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Hatch & Dispatch
Tales and Advice From a Midwife

Vicki Bryce
with
Alisa Bryce

,,
Two Commas Press

Sydney, Australia


Copyright 2016 by Vicki Bryce and Alisa Bryce

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means,
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Trademarks: In an effort to acknowledge trademarked names of products mentioned in this work, we have placed after
the product name in the first instance of its use in each chapter. Subsequent mentions of the name within a given chapter
appear without the symbol.

Disclaimer: Although the author and publisher have made every effort to ensure that the information in this book was
correct at press time, the author and publisher do not assume and hereby disclaim any liability to any party for any loss,
damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or
any other cause. The information in this book should not replace advice from your doctor.

The authors have tried to recreate events, locales and conversations from personal memories. In order to maintain
anonymity, in some instances the names of individuals and places may have been changed, along with some identifying
characteristics and details such as physical characteristics and occupations.

The moral rights of the authors have been asserted.

Bryce, Vicki and Bryce, Alisa

Hatch and Dispatch: tales and advice from a midwife.

ISBN: 978-0-9873291-2-7 (e-book)

978-0-9873291-3-4 (paperback)

First edition

Contents

Introduction
Chapter 1 First, Some Facts
Chapter 2 Common Complaints
Chapter 3 Its Complicated
Chapter 4 Be Prepared
Chapter 5 Classes and birth plans
Chapter 6 At the hospital
Chapter 7 Labour Part I
Chapter 8 Labour Part II
Chapter 9 Advice for Partner/Support Person
Chapter 10 Congratulations! Youve Successfully Baked a Mini-Me
Chapter 11 Advice will change
A final note
Bibliography

Introduction

On a cold evening in 1976, my boyfriend and I stepped into the smoky warmth
of a club in Kings Cross, Sydney. I un-hunched my shoulders and stopped shivering
in those days I was slim and always cold. My long brown hair was curled, having
spent the day hiding in rollers under my nurses cap, and I wore an almost non-
existent skirt that only an 18-year-old could get away with. My boyfriend wore a
brown cord coat (I hated that coat; thankfully it went missing a few years later
though he still thinks I threw it out) and bellbottom jeans up-to-the-minute
fashion.
I havent been to a club in over thirty years but I imagine one thing that hasnt
changed is the volume of the music. The recently released Play that Funky Music
was true to its name, being played at a horrendous volume again and again and
again. But we didnt go to clubs to talk; we went to dance.

At 11:15pm, after two solid hours of showing off my best disco moves, I found
my boyfriend lounging against the bar drinking a schooner of beer, froth catching
in his black moustache (it still does when he drinks beer, but the moustache is now
grey). I tapped my watch; it was time to go. Lockout was in forty-five minutes and
we had to travel from Kings Cross to the North Shore. Although I was no longer a
lowly blue belt, having survived my first six months of nursing training, the
midnight lockout at the Royal North Shore Hospital applied regardless of whether
you lived in Virgins Retreat or Menopause Mansion. The hierarchy must have
thought they were guardians of our morality but where do you suppose girls
went if they couldnt get into their own bed?
Dutifully, my boyfriend set down the remainder of his beer. We hopped in his
silvery-grey 1963 EH Holden station wagon and set off across the Harbour Bridge.
The Friday night traffic was worse than usual, trumping my more frequent concern
that this car with its steering that sort of worked, touchy brakes and no heating,
would splutter to death in the middle of the road.

The car survived the journey but it was a journey that took too long. I sprinted
as well as I could in platform heels and a miniskirt, hopefully pushing on the large,
oak doors. They did not give. I was three minutes late but we all knew one minute
late was too late. Doors were locked at midnight. Tardiness was not tolerated. I
was locked out.
I walked back to the car and flopped into the passenger seat, already tired and
cold and knowing I had a very long night ahead. Pancakes on the Rocks, I sighed,
and we took off south, back across the Harbour Bridge. Pancakes on the Rocks was
a gem of information gleaned from the nurses well practised in lockout. Our
quarters had no convenient low windows that could be left open to climb through,
no spare keys or other secret entry points. Pancakes on the Rocks was the only
safe, alcohol free place that stayed open all night to house the temporarily
homeless such as myself.

4
 Thankfully I no longer lived with my mother. What would she think? Out all
night, work tomorrow, and with a man! Worse still, a man who drove a station
wagon. The first time my mother met my boyfriend she also met his car. I saw a
rattly old thing limping its way through the end of its days. She saw a long, double
mattress-sized boot.

Vicki! she pulled me aside, whispering sharply, Do you know what could
happen in the back of a station wagon?
*

If youre reading this, you too have heard about and probably partaken in
what goes on in the back of station wagons, on the beach after one too many aptly
named cocktails, or in cemeteries if youre Scottish.
Youre pregnant, and youre (hopefully) excited.
Some of you have taken years to reach this happy event, and for others it has
snuck up on you like that first grey hair quickly plucked from your scalp. You
always knew it could happen, but now?
Hormones got you here.
A girls got needs you know, I was once told while delivering a womans fifth
baby to the fifth father.
And hormones are largely going to control this pregnancy.
In a matter of months youll meet a baby who will control your life for at least
the next 18 years (probably longer). Now is a good time to accept that you are no
longer in complete control.
If youre still reading you may have realised this is not a conventional pregnancy
advice book. Many of those already exist. If you want a step-by-step biological
guide detailing every cell division and pump of progesterone, and that gives
exhaustive descriptions of where, how and why you might leak in the next few
months, this is not the book for you. If you want a sugar-coated, Labour doesnt
really hurt approach to giving birth, this is not the book for you.
But, if you want some sensible advice gathered from delivering over 3,000
babies, that will make you smile and isnt likely to go out of fashion in five years,
keep reading.
I am a midwife with thirty-five years experience in a birthing unit, labour ward,
or delivery suite. They keep changing the name but its essentially the same place
the place where you go to have your baby transferred from your womb to your
arms.
I began my nursing training at the Royal North Shore Hospital in Sydney in
1976. Back then you became a general nurse first, and then specialised in
midwifery if desired. Career nurses became triple certificate nurses, with general
nursing, midwifery and psychiatric training.

