Author: development

First few hours after birth

Posted on by development

The first few minutes after birth

Congratulations! your baby is in your arms!

It’s exciting, its overwhelming, you are exhausted and blown away!

***Key Points***

The first few hours after birth are highly significant for mother and baby and partners as your baby emerges from the womb to the world and you get to you know your baby

Don’t rush anything, friends and family will be excited to meet your baby but use this time to connect with your new baby.

Keep the room as warm, quiet, dimly lit and relaxed as possible to create a calm environment.

Keep your baby skin to skin

***Key Points***

***Meeting your baby***

Your baby may appear pale in the first minute/60 seconds after birth.

They will gradually become a skin coloured over the first few minutes although your baby’s hands and feet may remain pale or blue for some hours after birth.

Your baby may have vernix on their skin This is a greasy white substance that protects your baby’s skin in later pregnancy in a water environment. This is normal and healthy and will absorb in the hours after birth

Your baby has been listening to your voice during the third trimester of pregnancy and will recognise it when you speak to them after birth.

Your partner or support person’s voice may also be familiar if they have also been talking near your baby.

Skin to skin your baby will also be able to hear your heart beating as they did in the womb

We believe your baby’s vision is blurred at birth but they will be able to focus on your face from about 30 centimetres away. It is roughly the distance from your breast to your face.

In the newborn stage, babies are guided by smells, sound and touch.  If undisturbed, you may notice that your baby will start to use their hands to touch and explore and start bringing their hands to their mouth as they use scent to help guide them towards the breast.

Trying to keep the room as warm, quiet, dark and relaxed as possible will create a calm environment.   Family and friends will be very excited to meet your new baby but this time as a new family, spent getting to know each other is really important.  You will also probably want to know how much your baby weighs but ideally all these interruptions should wait until at least after your first feed.

***Meeting your baby***

***Apgar score***

One of the formal observations made after birth is called an Apgar score. It assesses your baby’s adjustment to life outside the womb.

The Apgar score is measured at 1 minute and 5 minutes after birth while the baby is on your chest. Sometimes it is measured again at 10 minutes after birth.

It records your baby’s

  • heart rate,
  • breathing,
  • colour,
  • muscle tone
  • reflexes

The maximum score is 10. A score of 7 or above usually means your baby is doing well. It is not an ability or intelligence test, and it doesn’t predict your baby’s health later in life, it is simply a measure of your baby’s wellbeing immediately after birth.

***Apgar score***

***Weighing and measurement***

In a hospital the Midwife will place two name bands on your baby.

Within the first few hours your baby will be weighed and the midwife will do a physical check.

They will check the baby’s length and head circumference.

***Weighing and measurement***

***Vitamin K***

The Midwife will discuss with you Vitamin K which is recommended by Paediatricians to be given to all newborn babies in the first hours after birth.

Vitamin K helps our blood to clot. Administering vitamin K soon after birth to babies prevents serious bleeding in infants.

This is more commonly given to your baby by an intramuscular injection, however it can be given as three oral doses. Talk to your Midwife about the options.

You should discuss the options and reason this is being suggested with your Midwife or doctor in pregnancy and they will ensure you have consented prior to this being administered to your baby.

***Vitamin K***

***The first feed***

Allowing your baby uninterrupted skin to skin time and letting them explore and find the breast themselves can often take upwards of an hour after birth.  This time is really important for your body to help regulate your baby and create a calm atmosphere.

Initiate your baby’s first breastfeed in the early hour/s after birth.

It can be a very strange sensation when your baby first feeds and their suction can sometimes be quite strong but it shouldn’t be painful in the way of sharp biting and pinching.

Make sure to ask your midwife for assistance if it doesn’t quite feel right.  Often, newborns may need a little support to work out how to latch properly so that it doesn’t cause you any pain.

***The first feed***

***What will my baby look like?***

In most cases your baby is in a state of quiet alertness when they are first born. They will open their eyes to suck and make eye contact. They are seeking connection.

