Resources

Find a New Zealand LMC Midwife

The New Zealand College of Midwives www.findyourmidwife.co.nz 

Wellington region www.findamidwife.org.nz see https://www.ccdhb.org.nz/our-services/maternity/list-of-midwives-in-wellington-porirua-and-kapiti/   

Nga Maia Nga Maia is a national organisation supporting Maori in pregnancy and childbirth. www.ngamaia.co.nz 

COVID- 19

COVID-19 is a new illness that can affect your lungs and airways. It’s caused by a type of coronavirus. The guidance is based on what is currently known about COVID-19. The Ministry of Health will update this interim guidance as additional information becomes available. The symptoms of COVID-19 are:

• a cough

• a high temperature 

• shortness of breath.

If you have these symptoms and have recently been overseas, or have been in close contact with someone confirmed with COVID-19, please telephone Healthline (for free) on 0800 358 5453 or your doctor immediately.

More information about COVID-19:

COVID-19 website 

COVID-19: information for visitors to CCDHB

COVID- 19: MOH Information for pregnant women, and those who have recently given birth 

COVID-19: MOH information on breastfeeding and those who have recently given birth

New Zealand College of Midwives (NZCOM) information about COVID-19 for pregnant women and mothers

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) information for pregnant women

World Health Organisation (WHO) advice on pregnancy and breastfeeding

Pregnancy in a Pandemic information sheet from PADA (Perinatal Anxiety & Depression Aotearoa) PADA (Perinatal Anxiety & Depression Aotearoa) 

Manage My Health website

Some GPs use an online service called ManageMyHealth which is a secure website which can receive your health information. Ask your GPs practice if they use this system. Find out more on the ManageMyHealth website.

ManageMyHealth offers you the ability to have an online Personal Health Record which you can arrange prescriptions and online GP consultations through. You need an Internet connection, ideally broadband.

SmartStart - access government services

The Department of Internal Affairs, along with several other government agencies including the Ministry of Health, have created an online service called SmartStart.

SmartStart is an online tool for parents that makes it easy for them to access government services and support during pregnancy, and the first years of their new baby.

SmartStart provides users with integrated information about services provided by a range of agencies to help parents check that they’re not missing out on financial help and provides tips on keeping parents and baby healthy and safe.

Neonatal Trust

The Neonatal Trust provides support to families of premature or sick full-term babies as they make their journey through neonatal care, the transition home, and onwards.

Find out more about the Neonatal Trust here. 

In Wellington the Neonatal Trust Office and Shop is located just inside the entrance to the Neonatal Intensive Care Unit, Level 4, Wellington Regional Hospital.

Parenting help, information and courses

Plunket

Plunket provides support services for the development, health and wellbeing of children under 5 years old. For more information visit Plunket's website. 

Or phone PlunketLine - available 24/7 on 0800 933 922.

SKIP: strategies with kids, information for parents

Whakatipu is a kaupapa that encourages strong whānau connections which nurture and develop tamariki. Tikanga and pakiwaitara are interwoven with child development information, ideas and activities for whānau.

Find out more on SKIP's website.

Parent help Wellington

The only designated free national parenting helpline in New Zealand that is available from 9am to 11pm, 7 days a week. Find out more on the Parent Help website or phone 0800 568 856.

The Parenting Place

Early Years Toolbox Parenting courses for 0 to 6 years. This course that runs over 6 weeks and covers everything from behaviour management techniques to ways of creating great family memories.

Find out more on the Parenting Place website.

Space

A programme for first time parents and babies with weekly sessions covering a variety of topics such as sleeping, teething, temperament, childhood illnesses with play sessions with age-appropriate equipment to support infants' learning and development. It's also an opportunity to meet other new parents. Centres are throughout Wellington.

Find out more about the Space programme.

Tapuaki: Pacific pregnancy and parenting information

Here you will find information about pregnancy and parenting to help you stay safe and healthy during your pregnancy and to care for your baby when he or she arrives. Learn about what you, your partner and/or family can do to ensure the mother and baby are healthy, find links to different services and resources such as videos, and read stories written by other parents about their experiences in Tala (story) Tapuaki. The information is available in several different Pacific languages by clicking on the flags at the top right of the website.

There is also a Tapuaki app available on Google Play and iTunes.

Visit http://www.tapuaki.org.nz.

Download the Tapuaki app to find a midwife or to see what baby looks like week by week.

Support

Support for parents of twins, triplets or more

Wellington Multiple Birth Club provides support, information and resources.

