What If I Have Group B Strep When Pregnant?

Birth Is Birth However It Happens
Group B Strep In Pregnancy

What If I Find Out That I Am Group B Strep Positive?

So you have been riding the waves of early pregnancy and all things seem to be going quite smoothly. Next thing you know, you get the results back from a test you had done a month ago and you find out you are Group B Strep positive, what is next? Hopefully you will find this blog post helpful when navigating all things Group B Strep so please do read on.

 

What Is Group B Strep?

Group B Strep /  Streptococcus or Streptococcus Agalactiae is a bacterium that actually forms part of the normal flora of the human gut. This basically means that it lives within the human gut of plenty of men and women and the lower vaginal tract of women accordingly, without causing harm or disease.


Group B Strep is estimated to be present in the vagina and rectum of 2 – 4 in 10 women in the UK. Group B Strep does not usually cause symptoms however some women can experience symptoms if it is present in their urinary tract.

 

Group B Strep bacteria

In This Case How Is Group B Strep A Problem?

We can accept that Group B Strep generally is not a problem for the mother but how and why is it a problem for babies? 

Firstly babies have immature immune systems making it harder for them to fight off infection. This essentially becomes more of a problem the younger or the more premature a baby is. Secondly if a baby was to come into contact with Group B Strep it would likely make an entrance into the baby via somewhere where it does not form part of the normal flora i.e the lungs. 

Very rarely does a baby become infected with Group B Strep whilst in the womb as the membranes and amniotic fluid around the baby form an effective barrier against this. But if and once the membranes have broken and released amniotic fluid, this effective barrier is compromised and Group B Strep, if present in the vaginal tract can now reach and cause illness in the baby.

 

Is There Anything That Increases The Chances Of A Baby Becoming Unwell With Group B Strep?

  • Mother testing positive for Group B Strep 
  • Previous baby unwell from Group B Strep infection
  • Preterm baby (less than 37 weeks gestation at birth)
  • Maternal raised temperature or signs of infection in labour
  • Membranes broken more than 24 hours before baby is born

What Could Group B Strep Mean To A Baby?

It is fair to assume that many babies come into contact with Group B Strep during labour and or birth, and most of these babies do not become unwell as a result of this exposure.

An average of 43 babies a month (uk based numbers) develop an early onset Group B Strep infection where they become unwell as a result of the bacterium within the first week of their lives. (Late onset Group B Strep in the first 3 months of life is considered separately as antibiotic administration in labour has no benefit against this subset of the illness).

Of these 43 babies an average of 38 make a full recovery, 3 survive but with long-term mental and or physical disabilities and sadly an average of 2 die as a result of the infection.

These numbers do highlight that treatment for babies who become unwell with Group B Strep is highly effective, this may be relevant or important for some when deciding what to do following detection of Group B Strep in pregnancy.

 

baby receiving wellbeing monitoring

How Are Babies Monitored For Group B Strep Infection?

If someone who tested positive for Group B Strep in pregnancy, decides to opt for antibiotics in labour and receives it in a timely and appropriate manner then no monitoring of their baby is considered necessary. 

If someone declined antibiotics or received them less than 4 hours before they birthed, the recommendation is that their baby receives regular assessments of general wellbeing for the first 12 hours of their life. After this, and if they have remained well then the chances of their baby becoming unwell from Group B Strep is considered very low.

For anyone who had a previous baby who became unwell from Group B Strep, even if they received antibiotics based on recommendations, it is still considered most safe to have their baby receive regular assessments of wellbeing for the first 12 hours of their life also.

 

Intravenous antibiotics as preventative treatment against early onset group b strep infection in babies

Is There Anything More To Think About Here?

A problem commonly encountered around administration of antibiotics is with the timing of administration and how this is facilitated or guaranteed within the NHS in particular. This is something that needs to be factored into decision making around Group B Strep. Evidence suggests that unless antibiotics are given 4 hours or more prior to birth of the baby then they are not considered as effective. As a result the same length and level of observations for babies born in this situation are recommended after birth, before they are considered to have lower chances of developing an early onset Group B Strep infection if they remain well. 

Further difficulty lies with deciding on when to start intravenous antibiotics. When is too soon or too late? How long until someone’s labour starts? How easy is the person to cannulate? Who is available to cannulate? Is anyone free to check intravenous drugs ready for administration? When is this convenient to the woman? All of these things need careful consideration as they may impact on when antibiotics are administered and therefore how effective they are.

