Feb 2011 - growing bigger, loosing our figure

[angels1]

Just a new thread as I noticed we are near the limit (again)!

Oh yes and my libido is still on the rampage but sadly dh seems to have gone off me/it boohoo,i cant think why?
I would def tell the in laws not to come,remember mine invited themselves the day of my nucal scan in london when i was possibly going to need a cvs.

suzy Am 28 weeks tomorrow too : )
My next midwife/hosp appointment is next Friday - combined with Anti-D jab which they do at 29 weeks in my area for some reason. Has anyone else got that jab to look forward to?
V excited about tomorrow as lots of baby stuff arriving (we were told pram had 12 week wait, ordered, nope -just one week wait, nev mind at least it's done! Really can't face shopping expeditions what with dodgy pelvis and general knackeredness).

Hello all! Am so tired tonight I'm going to order a Chinese for me and DH as can't face cooking!
Ledkr, has your GP signed you off until mat leaves starts? How does it work? I don't think I will be going back to work either as I can barely look after my son let alone do a 7 hr day and then try and look after him! I guess itsup to the doc though...

It could just be from a serial namechanger, but I would at the very least treat it with caution rather than become best PM buds...

Should we share what we're bidding on on eBay so that we don't wind up bidding against each other? Not that I'm bidding on anything right now, because I really really don't need it, but I am feeling an Urge To Shop.

zero I wonder if we have the same doctor?! Sorry you are having a shit time, maybe try self-certifying for a week (thats what im doing) and ask mw to refer you to physio?

ledkr puffy eyed and headachey sums up EXACTLY how I feel! even after all day sleeping on the sofa. No way I could have put in a 10hr day at school looking after 5 year olds!

geekygiraffe we must have the same due date?! 4th Feb?! I dont have any more hospital appts (is that weird?) but my mw appt is on tuesday, they take bloods and listen to heartbeat I think.

professor that is a good idea! Someone outbid me on a john rocha baby bundle the other day at the last minute, I was very . Might give ebay a rest for a while tho, scared I am buying stuff for the sake of it.

I better spend my HIP money soon tho, otherwise it will no doubt get frittered away on chocolate household esentials!

suzy sadly we've proved that there are definitely at least two unsympathetic doctors in the country as you're in Newcastle and I'm down south...

suzy Yep, that's my due date too. Race you ; 0
My hospital appt is for Anti-D jab as I'm rhesus negative, so not weird you don't have one.

Hi everyone, Zero, really hope that SPD eases up soon, I agree Ledkr, there is a shocking lack of awareness of this condition. I do sympathise, I had it in my last pregnancy in a severe form but just for about 2-3 weeks then it seemed to pass. All I could do was take shuffling tiny steps, I couldn't open my legs at all (ha ha!) so even just getting out of bed or getting out of the car meant revolving my entire body. This time it's just a dull ache in my pelvis but sleeping with my big v shaped pillow wedged between my legs helps no end! I agree with Suzy, self cert sign off if necessary, it's downright insulting to not be taken seriously when we're talking about pain.

Smiling at the no blow job's comments! 40, def a no no for mr 40 after this! Plenty of arguments here too, I think I'm hormonal / irrational half the time but mr earl grey is not always the easiest person to live with. Despite this, like you Ledkr, I have the craziest libido right now, he simply can't keep up (he's not even trying grr!). There'll be no sex for a year once bub is born!! At least I can say he had his opportunity & missed out!

I had an appointment at the maternity hospital today with a consultant, to go over my birth notes from my last pregnancy with DD. I had a few questions and there were many blanks. I was lucky it was pretty much a text book labour & pretty fast for a first. However the threat from the midwife of her cutting me if I couldn't do better raised questions. My Doula suggested I ask how long do the NHS "allow" for being fully dilated and effectively ready to push & deliver. I was surprised that nature wouldn't be given the opportunity to take it's course and that you are effectively on hospital time once you go into the hospital environment. Well today, the NHS allow 2 hours for this second stage before intervention. In 2006 when I had DD they only allowed 1 hour. This shocked me, doesn't seem very long to me. Sure if you get this overwhelming urge to push that you hear so much
about then it would be ample. I didn't get that feeling, whether it would have come in due course (had I been given due course) I still don't know. The consultant I spoke to said the very fast delivery (my reaction to her threat) probably caused the tearing. She also agreed that if I hadn't have delivered when I did that there most certainly would have been forceps or some other form of intervention brought in at that point. Don't get me wrong, I'm not anti-hospital at all. I didn't considera home birth for my first and apart from that, every aspect of my hospital care was good and very supportive. I'm just still surprised by the hospital time frames, I thought you would be allowed to progress at your own pace?! We're all different and surely if the baby isn't in distress (DD wasn't) then there shouldn't be ANY time scales applied. Ideally when the head is birthed in a more controlled way the skin has time to adjust and this stretch. Anyway, sorry for the over-long me post but I would really like to hear everyone's thoughts on this.