Support for parents of children with special needs

Parent to Parent is a nationwide not-for-profit organisation that was formed in 1983 to support the families of babies, children, teens and adults with any type of disability or health impairment.

Find out more on the Parent to Parent website.

Postnatal and Antenatal Distress support

Support groups and a range of other services are available.

Perinatal Anxiety and Depression Aotearoa (PADA) website. It has information for pregnant women, new mothers, new fathers and families affected by depression or anxiety around pregnancy and a new baby. It also has a comprehensive list of support helplines and services.

Please see https://pada.nz/about-us/ 

Little Shadow offers counselling, support and information for those experiencing perinatal distress. We walk beside you in your journey, working collaboratively with health professionals and other organisations to help you on your journey to wellness.

PO Box 9362 Marion Square, Wellington 6141

p. 04 472 3135
e. hello@littleshadow.org.nz
w. www.littleshadow.org.nz

Mothers Helpers

Provide support to mothers experiencing ante-natal and postnatal anxiety and depression, also offer PND Recovery courses and follow-up counselling in 12 areas across the North Island as well as online.  These are delivered by qualified counsellors, social workers, life coaches or mental health nurses.

Phone:  0800 002 717  or  022 093 1822
Email: info@mothershelpers.co.nz
Web: www.mothershelpers.co.nz

Wellington Women's Refuge

Women's Refuge is an organisation for women and their children to help prevent and stop family violence in New Zealand.

Visit the Women's Refuge website.

Crisisline: toll free from anywhere in New Zealand 24 hours a day, 7 days a week on 0800 REFUGE or 0800 733 843.

Power to Protect

When your baby keeps on crying

One of the hardest times can be when your baby keeps on crying and you can’t work out why. If you find yourself getting upset, it’s OK to put your baby down gently in a safe place, walk away and take a break.

Do not pick up your baby until you have calmed down. Your baby is more likely to calm down when you are feeling calm and in control.

Look after yourself. Make a cup of tea or coffee, or phone a friend or someone in your whānau.

You could also phone PlunketLine on 0800 933 922 or Healthline on 0800 611 116 for advice or support.

Never shake a baby

Never, ever shake a baby. Never leave a baby alone with anyone who may lose control. A single moment of losing control may damage a baby forever. Babies can die if they are shaken.

If you ever think your baby has been hurt, call 111. Don’t let fear or pride stand in your way. It could save your baby’s life.

The Kidshealth website has a video called Power to Protect about how to cope with the stress of a baby’s crying and what can happen if a baby is shaken.

Related websites

Crying: what to do – Kidshealth
Why babies cry and what you can do about it.

Shaken baby syndrome – Kidshealth
Why you should never shake a baby. Also includes the Power to Protect video.

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Childbirth Education 

 

The pregnancy test instructions say two blue strips means positive, you read on but there is nothing to say what you do now!

Being pregnant or becoming a parent is a whole new world filled with lots of questions, dos and don'ts and conflicting advice. Sometimes being a parent can feel overwhelming. Sheila Kitzinger made this quote about what it is like to be a mother "to take on one of the most emotionally and intellectually demanding, exasperating, strenuous, anxiety-arousing and deeply satisfying tasks that any human being can undertake" this applies also to fathers.

Raising your child shouldn't be a complicated exercise. Reading all the books and trying to be a perfect parent is exhausting and you will stop having fun if you do this. Do the best you can and seek help if you are having difficulty. Children grow up fast take time to enjoy them.

I hope the following helps with some of your questions.

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Optimal Fetal Positioning

Trying to get your baby into an optimal position for birth was called "maternal posturing" in 19th century publications, so it isn't a new idea. Birth has a physical, emotional and mental side to it. There is nature and a bit of science involved. Psychics tell us that there is such a thing as gravity, and maths tells us about shape and sizes. Our heads aren't a perfect round shape and that there are diameters that are larger than others and our pelvis has certain diameters also. Thus the baby must maneuver to fit through the pelvis. 

 

So why do some babies get stuck. This may be due to the size of the baby, position or presentation of the baby, or shape of the woman's pelvis. Most women do have a baby to fit them. Our pelvis shape isn't something we can do much about but the position of the baby could be influenced.

 

The best position for a babies head to fit into the pelvis is occipital anterior (OA). As the back of the head (occipital) lines up with the babies back, you might hear OA as being said as "the babies back is toward your front". If occipital posterior the babies back is towards your back. Babies can be born in an OP position but most of the time they will rotate in labour into OA. Needing to rotate is why OP labours can be longer with more backache.