 

standard direct plating method to detect group b strep

How Is Group B Strep Detected? 

Group B Strep can be detected via traditional microbiological laboratory testing particularly through the standard direct plating method. This involves swabbing the lower vagina and the rectum, incubation of the sample on some agar growth medium and then identification or not of Group B Strep. This method usually yields results within 4 – 5 days give or take. It is also important to note that this traditional form of testing actually has around a 50% false negative result, so half of women tested for Group B Strep using this method are told they do not have Group B Strep at the time of testing when they do.

Another form of Group B Strep testing is called Sensitive Enriched Culture Medium (ECM) Testing. It is readily available privately however not widely available on the NHS (some trusts do offer this form of testing), I would imagine this is mostly due to it being more costly. It has a clear benefit of a quicker turnaround of results (by 2-3 days compared to traditional testing) alongside increased sensitivity and accuracy.

The other possible test is a polymerase chain reaction test, with a similar sensitivity to an ECM test, and very rapid results, the only downfall being it requires expensive equipment and therefore is not really used for this purpose and definitely not in the NHS.

 

Should And How Can Group B Strep Be Treated?

When detected in the mother, during pregnancy, Group B Strep is not treated (except if detected in urine especially if symptoms of a urinary tract infection are present), it is simply carefully noted for future reference. Current recommendations are that if Group B Strep has been detected at any stage of a current pregnancy or in a previous pregnancy, once labour commences or if membranes break, antibiotics should be commenced as soon as possible.

 

Why These Recommendations For Group B Strep?

So, when Group B Strep is detected in pregnancy for the first time, intravenous antibiotics in labour is recommended. The rationale behind this recommendation is as outlined previously in this blog, and mostly due to babies’ immune systems being immature. 

 

As for the previous pregnancies where Group B Strep was detected, more information and consideration is best… 

 

The first thing to consider here is whether or not the baby in the previous pregnancy, born to the mother who tested positive for Group B Strep, was affected or developed illness as a result of Group B Strep or not. If the baby was unaffected, evidence suggests that there is a 1 in 2 chance that Group B Strep might be present in the mother in subsequent pregnancies and the recommendation is actually to opt for an ECM test between 35 and 37 weeks of pregnancy to be able to better decide what to do. 

 

What If The ECM Test Comes Back As Negative?

If the ECM test is negative then the chances of the baby becoming unwell from Group B Strep early on after birth can be as low as 1 in 5000. For some this justifies not using antibiotics in labour but obviously some will still opt for it, it is a matter of personal choice.

 

decision making around group b strep in pregnancy

What If The ECM Test Comes Back As Positive?

If the ECM test is positive at this stage, then the chances of the baby becoming unwell from Group B Strep early on after birth is considered to be much higher, in fact as high as 1 in 400 and the recommendation remains to be administration of intravenous antibiotics in labour.

 

Surely It Is A No Brainer? Group B Strep Positive = Antibiotics

Currently the focus for avoiding illness in babies as a result of Group B Strep does indeed lie with antibiotics. Though receiving antibiotics may seem a simple win – win decision, for many it is not an easy one. Antibiotics do come with side effects and implications which extend to the baby also, such as the health and wealth of their fragile microbiomes or normal floras. And to make decision making around this harder, Group B Strep is considered a transient bacteria, meaning one time it may be present in someone’s body and another time not, with no control over or way of predicting when or how. 

The turnaround time for traditional Group B Strep testing is another problem. If someone has Group B Strep detected at say 15 weeks of pregnancy and they wanted to find out if they have it once their labour started, the results would not likely be back in time for the results to be used to inform a decision around receiving antibiotics or not.

 

considering the microbiome when preventing group b strep infection in newborn

 

So does the power lie with Enriched Culture Medium testing and resting decisions on this?

 

Or does the power lie with a fully informed and supported, autonomous decision? (Maybe even including an ECM test…) I will let you be the judge of this!

 

Learn more about antenatal midwifery care and support and what is available to you through The Nurture Mama Ltd, by clicking on the following link https://thenurturemama.co.uk/antenatal/. I am currently working on future services I will be offering for support with decision making, so please stay tuned. 