Posture
You will notice their posture is often as if they are still in the womb. Elbows bent, knees flexed and arms and legs close to their body. It takes a few days to stretch out and relax their hips.

Head
A baby’s head is usually the first  part of the body to pass through the pelvis and birth canal and the shape can be affected by the process.

This can cause the skull bones of the baby’s head, which are not fused together to shift and overlap, called moulding.

This can make the shape of the head look elongated, stretched out, or even pointed at birth.

The skull bones will realign and reshape over the next hours and days

The heads of babies born by caesarean section or breech (buttocks or feet first) delivery usually don’t show much in the way of moulding.

Face
Your baby’s face may look quite puffy. Your baby’s features often change quite dramatically in the first hours and days after birth.

Eyes
Immediately at birth your baby will open their eyes, look around and make eye contact. They often have difficulty focusing more than approx. 30cm they may appear cross eyed. At times a bay’s eyes , the whites of their eyes may appear blood shot or red. This will resolve in a couple of days.

Genitalia
The genitalia (sexual organs) of both male and female infants may appear relatively large and swollen immediately at birth. This is due to the high maternal hormones which have transferred to the baby via the umbilical cord.

Due to the effects of the female hormones, some female babies will have a vaginal discharge of mucous or small amount of blood.

In male baby’s the scrotum may be swollen and red

All these features will subside in the first 24-48 hours.

Within the first 24 hours your baby will probably pass urine and their first poo, called meconium at least once. Meconium is a black and sticky consistency. You babies poo will change colour and consistency over the coming days as they ingest milk and this travels through their digestive track.

Skin and birthmarks

Some babies are born with a birth marks. Some areas of reddened birth marks will disappear in the first 12 months, others remain for life.

Speak to your MCHN if you are concerned or notice a change in size or nature of the birthmark.

Strawberry or capillary hemangiomas are raised red marks on a babies skin. They are caused by collections of widened blood vessels close to the skin surface. These may appear pale at birth, then become a brighter red colour and enlarged during the first months of life. Then, they usually shrink and disappear without treatment after the first 12 months of life. They are unlikely to be of concern, but should be examined by a MCHN who may refer you to your GP, dermatologist or paediatrician.

Rashes
Several harmless skin red areas or rashes and appear at birth or during the first few days. Tiny, flat, yellow or white spots on the nose and chin, called milia, are caused by the collection of secretions in skin glands and will disappear within the first few weeks.

Primitive Reflexes
Infants are born with a number of instinctual responses or reflexes. Most gradually disappear as the baby matures. These reflexes include the:

  • sucking reflex– a baby will instinctively suck on any object put in the mouth
  • grasp reflex, – a newborn will tightly close the fingers when pressure is applied to the inside of the infant’s hand by a finger or other object
  • Moro reflex, or startle response, which causes an infant to suddenly throw the arms out to the sides and then quickly bring them back toward the middle of the body whenever the baby has been startled by a loud noise, bright light, strong smell, sudden movement, or other stimulus

***What will my baby look like?***

Resources

Skin to skin – Cochran report

Skin to Skin – Unicef

MHMRC – flyer for parents on Vitamin K

RANZCOG – information regarding Vitamin K at birth

 

Skin to skin contact

Posted on by development

Skin to Skin contact immediately after birth

The first hour after birth is highly significant for new parents and for the baby who has just transitioned from the womb to life outside.

***Key Points***

Skin to skin contact at birth

  • regulates a baby’s heartbeat and
  • regulates their breathing rate
  • improve oxygen levels in your baby’s blood
  • help to maintain your baby’s body temperature
  • calms your baby, reduces stress and crying
  • helps to establish breastfeeding and makes successful breastfeeding at 6 weeks of age more likely
  • we know from premature babies, skin to skin contact increase weight gain and improves outcomes for baby’s born early.

***Key Points***

***Skin to skin***

Skin to skin

Your baby will be placed skin to skin on your chest immediately after a vaginal birth. A warm blanket will be placed over both you and your baby, to keep you both warm. This assists the production of oxytocin and prolactin being produced (essential for bonding and breastfeeding) and assists your baby to regulate their own temperature, heart-rate and breathing.