5
 My first job as a nurse was in neuro intensive care in a time where sink or
swim was the motto. You could either cope and do your job, or you had to find
another job. There were no mentors, no support and no debriefing sessions to help
you cope with some very confronting situations.
For two years I took care of people in comas, resulting from activities that
people do every day; driving, swimming and horse riding. I managed the
respirators, IV lines and catheters, did hourly observations, and checked cardiac
monitors. Most of these people would never wake up again. I felt like a sad
mechanic operating machinery around a person, catching family members who
fainted while confirming it was their loved one lying in that bed. Sunday morning
shifts were the worst because of the Saturday night car accidents usually alcohol
related. Back then you were only breath tested after an accident and the acceptable
blood alcohol level was 0.08%.
I decided a career change was necessary the week the eight bed unit contained
six children, all of whom had come off horses. I was only twenty-two and couldnt
imagine spending the next thirty-five years watching people - especially children -
lie on a bed, surrounded by machines, often never to wake up. And if they did, they
usually had catastrophic head injuries and would never be the same again. It was
so sad; I didnt want to be this sort of mechanic so I went to the opposite end of the
spectrum bringing life in.
After doing my midwifery training and then working for a short time in the
postnatal and antenatal wards I found my niche in the birthing unit. Initially, it was
daunting. Delivering your first few babies is terrifying and the noises those
labouring ladies could make! How did you get used to it? I asked an obstetrician.
You end up not hearing it, he said. I didnt believe him at the time but he was
right. The noises of labour have become part of the job, like a jackhammer for a
labourer (except they get to wear ear plugs).
Over time I have grown to love it hatching babies into the world and
dispatching them and mum to the postnatal ward. I work with couples who, most
of the time, are in awe of the little human they have created.
You may think the midwifes job is to look after babies. It is not. Our job is to
look after you. We help you through labour, catch or extract baby when it leaves
the safety of your womb, and teach you the basics of baby care such as changing
nappies, feeding, and settling. You might not feel confident when you first leave the
hospital but the confidence will come. The most nervous moment of my life to date
was the first night at home with my first child, when the reality hit that this baby
was mine and I was responsible for it.
A midwife cannot labour for you and nor does she go home with you, so were of
no value to you if we completely look after your baby. Hence we teach, we show,
we try to make you feel at least a little more relaxed about the prospect of caring
for the tiny human whos just popped into the world.
If that means formula over breast milk, use formula (this is discussed more in
Chapter 10). It might mean your mum staying with you for a little while (sorry
guys; sometimes she may need that extra help). It will probably mean tag-teaming

6
with nappy changing and night settling because you both need to sleep at some
stage, and occasionally sleeping in separate rooms. If it works, stick with it.
Midwives are, for the most part, a tolerant group of people. We are not easily
flustered or embarrassed (a learned skill I assure you we rarely start out so thick
skinned), and you can discuss just about anything with us. But preferably not your
sex life, as one man once did. For some reason he felt the need to tell me how often
he would like it and what she should be doing. I lamented his lack of creativity, but
this is one conversation we need not be involved in.
Hopefully, very early on in our career we learn to keep our foot firmly on the
floor and out of our mouth. For some midwives it takes a bit longer. Please dont
feel too offended if you have a young midwife who makes awkward assumptions
like Your father has just arrived, when your father turns out to be your partner.
When I was younger I announced to a lady that her son had arrived; only to find
out her son was her very good-looking and much younger partner.

As a junior midwife in 1980, my eyes nearly popped when a woman presented

with two men accompanying her. Back then, it was still a very new concept to have
one man (other than a doctor) in the delivery room at all, and she had two! The
scandal! Who were they? Was one the brother, or perhaps the brother-in-law? It
turned out one was the father of the baby and the other was for good sex. Upon
learning this, many, many thoughts ran through my mind but I was too young to
ask or say anything, which as it turns out, was the right move. What question could
I possibly ask? I confirmed the only useful piece of information I could which one
of them was the father (not questioning at the time how she could be so sure). Both
men managed to work together to help the woman in labour, providing excellent
support in what I had thought would surely be a very uncomfortable situation. This
taught me that if it works for you, who am I to judge?

The 1980s was also before Brazilian wax or laser hair removal was the norm, so
we shaved the ladies nether regions before they gave birth. I was never quite sure
of the reason it was what was done and you never argued with what you were
told to do. Maybe it was because you might need some stitches after the baby was
born, but hair doesnt usually grow where the sutures go. Most women today are
either waxed or lasered again, trends of the times. They do some landscaping
work because they want to be neat and tidy for when their goods are on display.
Midwives dont mind either way, and a silky smooth area or not wont impress or
disgust us. Although, if your nether regions resemble a state forest, a little trim is
ideal once youve had the baby (you will leak, which can get messy). Vajazzle or
tattoos with directions on where to find your fancy are also unnecessary.
About thirty years ago, I lifted the gown on a newly admitted girl, disposable
razor in hand, and was shocked to see she was already shaved. Who shaved you?
I asked, knowing its very difficult to work a razor around such a sensitive area,
particularly when theres a nine-month belly obscuring the view.
My brother-in-law, she beamed, proud of her hair-free lady bits. Hes a
barber.
*