 

Now to finish with a quote by Sara Wickham, it summarises Group B Strep and decision making around this concisely.

‘The chance of Group B Strep disease is very small. The consequences can be serious.

It is always a good idea to get informed before you decide what’s right for you’.

– Sara Wickham

 

For more info on this topic, why not visit any of the following website pages:

 

https://gbss.org.uk/

 

https://www.groupbstreptest.co.uk/why-is-group-b-streptococcus-a-concern/

 

https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/group-b-streptococcus-gbs-in-pregnancy-and-newborn-babies/

 

Or if you enjoy reading books then have a look at the following book which you may find helpful when exploring the topic of Group B Strep in pregnancy

 

https://www.amazon.co.uk/Group-Strep-Explained-Sara-Wickham/dp/1999806425/ref=as_li_ss_tl?crid=3892VDEVJOIJ5&keywords=group+b+strep+explained&qid=1557207260&s=gateway&sprefix=group+b+stre,aps,151&sr=8-5-fkmrnull&linkCode=sl1&tag=sarawickham-21&linkId=a7e1784cd2d056fae5ad37f3762b1dc5&language=en_GB

 

Did you enjoy or find this blog post useful? Why not share it on your social media.

The Nurture Mama Ltd is a fully insured (through ZEST Health Innovation Consultancy Ltd), independent midwife service that offers Antenatal, Postnatal, Combined and Complete packages. Caring, supporting and empowering people throughout pregnancy, labour, childbirth and after birth – giving families complete continuity of care.

What Is Induction Of Labour?

Birth Is Birth However It Happens
Induction of labour

What Is Induction Of Labour?

I have decided that the first thing to discuss when exploring induction of labour is length of pregnancy and the famous due date. I believe this is especially important when it comes to an all healthy, good and well pregnancy, and often its careful consideration is overlooked even more so in this case. Almost as if we are ‘out the woods’ now or they are ‘well cooked’ now’,  and the baby coming sooner than not would not be such a bad thing and especially when the idea of the ‘failing placenta’ starts to get readily thrown about but that is another blog post on its own.

sterile gloved hands , induction of labour as an intervention in pregnancy

What Is An Estimated Due Date?

An estimated due date is literally an estimation of when a baby may be born, with the value lying in standardising everyone’s pregnancy length to in turn standardise care and timings of care, especially when maternity care has a duty of care and to so very many. Outside of this and with healthy, all good and well pregnancies, I often see no benefit of dating a pregnancy other than helping someone decide when to engage with maternity services.

How Is An Estimated Due Date Calculated?

Most commonly an estimated due date is calculated in one of two different ways and most likely both ways will estimate different due date dates. The first way people are most likely to have their estimated due date calculated is by using a due date calculator, which involves knowing the first day of the last menstrual period and then adding 280 days onto this date. This does not take into consideration any of the many variables in menstrual cycle length, ovulation timing, let alone the natural variations in length of pregnancy. 

 

first day of last menstrual period used when calculating estimated due date

The next way estimated due dates are calculated is through measuring babies size during an ultrasound scan. This is usually performed at a ‘dating scan’ around 10-14 weeks (by this means it is estimated well after calculating it using the above method, and it usually gives a different estimated due date). There is also a tendency for health professionals to go by estimated due date calculated by the ultrasound method over the above method and this is even if some are sure of all important variables.

 

pregnancy ultrasound scan measurements used when calculating estimated due date

 

When Might An Estimated Due Date Be Relied Upon For Decision Making?

Estimated due dates are commonly factored into decision making around induction of labour for whatever reason. And what is induction of labour? Induction in the simplest of ways, means to give rise to or start something. The next important word in the term induction of labour, is obviously ‘labour’ and this we can summarise appropriately as the process of childbirth.

 

What Consists Of Induction Of Labour?

The first thing to appreciate here is the when and how childbirth initiates naturally and therefore in the absence of induction. Evidence indicates that some key physiological changes occur coming up to and as late as the last 24 hours before labour begins. Let’s look at what some of these key changes are.

 

pregnant woman on ctg for monitoring during induction of labour by syntocinon infusion

What Are Some Of The Changes That Occur Before Labour Begins?