Your baby has spent months in an environment that is temperature controlled, if they become cold they need to use more energy and oxygen to keep their temperature stable.

They can smell you, hear your heartbeat and the familiar voice from the womb. They are warm and help firmly. Skin to skin is the best place for your baby immediately after birth…your baby will tell you that, and research supports it.

Skin to skin contact at birth

  • regulates a baby’s heartbeat and
  • regulates their breathing rate
  • improve oxygen levels in your baby’s blood
  • help to maintain your baby’s body temperature
  • calms your baby, reduces stress and crying
  • helps to establish breastfeeding and makes successful breastfeeding at 6 weeks of age more likely
  • we know from premature babies, skin to skin contact increase weight gain and imporoves outcomes for baby’s born early.

Following a Caesarean birth,  ask the Midwife with you to assist you to have your baby has skin-to-skin contact with you as early as possible. In theatre if possible or in recovery.

***Skin to skin***

***Warmth, quiet and calm***

At this time, the mother and baby’s needs are simple: warmth and a quiet, calm environment.

Babies have an innate instinct to seek the breast. Left unaided they will crawl to the breast and attach to the nipple. Swedish researchers in the 1980’s called this the breast crawl. Allow your baby to seek and explore as they initiate the first feed shortly after birth.

Prolonged skin to skin after birth allows you to get to know your baby and this attachment is critical for survival of your newborn baby.

This contact with the mother boosts the baby’s natural immune system. As babies emerge from the near sterile environment of the uterus they come in contact with the bacteria in the vagina and then skin of the mother, This kick starts the baby’s immune system and protects against disease in the future.

***Warmth, quiet and calm***

If birth doesn’t go to plan or there are complications and you are unable to hold your baby or do skin to skin immediately there are still many things you can do to ensure your breastfeeding journey isn’t interrupted.  Regularly hand expressing and/or using a pump with the guidance of your midwife will start to initiate your milk supply and still ensure your baby is getting precious colostrum.  Being close to your baby, touching them, holding them or being able to look at videos and smell clothing if you are separated from them will still help that magical cascade of hormones starting to work.

 

Your Recovery After birth

Posted on by development

The first 6 weeks – Your Recovery

What to expect in the first weeks home after birth

***Key Points***

You go through many physical changes as your body heals following birth as well as emotional changes in the early weeks after having a baby.

The first 6 weeks after birth are called the postpartum period.

Please visit the emotional health component of the Talkingbirth App for a comprehensive guide to emotional changes after birth.

***Key Points***

***Vaginal Blood loss***

Blood loss after birth is called lochia.

For the first few days this will be bright red in colour and like a heavy period.

The amount of blood loss will reduce over the coming weeks although it is normal to bleed anything up to 6 weeks after birth.

The colour will change from bright red to reddish brown to pink and watery.

If you have a sudden large increase in blood loss or pass a clot bigger than a 50c piece let your Midwife, Doctor or MCHN know.

***Vaginal Blood loss***

***Bowels and bladder***

Bowels and bladder

You may be reluctant to use your bowels after having a baby. Drink plenty of water and eat fibre rich foods to avoid straining. Do not ignore the urge to open your bowels or pass urine and take your time, so you feel you have completely emptied your bladder or bowel.

Ensure you have cleaned the area well after opening your bowels especially if you have had any stitches after birth.

***Bowels and bladder***

***Your uterus***

This amazing organ housed your baby for many months. It was the size of a pear before you became pregnant and grew to accomodate your baby. It will return to its pre-pregnancy size over the next approximately 6 weeks.

Immediately after birth your uterus will be around your belly button. It will slowly return to being below your pelvic bone. You might experience mild to moderate tightening’s as this happens, sometimes referred to as ‘afterbirth pains’. These are often mild after your first baby but become stringer as you have more children.