 

To explain why it best for the baby to have its head in an OA position and have the chin tucked towards the chest. Think of this metaphor: try putting on a tight polo-neck top without tucking in your chin, ie looking at the sky.

 

So why have the rates of interventions increased?

 

Sutton and Scott state "that the rate of posterior presentation has increased drastically in the last few decades, apparently in line with changes in the way women use their bodies. Sitting in car seats and leaning back on comfortable sofas, together with less physical work, has combined to produce an increase in posterior presentations." 

 

Optimal Foetal Positioning' (OFP) is a theory developed in the 1990's by a midwife, Jean Sutton, and Pauline Scott, an antenatal educator, who stated "that the mother's position and movement could influence the way her baby lay in the womb in the final weeks of pregnancy. Many difficult labours result from 'malpresentation', where the baby's position makes it hard for the head to move through the pelvis, so changing the way the baby lies could make birth easier for mother and child."

 

There was advice for pregnant woman to get into upright and forward- leaning postures as often as possible in later pregnancy. If you were pregnant with a single baby which was coming head first, then after 34 weeks to try:

 

• Leaning forward over a beanbag or large cushion

• Swim with abdomen down ie breast stroke or front crawl.

• When resting lie on your side, preferable the left.

• Going on all fours. Visualise the uterus as a hammock in which the baby lies thus in this position the baby would tend to lie with its back towards your tummy button.

• Sit with knees lower than hips.

• Turn a dining chair around and sit astride it facing the back.

• Use of a birth ball can encourage good positioning, both before and during labour.

• Don't lie back with your feet up.

 

With research there is often arguments for and against, same with optimal fetal positioning. Some research has said, "it's not what you do before labour which is important, so much as what you do during labour". There was from research saying "the majority of babies who are OP during labour actually started off in an OA". Also if your baby stays in an OP position according to Gardberg most posterior babies will turn during labour.

 

Try exercises and positioning during labour, which can help move the baby into the pelvis such as:

 

• Walk up and down stairs, sideways if you find it too hard.

• Move your pelvis, do figure '8' or rock from side to side

• Use squatting, leaning forward or all-fours positions

 

I see positioning and movement in labour as important and trying to get the baby into an optimal fetal position during pregnancy. I don't say that you have to get down and scrub the floor as our great grandmothers were told to do in preparation for birth, but maybe think about reading the paper in hand and knees/bottom on the floor position.

 

If birth ends with intervention it isn't your fault that you didn't position yourself correctly because there are also other factors involved. There needs to be trust in birth; go into labour thinking, "I can do this". 

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Practical Support

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Ideas of practical things for the Dad/Partner/Support person to do:

Antenatal (pregnancy):

• Learn how to change nappies

• Learn how to bath a baby

• Organise car seat and know how to use it

• Keep petrol in car

• Film in the camera

• Phone cards or phone charged

• List of phone numbers for whom to ring if needed

• Know how to contact your LMC (Lead Maternity Carer)

• Organise baby area

• Go along to as many of the doctor's visits as possible

• Take on more of the household chores

• Go for walks with her, encourage regular pregnancy safe exercise

• Eat healthy; ensure your home has all the right healthy foods available

• Keep your cool; your partner is going through some major emotional and hormonal changes (so it's not always about you)

• Communicate with her, and listen to her needs

• Do an antenatal class together

• Contribute to a Birth Plan

• Give her lots of TLC and tell her she looks great and is doing a great job

• Communicate with her, and listen to her needs and express your needs and concerns

• Assess your financial situation; planning well in advance often softens the financial blow Enjoy it as much as you can

If planning a Hospital Birth:

• Hospital bag

• Organise who is looking after any other children, pets, house

• Food, drinks to take to hospital

• Know how to get to hospital

• Where to park at hospital

• Waterproof covering on car seat/bed mattress for when waters break

If planning a Home Birth:

• May be asked to provide the following:

• Washing up bowl, cold and hot water

• Towels

• Sanitary towels

• Torch/spot light

• Container to put the placenta in

• Hot water bottle or heater to warm baby clothes and towels

• The room needs to be kept warm for when the baby is born.

• A working phone, though the most midwives carry a mobile phone

During Labour:

• Time some contractions: how long and time between start of one to start of next

 

Offer:

• Support and reassurance. Using the question to the Mum-to-be "what is your expectation of me at the birth?" can open up communication around advocating and support at a birth.