Firstly, we should explore the baby’s role in the onset of labour. Towards the end of pregnancy the baby’s adrenal glands (the glands that sit on top of the kidneys) start to release cortisol (the stress hormone). The purpose of this is to prepare the baby for the process of labour but also its adaptations to life earthside in the absence of the placenta. It does this by encouraging maturation of many major organs. For example cortisol helps to mature the baby’s lungs, something the placenta has been playing the role of throughout the baby’s time in the womb.

Once the organ maturation part of the process is complete the baby then sends a building block for oestrogen to the placenta. The placenta uses this to release oestrogen into the mother’s body, preparing her brain and body for labour. The really high levels of oestrogen in the mother help prepare her uterus for contractions, and increase the number of oxytocin receptors in the uterus, brain and breasts. All this contributes towards a well coordinated labour, birth and beyond. It also helps the mother’s body prepare for the physiological pain of labour and birth by priming pain relieving pathways and mechanisms within the spinal cord and brain.

baby in-utero with umbilical cord visible

Have You Noticed That The Cervix Is Often The Focus Point When Talking About Induction Of Labour?

Did you know that as explained above, the mother and baby both have equally important roles in creating the optimum conditions for labour to begin? And, that the cervix has no initiating roles in any of these? I am sure that the only reason why the cervix is the focus point for induction of labour within maternity care, is because it is more easily accessible and meddled with than, for example, the safely incubated baby.

The cervix undergoes important changes around the same time as the above mentioned, and all as a result of the higher oestrogen levels within the mothers body. The key factor in this being that the oestrogen levels in the mothers body are now higher than progesterone levels. Collagen within the cervix which is responsible for keeping the cervix firm and closed to serve as a protective barrier for baby, is now broken down by relaxin and prostaglandin also promotes softening and ripening of the cervix ready for labour.

 

What Are The More Readily Encountered Forms Of Induction Of Labour?

 

  1. Membrane sweep or stretch and sweep
  2. Artificially breaking of membranes releasing waters or amniotomy – Actually quite likely to occur during the above procedure
  3. Prostaglandin pessary or gel to ripen cervix
  4. Balloon catheter in cervix to mechanically stretch cervix open
  5. Syntocinon drip to stimulate contractions usually following procedure number 2 

 

Braun IV Infusion pump used for Induction of Labour with syntocinon

Whilst the above are the more commonly encountered methods of induction. Have you ever considered the fact that anything suggested as a way of bringing on labour, even if it is a more natural and potentially safer way of bringing forward labour and birth, it is still technically a form of induction of labour?… Not only does this undermine womens and babies innate abilities to know when the time to labour is right for them, but also all these options or things women could do to try and bring forward their labour and birth, sadly creates a feel that women should be doing something, or something more. That they are not quite enough or not doing things right,  if they are not successfully interfering or acting to control things themselves and that just being, or just trusting is not enough.

 

What Are Some Of The More Natural Forms Of Induction Of Labour?

I have listed below some of the more natural forms of induction of labour. Be warned once you have accepted this idea or grasped this different view of induction of labour there will likely be no going back for you. I am not ignoring the fact that induction of labour has a place within obstetrics, here I am talking about pregnancy and beyond when it is all healthy and well.

Here is that list of more natural forms of induction…

  • Exercise i.e brisk walking
  • Acupuncture or Acupressure
  • Reflexology
  • Castor oil
  • Spicy foods
  • Sexual intercourse
  • Nipple stimulation
  • Pineapple
  • Aromatherapy oils

 

clary sage aromatherapy oil can be used as a natural form of induction of labour

I will not be going into any specific detail about any of the above forms of induction of labour whether medical or more natural in this blog post. This post is more about induction of labour as a whole and as a decision that many people need to consider. 

 

How Can Women Best Consider Induction Of Labour?

The first thing to remember is something that remains true in any decision making situation, that is that no one can know what the best decision is for anyone, before they have decided for themselves and informed said person. And so very importantly in the case of induction of labour, anyone in a position where they wish to access support for their decision making around this, they should remember that they would be best supported by someone pointing them in the direction of well balanced, safe and appropriate evidence based information. Furthermore, they would be best supported by someone who helps them navigate all this important information. Lastly, a supportive and empowering environment is fundamental to holding safe and sturdy mother-centred space, and anyone can best encourage a truly autonomous and informed decision to be made by the person at the centre of this decision.

 

decision making

 

Learn more about antenatal midwifery care and support and what is available to you through The Nurture Mama Ltd, by clicking on the following link https://thenurturemama.co.uk/antenatal/.