***Your uterus***

***Your perineum***

Your perineum

You may have experienced a small graze, a tear or an episiotomy during birth and your Midwife or doctor will have add stitches to the area to allow the area to heal. The stiches are absorbable so they will disappear and do not need to be removed. Keep the area clean especially after passing urine or opening your bowels.

In the early days

Rest – lie flat for at least 30 minutes twice each day. This will reduce tenderness and reduce swelling  and reduce the weight carried by the pelvic floor muscles and lower abdominal muscles.

Ice – If you have had a vaginal birth or attempted vaginal birth ice applied to your perineum will help reduce the swelling. Place inside a pad for 20-30 minutes every 2-3 hours

Compression – Firm supporting underwear will help support the perineum and the lower abdominal muscles.

Exercise – pelvic floor muscles can be commenced when you feel ready, usually within 1-2 days after birth.

Your perineum will feel tender for days or weeks after birth. Apply ice and you can take over the counter medications for pain. Rest as much as you can.

Remember your pelvic floor muscles. It is important to start to retrain these muscles as soon as you feel comfortable after birth

***Your perineum***

***Recovery after a caesarean section***

Recovery after caesarean section

After a Caesarean section you will have  surgical wound in the lower part of you tummy. It is normal as with any major surgery to have pain around the wound site.

It can help to support your wound with pillows when you move or are getting in and out of bed. Your physiotherapist will show the easiest way to get in and out of bed to minimise discomfort. It can help to support your wound by lying with pillows under your knees.

To assist with healing avoid lifting anything heavier than your baby in the first 4-6 weeks. Limit vigorous exercise and increase gentle walking and exercise slowly, being mindful of how your body feels.

Wear loose fitting underwear with a high waist to avoid discomfort on the wound

Sleep, rest and accept the offers of help.

***Recovery after a caesarean section***

Resources

Sleep in the early weeks

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Sleep and settling in the first 6 weeks

Sleep and settling concerns are common issues affecting families. We recognising the importance of sleep for a child’s long-term development and for the health and wellbeing of families.

***Key Points***

You will find information to guide you but no single strategy but rather a number of safe evidence-informed options that allow you to adopt an approach that suits your individual values, preferences, beliefs and parenting style.

We cover only the first 6 weeks after birth here but further information in the resources below.

***Key Points***

***Our approach***

There is a large amount of unregulated advice, information and approaches that it can be difficult to navigate what information is reliable.

Attachment or bonding with your baby is key to your baby’s development and sense of security.

It allows you to understand your baby’s cues.

We support a family centered approach and base our information here on the guide developed by the Department of Health evidence- informed sleep and settling model of care.

***Our approach***

***Newborns and sleep***

  • Newborns do often not know the difference between day and night.
  • Newborns generally sleep 12 to 16 hours in a 24-hour period
  • Newborns need regular feeding to grow and develop  so they usually sleep in short periods.
  • This means they will wake frequently during the night to be fed or changed.

You can help your baby to learn to sleep more at night by exposing them to light, being outdorrs in the natural light during the day and providing more stimulation by playing with them during the daylight hours.

At night create a quiet, dimly lit environment to encourage your baby differentiate between day and night rhythms.

***Newborns and sleep***

***Sleep cycles***

Sleep cycles

  • They do not have established sleep-wake rhythms like we do.
  • Newborns sleep in short bursts, known as sleep cycles which are usually around 20 to 50 minutes long.
  • It is normal for your newborn baby to wake between sleep cycles. As they become older they will learn to settle themselves back to sleep

***Sleep cycles***

***Crying***

Crying

  • Crying is the way babies communicate with you
  • They may cry when they are hungry, need their nappy changed or are tired and need to settle to sleep.
  • The early days and months of becoming a parent are a time when you are getting to know and understand your baby.
  • The average newborn cries and fusses almost three hours a day until around 3 to 6 months of age.
  • From approximately two weeks to three to four months of age, newborns go through a stage of increased crying, which will be at its worst at 6 to 8 weeks of age.
  • They cry at times without a known reason, as  long as your baby is growing, gaining weight and at other times happy then it unlikely a concern.

