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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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? 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).

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. I really enjoyed Your No Guilt Pregnancy Plan by Rebecca Schiller (I used this to make my own birth preferences list as it lays out all of your ‘choices’ in one section which was really handy)"(Tried and tested by Mumsnet user glasspaw) Our verdict

Protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. It can be difficult to stop smoking, but it’s never too late to quit. Every cigarette smoked contains over 4,000 chemicals, so smoking when you are pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby. As a result, their heart must beat harder every time you smoke. 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 Yoga can benefit pregnant women in lots of different ways. Staying active through light exercise does your body and baby good, and Yoga for Pregnancy offers special benefits. Relax, sleep better, This book is REALLY good! It’s not patronising and it gives you a really good breakdown of what to expect and what’s going to happen and all your options from pain relief to cutting the cord."(Recommended by Mumsnet user MrsRose2018) In relation to the management of poor wound healing and anaesthetic coverage along with the additional risk of wound dehiscence in the postnatal period, our previous care considerations advocated the use of non-tension, non-dissolvable, deep double sutures, left in for at least 14 days in line with Chetty and Norton (2017), and individualised assessments of pain ( Pezaro et al, 2018). Frequent joint dislocations, along with difficulties in holding, caring for, bonding with, and breastfeeding can also further complicate parenthood for those with hEDS/HSD ( Pezaro et al, 2020). People with hEDS/HSD are at a greater risk of experiencing shoulder symptoms, which early findings indicate may be improved with strengthening exercises ( Liaghat et al, 2020). As such, there may be a heightened need to provide more bespoke, and practical postnatal care for those recovering from birth and engaged in early parenting with hEDS/HSD.

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/

Robin Grille Is a psychotherapist, psychologist, author, mentor, speaker, and educator. His work seeks to restore relationships to their natural flow and balance: include family relationships, partnerships, workplace relationships, and relationship to self. His work enlivens relationship to vocation, to community, and to the natural world that surrounds and nourishes us.

All adults need to be active and that includes pregnant women. Just 30 minutes of walking a day can help keep you and your baby healthy. What are your preferences?: You may already have some opinions and preferences about the pregnancy and birth experience you want, and this may dictate the kind of book that's right for you. If you have your heart set on a natural labour, a hypnobirthing book may be the obvious choice, whereas if you already know you're going to bottle feed, the breastfeeding specialism options may be ones to avoid. 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.Want to make a referral? See How can I access this support service? What is the Birth and Beyond Community Support Programme?