7
 Writing a step-by-step guide to pregnancy is difficult because everyone is
different, and every pregnancy you have will be different. You may get morning
sickness this time, but not next time. Maybe your first baby was one week overdue,
and the next one is a month early. The deeper you dig into pregnancy, the more
youll find yourself in an Alice-in-Wonderland type world of things that might or
could happen, of strange dreams, odd food cravings, and a distinct lack of
predictability.
As one observer has said, telling mothers and fathers how to bring up their
children in books is arguably as silly as sending false teeth through the post and
hoping they fit.1 There is no one-size-fits-all in this game, yet we still search for
the perfect pregnancy and childrearing instruction manuals. Today, with the
double-edged sword that is the internet, we trawl for hours, our poorly defined
searches dredging up pages and pages of what can go wrong advertorials that try
to mitigate your terror by selling you stuff you just dont need. Like a baby change
table. I assure you, you will end up changing baby on the kitchen bench or even the
lounge, because when baby is screaming while poop fills its nappy like a soft serve
machine stuck in the on position, you wont be calmly putting together the baby
change table. Youll be using the closest flat(ish) surface.
And while Im on the subject, think about the pram. Does it fit into the boot of
your car, and can you collapse it while holding a baby?
My advice take a breath, forget the horror stories youve read and been told,
and realise that to get through this pregnancy there are only two things that need
to happen:
1. You bake this baby, ideally, anywhere between 37 and 42 weeks.
2. Your baby exits your body.

Thats it. Thats pregnancy and birth in 16 words.

If this is your first pregnancy, your head probably resembles a cloud of thought-
gnats, buzzing around and obscuring other useful thoughts such as I should
remember to put on pants today, or the TV remote is not a wooden spoon to stir
the soup.
Youre so excited about this pending baby that by the time this child is born you
will have decided which school you would like it to go to and which cake you will
bake for the caterpillar-themed fourth birthday party. Unless they dont like
caterpillars, then so much for that plan. Then, as you kiss Uncle Fred hello for his
eightieth birthday, a horrifying thought grips you. What if babys ears stick out as
much as Uncle Freds? What if theyre as hairy? At least I can wax off the hair, you
think, and if I start saving now I can pay for the ear pinning surgery.
One lady preparing for birth a few years ago confided to me through gentle sobs,
I hope he doesnt have red hair, sniff, then hell never get a girlfriend. Now
thats thinking unhelpfully ahead.

1 Hardyment (1983: 15)

8
 A first pregnancy can be terrifying. The morning sickness doesnt seem to want
to go away and for some it doesnt. Everyone is telling you what you must eat,
which isnt remotely helpful because you might not be able to keep anything down
for a while as long as you stay hydrated you will be fine. Your body changes, and
parts of you that you didnt know could get bigger seem to swell in size. You have
strange aches, outrageous dreams and at the end of it all you have to care for a tiny
baby.
At times you will be scared, worried, confused, nervous maybe even all at
once.
Breathe. You didnt do your final year of school before completing the others.
This is the same process step by step with the added bonus of no pass or fail. All
you need to do is get to the end of the pregnancy and then have the baby. Most of
the other chatter is largely irrelevant.
A modern pregnancy is full of experts, advice, products, and guilt. Oh, the guilt!
We live in the information age but I dont think we have empowered women with
all this (often contradictory) advice. Most pregnant women question their every
move, and if they dont, someone else will their mother-in-law, colleagues,
strangers at the cinema. Anything to do with pregnancy and child rearing tends to
elicit a strong emotional response from people who are not afraid to share their
opinion. Remember that it is their opinion and not necessarily the right thing for
you to do.

After thirty-five years in this game, I can tell you that advice changes, and the
right thing now will probably be wrong in a decade or so. The only certainty is
change.
Until I started writing this book I had never read a pregnancy book and I am
very pleased I didnt. I would have been terrified. Some of the horrors Ive read in
the last few months: If you have pain relief in labour your child might be a drug
addict. If you dont get skin-to-skin you wont bond with your baby. If you dont
breastfeed you lower your babys IQ, and youll also probably get post-natal
depression. Its really lets blame mum for everything. Plus, its largely nonsense.
While skin-to skin is lovely and has benefits for you and baby, it is not required to
bond. If it was truly necessary, only the babies born in the last ten years have
bonded with their mothers, because a decade ago skin-to-skin wasnt part of
mainstream vocabulary. And almost no-one has bonded with their father, because
the fathers dont usually do skin-to-skin. You might be sad if you cant breastfeed
but thats probably because everyone else is making you feel like a failure. Now
that is depressing.
Much advice is based on current trends, and trends come and go. When I first
started midwifery, delayed cord clamping was the norm. We waited for the cord to
stop pulsating about a minute before clamping and cutting. Then that went out
of fashion for a while, and now delayed cord clamping is the correct thing to do
again.

Advice on smoking, alcohol, drugs and SIDS, however, is proven, so please

adhere to that. Otherwise it is just current thinking. Im sure in two hundred years

9
people will wonder what we were doing and how on earth we survived. For a good
giggle, turn to Chapter 11 where Ive compiled some of historys more interesting
pregnancy and childrearing advice.

There are some certainties. The basic function of getting a baby in and getting a
baby out hasnt changed much over the centuries, although science is evolving. IVF,
with the help of donor eggs and donor sperm, has helped many women who would
never have been mothers now fulfil that desire.

Expectant fathers will probably keep their access pass to the delivery room.
Until the mid-18th century all males were banned from being anywhere near a
woman having a baby. It was considered immoral to have a male in the room when
a woman was giving birth, for childbirth was secret womens business.
In 1522, German Dr. Wert had the brave idea of dressing up in womens clothing
to gain entry to a labour room and actually see what went on2. Unfortunately, the
reality beneath Dr. Wurts skirt was discovered and he was burnt at the stake for
his valiant self-education efforts.

