sleeping environment include placing your baby on their back to sleep in a smoke free environment, sleeping your baby in the same room as you, and removing excess blankets, toys and even cot bumpers. Safe sleeping guidelines are simple and easy to follow so make sure you discuss where your baby is going to sleep with your midwife or care provider before your baby arrives. This may save you from buying unnecessary and potentially harmful cot bumpers, wedges and sleep positioners.

Dr. Google

How wonderful and privileged we are to have resources and platforms for education at our fingertips. However, if you have a question you are likely to find many different and often conflicting answers online. As a pregnant woman and new parent this can be overwhelming and confusing. Remember to take what you read with a grain of salt. Stick to evidence based information and reputable websites over forums.

The same goes for new mother forums and Facebook groups. These are wonderful tools to meet other mothers/parents and discuss the ins and outs of pregnancy and parenthood. Though remember, if you have a clinical question or concern regarding your pregnancy or newborn please seek advice from your qualified midwife, health visitor, doctor, or lactation consultant.

Crotty advises new mothers to rely on those around her for help. "Identify those around you who will be your emotional and practical supports, " she says. That may be a family member or close friend who can cook you and your new family a meal, put the laundry or just sit with you to listen to how you are feeling.

Be kind on yourself, both you and your baby are learning and getting to know each other.

Sleep when your baby sleeps, we all say this but it really is important. When your newborn is sleeping during day this might be a good time to turn off the phone, shut the door to visitors and rest for a few hours also. You will be grateful for the extra hours of sleep at 2am when your baby is wide awake and doesn’t realise it’s the middle of the night.

Ask for help and reach out if you’re not coping, whether that’s to your partner, friend, another mother, or your GP. Chances are someone will be feeling a same way in your new mummy play group and will be relieved to have an open and honest conversation about how you are each navigating motherhood.

If you are concerned you are developing postnatal depression, seek advice from your GP and identify someone you can talk to. There are many supports available for new parents, asking for help is the important first step to take.

"Try and savour each overtired, wonderful moment because they will grow up so fast!!