Foetal alcohol syndrome case dismissed by Court of Appeal

Our previous post mentioned a case being brought by a council in the North West of England because a child was born with foetal alcohol syndrome after the mother drank heavily during pregnancy.

The child is now in care after being born with severe brain damage, and lawyers for the council argued that the mother had poisoned her foetus.

Appeal judges have ruled that the mother had not committed a criminal offence.

Read more here.

Calls for stronger warnings about drinking during pregnancy

From the BBC website:

Campaigners and doctors are calling for stronger warnings about drinking during pregnancy, ahead of a legal test case on foetal alcohol syndrome.

The case will decide if a child born with serious disabilities caused by her mother's alcohol consumption should be compensated as a victim of crime.

Some estimates suggest thousands are born every year in the UK with serious health defects caused by alcohol.

Senior health officials have said there are mixed messages on the issue.

Read more.

Mother's pregnancy diet affects baby's food preferences

Julie Mennella of the Monell Chemical Senses Centre in Philadelphia says, "amniotic fluid is a complex 'first food' that contains chemicals that have both tastes and smells."

Pity the poor participants in this experiment carried out by Mennella. They had to sniff a bunch of amniotic fluid samples, and apparently had no trouble identifying the womb juice that had been extracted from women who had taken a garlic capsule 45 minutes before. All flavours tested so far, says Mennella, have been detectable in the fluid, including mint, aniseed, carrot and vanilla.

Another experiment by Mennella involved one group of mothers drinking 300ml of carrot juice four days a week for three weeks during the last trimester of pregnancy, a second group doing the same during the first two months of breastfeeding, and a control group giving carrot juice a wide berth altogether. The babies who tasted high concentrations of carrot in utero and in their mother's milk went on to happily eat more carrot during weaning. According to Peter Hepper, director of the Fetal Research Centre at Queen's University in Belfast: "foetuses exposed to garlic in the womb are more likely to prefer garlic in later life, indeed studies show up to the age of eight at least."

Read more: How a child's food preferences begin in the womb from The Guardian 8/4/14

Peterborough teen pregnancy rate falls

Improved sex education in Peterborough has been credited with reducing the number of teenage pregnancies in the city.
New figures show that for every thousand pregnancies in the city, girls aged 15 to 17 accounted for 28.1. The statistics relate to the last quarter of 2012 and for the same period in 2011, the number stood at 34.7 - and were even higher earlier in 2012 when it reached 43, one of the highest rates in the country.
Dr Henrietta Ewart, interim director of public health for Peterborough City Council, said: “We want young people to have the knowledge and confidence to delay sex until they are ready, and to be able to make informed and healthy choices."
Dr Ewart praised the work carried out by Peterborough Regional College (PRC) with youngsters, including young mums.
Despite the reduction in the city, the rate is still higher than the English average, which stands at 26.3.
The number of teenage pregnancies fell across Cambridgeshire as well as in Peterborough, according to figures from the Office of National Statistics. In the county there was a rate of 17.7 teenage pregnancies in every thousand in the final quarter of 2012, compared to 20.4 the previous year.
The national rate for England and Wales has been falling for a number of months, with the figure at the start of 2011 standing at 31.6, but falling to 26.1 by September 2012. There was a slight rise in the final quarter of the year, to 26.4.

Teenage pregnancy rate in Peterborough falls to lowest level for two years Peterborough Telegraph 9th March 2014

Legal status of foetus at centre of landmark case

A council - which cannot be named for legal reasons but is located somewhere in the north-west of England - is set to argue that a child who was born with serious health defects as a result of her mother's drinking habits should be given a compensation payout for being the victim of a crime. The child, who also cannot be named, was diagnosed with foetal alcohol syndrome (FAS) at birth. She is now six years old and living with foster parents.

Susan Fleisher adopted a three-year-old girl who she later learned was suffering from FAS, and has since set up a charity - the National Organisation for Foetal Alcohol Syndrome UK - to help people deal with the condition. The 67-year-old, whose daughter Addie is now 25, believes drinking while pregnant should never be considered a crime. "No mother deliberately holds a gun to their child's head," Mrs Fleisher said.

