The Modern Midwife's Guide to Pregnancy, Birth and Beyond: How to Have a Healthier Pregnancy, Easier Birth and Smoother Postnatal Period

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Jane has many gifts of wisdom from her decades of experience in regards to birthing well. Not only is Jane and her school a wellspring of knowledge but she is a keen collaborator and her generosity to other groups and organisatins including ours is a testament to her ability to evolve our field and work together for a better future. Whilst women can self-refer into the service, it can be difficult accessing services when in need. Our team works closely with health professionals across the area to encourage them to refer mothers who may be at risk of social isolation. Postnatally, some with hEDS/HSD can struggle to recover from birth, both physically and psychologically ( Pezaro et al, 2020). For example, tissues compromised by hEDS/HSD can be problematic to heal ( Hakim and Grahame, 2003; Hakim and Sahota, 2006; Castori, 2012). Our previous review also highlighted specific complications in relation to abnormal scar formation, haemorrhage, pelvic prolapses which may be associated with episiotomy, deep venous thrombosis, complicated perineal wounds, and coccyx dislocation ( Pezaro et al, 2018). Complicated lacerations and increased episodes of postpartum haemorrhage have also been reported elsewhere ( Volkov et al, 2018), along with further episodes of coccyx dislocation and separation of the pubic symphysis ( Gilliam et al, 2020). Healthcare practitioners should be aware of the risk of these potential complications, along with the potential for increased risk of urogenital and pelvic complications such as recurrent urinary tract infections or incontinence, and gynaecological symptoms such as pain or prolapse ( Gilliam et al, 2020). As in the antenatal period, early physiotherapy based interventions along with early input from the multidisciplinary team may be useful in the management of such complications. In this interview, Jacqui shares her diverse and personal experience as a mother, including motherhood and work, creativity, and tuning in to your own wisdom in a world saturated with information. We also discuss Jacqui’s book ‘Mothers Mind Cleanse’ and hear about her own impetus and writing process. Enjoy this conversation Key to the success of this service is the local parents who have the passion, skills and commitment to train as Birth and Beyond Community Supporters and volunteer in their local community supporting other parents.

I would definitely recommend Hypnobirthing: Practical Ways to Make Your Birth Better by Siobhan Miller (founder of the Positive Birth Company). I was absolutely TERRIFIED of giving birth but [this book has] made me feel much more empowered and positive, even a little bit excited now!"(Recommended by Mumsnet user NicNac100) Our verdict Bears of Hope – Bears Of Hope Pregnancy & Infant Loss Support provides leading support and exceptional care for families who experience the loss of their baby. Bears of Hope has a great Facebook group for grieving parents. There is also one group set up just for Dads. http://www.bearsofhope.org.au/ Written specifically for men, this book is an excellent read for fathers-to-be who want to be more involved in their partner’s pregnancy or a good book to give to your other half to help them understand some of the physical and mental changes you’re experiencing during pregnancy.Many parents feel that while most practical and emotional support is available from family and friends, learning with other expectant parents is highly valued. Evidence suggests that parents need help to make sense of the emotional as well as the physical changes, the recognition of new responsibilities and implications for their relationships. This is particularly true when this is their first pregnancy. Anita believes, “It doesn’t just take a village to raise a child. It takes a village to raise a mama.” As a new mama, she sees how important it is to have a support team surrounding a woman during pregnancy, birth and beyond. She loves to collaborate with other birth, health and fitness professionals to help each women attain their health goals. The programme is an innovative peer support service that focuses on engaging and supporting women and vulnerable families.

Volunteers signpost to local services, accompany women to appointments or local services such as children’s centres, foodbanks or financial advice services, and provide vital non-judgemental listening and emotional support. There are a huge number of pregnancy books to choose from, some covering the entire pregnancy journey and others more specialist or niche in focus. Area of focus: Are you looking for one book that covers everything from conception to childbirth, or are you happy to read a book focused on a specific area such as nutrition, breastfeeding or labour? The management of hEDS/HSD in childbearing remains complex. Yet, considering the new approximate figure of 1 in 20 put forward for the proportion of pregnancies affected by hEDS/HSD, cases in maternity services should no longer be considered rare, only rarely diagnosed ( Pezaro et al, 2020). It is considered that the recognition of hEDS/HSD is now critical ( Tinkle, 2021). Though as outlined in our previous review, the role of the midwife in this context is not necessarily to diagnose cases of hEDS/HSD but to work in partnership with those affected as part of a multidisciplinary team in making evidenced-based care plans along with early and appropriate referrals ( Pezaro et al, 2018). Nevertheless, it may be useful for midwives to remain informed and alert to the possibility of many pregnancies occurring in people affected by hEDS/HSD who are as yet undiagnosed.

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Milli Hill is the founder of The Positive Birth Movement, a global network of antenatal discussion groups that championed positive births for all women. The groups aimed to create spaces for women to consider what they really wanted from their childbirth experience and to challenge any fears or negative expectations they might have. It starts with exploring the right time to add an additional family member and then goes on to give practical advice around introducing a new sibling, as well as how to actually cope as a mum to two children.