Men eventually found their way into delivery rooms as doctors. Until fairly
recently, most obstetricians were male, but this is rapidly changing. Many female
obstetricians have children of their own so they know pregnancy from both sides
of the sheets.
In Australia, it wasnt until the 1970s that husbands were allowed in labour
rooms. Before that they were sent to the pub where they wouldnt get in the way.
They could see their wife during visiting hours and view their baby in the nursery
through a glass window. Husbands could not stay overnight in the hospital to be
with their wife. Even when I had my children this was not allowed, though visiting
hours for husbands and siblings were beginning to relax.
I was a midwife before I had children and I can tell you that labour is a great
equaliser. Although I had helped hundreds of ladies through labour and delivered
all those babies, giving birth is something you need to experience to fully
understand. It didnt matter that I knew that once you can see the babys head the
job is almost done, and that it usually takes an hour plus to push a first baby out. I
just wanted him out. It was hard work, I was frustrated, and I felt like he was never
going to be born.
The other two were born very quickly. This was great for me, but not so great
for the babies. Babies that come out quickly often look like theyve been bashed
around the head a bit. Nothing permanent of course, but the black eyes and
contused face can be a little confronting.

Some days it feels like theres a serious design flaw in the way we have to labour
and deliver our children, particularly when other species in the animal kingdom
have much better ideas. Kangaroos have a tiny thing that crawls into a pouch,
suckles without assistance, and in time becomes a joey. If only. Those marsupials
really got the better deal, except for the part of always being pregnant. Imagine if

2 Hutter-Epstein (2010)

10
you had a pouch you could pop it open, show your girlfriend the newly growing
offspring, check out whether its a boy or a girl, and then go shopping.
Elephants can stop their labour when they get tired or are in danger, and start
again when theyre ready. Unfortunately, we cant, but thankfully we also dont
gestate for twenty-two months.
Although we didnt get these biological advantages, we do have the benefit of a
higher functioning brain, so use it to decide how you are going to manage this part
of your life.
This book contains stories and advice, which you may or may not choose to
follow. The stories are all real, taking place over the last thirty-five years. Where a
name is used Ive called the women Tasmin, because not one of the women from
these stories was actually called Tasmin at least that I can remember. I have done
this over three thousand times so I tend to forget names, faces and vaginas.

The stories are funny, sometimes serious, a bit odd, and will occasionally make
you squeamish. They are here to show you that what youre about to do is done
every single day, almost everywhere in the world. Women have been giving birth
since the beginning of human existence, long before the advent of books, birthing
classes, and bassinettes. The next few months do not have to be terrifyingly full of
advice, direction, misdirection, rules, more rules, then more rules, fear, hope and
tears although these are going to happen anyway so stock up on tissues, or toilet
paper which is usually cheaper. If everyone thought of every What if there
probably wouldnt be any babies, and if the men had to give birth there definitely
wouldnt be any. Many men comment, Thank God Im male, when they see their
partner in active labour.
Hopefully by the end of this book you will have gathered enough information to
make choices that are right for you, and are not governed by what you think
someone else wants you to do. The pressure to do the right thing will be
enormous. What is right is what works for your family.
Pregnancy, labour, and raising the child are fluid movements. You take a step,
see what happens, judge the situation and move forward. Like life, there isnt a
control+z function when you make a mistake, so you just keep moving, hoping you
get it mostly right.
This book, like your pregnancy, is a journey.

Here we have the facts, and some stories

11


Chapter 1 First, Some Facts

First, lets cover some of the more solidly proven facts:

Number 1: Babies usually come out the way they got in, approximately 9 months
later.

The Caesarean section rate these days is about 30%, and higher in private
hospitals than public hospitals3. Private hospitals tend to do more elective LSCSs
Lower Segment Caesarean Sections. LSCS is what we use in our notes but to
everyone else its a Caesar, or if youve been watching American TV programs a C-
section. We may even call it, tongue in cheek, a vaginal by-pass. There is a
consumer-driven market for LSCS as some women do not want to labour or deliver
vaginally.

Exactly when baby is supposed to make their debut is calculated by the

Estimated Date of Confinement (EDC). The term confinement is left over from the
days when pregnant mothers were confined to bed in late pregnancy to reduce the
risk of premature delivery, and when pregnancy was an embarrassing word. To be
pregnant meant that youd had sex - an impolite idea for polite society.
Other terms are estimated date of delivery (EDD), or estimated date of birth
(EDB). These more modern terms are used to reflect the fact that pregnancy is no
longer considered an embarrassment or ailment.
I wouldnt bother planning the big day for that particular date, as the EDD is
just that an estimate. A term pregnancy is from 37-42 weeks and you only have
about a 4% chance your baby will be born on the EDD. Baby doesnt know about
this EDD the doctor gave you, and will show up when they feel like it (unless you
organise a LSCS or an induction). Next time youre placing bets on someones due
date, remember your odds of winning if you choose the EDD.
A pregnancy is measured in weeks from the first day of your last menstrual
period (LMP). This means that for your pregnancy term you might not be pregnant
for the first two weeks in week 1 you have your period, in week 2 you are
ovulating, by week 3 the sperm has found the egg and you are now pregnant.

At this stage that fertilized egg, known as an embryo, is only the size of a full
stop. It now needs to nestle itself into the comfy lining of your uterus, ideally away
from the bottom of the uterus (see Chapter 3 regarding placenta praevia if the
embryo decides to head south).

A few years ago I had an in-depth discussion regarding the LMP with one of my
sons friends. He had a pregnant girlfriend but didnt believe he was the father. He
had taken the due date, counted back 40 weeks (to work out the date of
conception), and noticed that at that time they had been 1000 kilometres apart.