Current guidelines do not explicitly prohibit the consumption of alcohol for expectant mothers. The Department of Health guidance says that "women who are pregnant or trying to conceive should avoid alcohol altogether". But then it goes on to say that "if they do choose to drink, to minimise the risk to the baby, we recommend they should not drink more than 1-2 units once or twice a week, and pregnant women should not get drunk". The National Institute for Health and Care Excellence also concedes there is "uncertainty about how much alcohol is safe to drink in pregnancy".

However, in the case of the six-year-old girl at the centre of these ongoing proceedings, the mother did not adhere to anything close to these restrictions. An earlier tribunal hearing found she had "consumed grossly excessive quantities of alcohol" and had been "using drugs".

Janet Fyle, professional policy adviser at the Royal College of Midwives, said while FAS was not common, it could have devastating effects. While she could not comment on the legal case specifically, she added: "It's wrong for a woman to consume large amounts of alcohol while she is pregnant. But let's get away from the moral judgement. It is sold over the counter, as are cigarettes. And the law says the foetus has no legal status as it cannot live independently of the mother."

Pregnancy drinking examined as possible crime in landmark case bbc.co.uk 5th March 2014

New evidence of pregnancy discrimination

The number of women forced out of their jobs because they are either pregnant or on maternity leave has more than doubled in the past decade, according to a major report. Research published today estimates that about 60,000 women suffer such discrimination annually, while the introduction earlier this year of £1,200 up front tribunal fees has exacerbated the problem by deterring tens of thousands from taking legal action against their employer. One in three of those who unfairly lose their jobs and win a tribunal are paid no compensation at all, and only four in 10 tribunal awards are paid in full. Since 2008, as many as 250,000 women have been forced out of their job simply for being pregnant or taking maternity leave, according to the report by the charity Maternity Action.

Pregnant? Don't expect your job back The Independent 8th December 2013

Probiotics in pregnancy not linked to asthma rate in infants

Taking probiotics has health benefits but preventing childhood asthma isn't one of them, shows newly published research led by medical scientists at the University of Alberta. "Taking probiotics had no effect on the asthma rate," said Azad, who works in the Faculty's Department of Pediatrics. "We haven't shown there's any harm in giving probiotics, but it can't really be advised as a strategy to prevent asthma. "That doesn't mean probiotics aren't good for other reasons. There's really good evidence that probiotics are beneficial to infants who are born pre-term and suffer from a bowel condition. There's also good evidence that probiotics might prevent eczema. Her team made another interesting finding that warrants more research: babies who received probiotics as infants or in utero had higher incidences of lower respiratory infections. But "more research is required "

Taking probiotics during pregnancy has no effect on asthma rate amoung infants News Medical. net 9 December 2013

Exercise in pregnancy boosts babies' brains

Babies' brains showed more mature patterns of activity, linked to better mental performance in later life, when their mothers took at least three 20-minute sessions of moderate exercise a week. The early stage findings are the first from a randomised controlled trial in humans to show that a pregnant mother's exercise routine could have such an impact on her baby's brain.
"We know exercise is good for all kinds of things in pregnancy. It makes mothers feel better, gives them more control over their weight gain, and also has an impact on their child's weight gain in life. We're saying here's an added bonus, that exercise gives your child a head-start in brain development," said Elise Labonte-LeMoyne at the University of Montreal.
Pregnant mothers who exercise boost babies' brains, claim researchers The Guardian 10/11/13

Pregnant women who snore give birth to smaller babies

Experts said snoring may be a sign of breathing problems which could deprive an unborn baby of oxygen. A new study led by Dr Louise O'Brien, from the University of Michigan's Sleep Disorders Centre found that pregnant women who snore are more likely to give birth to smaller babies. The study found that chronic snorers, who snored both before and during pregnancy, were two thirds more likely to have a baby whose weight was in the bottom 10%. They were also more than twice as likely to need an elective Caesarean delivery, or C-section, compared with non-snorers. Snoring is a key sign of obstructive sleep apnoea, which results in the airway becoming partially blocked, said the researchers, whose findings appear in the journal Sleep. Dr O'Brien added: "If we can identify risks during pregnancy that can be treated, such as obstructive sleep apnoea, we can reduce the incidence of small babies, C-sections and possibly NICU (neo-natal intensive care unit) admission that not only improve long-term health benefits for newborns but also help keep costs down."