However if you are concerned call the MCHN line or speak to your MCHN about this.

***Crying***

Settling your baby to sleep

***Your baby’s tired signs***

When your baby is tired, they show signs or cues that they are tired. If you learn to recognise these signs, you can encourage your baby to go to sleep at the right time.

Babies from 0 to 3 months might start showing tired signs after 30 minutes of being awake.

These will include:

  • jerky movement
  • frowning
  • clenching of fists
  • yawning
  • staring
  • poor eye contact
  • fluttering of eyelids
  • rubbing eyes
  • sucking on fingers
  • back arching, grizzling and crying, which are late signs

***Your baby’s tired signs***

***A consistent approach***

Put your baby in their safe sleep space, such as a cot or bassinet when they are tired but awake

Use a consistent each time you settle your baby. Use a gentle and positive approach.

As part of a consistent approach your baby will usually benefit from cue to tell them it’s time to go to sleep. This may be swaddling, wrapping, dimly lit room or bath or massage.

A predictable routine before bed and settling to sleep will be calming for your baby and help prevent ongoing sleep issues.

***A consistent approach***

***Your baby’s sleep environment***

Your baby’s sleep environment

  • reducing stimulation around your baby – for example, sit in a quiet room with dim lighting.
  • swaddling or wrapping your baby (if they cannot yet roll over).
  • giving your baby a bath in the evening in preparation for sleep
  • giving your baby a gentle massage.
  • creating a pre-sleeping routine, like singing lullabies, reading a book or repeating the same phrase, ‘it’s time to seleep’

Try to have regular bed times, nap times and wake times to help your baby develop a rhythm to their day and night.

***Your baby’s sleep environment***

***Safe Sleep***

To sleep your baby safely

  • sleep your baby on their back
  • keep their head and face uncovered
  • ensure baby’s environment is smoke free
  • have a safe sleep environment
  • sleep baby in a safe cot in your room
  • breastfeed your baby

***Safe Sleep***

Resources

 

 

 

The MCHN service

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 Maternal and Child Health Nurse (MCHN) service

Taking your baby home brings much joy but also many challenges and the Maternal and Child Health service is available to offer information, guidance and support on issues about parenthood and child health and development.

***Key Points***

The Maternal and Child Health Service is a free service available to all Victorian families with children from birth to school age.

There are Maternal and Child Health Centres located in each local council area.

***Key Points***

***What is a MCHN***

The MCHN service is run by Maternal and Child Health Nurses (MCHN’s) who are registered nurses with extra qualifications in midwifery and maternal and child health.

They can offer support and guidance on such issues as

  • Breastfeeding
  • Child health and growth
  • Child development, communication, language and play
  • Safe sleeping
  • Starting solids, infant and child nutrition
  • Mental health support
  • Parenting skills
  • Oral health
  • Vision checks
  • Home safety for your child and injury prevention
  • Immunisations
  • Your family relationships
  • Family violence
  • Local groups and referral to support services.

Most Maternal and Child Health Centres run some additional sessions, such as sleep and setting sessions, breastfeeding support and guidance or mental health support groups. Ask your MACHn about other groups in your local area.

MCHN’s will commence new parent groups which gives you an opportunity to connect with other parents in your local area.

***What is a MCHN***

***Access to a MCHN***

How to access the MCHN service>?

After you have given birth to your baby, the hospital or midwife will contact the Maternal and Child Health Service in your local council.

A MCHN will call you a few days after you get home and arrange to visit you at home. You can contact them before this time if you have any concerns.

If you have not had contact with your local MCHN, e.g. if you have moved or your baby has been in hospital for a significant time, contact your local council for details of the nearest Maternal and Child Health Service. Call them to make an appointment.

Your place of birth will have given you a  My Health, Learning and Development Record (green book) remember to take it to each appointment so that your MCHN can record relevant information about your child’s health and development.

***Access to a MCHN***

***The Key Age and Stage Framework***

Key age and stage framework

There are certain times of development for your baby or infant that are known as key ages and stages, and visits to your MCHN are scheduled to correspond with these stages.