3 AIHW (2002)

12
Half an hour with calendars, diagrams and repeated explanation, and he eventually
accepted that they were in the same place when baby was conceived he was the
father.

There are many online calculators to help you work out the EDD, but given that
the average age of midwives in Australia is about forty-five, we use our favoured
pregnancy calculator wheel, or The Wheel. There is usually more than one sitting
on every desk in a birthing unit. Midwives work in weeks and days, not months
especially if there is the potential of a premature birth.
The EDD is also calculated by:

Noting the first day of your last period

Adding one year
Subtracting three months
Adding 7 days
And voila, you have your estimated due date. Place your bets now.

Number 2: Everyone will give you advice.

Which is the nice way of saying Everyone will tell you what to do.
When I was pregnant most people didnt give me advice, possibly because I was
a midwife and they assumed I would know what I was doing. Society was also less
bold and strangers were, for the most part, were unlikely to comment to each other
regarding childrearing and pregnancy at least to your face.
I attribute this change in attitude partly to the mountain of information now
available, and the tendency to believe that if it is written down it is correct.
The exponential growth of accessible information only began ten or fifteen
years ago. In my grandmothers generation, some women didnt know how they
got pregnant (theres a long time between having sex and a baby forming that
conspicuous bump) and some didnt know which hole the baby would come out.
At high school I didnt know exactly how this baby business happened. We were
told that the sperm from the male fertilised the egg from the female, but werent
told how this miraculous transfer happened. I did know that the girls at school who
dated the army boys usually got pregnant, and army boys were therefore very
skilled at making babies. If I didnt want a baby, I simply had to stay away from the
army boys.

It wasnt until fourth form (Year 10), in Mrs. Porters science class, that I found
out how the egg and sperm got together. On the overhead projector was an image
of copulation enlightening. Oh thats how it works, I whispered to the girl next
to me. She looked as shocked as I did my friends and I couldnt believe that
people would do that. I went to a girls school and we must have been quite nave,
as I dont remember the birds and the bees being discussed in the playground.

13
 Today, everyone is an expert with opinions on what to do for every aspect of
pregnancy, birth and raising the child not just your well-meaning and
overzealous mother-in-law, but also random people at the shops and the
electrician who comes to fix your dishwasher. And they dont mind sharing their
opinions. They will offer advice from how and when to sleep, what, when and how
much to eat, what type and how often you should exercise, and more. The advice
will probably be contradictory and it seems you cant do anything, because
everything is either wrong or is potentially dangerous. This expert advice is also
usually embellished with evolving horror stories of a friend of a friend or a
neighbour.
People are usually well meaning when they do this. It is not an attempt to
deliberately scare you, and they often truly believe they are helping. But, its
probably best if you smile sweetly and let most of their advice and opinions go in
one ear and out the other. Some information you hear might resonate with you, so
store it away for later use.

People say they want to give you advice, but what they really want is to tell you
their story and have you validate their choices, a Scottish lady recently told me
while I was monitoring her babys heart rate. Everyone is nervous during
pregnancy and they want to know theyve done the right thing. Or more
importantly, that they havent done anything wrong. Its tough being a guardian of
someone elses life.
Youre confused, so you do the only thing you can do. Youre a modern woman
and this is the information age. You will do your own research and find out The
Truth. You boil the kettle, turn on the computer with a determined flick, and
navigate to the all-knowing Dr. Google, only to find the internet is steroids for your
fears. Thousands of pages littered with expert advice and grammatical errors;
forums filled with stories gruesome enough to rival horror movies. Every
testimonial, article, and expert is certain they are right, leaving you with an
information overload of conflicting advice on almost every single topic.

Its not possible to navigate that much information without scaring yourself.
Instead, you need to trust yourself. You have been given the ability to sense when
something feels right or wrong listen to it. Remember that women have been
giving birth since the beginning of the human race. Since then, the population has
continued to grow, indicating that even without the tonnes of scientific and
seemingly contradictory information we have today, we did something right4.
Expert advice may be the latest in scientific advancement, but since it is highly
unlikely that any of those experts will be coming home with you to look after the
baby, you need to find what works for you.
Number 3: This advice will probably make you feel guilty.

Guilt in pregnancy began when Eve cheated on her diet and ate that apple. Eve
got the guilt even without all the mothers, sisters and strangers picking on her.
Since then it seems the guilt has only compounded.

4 We also did many things wrong see Chapter 11 and yet were still here.

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 Women are held to very high standards much higher than men and this is
heightened when baking a baby. What you eat, drink, wear, how you look, how you
exercise, your work, and more, will all come under intense scrutiny the minute that
bump is visible, and will continue once baby is born.
The internet has amplified the guilt. Take to the web and it might seem like
every single thing you eat, drink, inhale, accidentally look at or go near, will
somehow do damage to your unborn baby. You cuddle your baby too much; you
dont cuddle her enough. Youre underfeeding your baby; now youre overfeeding.
You take a paracetamol tablet for a fever, knowing a fever is even less ideal when
youre pregnant, only to read that some studies are now linking paracetamol with
ADHD5.
If an article starts with A recent study shows but has no reference to the actual
study, be wary. Studies, like statistics, can say just about anything if you canvas a
select group of people. Consider the practicality, and source, of the advice. News
these days consists largely of attention-seeking headlines because that is what
sells. I dont doubt millions of women have taken paracetamol when pregnant and
their children dont all have ADHD6.