Pregnant women who snore give birth to smaller babies, study reveals The Mirror 31st October 2013

New Research May Lead To Pre-eclampsia Test

Pre-eclampsia is a complication of pregnancy where the mother develops high blood pressure and protein is present in the urine. In some cases, this can develop into a serious condition for both mother and baby and the only cure is delivery of the baby, often prematurely. Women who have had pre-eclampsia previously are at higher risk of recurrence and are closely monitored during pregnancy, but there is no way of determining who is at high risk in first-time mothers. The researchers, led by Dr Richard Unwin and Dr Jenny Myers from the Manchester Biomedical Research Centre, a partnership between the Trust and the University analysed samples which had been collected as part of the international SCOPE study at 15 weeks of pregnancy - before any clinical signs of disease are present. Proteins were identified which differed between those women who developed pre-eclampsia and those who did not.
Research could lead to a new test to predict risk of pregnancy complications: University of Manchester 3rd September 2013

Birth Plans - to write or not to write?

by Sarah Bernstone

To write, or not to write, that was the question.  At first it seemed obvious; this was all part of the antenatal process.   It was talked about in all the books and at all the classes (we attended NHS and Active Birth as our local NCT groups were heavily over subscribed), and it was clearly the ‘Done Thing’ to write a ‘Birth Plan’.

But wait a minute, then there were the articles in commercial magazines telling you on the one hand, Birth Plans were useful, but on the other hand giving countless experiences of mothers who had abandoned every last plan for drug free childbirth the moment the contractions hit home: "Give me drugs, give me total sensory deprivation and back up drugs" as Edina Monsoon yelled in Ab Fab!  Or mothers who had been in such a flurry that they never even looked at the plans and felt chastised by them afterwards as they felt they had somehow failed to live up to their own expectations of themselves and childbirth.  Talking to other mums at work many of them were dismissive of the value of birth plans too.

So what to do?  Would I be setting myself up for a fall with my positive birth plan, or should I simply venture off into the unknown without a ‘map’ and hope for the best?

Well, being Mrs Organised (in those days anyway) I sat down at the PC and typed up a long plan with a hundred and one provisos, and boy, am I glad I did!  With the help of the NCT book, Sheila Kitzinger's guidance, and input from both sets of antenatal classes, I put together a plan which covered all options at all stages:

• Pre-labour & induction
• Early stages of labour
• Later stages of labour
• Transition & delivery
• Third stage & post delivery

Within these areas I planned my ideal scenario - natural methods with no medical intervention - breathing, movement, aromatherapy, massage, water etc - and then acknowledged that things may not go to plan.  In these secondary scenarios I planned what courses of action I was prepared to take if intervention were required - Tens, gas & air, epidural (but NOT pethidine) - and how I would like things to happen if a Caesarean became necessary.

In the event, at three weeks overdue, having tried all the usual methods of self-induction (hot bath, sex, massage, reflexology) and a few others besides (bouncing on a trampette was recommended by one midwife!) I had to go into hospital for my induction and my plan swung into action.  After two pessaries and 12 hours I was about 2cm dilated. 

Having given that my best shot, we were happy for the midwife to break my waters to speed things up.  I managed 2½ hours of movement and breathing to cope with the intense contractions which resulted (as well as wearing the Tens machine), before caving in and screaming for an epidural!  Having read my plan, the midwife offered me entonox as an interim solution, but I didn't like that & was still determined to go for the epidural.  An examination once that was in place showed a mere 4.5cm dilation, so I was glad I had made the decision.  Eventually, 18 hours later, and 35 hours after the first pessary, the surgeon recommended a Caesarean. We asked for 10 minutes alone to consider this, then half an hour later our beautiful baby daughter, Ella Phoebe, was born by Caesarean Section. 

The best thing about my birth plan was that even though things did not ever reach my ideal scenario, we always felt in control as we had planned for all the "what if's…" and the hospital had followed our requests.  My top tips for all new mums-to-be are:

• do make a birth plan
• consider all scenarios and plan for them
• share your birth plan with your antenatal team in advance
• ‘learn’ it in case there is no time to refer to it specifically on the day
• revisit it afterwards and congratulate yourself on such great planning and execution!

Remember, birth can be an exciting or harrowing event - but if your planning is in place, you have the power to feel confident and in control, which is the key to a positive childbirth experience.

Any plans for your birth….?