• Drinks, Ice to suck on

• Heat Packs

• Distractions

• Music

• Visualization: eg peaceful pictures or photos of places you have visited (use rotating photos on a lap top if available)

• Massage and acupressure

 

Debra Betts is a New Zealand registered nurse qualifying as an acupuncturist in London. You can download her acupressure booklet via her web site.
Web Site: http://acupuncture.rhizome.net.nz/
Booklet: http://acupuncture.rhizome.net.nz/downloads/Acupressure.pdf

Postnatal

• Restrict visitors if partner tired (allow for rest during the day)

• Baby Bathing

• Laundry, Housework, Meals

• Home Safety: gates where needed, move poisons before baby is mobile

• Email message or message on answer phone re birth details and visiting

Message to visitors

Visitors is a personal thing, some people will welcome them others won't. Sometimes all can depend on how much sleep you have had. Everyone wants to come see the new baby and it is hard for tired new parents to say "No".

 

Messages via email, answer phone or even a note on the front door can help eg:

 

• New family needs some settling in and recovery time.

• If you wish to visit us prefer this to be ...(day and time)

• If we are at the hospital please don't ring the staff, as they don't have time to answer calls.

• The visiting hours at the hospital are...

• You can contact us on...please ring before you come, we may be catching up on sleep.

• If you have a cold or flue could you wait till better as babies immune systems are immature.

• All food very much appreciated.

 

It may sound rude telling when they can or can't come but you and the baby need to come first.

 

As a Nurse and Midwife I have learnt to be able to care for other people, you need to care for yourself first. Same goes with parents, how are you going to look after a baby if you are not meeting your own basic needs of food and sleep.

 

Birth is holistic it is not just physical it is emotional and spiritual. People present who are important to the labouring woman are part of this.

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Babies

I have had it said to me that babies are all the same. I disagree with this they are all individual human beings with their own unique appearance and personality. They do generally have similar physical needs and development which is good to know about.

 

Newborns sleep a lot; on average 16.5 hrs per day and the rest of the time is mainly spent feeding and getting cuddles. This little person is taking in a lot about their environment and is learning about him or herself, for example they have to learn that their hand is actually attached to them and all the things they can do with it. Their eyesight isn't that great at birth, they can only see about 20-30cm. Observe to see that they are following objects that are close to them. They have adult vision at three months and their eye colour can change. Their hair colour can also change, so your grey/blue-eyed baby with blonde hair may become a burette with brown eyes.

 

Hearing is often better than yours; as it hasn't been damaged by loud noise. Signs that they can hear are turning their heads towards noise and getting a fright with a loud bang.

 

Babies are putting weight on, doubling their weight at 6 months and tripling by a year, consider an adult trying to do that! They have little stomachs; an average size baby's stomach (3.5kg) at birth only holds 20-30mls. Thus they need to feed often, including during the night.

 

Some babies will sleep through the night by 6 weeks (for 6-8hrs) but not many, most  take several months or more!

 

With breastfeeding it will take time to feel confident, it is a skill and it takes you and the baby time to learn how to do this. If you are having problems Plunket Karitane centres, La Leche League or a Lactation consultant's ph 0800 4 Lactation, can help.

 

Babies normally cry on average 1-4 hrs in total each day. At the start it can feel like quess work working out why they are crying. This is how babies communicate that they want something. It is hard for parents to listen to their baby cry. With time you get to know your baby and start to work out what they may want. If unsure work down a list, could they be hungry, tired, wet/dirty, bored or want a cuddle. If they cry a lot it may be due to colic, if you are concerned always have them checked by a health professional in case it is related to a health problem. From 2-3 months they will start responding to you more with smiles and baby noises (coos, squeals and laughs).

 

In the first month three months they are learning to hold their head up, this is an important part in the process of learning to walk. They may even start doing baby push-ups from 3 months onwards. This is why it is important to have an awake tummy time on the floor. From around 5 months of age they learn to roll over, but sometimes they can do this from 3 months of age, so never think it is safe to leave your baby on a high surface, because you never know when they may learn to roll. A major reason for admissions of children to hospital is falls. A baby falling off a table is like you falling off the roof of your house.

 

There are a hundred and one books written on babies. I try to avoid any books that read like instruction manuals. There is helpful information in the Well Child Tamariki Ora Health book, and this is free from your LMC (Lead Maternity Carer) or Plunket nurse.

 

Also www.babycentre.com has a lot of information. BabyCenter is an online resource for expectant and new parents, filled with parenting information. You can have emails sent to you from this site each week with guidelines re your child development.