Also be wary of the word linked. Linked is a soft word and data can be linked or
correlated in many ways correlation does not mean causation. For example, there
are very strong correlations between the divorce rate in Maine and the per capita
consumption of margarine. Theres also a strong correlation between the number
of people who die falling out of bed and the number of lawyers in Puerto Rico7. If
you want an excuse to eat more chocolate, there is a correlation between per
capita chocolate consumption and Nobel Laureates.

Use your common sense. Two paracetamol arent likely to be a problem, and
neither was the accidental drink, fish or cheese you had before you found out you
were pregnant. Driving to work every day is far more of a risk.

When baby is born the guilt will ramp up. Now you can be judged on what both
you and your child do. Do what you need to do to make it work.
Number 4: And then the advice will change.
You get the guilt, and then the latest research is published and you learn your
instincts were right all along.
Before I had my children, someones grandmother told me, If it doesnt matter
in ten years, dont worry about it. Not only is it applicable to babies but generally
to life. When the little bundle becomes a teenager and defiantly comes home with
blue hair, will it matter in ten years when theyre twenty-five? Probably not. In my

5 A variety of these articles were published in July and August 2016. If you must read them, read the
whole article, not just the headline. The articles usually clarify that the researchers themselves say
more research is needed. If youre still worried, try and read the scientific paper where you can
read what the researchers actually wrote, not what a newspaper published to get your attention.
6 I would also query whether ADHD is as prevalent as we think. Children (and adults) are designed
to move, not sit at a desk all day.
7 www.tylervigen.com

15
experience they grow out of this phase after they realise the time and cost required
to keep those colourful locks.
Over the last thirty-five years Ive seen the advice regarding pregnancy and
parenting change significantly. Had I read pregnancy and parenting books thirty-
five years ago, Im sure much of what I would have read would now be wrong. Even
something as seemingly simple as how babies should sleep has changed
dramatically.

Today we like baby to sleep on its back. However, when I first started midwifery
and up until the late 1980s, we preferred babies sleep on their stomach. We
believed that if baby was lying on its back it might vomit and choke. This is actually
quite rare.
In Australia, the 83% decline in SIDS is attributed to placing babies on their
backs, rather than their stomachs, to sleep. My youngest child was born when back
sleeping was a no-no. He slept on his back because he wouldnt settle any other
way. What a conflict between the midwife and mother in me, but he was my third
child so I let him do what he wanted (you tend to stress less the more babies you
have). With three small children and work, sleep was critical. Hes in his late 20s.
As it turns out, I was just ahead of the times.
Today we dont like stomach sleeping from fears of asphyxiation. However,
mattresses are much firmer today than they were in the 1980s. I wonder if
stomach sleeping will become right again one day?
To prevent infection, the umbilical cord stump used to be cleaned with
methylated spirits at every nappy change. Now, no disinfectant is used and the
cord stump is simply wiped with a cotton tip as it separates from babys belly.
Babies used to go into the nursery overnight and were given a bottle of 5%
glucose water. It was thought that the mother receiving a good nights sleep was
more important than spending nights with the baby. These days, baby usually stays
in the room with Mum, though I guarantee there is a 50/50 split of opinion some
nights as to where you would like the baby to be.

A little alcohol during pregnancy used to be OK but is now a no-go zone. In my

mothers day, alcohol infusions were used in an attempt to stop pre-term labours. I
dont know how successful they were but I can only imagine the headache those
girls had.

Soft cheese used to be OK, but is now bad. This advice will stay as soft cheeses
can contain listeria, bacteria that causes an infection known as listeriosis. Although
the infection is very rare, its best to avoid soft cheeses because listeriosis can
cause miscarriage, severe illness or stillbirth.
Follow your instincts where you can because they will probably be right. You
were designed to bake this baby.

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Number 5: Antenatal care is important.
Ante- or pre-natal care is the care that happens before baby is born. It should
start as early as possible in your pregnancy, or before youre pregnant if youre
currently trying. Check your immunisations are up to date and that you are
protected against measles, mumps, rubella, chickenpox, and whooping cough. If
you need a booster it should be done 28 days before conception. The only
vaccinations you can have while pregnant are the flu vaccination and whooping
cough/tetanus/diphtheria combination. All others need to happen before or after.
When you are planning to get pregnant, or first realise youre baking a mini-me,
go visit the doctor or midwife to discuss your plan for the next eight or so months.
The plan should involve organising antenatal care, be it through a midwives clinic,
hospital clinic or a specialist. Common antenatal activities youll undertake include
ultrasounds, urine analysis, blood pressure checks, and blood tests. You will need
to know your blood type (more on this in Chapter 10), whether you carry Group B
streptococci (see Chapter 4), and to monitor your blood pressure. Between 24 and
27 weeks you will have a glucose tolerance test to check for gestational diabetes
(Chapter 3). You also start to get to know who will be looking after you throughout
your pregnancy.
Many women are concerned about nutrition during pregnancy. With the wide
variety of foods available year round, micronutrient deficiencies are becoming less
common. Check with your doctor before stocking up on expensive and potentially
unnecessary supplements.
The key vitamin that is recommended you supplement when pregnant is
vitamin B9 or folate. Folate is used in making new cells, and a lot of new cells are
generated during pregnancy. Consuming folate prior to conception reduces the
chance of neural tube defects such as spina bifida and may reduce the risk of cleft
lip and palate. Folate is found in a variety of foods including dark green leafy
vegetables (though some is lost during cooking so go for the salad), oranges, nuts,
peas, beans, and Vegemite. Many grain products in the United States, United
Kingdom and Australia are also fortified with folate. When buying supplements,
look at the dose of the vitamin you can usually find a cheaper version with the
same dose. Like buying clothes, sometimes youre paying for the quality,
sometimes youre paying for the brand name.