Sourced from Sarah’s Active Birth class notes and Mother & Baby 2000

Planning your birth starts the moment you find the thin blue line on the pregnancy test – do you want home or hospital?  Which hospital?  Water or not?  Drugs or alternative therapies?  Natural or caesarean?  Many of your early thoughts may change through the coming months, but then plans should always be flexible.

Your birth plan can be written or memorised, a short note, a form from the hospital or a list of your priorities.  The most important thing is to say that you and your partner should be consulted and remain informed at all times – whatever else you decide to include is entirely up to you.

The best time to pull together a formal plan is after your antenatal classes (NHS or NCT or both) when you have had time to discuss and learn about all the options open to you – but preferably at least a month prior to your estimated due date or else you might just run out of time!

When you have formulated your plan, make sure you discuss this with your midwife or consultant, that your plan is practical and that you have planned for all contingencies.

Here are some things you may like to consider when drafting your plan:

Induction & Acceleration – when, why, how soon and what methods?  

Early labour – at home?  Midwife in attendance?  When to go into hospital?  

In hospital – how many people can attend?  Do you want your partner, sister, mum, a friend, a doula?  Are you happy to be observed by medical students?  Privacy?  

Environment – what are in the rooms already – beanbags, balls, birthing pools, cushions, private toilet/bath/shower etc?  Can you bring in your own props?  Are candles allowed, aromatherapy, music?  Do they allow homoeopathy, hypnotherapy, acupuncture, massage?

Mobility & position – do they expect you to lie still and be monitored constant  Can you use a birthing stool?  Give birth in a pool?  
ly, or can you move, stand, squat, lean over?

Monitoring – how often and how long?  Belt monitoring or internal monitoring? Can vaginal examinations be kept to a minimum?  Will they check your dilation before administering drugs or an epidural (at 8cm the pain may be unbearable but you will probably be on stage 2 before the drugs kick in, so it may be best to hang on in there)?

Food & Drink – what can you bring?  What is available – think of your partner too!  What is allowed?  

Pain relief – what is your order of preference – Tens, entonox then epidural?  Is there anything you want to avoid?  If you prefer to try not to use drugs, you can ask the hospital not to offer them but to have them available in case you ask for them.

Second & Third stage – are there time limits – can you negotiate longer times before intervention?  How long would you like?  Are episiotomies routine or is tearing accepted?  Is syntometrine routinely given?  What positions would you prefer to try/are you allowed?  Can your partner cut the cord?  Can you look at or even keep the placenta?  Who stitches up the perineum and how experienced are they – hold out for the best!

Intervention – forceps?  Ventouse?  Caesarean Section?  Epidural or general anaesthetic (GA)?  Can your partner attend?  If you have a GA, can your partner look after the baby until you come round?  If possible, parents should have time to discuss any interventions alone and may request more time to decide.

Baby – will it be delivered onto your stomach or taken away and cleaned & wrapped?  Which would you prefer?  Can you find out the sex before they announce it?  Can the baby stay with mother, or father if mother needs treatment?  Breastfeeding straight away?

Intensive Care – can you breastfeed or express?  Can you get a bed nearby?  Can your partner stay?

Feeding – is there full breastfeeding support?  Are milk or water ever given without asking – if you are concerned you can put a notice on the crib: ‘mother’s breastmilk only’.

Night time – do you want the baby in your bed, a crib or in a nursery so you can rest?  What nursing/midwife cover is available overnight?

Whatever you do, make sure your birth plan shows not only your ideal choices, but in the event that things do not go to plan, ensure that you have covered all other options.  This way, if you end up having a less than perfect birth, you can still feel informed and more in control.  In the words of Chris Salvage, midwife, “Being flexible in the initial approach will help alleviate any feelings of disappointment afterwards.”  She also recommends a full debriefing with your midwife afterwards to discuss what happened and why.  Read your delivery notes, ask lots of questions and ensure you understand your own personal experience.