After the initial home visit – these are

  • 2 weeks
  • 4 weeks
  • 8 weeks
  • 4 months8 months
  • 12 months18 months
  • 2 years
  • 3-5years

During these visits your MCHN will ask you about your child’s

  • the health and development of your child
  • physical and emotional effects on the family
  • your own health and wellbeing
  • any concerns you may have.

You can of course make an appointment outside these times if you have any concerns.

***The Key Age and Stage Framework***

***MCHN 24 hour Help Line***

The Maternal and Child Health Line is a 24-hour telephone service (phone 13 22 29 in Victoria). Qualified MCHNs offer information, advice and referral to all families with young children.

An interpreter service is also available.

***MCHN 24 hour Help Line***

Resources

Call the 24 hour Maternal and Child Health Line: 13 22 29

Department of Education: Maternal and Child Health Services

The Royal Children’s Hospital: Mother and baby units

Download the Victorian Maternal and Child Health Services app.

 

Other states and territories in Australia have their own services for parents and babies:

ACT: Maternal and Child Health (MACH) Nursing Service

NSW Government: Maternal, child and family health

Queensland: Child Health Service

South Australia: CaFHS Centre Search

Tasmania: Child Health Centres

Northern Territory: Baby and child screening and assessment clinics

Western Australia: Child Health

 

 

Meditation Mp3 Downloads

Posted on by development

Our meditations are specifically designed for use during pregnancy and in preparation for birth.
They are designed to promote relaxation, confidence, mental clarity and expand your sense of awareness and connection to your baby.

Downloadable here

There is sufficient evidence to support the practice of mindfulness practices in pregnancy to reduce anxiety, depression, and stress during pregnancy, which may continue to have beneficial effects through the postpartum period.

Babbar S, Oyarzabal AJ, Oyarzabal EA. Meditation and Mindfulness in Pregnancy and Postpartum:
A Review of the Evidence. Clin Obstet Gynecol. 2021 Sep 1;64(3):661-682.

Birth Preparation Course

Posted on by development

The complete program includes 7 video modules, birth videos and downloadable Mp3 meditation tracks.

All facilitated by the same two Midwives who have created the Talkingbirth App

If you love the app you will love the course!

Click here to purchase access

Talkingbirth Birth Preparation Course

 

 

 

 

Why prepare for birth?

Posted on by development

Enjoy Module 1 of 7 here – the complete course can be accessed at learn.talkingbirth.com.au

 

 

Hey there,

Welcome to Talkingbirth’s Birth Preparation Course

We are thrilled you have joined us as you prepare for the birth of your baby.

We are both Midwives and the founders of Talkingbirth and we are passionate about making a difference to women’s experience of pregnancy, birth and parenting.

After many years of working as Midwives, learning from women, we observed that pregnancy, childbirth and parenting can be remarkably transformative when implementing the life-skills of preparation and presence.  Preparing for childbirth has many benefits to both mother and baby as does parenting with gentle presence in the now, from the moment of birth.

It became clear to us that women found tremendous benefits being in the present moment, enabling them to live through their ordinary and extraordinary life transition with greater confidence, wisdom, power and joy.

We have shared this content with 1000’s of women as childbirth and parenting educators and using this experience and feedback from women we have developed this 7 part online course.

Welcome to Talkingbirth’s childbirth and parenting preparation course, a series of online information sessions bringing together our experience as Midwives supported by a solid framework in the practice of mind/body connection.  

Our goal is for you to feel informed and confident as you approach the birth of your baby.

Please enjoy this first Module.

The complete workshop can be accessed here

Talkingbirth Birth Preparation Course

 

 

 

 

Nausea in pregnancy and hyperemesis gravidarum

Posted on by development

Nausea and vomiting in pregnancy and hyperemesis gravidarum

***Key Points***

Nausea and vomiting of pregnancy is a common condition that usually settles by 12-14 weeks of pregnancy.