 

There will be conflicting advice about the care of your baby, but remember to trust yourself - you are their parent and you know this baby better than anyone else. Everyone has an opinion on parenting, your opinion is important when it comes to your child.

 

Let your child also teach you, you will learn from them and talk to other new parents about any helpful hints they have.

Baby Names

What to name your baby? One of the many decisions parents have to make.

 

Names distinguish us from one another, but in some cultures can serve other purposes as well, such as the Chinese generation name which identifies the generation of the bearer, or the names used by some African cultures which describe the order in which siblings were born.

 

When choosing a name you may wish to use a family name, or one you like the sound of. As a parent you are going to have to say that name a lot of times. Say it 10 times fast in your head and then think are you still happy with it. What is the meaning behind the name is also interesting to find out.

 

There are a lot of books or web sites which will give you the meaning or history of names. Google Baby names and a lot of sites will come up.

You can look at http://www.bdm.govt.nz/ to find the top 100 male and female names since 2004, based on births registered in New Zealand during each year. 

 

Information from Department of Births, Deaths and Marriages

Registering a birth and your child's name.

By law, both parents of a child born in New Zealand must notify Births, Deaths and Marriages, as soon as is reasonably practicable after the birth (deemed by the Registrar-General as generally being within two months of the birth). Once registered and on payment of the fee, a birth certificate is available. Birth registration is free. If you would like a birth certificate for your child you can request one via http://www.bdm.govt.nz/

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Parental Leave and Budget

There are many things you think of when you have a new baby and one of these can are the costs involved. I have collated some web sites, which provide information on entitlements, assistance and budgeting.

Parental Leave

For information on parental leave entitlements you can talk to your employer or find out information via the Department of Labour, their web site is: www.ers.dol.govt.nz go through to the parental leave page.

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The web site for Work and Income is http://www.workandincome.govt.nz/

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Childcare and OSCAR Subsidy

The Childcare Subsidy programme makes quality childcare more affordable for families with dependent children, especially if you need a bit of extra help so that you can work or prepare for a working future. .

 

Income support payments (include benefit payments and any extra help such as Accommodation Supplement, Child Support, etc) - Call free on 0800 559 009 if you don't know what your payments are

Working for Families Tax Credits

Formerly known as "Family Assistance".

 

The online calculator "Estimate your Working for Families Tax Credits" available on the Inland Revenue web site: http://www.ird.govt.nz

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Postnatal Depression/Distress (PND)

The baby is born the discomforts of pregnancy are gone; you know that looking after a baby will be hard work and tiring. There will be the feeding day and night, nappies to change, crying to cope with. Yes, crying to cope with, you expect this from the baby but there seems to be a lot of crying from you, what is going on. You should feel happy, everyone says: isn't your baby lovely, aren't you lucky, aren't you happy?.

 

You don't feel lucky, you don't feel happy. Instead there are feelings of stress, anxiety, confusion, fear and exhaustion. You love your baby, you wanted this baby so much, and you remember how you dreamed of holding them in your arms and preparing for their arrival. In the dream you did not cry, you did not feel alone, nervous and useless.

 

Post natal depression, no, you can't have that, you wanted this baby, you don't get depression, no that wouldn't happen to you. Then you start to cry again. No one plans to get PND; no one wants to get it. It is not your fault, it does not make you a bad parent, and it does not mean you don't love your baby.

 

It can happen to anyone. Brooke Shields, a Hollywood actress, wrote her story on postnatal depression called "Down came the rain". The title is based on the poem "Itsy bitsy spider": "down came the rain and washed the spider out".

 

Quote from her book: "At first I thought what I was feeling was just exhaustion, but with it came an overriding sense of panic that I had never felt before. Rowan kept crying, and I began to dread the moment when Chris would bring her back to me. I started to experience a sick sensation in my stomach; it was as it a vice were tightening around my chest. Instead of the nervous anxiety that often accompanies panic, a feeling of devastation overcame me. I hardly moved. Sitting on my bed, I let out a deep slow guttural wail."

 

Brooke also talks about her recovery ending the book with the rest of the poem "out came the sun and dried up all the rain, and itsy bitsy spider went up the spout again".

 

Most parents have some tearful days, it is hard work looking after a new baby. Sometimes you will feel exhausted and overwhelmed. You may feel you don't get much time to yourself and sometimes feel lonely if you are unable to get out of the house. It is normal to have "bad days" but it is different if "every day is a bad day" then it is important to talk to someone.

 

If you think you may have PND look at the following list and circle the words that you feel like most of the time.

