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Saturday, June 22, 2013

Science & Sensibility » Childbirth-Related Psychological Trauma: It’s Finally on the Radar and It Affects Breastfeeding

Posted by Jo Lundman at 1:15 AM No comments:

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Dee and Flynn (Aug 2011)

Beautiful mother baby love!

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Billy Foote

born 6th May 2011

Very cute photo of Cayden Bryan.

born 2 July 2008 first baby for Kirsty and Scott Tuatapere

Cayden Bryan

Georgeous De Thierry Children

Amelia-Jayne born 05/03/2009 Shahn born 06/01/2008

Caleb Todd (April 09)

He is such a cute wee man!

Emma O'Brien (15/12/2009)

There were heaps of very cute photos of Emma but this one bought a huge smile to my face!

Liam Race

And then comes moving...

Thea born 16 July 2010 Charlie and Karta

Proud big brothers born June 2008

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Christmas 2010

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Michelle, Jo, Sarah

With baby Maisie

About Me

Jo Lundman: I was born in the North Island of New Zealand (Otaki) in the late 60s and have lived in Southland for 11 years and LOVE IT!! This is the most beautiful place on earth with the national parks, milford and doubtful sound and the rugged coast between Riverton and Tuatapere. Mike and I have three children and I have been a midwife for 6 years (which I feel really grateful for). I take every day as a blessing and a gift and pray thanks to God for the support he puts around me in the form of my husband, my father-in-law, my children my friends and Colleagues. To all the women who said yes to have me as their student midwife and then their midwife - thank you it is an honour to be invited into your family.

View my complete profile

Alex (10), Rileigh (9) Thomas (13)

Speel!

14 years ago shortly after my first son was born my wonderful mother-in-law (now deceased) asked me 'what I would want to be if I didn't want to be a farmer any more'? And once i had the revelation I couldn't wait to do it!

So with just one child knowing I wanted more I decided to do the Childbirth Education Course (learning to take the Ante-Natal Classes) through Aoraki Polytechnic. This was a great course as it was distance learning with two workshops away from home and I would like to say a huge thanks to Debbie and Cindy my Aunty and Cousin who agreed for me to attend the births of Charlie and Alex (I love you)! I finished this 3 weeks before my youngest child was born in 2001. I don't know what I was thinking because I hate standing up in front of the class but the knowledge base was an excellent foundation for the midwifery degree. I now love taking the courses!

In December 2001 I was sitting reading the newspaper between Christmas and New Year and saw an ad that said the Otago Polytechnic was running a 'one off' midwifery course in Invercargill. Well I couldn't NOT APPLY! And so With Rileigh just 7 months old I started the adventure of full time study! Midwifery my 4th baby!

Having left school 20 years prior and not remembering how to write a formal essay the first year was a HUGE learning curve. But I did it a bit like running a marathon one step at a time, and in 2005 graduated with a Bachelors degree. I confess to shedding a few tears at the graduation because it was a real hard journey. God bless my family and friends for all the support from babysitting, accepting my messy house, and just being there I couldn't have done it without you!

The first 6 months after graduation I worked at Southland hospital and this was a wonderful experience to get to know how to do a few of the secondary care things that the wonderful core midwives do but working in a hospital environment wasn't for me at this stage of my life so I then began as an LMC midwife caring for women in the Invercargill/Winton areas and covering for the sole Tuatapere midwives.

My dream when studying was to be a rural midwife, I am a rural women and understand the challenges we face when we are pregnant and birthing out of town. I had a little bit of experience of this during 2006/2008 but the real dream of this began in June 2009 when the wonderful Waiau Health Trust at Tuatapere employed me to be their support midwife. We have been so privileged to care for so many women that the support midwife role became a full caseload role but I am so excited about this - I love to see Tuatapere Maternity thriving it is such a wonderful asset to the community! Thank you for choosing us.

The dream continues- I am really excited about the coming year and look forward to updating this regularly with photos and your stories if you are willing to write them! It's a great way for first time parents to hear what its really like to become a parent! And its such an empowering experience for women to share and no birth story is ever the same:-)

Jo

Mikaela Brown

Born 7th September 2010

From midwifery today

Keeping Childbearing Normal Through Nutrition

by Marion Toepke McLean, CNM

[Editor's note: This article first appeared in Midwifery Today Issue 48.]