Hyperemesis gravidarum is a severe form of this condition and can affect up to 1 to 3 in 100 pregnant women.

Nausea and vomiting and hyperemesis gravidarum can affect your mood, your work, your home situation and your ability to care for your family. Extra support from family, friends and healthcare professionals can help you.

While most women can be treated at home or as outpatients in hospitals, some may need admission to hospital for treatment.

A variety of anti-sickness medicines are available that may help your symptoms. While some of these medicines may not be licensed for use in pregnancy, there is no evidence that they are harmful to your baby.

***Key Points***

***Nausea and vomiting***

What is nausea and vomiting during pregnancy?

Nausea and vomiting is a symptom of pregnancy and affects most women to some degree. It begins early in pregnancy, most commonly between the 4th and 7th week. It usually settles by 12–14 weeks, although in some women it may last longer. It is often called ‘morning sickness’ but it can occur at any time of the day or night.

The cause is thought to be pregnancy hormones but it is unclear why some women get it worse than others. However, it is more likely if:

  • you have had it before
  • you are having more than one baby (twins or triplets)
  • you have a molar pregnancy (a rare condition where the placenta overgrows and the baby does not form correctly).

It is important that other causes of vomiting are considered and looked into, particularly if you are unwell, have pain in your tummy or your vomiting only starts after 10 weeks of pregnancy. Possible other causes include gastritis (inflammation of the stomach), a kidney infection, appendicitis or gastroenteritis.

***Nausea and vomiting***

***Hyperemesis gravidarum***

What is Hyperemesis gravidarum?

If the nausea and vomiting becomes so severe that it leads to dehydration and significant weight loss, it is known as hyperemesis gravidarum. It may affect 1 to 3 in 100 pregnant women. Signs of dehydration include feeling ‘dry’ or very thirsty, becoming drowsy or unwell, or your urine changing from a light yellow to a dark yellow or brown colour. Women with this condition may need to be admitted to hospital.

In severe cases, vomiting can last up to 20 weeks. Occasionally, it can last until the end of pregnancy.

***Hyperemesis gravidarum***

***Your experience***

How will it make me feel?

Nausea and vomiting of pregnancy can be a difficult problem to cope with. It can affect your mood, your work, your home situation and your ability to care for your family. Support from family and friends can help. In some women, the symptoms can be so severe that they become depressed and need extra support such as counselling. If you find that you persistently feel down then you should speak to your healthcare professional.

Will it harm my baby?

There is no evidence that nausea and vomiting has a harmful effect on your baby. In fact, you have a slightly lower risk of miscarriage.

Women with severe nausea and vomiting or with hyperemesis gravidarum may, however, have a baby with a lower than expected birthweight. You may be offered scans to monitor the growth of your baby.

***Your experience***

***What can help?***

What can I do to help?

Most women with nausea and vomiting of pregnancy will be able to manage their symptoms themselves. You should:

  • eat small amounts often – meals that are high in carbohydrate and low in fat, such as potato, rice and pasta, are easier to tolerate; try plain biscuits or crackers
  • avoid any foods or smells that trigger symptoms.

Some women find eating or drinking ginger products helps. However, these may sometimes irritate your stomach. Complementary therapies such as acupressure or acupuncture may also be helpful.

If your symptoms do not settle or if they prevent you doing your day-to-day activities, see your GP, who will prescribe anti-sickness medication. This is safe to take in pregnancy.

 

What if my symptoms do not settle with these measures?

Contact your GP or your midwife. They will arrange for you to be seen in the assessment unit at your hospital. This may be in the maternity department or be part of the gynaecology unit.

***What can help?***

***An assessment unit***

What happens on the assessment unit?

You will have a check-up that may include:

  • a discussion about how long you have had your symptoms for and whether:
    • you are keeping fluids and food down
    • you have tried any medication
    • you have lost weight
    • you have any other symptoms
    • you have had this in a previous pregnancy
  • a check of your general health including your temperature, pulse, respiratory rate and blood pressure; you will have your weight measured and an assessment of whether you are dehydrated
  • urine tests
  • blood tests
  • an ultrasound scan. This is to check how many weeks pregnant you are. It will also check for twins and rule out a molar pregnancy.