 

Anxious, Annoyed, Happy, Frustrated, Peaceful, Lonely, Resentful, Weepy, Guilt, Joyful, Shame, Stressed, Tired, Love for your baby, Despair, Pleased, No confidence, Exhausted, Angry, Pride, Confident, Fearful, Numbness

 

Have you picked all the unhappy and upset words? You may wish to use the Edinburgh Postnatal Depression Scale

 

With this check the answer that comes closest to how you have felt in the past 7 days, not just how you feel today. Fill it in yourself and then show this to someone close to you or to a health professional such as your Midwife or GP, or complete it with their assistance.

 

Postnatal depression is an illness that can affect mothers and some fathers. It is not the same as the baby blues or psychosis.

 

The baby blues is common in approximately 75% of women on the 3-4 th day after giving birth. It includes crying, feeling low and anxious. It often doesn't last long.

 

Postnatal psychosis is an uncommon condition which effects around 1 in 1000 women after giving birth there are often delusions and hostility. This will need psychiatric treatment.

 

Birth trauma can also cause depression and/or post traumatic stress disorder (PTSD). For more information about this contact Trauma and Birth Stress (TABS): www.tabs.org.nz, 

Postnatal distress (often people prefer to call it distress than depression) which includes sleep deprivation, anxiety, depression, low mood, effects of birth trauma and stressful coinciding life events, happens in approximately 20% of women. Severity can vary and for some it lasts a short time and others longer. The sooner it is accepted and talked about the sooner you will feel better.

Cause of Postnatal distress

There are lots of different theories about the cause of postnatal distress/depression. Most of them talk about hormonal imbalance, lack of sleep, lack of support and stress.

 

The Post and Ante Natal Distress Support Group (Wellington) Inc. http://www.pnd.org.nz/ is a voluntary support group, lists the following as some of the most commonly proposed contributing (predisposing, precipitating, and perpetuating) factors:

Physical/biological

• Hormonal and biochemical changes (including thyroid dysfunction).

• Sleep deprivation and physical exhaustion.

• Pregnancy or post-natal recovery complicated by health issues such as hyper-emesis, gestational diabetes, pre-eclampsia, post-partum haemorrhage

Reproductive

• Difficulty conceiving

• History of miscarriage, adoption, death, or other 'loss' of a child (eg. health issues)

• Birth trauma - physical and emotional (sometimes this triggers memories of earlier experiences of abuse/abandonment, even though the trigger itself can seem relatively minor to others)

Emotional

• Unresolved issues (eg. related to identity, independence, self-worth, control, competence and achievement) from earlier experiences

• Unresolved grief for loss of valued relationships, places, roles, status, health, hopes, lifestyle

• History of trauma and abuse - physical, sexual, emotional - which is unresolved - whether recent, or many years ago

Personal/psychological

• Previous or existing mental health issues - including eating disorders, alcohol or drug abuse, depression

• Not feeling ready/wanting to be a mother

• A big negative difference between expectations (of pregnancy, labour and delivery, the baby and parenting) and reality - resulting in a sense of incompetence, dissatisfaction, unwelcome dependence, and loss of control

Family/relational

• Family history of mental health issues

• Unsatisfactory relationship with own mother/father/caregivers - as a child, and/or now

• Current relationship difficulties (with partner, children, family and friends)

• Difficult 'fit' with the baby eg. hard to feed, predict, or comfort; health problems; not liking the baby, or feeling as if the baby doesn't like you?

• No-one to confide in or share with

Practical/environmental

• Lack of practical and emotional support (from people you feel OK accepting this from)

• Lack of experience with babies/feeling helpless and hopeless as a consequence - especially if there are no parenting models around who you trust and respect

• Feeling as if you don't have the resources available to meet the demands on you (eg. time and energy, support, money, skills and knowledge) - whether actual or perceived

• Stressful life events/circumstances with negative consequences

Societal

• A society that devalues and disempowers mothers in many ways, but also seems to expect them to be able to manage everything - often in the absence of sufficient support.

• Pressure to 'achieve' as a parent

• Conflicts between mothering and other roles (eg. work)

• Stigma about expressing difficulty or dissatisfaction with mothering

• Cultural differences which result in isolation and disadvantage eg. minority group, refugee, and immigrant experiences.

 

Taken with permission from The Post & Ante Natal Distress Support Guide

How to help yourself

• When in doubt, just take the next small step

• However bad a situation is, it will change.

• Get outside every day.

• Put some laughter and singing into your day.