The skin has time to adjust and THUS stretch!

Very interesting about the 2 hour time limit... any idea to what extent this is a hard and fast rule or just a guideline?

Hi Giraffe - I've got an anti-D jab in a couple of weeks too. It's just fun, fun, fun isn't it!

Loving the website Prof. My DH and I were crying with laughter at some of them - I had to stand up because I was laughing so hard I could no longer breathe. Was feeling very low, but now sooooo much better. :)

Back to the chocolate tin...

I have nightmares about them threatening to cut me :( I'm not sure where I have got this fear from as it wasn't when DS was born...

NICE guidelines discuss what should be used as the definition of "second stage" and conclude (section 8.1) that these terms should be used

Passive second stage of labour:
º the finding of full dilatation of the cervix prior to or in the absence of involuntary expulsive contractions.

Onset of the active second stage of labour:
º the baby is visible
º expulsive contractions with a finding of full dilatation of the cervix or other signs of full dilatation of the cervix
º active maternal effort following confirmation of full dilatation of the cervix in the absence of expulsive contractions.

---

So far as duration goes (section 8.2), they comment that "Limited quality of evidence makes it difficult to assess the significance of a prolonged second stage of labour on perinatal outcomes for both woman and baby."

Their recommendations on duration and definition of delay in the second stage of labour

Nulliparous women:
? Birth would be expected to take place within 3 hours of the start of the active second stage in most women.
? A diagnosis of delay in the active second stage should be made when it has lasted 2 hours and women should be referred to a healthcare professional trained to undertake an operative vaginal birth if birth is not imminent.

Parous women:
? Birth would be expected to take place within 2 hours of the start of the active second stage in most women.
? A diagnosis of delay in the active second stage should be made when it has lasted 1 hour and women should be referred to a healthcare professional trained to undertake an operative vaginal birth if birth is not imminent.

If full dilatation of the cervix has been diagnosed in a woman without epidural analgesia, but she does not get an urge to push, further assessment should take place after 1 hour.

So effectively, they say

that there should be "further assessment" if you don't get the urge to push within an hour of being fully dilated

that you'd normally expect birth within three hours (for first-timers) or two hours (for Second-timers) after the onset of "expulsive contractions" or starting to actively push

that there is "delay" if the birth hasn't taken place within two hours (for first-timers) or one hour (for second-timers) of the onset of "expulsive contractions" or starting to actively push.

that if there's "delay" someone should decide whether the birth is "imminent" and refer for consideration of instrumental or surgical delivery if not.

i.e. it sounds as though you should be able to point out that NICE guidelines say you should be given an hour after being fully dilated to see whether you get the urge to push, and then once you do start pushing (or you get spontaneous "expulsive contractions") you get another hour to get to a point where the birth is "imminent".

So his 2 hours is broadly and basically what NICE says, but it's important given your history to be aware that no one should be shoulting at you to start pushing until you've been fully-dilated for an hour (and even then there should be "further assessment" rather than anyone shouting at you).

Thanks so much Prof for all of these facts, I'm going to go back over what you've relayed here, this is fascinating for me given what happened and my new found knowledge. The facts are that it was noted that I was fully dilated at 5.45am. The midwife noted at 6.20am that she felt I DID actually have the sense to push as she kept seeing the baby's head. The threat must have been issued just over an hour later after full dilation as DD was born 1 hour and 9 minutes later at 6.54am. I was out of my tree with gas & air & just focusing on my breathing and getting through each contraction when the threat was issued. I have absolutely no recollection of any urge to push and I'm pretty sure, even with gas & air, that I'd remember that. I'm considering trying to go without gas & air this time for increased clarity! Thanks so much again Prof for your insight, I really appreciate the time you've given to this. Are you a health professional?! I need to go back to look for this link everyone is talking about, I could use a laugh!