A higher dose of folate is recommended if youve had, or if theres a family

history of, neural tube defects, and also if you are taking anticonvulsants. Folate
supplements sometimes come with iron. Vitamin C increases iron absorption, but
iron can cause constipation. Keep up the veggies to help your bowels.
If you have a pre-existing condition like epilepsy, diabetes, thyroid issues or
depression, your medications may need to be changed while you are pregnant.

Number 6: People will try and pat you like a laughing statue of Buddha.
People seem to think pregnant bellies are public property. Family, friends and
even random strangers will come up and talk to you about your belly. They might

17
ask how far along you are and then comment, Oh youre sooo big! or Gee, its
small, followed by a look of concern while they chew their bottom lip.
They then have the desire to touch and rub your tummy like it has some
mystical power. Its bad enough to be kicked from the inside without the pat, pat,
pat from the outside. They seem to confuse you with a laughing Buddha statue,
rubbing your belly for luck.
As people dont walk up to men with beer bellies, ask how many beers it took to
grow it, then without permission begin to rub it, Im not sure why they think its OK
when youre pregnant.

In Pennsylvania in the USA it is illegal to touch a pregnant womans belly

without permission, and you may be charged with harassment if you do. There are
many t-shirts available with the slogans Dont touch! or Hands off!
You could tell people youre not pregnant and see how fast they try to backpedal
out of that one.

Things to give up

The oven is on and there are three ingredients you dont bake with alcohol,
cigarettes, and other drugs.
Everyone seems to know pregnant women shouldnt drink alcohol. What they
dont know is that advice refers to heavy drinking, not half a glass of wine in your
second trimester. Research into alcohol consumption during pregnancy is
contradictory, and unsurprisingly fraught with issues. You cant force women to
drink so any heavy drinkers in the studies come to the table with a history of
excessive alcohol consumption, and likely different diets. Controlling for the one
factor of alcohol consumption is effectively impossible without breaching human
rights.
The one common theme amongst the research is there is no known limit for
how much alcohol pregnant women can have. One pregnancy can be completely
unaffected by an alcohol consumption and another will have effects from very
little. Danish researchers8 found that low alcohol consumption (14 standard
drinks a week) in early pregnancy did not affect the childrens IQ or attention span.
Conversely, a twenty-three year study from the University of Pittsburgh9 found
that pre-natal exposure to alcohol caused behavioural problems. Both studies
concluded that if youre pregnant you shouldnt drink.

There is no way to determine who will or wont be affected so its best not to
touch the juice.

8 See papers in references: Falgreen et al (2012), Kesmodel et al (2012a), Kesmodel et al (2012b),
Skogerb et al (2012), Underbjerg et al (2012)
9 Day et al (2013)

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 Will one celebratory glass in the nine months cause damage? Unlikely, so dont
fret if youve done this. The biggest problem youre likely to encounter from that
one glass is social stigma.

A little lime juice and mineral water in a wine glass looks like wine so you can
feel like youre having a drink without having one. If you get the ratio right it really
does look like white wine, so expect someone to comment.
Smoking
When I first started nursing the ceilings of the staffrooms were yellow. Most
adults smoked back then, exhaling nicotine and tar that wafted upwards to settle
on the ever-darkening surfaces. I didnt smoke but I was one of the minorities.
Nurses and doctors werent allowed to smoke while seeing patients, but some
patients smoked in bed. In my early nursing days, I remember a man presumably
with lung disease from smoking asking if I could turn his oxygen off because it
kept blowing out his match while he was trying to light up.

When I started my midwifery training it was not uncommon for women to

breastfeed and smoke at the same time baby in one hand, cigarette in the other.

Smoking is a common cause of adverse outcomes for new babies. From the
1930s to 50s it was not uncommon for doctors to smoke when seeing patients.
Today the dangers of smoking are no secret. Interestingly, of the 4,000 chemicals
you inhale when you take a puff, two of them cause the most grief for pending baby
nicotine and carbon monoxide. Nicotine is, unfortunately, also the compound that
makes cigarettes so addictive.
Together, these compounds wreak havoc on oxygen flow to the baby. Carbon
monoxide restricts blood flow while nicotine constricts your blood vessels,
narrowing the amount of oxygen you can deliver to your baby. Its a double
whammy you cant deliver as much oxygen as before and the blood you can
deliver contains less oxygen. Babies born from mothers who smoked are often less
developed, can be premature (would you want to hang around in a sack that was
slowly suffocating you?), are more likely to have heart defects, asthma, and have a
greater risk of SIDS10.

Some teenage girls take up smoking when pregnant in the hope they will have a
smaller baby and therefore an easier labour. It wont work - any reduction in birth
weight from smoking is in grams (i.e. not enough to significantly decrease the size
of the baby), and labour is labour.

A labour pain is a labour pain no matter what size the baby is. Pushing out a two
kilo baby is easier than a four kilo baby, but the pushing part is only a small part at
the end of labour.
In my parents generation some women were applauded for how little they
showed their pregnancy. This often encouraged them to restrict their diet and/or
smoke to obtain the fashionably small baby bump.

10 SIDS and Kids (2009)

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Drugs
The final on our list of banned baking ingredients are drugs the illicit,
addictive kind. Think heroin, speed, and so on. If you regularly take addictive
substances while pregnant, baby will be born addicted. The two of you share a
bloodstream, so what goes into yours also goes into theirs. Babies born to mothers
who use are born addicted and need to withdraw.
These babies have a high-pitched cry, tremors, tense arms and legs, diarrhoea,
and an increased frequency of yawning and sneezing. They need to stay in a special
care nursery for a few days, and have medication to slowly help them withdraw.
Dont panic if your baby sneezes they nearly all do. They are just clearing their
nasal passages and we havent taught them how to blow their noses yet. Theyre
also not quite aware that they have arms so youll have to do the nose cleaning for
a few years (it is fun when baby first discovers its hands or feet). Nobody is going
to think you have a hidden drug habit if baby sneezes.