Did you write a birth plan? Did it go to plan? Do you have any advice on writing birth plans? Let us know by commenting below:

Breath tests to target smoking in pregnancy

Pregnant women should be tested to see if they are smoking, and if they are they should be helped to quit, according to the body which issues guidance to the NHS. The National Institute for Health and Clinical Excellence (Nice) says midwives should give carbon monoxide tests to all women they see at antenatal appointments. An estimated 21% of women smoke during pregnancy. This harms foetal growth and development, with smokers three times more likely to have a baby with low birth weight — a leading cause of infant death.
Pregnant mothers to be tested to see if they are smoking, under new NHS guidance - The Independent 12 May 2013

Risk of vaginal tearing during childbirth increased by excessive pregnancy weight-gain

Excessive weight gain during pregnancy significantly increases the risk of lacerations during vaginal childbirth, according to a study conducted by researchers at Montefiore Medical Center. Among more than 1,000 women who participated in the study, 126 experienced a significant increase in their body mass index (BMI).  Of those women, 85.5 percent experienced lacerations compared to 69 percent with no change in BMI category.

Gaining weight during pregnancy causes increased risk for tears during delivery - News-medical.net 8th May 2013

Pregnancy permanently alters foot-size

A study of 49 pregnant women found that in 60 to 70 per cent of cases the feet became longer and wider after the first trimester, but had not even begun to shrink five months after giving birth.
The lasting change in foot shape could put mothers at higher risk of arthritis later in life and explain why the condition is more common among women than men, researchers said.
Dr Neil Segal, associate professor of orthopaedics and rehabilitation at the University of Iowa, who led the study, explained: "We know that women, and especially women who have had children, are disproportionately affected by musculoskeletal disorders."

The Telegraph 1st March 2013

Midwifery shortage leaves pregnant women unsupported

A survey in the annual state of maternity services report by the Royal College of Midwives found that four in ten women see up to nine or ten midwives during their pregnancy instead of being able to build a relationship and confidence in one, as is recommended. Also one fifth of women are left alone during labour, contrary to guidelines saying women should have one to one care.

Midwives are overstretched due to a baby boom and increasing numbers of women over the age of 40 having babies who require extra care due to a high risk of complications, experts said. The birth rate has increased rapidly and the rise in midwife numbers has not kept pace, the College said, meaning around 5,000 more are needed to meet the one-to-one care in labour pledge. Cathy Warwick, general secretary of the RCM, said: “In antenatal care, the problem for women is they are not getting the continuity of care they need."


The Telegraph 20/1/13

Sleep Problems Worsen in Late Pregnancy

This probably won't come as a surprise but a recent study has confirmed that sleep problems increase in late pregnancy.

Sleep disturbances in late pregnancy are common. The study, 'A postal survey of maternal sleep in late pregnancy,' aimed to survey sleep problems in third trimester pregnant women and to compare sleep in the pre-pregnancy period with the third trimester.

Third-trimester women were sent a postal survey containing questions relating to sleep experience, including perceived sleep quality, sleep difficulties, night waking, sleep environment, snoring, daytime tiredness and daytime napping. The women were asked to report on sleep before pregnancy and in the last week.

The main findings were as follows:

• Before pregnancy, the average reported duration of night-time sleep was 8.1 hours; in the last week this had decreased to 7.5 hours. 
• Only 29% rated their sleep quality in the last week as very good or fairly good, compared with 82% rating their sleep this way before the pregnancy.
• The main reasons for sleeping difficulties were discomfort (67%) and pain (36%).
• Snoring increased significantly over the course of the pregnancy, with 37% reporting snoring often or every night in the last week. Those with a pre-pregnancy body mass index of greater than 25 were significantly more likely to snore.
• Only 4% of women had an abnormal Epworth Sleepiness Scale score prior to pregnancy, whereas in the last week 33% scored in the abnormal range.
• 5% had regularly napped during the daytime before pregnancy, compared with 41% in the last week. 

The study concluded that sleep problems are common in women in late pregnancy, and increase markedly compared with before pregnancy

A postal survey of maternal sleep in late pregnancy. Hutchison BL; Stone PR; McCowan LME; et al, (2012). BMC Pregnancy and Childbirth , vol 12, no 144, 10 December 2012 .
Full text available via http://www.biomedcentral.com/bmcpregnancychildbirth/contenthttp://midirs.us5.list-manage1.com/track/click?u=e4298fe3c18412b19e25c1507&id=70179eea15&e=709b0c7d49> 

Babies Learn Language Basics While Still in Womb

A study reported in this Medical Daily Article recorded the responses of babies at 30 hours old to sounds some in their native language and others from different languages and found that babies can already differentiate.