During the months of pregnancy, every system of a woman's body changes. The blood and circulatory system expand and work for two. The basis of this expansion is nutritional.

Iron is a primary need during pregnancy. Baby's muscles, blood and other tissues contain iron, protein and scores of minerals, vitamins and other factors that are supplied through the mother's bloodstream by way of digestion or her own body stores. Iron is a vital part of the hemoglobin molecule, the building block of red blood cells that enables the blood to carry oxygen to body tissues. The mother adds around one-third extra blood herself, plus the baby must create its own supply and some extra that will remain in the placenta and cord after birth.

The placenta soaks up iron for the baby; the heavy concentration of transferrin receptors on the placental trophoblastic membranes hungrily attaches the molecules of serum iron that come its way. The mother's bone marrow, responsible for creating her blood cells, soaks up serum iron and draws on the body's pool of stored iron (stored in the bone marrow itself), which in a healthy woman averages 500 mg. It has been estimated that 1,000 mg of iron are required for the demands of normal pregnancy and birth.

However, although we know that pregnancy is an "iron hungry" state, it is a mistake to focus on iron at the expense of other nutrients. Two to three pints of blood and a 7-pound baby, plus a placenta, amniotic fluid and other maternal tissues, requires sustenance. Food. The mother needs regular feedings of protein and all the other essential elements of a balanced diet, including grains, fruits, vegetables and healthy liquids.

Increased growth of blood volume and other maternal tissue is notable from 12 weeks and is in full swing by 20; the greatest nutritional need per day in pregnancy occurs from 20 to 30 weeks. After that, though baby's growth takes off, the increase in maternal tissues is essentially complete. This is fortunate, because by this time the pressure of the growing baby has reduced the capacity of the stomach. It is important that the mother choose foods that are high quality when the amount is limited by mechanical factors. Remind the mother that her baby is growing all the complex tissues of a human body.

Discuss nutrition as early as possible. For those with morning sickness, talk about what they are able to eat, what appeals to them. Be sensitive! Even discussing certain foods can make a woman feel sick.

When the time is right, take a diet history. Discuss categories of food so that she can fill in nutritional gaps with foods she likes. This is difficult with some younger teens, who are still in the "there is no vegetable I like" stage. When you persist without putting them down for their diet, you can usually come up with a core of nutritional food they enjoy. The increasing appetite of the second trimester is on the midwife's side. Women tend to get hungry for the kinds of food they need. Protein is a notable example. Be sure your clients know both what good nutrition is and why it is important. Compression of the stomach by the growing uterus is felt by most women in the second trimester or before. They are hungry, yet they get full rapidly. Eating six small meals a day makes more sense than three larger ones. Talk about budgeting and using a shopping list so that appropriate foods will be on hand.

The increased need for water to build the serum portion of the bloodstream is signaled by increased thirst. Sometimes there is a family member who wants to get scientific and precise about how much water the woman should drink. I tell that person the body has a signal system that tells you when more fluid is needed. The mouth gets dry. A woman who tunes in to her body will drink what she needs in pregnancy, but she may forget on a busy or stressful day. The midwife, by verbalizing the need, makes the woman aware of it and encourages her to fulfill it.

Along with thirst, there may be a hunger for salt as the body creates new blood. Don't discourage this need. Blood is a salty fluid. Salt to taste.

The woman who eats well arrives at delivery with a healthy baby, an expanded blood volume and a substantial store of iron in her bone marrow. Good nutrition is still important after birth, which is often the period between pregnancies. I have seen too many women coming to the same facility for consecutive pregnancies who have a lower hemoglobin and hematocrit each time. This does not have to be true if attention is paid to eating right. Even when the body has been depleted by hemorrhage, proper care and feeding can bring it back to health. It takes a continuing effort. Good health through good nutrition is a lifelong endeavor.

In addition to her work at Midwifery Today, Marion Toepke McLean is a part-time clinical midwife, a part-time international studies student and a full-time Alzheimer's caregiver.

References

Duffy, T. (1995). Hematologic aspects of pregnancy. In R. Hoffman et al., eds., Hematology, Basic Principles and Practice. 2d ed. Two and a half decades of midwifery.

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