If you are able to tolerate some fluids but are unable to drink enough, you should be offered fluids through a drip in your arm over a short period of time. This is called rapid rehydration. You will also be given anti- sickness medication. Many women feel much better after this and are able to go home.

***An assessment unit***

***In hospital***

Will I need to be admitted to hospital?

Admission to hospital may be advised if you:

  • are dehydrated; having ketones in your urine is a sign of dehydration
  • have severe vomiting and are unable to tolerate any fluids
  • have abnormal blood tests
  • have lost weight
  • have a medical condition such as a heart or kidney problem or diabetes.

What happens in hospital?

You will be given the fluids you need though a drip in your arm. This will be continued until you are able to drink fluids without vomiting.

Each day your fluid intake and how much urine you are passing will be recorded. Your temperature, blood pressure, pulse, respiratory rate and weight will also be recorded.

You should be offered:

  • anti-sickness medication and a B vitamin called thiamine; both of these can be given through the drip in your arm if you are unable to keep tablets down
  • special stockings (graduated elastic compression stockings) to help prevent blood clots
  • heparin injections (to thin your blood). Pregnant women are at increased risk of developing blood clots in their legs, called deep vein thrombosis (DVT) or in their lungs (called pulmonary embolism). Being dehydrated and not being mobile increases this risk further. Heparin injections reduce this risk. You will be advised to continue these until you leave hospital and sometimes for longer.
  • There are a variety of anti-sickness medicines that you may be offered.

If you are taking iron medication, this will be stopped because it can make sickness worse.

When you are feeling better, you can start to drink and eat small amounts and slowly build up to a normal diet.

***In hospital***

***After discharge***

After discharge

You will be given anti-sickness tablets to take home. If you feel better, you can cut down the number of tablets. If your vomiting gets worse, stop eating but try to keep sipping fluids and taking the anti-sickness tablets until you start to feel better. Ask your GP for a repeat prescription before your tablets run out.

Your symptoms may return and you may become dehydrated. If this happens, contact your midwife, GP or maternity unit to be assessed again.

Although this can be a difficult situation for you and may affect you throughout your pregnancy, the symptoms usually resolve or improve after your baby is born. If you have any ongoing concerns, contact your midwife or GP for advice and support.

***After discharge***

Resources

Resources for Indigenous Families during pregnancy

Posted on by development

Culture is protective. Seek out flexible, inclusive, culturally appropriate pregnancy care and postnatal support for yourself and your family.

***Key Points***

CONNECT with an Aboriginal and Torres Strait health service

GET HELP to stop alcohol, cigarettes or other drugs and understand how they impact you and your baby.

ATTEND regular antenatal appointment

Eat well, exercise and look after your mental health

Take steps to get the support you need to have a healthy pregnancy

***Key Points***

 

Find out if your local maternity hospital provides pregnancy care options for Aboriginal and Torres Strait Islander women. If you are Aboriginal or your baby will be Aboriginal [so you might not be but your baby’s father is] you will be eligible for these services. Here are some in Victoria – Koori Maternity Services click the link to find contact information.

The Women’s – resources for Aboriginal and Torres Strait Islander women

Pregnancy Birth Baby – Indigenous Families

The Women’s – You and your Boorai – resources and information for Aboriginal and Torres Strait Islander women who are pregnant and their families experiencing problems with alcohol or other drugs.

The Women’s – Being a Strong Parent – a worksheet to help you identify your strengths.

Baby Coming You Ready is a platform aimed to support relationships between non-Indigenous care providers and Indigenous pregnant women and their families. There are a range of resources and videos available to help inform you during your pregnancy.

Baby Coming You Ready – Mums

Baby Coming You Ready – Dads

Pregnancy Birth Baby – support services for Aboriginal and Torres Strait Islander families – includes mental health support services, relationship support and family health services.

Aboriginal Mothers and Children

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