Some reviewers found the jovial writing style a little patronising, as it does assume very minimal knowledge about pregnancy The symptoms of pregnancy can be exacerbated by hEDS/HSD and vice versa ( Pezaro et al, 2020). Those pregnant with hEDS/HSD can experience disabling increases in joint laxity along with a variety of urogynaecological complications ( Gilliam et al, 2020). Pelvic pain and joint instability are common ( Lind and Wallenburg, 2002; Volkov et al, 2018; Ali et al, 2020) and pelvic girdle pain can be especially notable in the first trimester of pregnancy ( Ahlqvist et al, 2020). In our previous review, we promoted the need for early referrals to physiotherapy services and general practitioners in such cases ( Pezaro et al, 2018). Due to increased elasticity in the soft tissues of those with hEDS/HSD combined with increased levels of relaxin during pregnancy, our previous review also highlighted that the occurrence and severity of varicose veins and/or gastrointestinal reflux may be increased ( Pezaro et al, 2018). Such cases of problematic varicose veins may be managed with the use of compression hosiery and/or a referral to a vascular service ( Marsden et al, 2013). Increased gastroesophageal reflux may be managed via standard treatments. For those with hEDS/HSD, joint hypermobility and instability are generally best managed conservatively with the use of physical therapies, orthotics and avoidance ( Tinkle, 2021). She has worked with all ages, supported thousands of women and girls in their understanding and integration of menstrual awareness. Her widely loved online course, the Cyclical Living Immersion, has been received and celebrated by participants from around the world. Most recently, she has started an online container called ‘Altered’, a 4 week course exploring the liminal dimensions of menstruation. She is always tending budding projects as well as serving weekly tea ceremonies, continuing her deep studies and exploring under the guidance of her mentors Dr. Lara Owen and Moana Pearl. We researched the pros and cons of each pregnancy book, including its format, the complexity of the information and the reputations of the authors. Finally we looked at which pregnancy books worked best for each scenario to bring you our final list of recommendations. About the author Whilst not the most detailed of texts, and covering mostly pregnancy and pre-birth content, this is a lighthearted and informative read suitable for even the most reluctant of readers.Whether you’re preparing for your first baby, considering hypnobirthing, seeking guidance on eating well during pregnancy or simply looking for a lighthearted read to raise some much needed laughs, we’ve got you covered. Central to the programme is the training of and working with local volunteers to lead the peer to peer support programme, giving other new mums skills supporting others in their community. The functional state of the autonomic nervous system plays an important role throughout pregnancy, childbirth and in the newborn condition ( Atallah et al, 1999; Egliston et al, 2007; Dmitrieva et al, 2011). Postural orthostatic tachycardia syndrome (POTS) is a form of autonomic dysfunction that can cause orthostatic intolerance, with up to 78% of women with hEDS/HSD potentially affected ( Gazit et al, 2003). Significantly, in one study of pregnant women diagnosed with autonomic dysfunction, where autonomic dysfunction was present in 55% before pregnancy, this figure rose to 100% during pregnancy ( Taitubayeva et al, 2020). Those with POTS may also experience symptoms such as trouble concentrating, light-headedness, palpitations, fatigue, exercise intolerance, and in severe cases, syncope (fainting) ( Fedorowski et al, 2021). The authors of a recent review of the literature have determined that there is inadequate published evidence to confirm any relationship between hEDS, POTS and mast cell activation syndrome ( Kohn and Chang, 2019). However, others have argued that the overlapping symptoms of these conditions and their under-diagnosis means that the potential link should not be ignored, as clinical experts find these three conditions together commonly in practice ( Roma et al, 2018; Afrin et al, 2020). Such academic debates highlight the need for further inquiry. How might parents affected by hEDS/HSD be supported to engage in evidence-based decision making about their maternity care? The service is currently available to pregnant women or mothers with a child under the age of two living in one of the following areas:

Want to make a referral? See How can I access this support service? What is the Birth and Beyond Community Support Programme?

What to look for in a pregnancy book

Volunteers offer a kind, listening ear and can signpost and accompany women to services and organisations that may be helpful to an individual's circumstances. We find that this really helps to connect mothers with their local communities. The project regularly supports women who may have no recourse to public funds, who may be very isolated physically and emotionally, and who may be experiencing low to moderate mental health difficulties. Why is community support important? Breastfeeding for the first time can be incredibly daunting. Whether you’re worrying about feeding positions, the quality of your baby's latch, engorgement or simply if your baby is getting enough milk, establishing a breastfeeding routine can be really overwhelming, particularly when met with well-meaning but conflicting advice from friends and family. The programme aims to provide support to new mums and women from groups and communities who often experience day-to-day challenges and social exclusion. Some popular choices that have been tried, tested and recommended by Mumsnet members include Taking Charge of your Fertility and The Impatient Women’s Guide to Getting Pregnant, both of which focus on the steps you can take to prepare your body for pregnancy, monitoring your ovulation cycle and maximising your chances of getting pregnant. What books should I read in my first trimester?