If you have been using, admit to it when you come to the hospital to give birth. It
also helps if you are accurate with how much and what you are taking. If we know
what youve taken, we can get you and the baby the right help.
About twenty years ago, a lady arrived late at night with her five-year-old son in
tow. She was in early labour and knew it was time to come to the hospital. She gave
vague responses to my questions, was very thin, hadnt washed her body for a few
days or her hair for a few weeks. She refused to make eye contact for fear of me
seeing her tiny, pinpoint pupils. Most ladies I met on illicit substances avoided eye
contact, except for the ones who wanted more methadone11; those women would
stare at me, often not blinking at all, assuring me that they had dropped or lost
their last batch and needed more.
This lady was on something more than one thing, as it turned out. She couldnt
remember when she had taken what, but her child gave a very clear rundown of
what she had used and when in the last 24 hours.
Have you had any alcohol? I asked, finding a teddy and a bed for her sleepy
son. Wine, spirits?
No! she shook her head, offended enough to finally make eye contact. I dont
drink that stuff. Its bad for you.

Boy or Girl?

Most women have at least one ultrasound during their pregnancy, and many
want to know whether theyre baking a boy or girl. Thank Professor Ian Donald of
Glasgow and WWII for this fabulous device. A medical officer in the RAF during
World War II, he developed an interest in adapting radar and sonar technology for
medical diagnosis. Ultrasound machines were originally invented to find German
submarines in WWI. Professor Donald noticed the similarities between babies in

11 Methadone is an opioid used for pain relief, or for people trying to kick an opioid habit.

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utero and submarines in the ocean12, and adapted the technology to create the first
diagnostic ultrasound machine in 1958.
Personally, I think not knowing is better. There are few surprises in life these
days and the birth of your child is a wonderful moment. Finding out when you
meet them whether you have made a little boy or girl is even more magical. The
conversation with family and friends after the baby has been born, when the sex of
the baby has been known for months and they have decided on a name, tends to
sound like theyre informing the family they have just collected someone from the
train station or airport.
Hi Mum, James has just arrived you can come and see him, or Hi Mum, with
a sob, ITS A BOY!! with all the wonder and excitement of that Christmas present
you didnt think you would ever get when you were a child.

Whether you find out or not is up to you. The temptation to find out is a very,
very difficult temptation to overcome. I didnt have this problem with my babies.
Ultrasound technology wasnt good enough back then at least at the hospital I
was at to determine gender. I got the surprise for babies one and two.
But for baby number three, an overexcited obstetric registrar blabbed. The
hospital I worked at had just got a shiny new portable ultrasound machine. This
meant that instead of sending a lady to the ultrasound department and hoping they
could be fitted into the busy schedule, a basic ultrasound could be performed in a
delivery suite. As I was the only pregnant person on staff, every obstetric registrar
wanted to practice using the machine on my belly. Dont tell me the gender, I
warned them. Unfortunately, one of the registrars grabbed my arm and pointed at
the screen - Its a boy! when he saw the tell-tale boy bits clearly for the first time.

Ultrasounds good enough to determine gender have only been available for
about twenty-five years, introducing the temptation to know if you will have a boy
or a girl. Before then, every culture and generation had ways of telling the gender
of the baby. All seem rather successful, but thats probably because theres about a
50% chance of getting it right. Here is a list of some Ive heard over the years. You
can see how some of them would have seemed logical at the time men are
generally hairier than women so if your legs get hairier, youre going to have a boy.
The presumption that girls are sweeter than boys was obviously invented by
someone who didnt have a teenage daughter. The others, however, are perhaps
the product of overly creative guesses?

If you crave salty food its a boy, and sweet food is a girl.
How you carry. When looking at you from behind, if you show from the
sides its a girl, and if you dont its a boy. If youre carrying high, invest in a
couple of pink onesies, if youre carrying low, prepare for your little man to
pee in your face at some stage when you undo his nappy.
If you have the Linea Nigra, the dark line running from your belly button to
your public bone, you are having a girl. If it runs from the navel upwards,
its a boy.
Heartburn? Blame the little lady.

12 Hutter-Epstein (2010)

21
 Dry skin means a boy, and soft skin a girl. This is probably because women
are expected to have soft smooth skin, while men can get away with dry,
cracked skin.
Fast heart rate = girl. Slower heart rate = boy. Note that babies heart rates
should be between 120160 BPM, which is very fast compared to the
average adult.
The wedding ring swing. This is a fun one to try because both parties can be
involved. Tie a piece of cotton or string to the wedding ring. Then, lie down
and hold the string so the ring dangles over your belly. Be as still as
possible, until the ring starts to move. If it moves in a circle youve got a boy.
Side to side is a girl.
Partner picking up padding with you? Partners who put on weight do so
because a girl is on the way. If their weight doesnt change, its a boy.
If youre putting on weight all over its a girl. If most of the weight is in the
belly its a boy.
Cold feet? Boy genes.
Bigger right boob = boy. Bigger left boob = girl. Most women usually have
one breast bigger than the other regardless of pregnancy. The origin of this
one most likely dates back to the Trotula, a 12th century set of texts on
Womens health from Southern Italy. A translation13 states Whence
Hippocrates says: a woman who is carrying a male is well-coloured and her
right breast is bigger. If she is pale, she is carrying a female, and the left
breast is bigger.
More frequent headaches = boy.
Moodier than your already moodier pregnant self? Girl.

If anyone would like to catalogue the results of these Id love to know the
statistics.

Get your copy from www.hatchanddispatch.com

13 Green (2002)

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