MedicalDaily.com 2nd January 2013

Health Protection Agency Urges Pregnant Women To Take Up Whooping Cough Vaccine Offer

Three babies died from whooping cough in October as one of the worst outbreaks of the disease in decades continues, Health Protection Agency figures for England and Wales show. It brings the number of deaths in newborns, who are most at risk of fatal complications, to 13 this year. There were 1,614 infections last month, bringing the total to 7,728 this year. A UK-wide campaign to vaccinate pregnant women, to pass protection on to their children, is under way. There are surges in whooping cough cases every three to four years. However, the current outbreak has affected nearly 10 times as many people as the previous outbreak in 2008.

30/11/12 BBC News

Pregnant women advised to avoid all alcohol

 A study of over 4,000 mothers and their children by researchers from Oxford University found women who consumed as little as one glass of wine a week had babies with IQs that were almost two points lower than non-drinkers. The normal span of intelligence is 20 points – from 90 to 110 – so though the effect is small for any individual it could have a noticeable impact on the population as a whole.
The National Institute for Clinical Excellence said in 2007 that alcohol should be avoided for the first three months of pregnancy but one to two drinks a day was safe thereafter. The Department of Health said in 2006 there was no safe limit throughout pregnancy.
The new findings are published on-line in the journal Plos One (Public Library of Science One) and indicate that genes determine the sensitivity of the foetus to alcohol.
The researchers studied four genetic variants that determine how fast individuals metabolise alcohol to remove it from their bodies. They measured the IQs of children at age eight and found the effects were greatest in those who were slowest to clear alcohol while in the womb.
Ron Gray, who led the research, said: "This is a complex study but the message is simple: women have good reason to choose to avoid alcohol when pregnant."


15/11/12 The Independent

A Positive Second Birth

by Michelle Maurice (Vale of Evesham NCT)

As the birth of my first child had not gone anything like according to my birth plan, I was pretty nervous about having my second. My wonderful plan of a homebirth for my first baby with soothing music, candles and a birthing pool was cruelly shattered at 38 weeks and 4 days when I was diagnosed with pre-eclampsia and had to go into hospital for an induction. After a 28 hour labour, much pain relief (including an epidural) and a forceps delivery, my beautiful baby boy was born. I was delighted, but I was exhausted and I felt a failure for not having delivered him drug-free and ‘naturally’. This was all compounded by my developing blood clots a few days later which led to 6 months of medication and further feelings of having failed and wondering how anybody could ever have a second – even third! – baby. Perhaps worse, I never met anyone else at Mum and baby groups later who’d suffered a similar fate, so I felt isolated as well as suffering depression and panic attacks.

Yet this second baby was exactly what I knew my husband Martin and I both wanted, and wanted also for our son. When Seth was less than a year old, this knowledge was something which used to make me feel depressed and panicky ... it was something I ‘couldn’t’ do (despite doctors saying actually, I could – although I’d be given heparin as a safeguard against the possibility of any clots forming again).

When Seth was about 3, my body and mind had recovered as much as they were going to, and I genuinely felt fine to see if I might fall pregnant again. This wasn’t a 24 hour a day feeling – I don’t know if the decision to have a baby ever can be – but I knew it was the best time for me.

I was determined to make everything different about this pregnancy, and so hopefully birth. The pregnancy hormones that make one calm in so many ways kicked in almost straight away, and in themselves shielded me from anxiety. I prepared for this second baby in a more indulgent way. Silly, small details now made a difference, and were a bizarre way of ‘ensuring’ a better time this time around. For example, whereas items for my son had been practical and plain, sourced often from Tesco’s, now I determinedly went out and indulged my passion for gorgeous accessories – a Cath Kidston nappy bag was a must! Friends laughed along with me, knowing my passion for handbags. But for me, psychologically, this sort of behaviour was different from the first time around and so in some way might help to lead to a different birth. (Illogical? Yes. Comforting? Definitely.)

The run up to the birth was very different to my previous experience. This time, my blood pressure remained resolutely normal. Amazing! Especially in view of the fact I could never have my blood pressure read without feeling some anxiety as the familiar band was wrapped around my arm. Already, I was feeling a small sense of achievement ... 

