Mother and Baby

Wednesday Lunch Club Q+A With Midwife Denyse Kirkby

Missed our Wednesday Lunch Club with midwife Denyse Kirkby? Don’t worry, you can read all of the expert advice she shared here

Every week at Mother&Baby we bring you the Wednesday Lunch Club – a chance to get brilliant advice for your parenting questions from a top expert. This week, midwife and author Denyse Kirkby was on standby to answer questions.

Denyse is a registered midwife, public health practitioner and midwifery teacher. She’s also the author of a brand new book, My Mini Midwife, £8.99, VIE Books. Set for release next week, Denyse’s book is a guide to everything you need to know about conception, pregnancy, delivery and beyond.

If you missed the chat, here’s what happened…

This may be a silly question, but I had a breast reduction two years ago and have just found out I'm pregnant. Will I be able to breastfeed my baby when he or she is born?

Denyse: The answer very much depends on the type of surgery and where the surgery was done. Here in the UK, it will depend on whether your nipple was removed during the surgery (and in what way it was removed). These questions can be answered by the consultant who did your surgery. Your obstetric consultant or GP can write and ask him.

Having said all of this I think you have a better chance of being able to breastfeed than not being able to, but it may be a case of 'start breastfeeding and find out'. One reassuring sign will be if you can express colostrum from your breasts in the last few weeks of pregnancy.

I'm 10 weeks pregnant with my second child and my morning sickness is far worse than with my first pregnancy. I've been to the doctor but he says it's normal but I really don't think it is! Any suggestions?

Denyse: I’m not sure if this is the same GP you had with your last pregnancy but it is important that you trust your instinct. If you feel your level of nausea with this pregnancy is not normal then you need to look into it further.

Have you seen your midwife yet? You need to be booked in for your first trimester screening as a matter of urgency if you haven't already been given an appointment for this. This should be done before the end of 13 weeks pregnancy. One of the things which can cause excessive nausea is if you are pregnant with more than one fetus so your early screening will pick this up for you if it is the case.

Other things that can cause excessive pregnancy nausea are: if this is the first baby with this father, if you are run down or undernourished, if you are not drinking enough fluids, or, more rarely, if this baby is a different gender to your last one.

Have you tried using Sea Bands? They are accupressure bands which are known to relieve nausea - you wear them on your wrists.

Sprinkling ginger essential oil onto a flannel and breathing it in can also help along with keeping well hydrated and nourished – but this difficult if you are vomiting.

I'm due to have a baby in the next few weeks but I haven't thought about a hospital bag yet. What are the essentials?

Denyse: The essentials are everything you need for your daily hygiene – flannel, soap, towels, hairbrush, hair product, toothbrush and paste, soap, something to read for a few seconds before you fall asleep, maternity pads, disposable pants (either cheap cotton ones or paper ones) daytime clothes, PJs, nursing pad, nursing bra, extra socks, labour and birth music, healthy snacks, camera etc.

You also need to pack essentials for your baby which will include nappies, baby grows, receiving blankets (for winding and wiping post feed milk possets), cotton wool balls for top and tailing, a soft blanket, going home clothes and so on.

Hopefully you will only need to stay in hospital for a few hours after birth so most of this will not be needed, but it is better to be prepared.

The essentials for your hopsital bag are everything you need for your daily hygiene and you need to pack essentials for your baby

I had a C-section for my last baby and desperately want to give birth at home. But my current midwife is saying that could be difficult. Is she right? I don't want to go against what she says but want to check.

Denyse: The key thing I am picking out of your question here is that your midwife has not said 'no', simply that it 'could be difficult'.

Although I am an advocate of home births I would agree with your midwife here. The final answer to your question will depend on a lot of variables, including the reason you needed your caesarian last time, how healthy you are during your pregnancy, what your body mass index is, how far you live from hospital, the reasons why you are desperate to have a home birth and more.

Do you have a VBAC (vaginal birth after caesarian) clinic at your local maternity hospital? If so then you need a referral there to discuss your individual case in depth.

I am pleased that you don’t want to go against what your midwife is advising (she is there to give you the information you need to make an informed choice about all of your health care) but it does sound as if you need more information from people who know your individual pregnancy and birth history before you can make your choice about place of birth.

I'm terrified about what birth will do to me physically – I've heard you often tear. Is there anything I can do to stop it?

Denyse: You are not alone in this worry about what you may go through physically when you birth your baby! One reassurance I can give you is that when your baby's head is crowning (when some women may tear, but only some rather than the 'many' you have heard of) you will be numb in the area that would tear. This means you shouldn't feel anything more than a 'giving way' sensation.

There are some positions that you can adopt while pushing that will ease the pressure on the tissues around the outside of your vagina which will help to prevent tears too. In particular the all fours kneeling position or lying on your left side. Some positions such as standing upright can make you more likely to tear.

I would like to be pregnant between the time my first baby is six to nine months old, so I can have an age gap of around 15 and 18 months between my first two children. My son will be six months in May which is when I plan to stop breastfeeding, but I'd like to know how is the best way to get pregnant. I know I may not have my period for a couple months after I’ve stopped breastfeeding but I also know you can get pregnant when breastfeeding and you've not restarted your period. So I am slightly confused on what to do and the best ways to help me become pregnant.

Denyse: In my book I devote a whole chapter to the importance of planning pregnancies because I think, if at all, possible people should treat future pregnancies with as much anticipation as they do when planning a special holiday. Not that I am in anyway implying that a pregnancy or being a parent is a holiday (far from it).

Since you have already successfully fallen pregnant I think you should simply relax and enjoy lovemaking whenever you can fit it in amongst your busy life. Breastfeeding only has a really good chance of preventing conception if you are feeding every two hours, 24 hours a day. So, you are more likely to fall pregnant while breastfeeding than not.

If you wish to continue breastfeeding while trying to get pregnant again then you can do so without worrying that it will stop you from conceiving. For your best possible chance if you want to conceive before your periods are fully back to normal, or while breastfeeding, try to make love every few days during the month. Sperm lives after ejaculation for three to five days so this will ensure that there is sperm lingering around should they happen to chance upon one of your eggs.

I am currently off sick with sciatica and just been diagnosed with SPD also. I am 26 weeks. My GP said there's no chance of me returning to work but I have been off since December. I’m not sure when to put my maternity notice in as my due date isn’t until the end of May. I could start it as early as March according to a government website, but obviously the sooner I take it, the less time I’ll get with my child once he/she is born. My employer isn’t being the most understanding of people regarding my pregnancy either. Will they tell me I have to take early maternity or can I choose?

Denyse: Have you been referred to a maternity specialist physiotherapist and to an obstetric consultant? I am surprised your doctor has said there is no chance of you returning to work without the advice of a physiotherapist or obstetric consultant.

I am afraid that from 28 weeks your employer can ask that you begin your maternity leave early if there is evidence that your absence from work is related to your pregnancy and in the case of the SPD, it is.

However, if you can show your employer that you are working with a physiotherapist on a return to work programme of exercises with a view to returning to work in a certain number of weeks then they may be willing to give you this chance to get work fit again instead of making you begin your maternity leave sooner than you would choose yourself.

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