• Put love and joy into your day, cuddle baby, hug your partner/friends, pamper yourself with a longer shower or bath, and put lovely photos of baby on your cell phone and round the house.

• Find out about relaxation and breathing and do it regularly.

• Notice the thoughts which keep you feeling anxious, sad, down, irritable and guilty and try to substitute them with ones that are more helpful.

• At the end of every dark tunnel there is light but you will need help to get there.

• Talk to someone.

Support Services

Mental Health Foundation of New Zealand
Web: www.mentalhealth.org.nz
 

Having Another Baby

Talk to friends about what they did. The best parenting advice you can often get is from people who have "been there, done, that". Like any advice use what works for you. Comments from other parents:

Jack and Charlie's Mum:

"Well before Charlie's arrival we made sure that we had moved Jack into his 'big boy bed'. We made a big song and dance about buying the bed and the cover. Jack also enjoyed getting out the toolbox to put the cot away ready for the new baby.

 

As Jack was sure that he was getting a new puppy and not in fact a brother we had a lot of groundwork to cover.

 

I made lots of books about Jack as a baby so that he learned what babies did (they were short books). We spent hours reading them before Charlie's arrival and once Charlie came he got out the books and showed me the pictures of Jack having a bath when I was bathing Charlie. The more that you include them the more important they feel I suppose. Other things I did was buy a gift Jack could give to the baby and one that the baby could give to him. Also gently suggest that friends buy something small for the eldest so they get a gift too, not just the baby.

 

When Jack came to the hospital to visit I made sure I wasn't holding the baby so he got lots of cuddles from me. Also if in hospital order the chocolate milk for breakfast and save it to give to your older chid... Jack was greatly impressed!"

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Jade and Deren's Mum:

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"Well I guess with me it was lot easier than some... Jade was too small to feel any jealousy however we did prep her up for a baby in the house. She knew what a baby was and we spent time playing with a plastic baby and looking after it. We also spent time with friends who had newborns. At her age we taught her how to be gentle, how to pat nicely and made her part of the routines, like bring nappy to mummy etc. She watched every move I made with Deren and knew what was going to happen next e.g. when Deren woke up and it was time for feeding she would bring mummy's breastfeeding pillow and give it to me. Praising is huge for toddlers and every time we did so she was gleaming!

 

Now, they are best of friends and look forward to the other waking up so they can play. We taught them how to play together and enjoy each others company, it's such a relief."

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I remember a teacher telling me that when she was pregnant one of the children in her primary class told the rest of the children to be quiet because the baby was asleep in the teacher's tummy. It is interesting the comments children come out with re babies. When I told my first child I could feel the baby kicking me, "he said that is a naughty baby for kicking you".

 

Books with pictures of babies and their basic needs can be helpful:

 

There is a baby in my Mummy's tummy.
One day soon it is going to come out.
When it comes out it is going to need...
A bath
Help to get dressed
Lots of drinks
Its nappies changed
Walks in the pram
Sleep
Playtime
To learn new things
And cuddles

 

It is a personal decision if you wish to have your children present for the birth. There is a video called "Sister for Hugo" which is a homebirth of a second child where the sibling is there. Hugo seems happy about being present though does make the comment at one stage "how much longer".

 

If you are going to have young children present it is a good idea to have someone who can look after them also so you don't have to take them to the toilet in the middle of a contraction.

 

"How can I love another child as much as the first?"... your heart expands

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Infant and Child Health

Although we never want it to happen, children and infants do have medical emergencies. These can be very stressful, especially if you are not sure what to do. Knowing how to react, and where to start, are key in keeping calm and doing the right thing.

 

The most critical emergency is when a child or infant's breathing stops. Often the heart stops beating as well. A range of things can stop a child breathing such as suffocation with a plastic bag, drowning or medical conditions. Sudden unexpected death in infancy (SUDI) is when a infant dies during sleep. SUDI is the new term for SIDS or cot death. It is the main cause of death of babies.

 

To reduce the risk of SUDI Plunket recommends to have:

 

• a smoke-free pregnancy and household

• on their back for sleeping

• a clear face and head free from hazards that can lead to suffocation

• to be close to parents when asleep (in the same room)

• breastfeeding.

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Medical care

 

Severe bleeding in a child or infant is serious because they don't have as much blood in their system as adults. Any severe bleeding must be stopped immediately. Direct pressure on the wound and elevating the wound if it is on a limb is the best way of stopping any bleeding. Call an ambulance or seek medical advice if the bleeding is severe.

