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State of the Sprocket - shadows of echoes of memories of songs — LiveJournal
j4
j4
State of the Sprocket
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julietk From: julietk Date: February 24th, 2011 08:04 am (UTC) (Link)
Ani (now at 38 weeks so just ahead of you) is having both the iron problem and the back-to-back baby problem as well, so I've been doing some reading up on both for her! Http://homebirth.org.uk has a useful page on iron deficiency & its implications, if you want to read it. They quote some evidence that low iron in very-pregnant women is in fact normal & shouldn't be treated as concerning in the same way as it would in non-pregnant women (which is what tends to happen).

The NICE guidelines only count it as "low iron" & thus recommend a hospital when it's below 8.5; between 8.5 and 10.5 they recommend an "individualised assessment". Different trusts policies vary, of course (Southampton says below 10 they're unhappy with a home birth too). They can't actually refuse you a home birth if that's what you want - if you just stay home they are obliged to send someone - but whether you want to do that is a matter of personal preference, risk assessment, how strongly you want to be at home rather than in hospital, whether you (well, your birth partner!) is happy insisting... & so on. (A very strongly does not want to be in hospital, but she has a handful of specific personal reasons for that.)

Apparently 87% of babies who go into labour back-to-back turn during labour; lots of upright & forward-leaning positions in early labour seem to be the recommended option!

I have ongoing (since my teens) low-iron problems (obv not pregnancy-related) and have found that liquid Floradix works better than Floradix tablets and much better than regular iron tablets; also actually tastes quite nice (sort of fruity) and didn't give me any side effects. YMMV. Never tried Spatone (A has; no side effects but didn't make a difference either; she's now onto high-heam content fish & shellfish, so if you eat those you could try that?).

Good luck with the next few weeks!
j4 From: j4 Date: February 24th, 2011 12:37 pm (UTC) (Link)
They can't actually refuse you a home birth if that's what you want

Yeah, but I don't think a home birth would be much fun either if the midwives were resenting me & thinking I was an idiot for insisting on my entitlement to a home birth against their expert advice... :-}

Annoyingly, my GP (as I'd correctly guessed) didn't know that there was a cut-off point for a home birth -- he certainly doesn't think 10 is worryingly low though. I wish they had some kind of joined-up policy here!

I do strongly want to be at home, but part of the reason for that is that I don't want to have to waste all my energy fighting with doctors all the way through. :-( I wouldn't know how to begin insisting.

lots of upright & forward-leaning positions in early labour seem to be the recommended option!

Yes -- that's one reason why I really don't want to have to stay lying on my back while doctors prod at me... I just fear that if I'm forced on to my back then the baby won't turn and the labour will go on for far longer, I'll run out of energy and/or time and they'll just say "oh well, time to fetch the knives, can't have you taking up this bed any longer" etc. I know it needn't be like that, but there does seem to be evidence that every intervention just increases the likelihood of needing the next intervention.

high-heam content fish & shellfish

I thought you were supposed to avoid shellfish altogether in pregnancy because of, er, whatever it is. Though I'd be very happy for an excuse to start eating it again! I will try the Floradix since a few people have recommended it now...

Thanks for all the info & good luck to you & A.
julietk From: julietk Date: February 24th, 2011 02:28 pm (UTC) (Link)
I know quite a bit now about how to go about resisting pressure (of various sorts) to go into hospital; so if you do want any of the stuff I've dug out about it, let me know. A's and my attitude has been that she gets to make (informed) choices about her own body & baby & labour, & once she's done that, I get to be gatekeeper & deal with any external pressure against that (without distracting her, as she will be busy!). But yeah, it can be a bit of a balancing act & certainly *you* don't want to feel put under any extra stress. I'll let you know how it goes!

There is also the option of refusing further blood tests (if you're happy that you feel healthy enough etc). If they haven't got anything saying you're below 10, they can't act on it :)
claerwen From: claerwen Date: February 24th, 2011 10:24 pm (UTC) (Link)
Shellfish just has to be cooked thoroughly. And there might be a maximum amount you're supposed to have each week in order to avoid toxins that accumulate in filter-feeders, but I'm not keen enough on well cooked shellfish to have had to worry about that!
jvvw From: jvvw Date: February 26th, 2011 01:58 pm (UTC) (Link)
On the positioning side of things, my understanding is that it's much more important to know what to do about position once you are in labour - babies move a lot in labour and babies that aren't posterior can suddenly turn posterior and vice versa. Owen was ROA which wasn't ideal, but realised after a while that there wasn't any way he wasn't going to move, however much I did all the things that I was supposed to get him 'optimally positioned' and trying to do so was just not worth the effort.

I didn't really have choice for a home birth as I was classed high risk for labour from the start annoyingly (due to my height) and eventually decided that the stress of trying to persuade them let me have a water birth in hospital wasn't worth it, but could move about as much as liked during labour in hospital and wasn't on my back right until the last few minutes when I needed to be for various reasons. In fact I was quite impressed how much the midwives contorted themselves in order to do the periodic monitoring without disturbing me! So even in worst case scenario it might not be as bad as you imagine, though can understand why you would want a home birth.

I hate liver and am allergic to shellfish so didn't have the same dietary dilemmas as you. There was a blog called 'bumpology' that New Scientist ran last year written by one of their journalists who was pregnant that I seem to remember looked at whether there was actually any evidence for various of the recommendations, so could be worth looking there.
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