No, I've just got the NICE guidelines on most things to do with pregnancy and childbirth bookmarked so that I can argue have informed discussions with health professionals .

Based on current NICE guidelines, if she could see the baby's head then she could count it as onset of active second stage at 6.20, but as a first timer you should have been given two hours from that point (not from being fully dilated) before there was classed as being a delay. If the same thing happened again you should get an hour from the onset of active labour (again, not from being fully dilated).

Hope your dh makes it up to you over the weekend 40! I hope your bloods come back ok too American. I had the glucose load test this morning, which, if I fail, will mean I have to do the full GTT next week. For some reason I feel really tired now! The snow has gone from the garden but it's still really cold so I don't want to kick send the dcs outside either! I'm so sorry for everyone suffering with SPD. I only notice that my hip gets stiff if I stand for too long Mning cooking, so I can't imagine how rubbish it is for you. Fingers crossed you get some help with physio or massage.

Nice one Prof! Great to be informed as I am realising with this second pregnancy! Everything I've learnt today and that you have elaborated on has always been my instinct on this; I wasn't ready, but it was just a big unknown as I was in the dark about the facts. Thanks truly for helping to fill in some of those blanks. So even going by the 2006 model of 1 hour of active labour (seeing the head rather than full dilation - another new fact to digest) then I should have been given until 7.20am, 25 more minutes. Could have made all of the difference. The shocking thing for me is that it was confirmed that if I hadn't delivered at the hour when I did, there likely would have been intervention & DD was showing no signs of distress! Total violation. I fully appreciate that this is nothing to what some women have experienced in various forms but it's been a huge kind of journey for me. Thanks for bearing with me & allowing my bit of self indulgence! Are there any other 2nd / 3rd / 4th timers who have similar experience of these hospital time frames?

I had intervention after about 3 hours of pushing (well by the time they had given me the spinal block and wheeled me into theatre it was 3 hours) but then dd was in distress at that point and had the cord wrapped round her neck. She was delivered by ventouse, 2nd time lucky, which was good as would have meant an EMCS if they hadn't pulled her out then. This was 2006. Ds was born 19m later, but he was a water birth and that stage took half an hour. He was also 2 1/2 lbs heavier! The experience was so different earlgrey, I can't tell you. Bonding was easier too, unfortunately for dd.

Well I mean unfortunately for both me and dd. I'm hoping 3rd time round will be easy too, but I am in America and I don't know what the guidelines are here (they vary state to state and hospital to hospital) but there is no chance of a water birth sadly.

That must have been a frightening experience tadjenny, thankfully the venthouse worked in getting her out. What a contrast your second birth was, sounds perfect and wow that's fast! Water sounds like the ideal to me, I really hoped for it with DD but the one and only pool was already taken! I was talking to my friend today about her water birth (also her second) & her entire labour & birth was just 9 hours. She really wanted a water birth though said she had concerns that it may slow the contractions but the opposite actually happened and it really speeded them up so she gave birth in there in just 40 mins. Why can't you have a waterbirth this time tad? I have heard that it all varies state to state in the US, it's confusing enough here so must be even more complex to get your head around there! I'm sure 3rd time around will be fast for you & straight forward. All the best with it! Have a good day there :)

The hospital doesn't allow it, though they do have jacuzzis in all the rooms! I'm sure we'll all get through it just fine, earlgrey. Must get off computer and do something useful now!

Hello all

earlgrey that info looks very helpful, forewarned is forearmed as they say - that in itself should help you this time round, just knowing what's what and being in the right frame of mind can work wonders.

Anyone tried hynobirthing??

For anyone interested, dh brought home a bottle of fizz last night, to 'celebrate' bless him, he obv forgot I was pregnant and therefore not drinking!

wow 40 you are having a whale of a time at the moment with DH! surely you can have a tiny glass of bubbly?.....

Very interesting earl and prof posts. thanks for sharing!

I heard this morning on the radio that the masterchef professionals winner this year was in her first trimester and with ms during the final stages of the competition! can you believe the stress, the energy and having to cook, taste and eat during that time? I am in awe of her, I couldn't even be awake for more than 8 hours a day!

God she was great though wasn't she? Am so pleased she won. Can have a small glass yes but diamonds would last longer!!! Hahahahaa