My reflexologist had confidently predicted that my baby would be born around week 39, with a certainty that I found charming if unconvincing. I continued to enjoy my monthly pampering at her hands and was happily attending a visit to my midwife for a check-up in the middle of my 39^th week when she said, ‘I think you’re going to go into labour very soon, Michelle’. Panicking at the thought of my waters breaking suddenly and publicly on my planned visit to the local swimming pool, I questioned the wisdom of proceeding with my schedule for that day. Her confidence and calmness in stating that it would be fine for me to carry on was in fact typical of my treatment from pretty well all the medical staff I encountered the second time around: eminently reassuring and confidence-inspiring.

So on that fateful Friday, despite some odd sensations that started in my back around midday (nothing you could exactly call an ache, however) I swam my 30 lengths before rolling my rotund frame into the oh-so-small shower cubicles at the local pool. I came home, remembered I’d promised to buy my son some Christmas cards to send his friends at school, rolled round to the shops (which were also starting to feel oh-so-small these days). I came home and plopped myself onto my birthing ball to see if some pelvic rotations might help my back which was still feeling...odd. I thought that perhaps some distraction might help ... watch a good film, brilliant idea! I lowered myself towards the DVD (whose idea had it been to put it practically on the floor? Why had I agreed? Madness!) and put ‘Atonement’ on.  James McAvoy therapy, that should do it.

By the time my husband returned from work about an hour later, it hadn’t done it – my back still felt odd and I felt a sense of excitement that I found hard to restrain. We decided to summon his parents, and snap a photo of my truly impressive profile before it might be too late. My in-laws arrived a few hours later, having travelled up from the coastline of South Wales, to find me decidedly restless and my husband quite calm. I decided to have an early night (‘just in case’) and retired to bed feeling guilty in case I’d caused them an unnecessary journey.

I managed to drop off to sleep quite late – I was still trying not to be excited and nervous about what the midwife (and my reflexologist!) had said. I awoke at 1.30am, experiencing period type pains, which were followed at about 2am by a distinctive ‘pop’ from within my stomach that told me my waters had broken. Things then happened quite quickly.

Pacing around the living room and sitting on my birthing ball helped me through the next half an hour or so. My husband calmly rang the hospital at about 2.30am to see if it was time to go in: they thought not. An hour or so later of trying all my breathing exercises and walking/waddling round the living room forced me to conclude that nothing was now really relieving the pretty strong contractions, and I definitely wanted to go to the hospital. My now slightly-less-calm husband rang the hospital again at 4am, and spoke to a midwife who happened to know me from my first baby. She said I could go in. Hurrah!

Having jammed my birthing ball and overnight bag into the boot of the car, Martin jammed me into the front and set off for the hospital with some haste ... thank goodness the night roads were so clear. I remember saying in between contractions that the first thing I would have when arriving at the hospital was pain relief, thank you, and thinking that we couldn’t get there soon enough. Our arrival at 4.30am was suitably dramatic, with me being unable initially to get out of the car because of an almighty contraction, and really just wanting to press myself down onto the cold, wet tarmac of the car park, which looked strangely inviting ... My panicky husband kept asking what he should do – bless him, with my birthing ball wedged under one arm and bulging overnight bag locked in the other hand he didn’t really look able to do much. Somehow we made it to the foyer, where he got a wheelchair and somehow manoeuvred me into it.

The birthing ball and overnight bag were abandoned temporarily as we made our way to maternity triage, en route losing one of my shoes (although this was only discovered later). Two lovely calm WONDERFUL midwives inspected me and said ’Oh, we can see the head’, which explained my difficulties in getting out of the car and into the hospital. I remember at this stage being very conscious of everything that was being said around me, but of not being able to talk myself in response. I felt happiest remaining on my knees gripping the headboard of the bed (not a practised position, or even a planned one, but it just felt right at the time). With a few sets of pushes, and LOTS of breathing, our beautiful daughter Scarlett May was born at 5am.

I felt such an incredible rush of love when I looked at her (and even at my husband and the midwife) – it just goes to show what oxytocin does to you. Marvellous stuff.

So there it was. A beautiful baby girl, and finally ‘closure’ from my scary first birth. This time, no pain relief and not a forcep in sight. The words of my fab NCT teacher rang clear in my mind: ‘Every labour is different, every birth is different.’

Ladies, go get yourselves that designer nappy bag!