 

Children and infants are smaller than adults which means parents and caregivers often take injured or seriously ill kids in their car to the medical centre or hospital. Unfortunately this can be very dangerous. Driving a car while your child is seriously injured on the backseat is a highly stressful situation and the likelihood of you crashing increases. Moving a seriously injured patient - whether an adult or child - can be very risky as the injury can be made worse. And, if something further goes wrong while you are on your way to the hospital, what will you do? If your child stops breathing do you stop and do CPR or do you carry on to hospital - delaying lifesaving treatment. Don't put yourself in such a position - simply call 111 for an ambulance!

 

One of the most difficult decision to make sometimes is whether you should call for help or not. Do you take your child to the doctor? Do you call an ambulance? It is important to realise there are people waiting to help you make that decision!

 

If your child is having trouble breathing, bleeding severely or is unconscious call 111 for an ambulance immediately. If something else is wrong and you are not sure what to do, get in touch with one of the following:

 

• Phone Healthline on 0800 611 116 available 24hrs/day. Healthline registered nurses assess a person's condition and health needs and recommend the best course of action and a time-frame in which to take action. They can also provide general health information and location of services.

• Phone Plunketline on 0800 933 922 24hrs/day. When you call PlunketLine your call will be answered by a Plunket nurse, who can give you advice and information on your child's health

• Call an ambulance on 111. The Ambulance Emergency Communication Centre can give you advice and will send an ambulance if required

 

You can always prepare yourself to cope with any emergency relating to your child. St John runs regular Child First Aid courses throughout the country. These four-hour courses focus on key things to do if your child becomes seriously injured or unwell. It is always better to be prepared!
Visit St John on www.stjohn.org.nz/training or phone on 0800 FIRST AID (0800 347782)

 

Parents who have had their baby in a Neonatal Units are often strongly advised to go to a CPR class. CPR classes may be run at your hospital, by St John, Parent Centre or by your Plunket nurse.

 

Your Well Child/Tamariki Ora health book has a helpful section on care for the unwell baby/child including first aid and CPR. Please read it before you need it.

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Sleep

With my second child I wasn't so stressed about getting her to sleep during the night. During her day sleeps I managed to catch up on missed sleep by having a nap at the same time. I hadn't done that with my first child.... I used to run around trying to tidy the house, cook do washing.... all the superwoman stuff. Then get up at night to feed. Of course I crashed after awhile with exhaustion.

 

Research says newborns normally cry a total of 1-4hrs/day usually pre feed and pre nap (for 10 minutes) and often have personal fussy time often late pm. Babies may take up to 10 minutes to settle off to sleep, may grizzle and cry before hand. Newborns sleep approx total of 16-18hrs in 24hrs. Sleep needs decrease over the first year.

 

They are waking at night because they need food and because they have not developed circadian rhythm. The circadian rhythm is our internal clock which controls sleep patterns, and it takes time to develop and then change into a long stretch of sleep.

 

Babies can't talk but they can communicate in other ways. Think about what you do when you are tired.?Signs of being tired include jerky movements, grimaces, grizzling, making fists, yawning, rubbing eyes, staring vacantly into space or crying. Signs of wanting a feed include hand to mouth movements, fussiness, sucking action or sounds, cooing or sighing and nuzzling at breast. With your first baby you may take some time to clue into these. You won't be the first parent to think if only they could tell me what they want then rush off to buy some book. Some books can be great, but don't forget to trust in yourself and take time to try and work out what your baby is communicating.

 

If they are crying think could they be hungry.... when did they last feed? When having a growth spurt (putting on more weight) they can feed often.

 

Do they have wind? Do they have a dirty nappy? If they cry a lot it could be colic or there may be a medical reason which needs checked out. My son used to be up a lot at night when he had an ear infection or was getting teeth.

 

A routine at night can help to settle babies and as they get older they get to know that this is a message that it is bed time. A bath and then massage can be relaxing for them. Keeping lights low and reducing the stimulation they get. Again think of yourself it is hard to relax and go off to sleep if there is a lot going on. Most of us need some wind down time before sleep and so do babies.

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Plunket nurses provide support through home and clinic visits, mobile clinics and PlunketLine, a free telephone advice service for parents (0800 933 922, 24 hours a day, 7 days a week)

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This information is not a substitute for professional midwifery or medical care. You should always seek the advice of your midwife, doctor or health professional for any concerns you may have regarding your health. Information and health practices change with ongoing research, the answers are to the best of our knowledge on the date this was written. All web sites mentioned above are independent thus we cannot take any responsibility for the accuracy of their content.

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