 

I shall leave you with a quote by Rachel Reed during an interview with the Positive Birth Movement. If there is one thing that not only service users but also health professionals need to remember during induction of labour talks – it is this!

 

‘We need to start considering the woman as the expert regarding her body and her baby. Health professionals need to share information and support decisions without judgement, and respect the woman’s expertise’.

– Rachel Reed

 

For more information on this topic, why not visit any of the following website pages:

 

 

 

 

Or if you enjoy reading books then either of these books you may find helpful when exploring the topic of induction of labour

 

https://www.rachelreed.website/wim

 

https://www.amazon.co.uk/Your-Own-Time-medicine-controls/dp/1914465024?_encoding=UTF8&qid=1636221153&sr=8-1&linkCode=sl1&tag=sarawickham-21&linkId=432831dd479dbe8a95b0750b6afb28fe&language=en_GB&ref_=as_li_ss_tl

 

Did you enjoy or find this blog post useful? Why not share it on your social media.

The Nurture Mama Ltd is a fully insured (through ZEST Health Innovation Consultancy Ltd), independent midwife service that offers Antenatal, Postnatal, Combined and Complete packages. Caring, supporting and empowering people throughout pregnancy, labour, childbirth and after birth – giving families complete continuity of care. 

Birth Is Birth However It Happens…

Birth Is Birth However It Happens

BIRTH IS BIRTH, HOWEVER IT HAPPENS…

hospital birthAnd the birth was her story…

The collective, matricentric (mother centred), birth culture that over many many years, had been built and nurtured by women for women, upon foundations of generational, invaluable hands on experience and knowledge. It has over an equally lengthy period of time, been challenged and gradually phased out by being made less acceptable and accessible. Over time the safety culture within hospitals and the availability of pain relief for example meant that on top of it often being a sign of social status to access a doctor or man or male midwife for labour and birth care, it became increasingly appealing to birth in a hospital. 

Seemingly Growing And Changing Birth Needs…

The need for an ever growing and providing maternity service grew and with that came bigger boots to fill. Boots soon to be filled by men, making history of course. A need fueled by women being heavily perceived as the lesser gender, the flawed, good for one thing, but still not able to do this correctly. Furthermore, coupled with men dominating the medical field due to them being deemed more mechanically minded and better suited to studying and learning about and understanding the complex mechanism of the human body. Man soon became very acceptably ‘proficient’ in the previously female dominated ‘field’ of midwifery (and all things related) and they redefined it completely. 

caesarean birth

Machines Who Birth…

Women’s bodies were machines that needed controlling and childbirth well, this was just another mechanism performed by the machine. This machine with flaws, ultimately lead to the increase in the perceived need for interventions, instruments to assist or fix. All of this and more (which I am sure I will cover in another post) was instrumental in the up-rise in challenges faced by midwifery services still today. 

RE Birth Of The Midwife…

Core midwives, as they originally came, whether it be as a wise woman, gossips or women ‘with – woman’, are not so prevalent these days. However, the many important and empowering concepts attached to the original breathtaking Midwife prevail. And the very fact that these concepts prevail and are making a comeback, despite all the above, I think speaks wonders about true heart and soul, mother centred midwifery care. Value clearly remains and hopefully with strong drive and good direction, we can see that the original midwife is reincarnated.

Changing The Way We View Birth

The pivotal point at which I changed the way in which I view birth was not so long ago and I always think what a shame. What a shame that it took so long for me to appreciate the following incredible and life changing ideas. However all is not lost as I am really hoping that I can reach a few people through this blog post. One by one, together we can spread the word and the ideas to bring back pregnancy, birth and beyond, as we should all see it and experience it.

water birth

What influenced this change in the way you view birth? One influential woman, one incredible book and a few intense core labour and birth related experiences. The one influential woman – Rachel Reed, a midwife, author, educator and much more. An incredible book by the one influential woman – Reclaiming Childbirth as a Right of Passage. Those intense core labour and birth experiences – well they are for another blog post in itself.

A Better Way Of Viewing Birth…

We need to look at birth as it being the entire process the mother or birthing person navigates and goes through to birth their baby earth side. The noticeable changes, but also the more subtle yet powerful and often invisible changes. Some of the navigation may be prepared for or guided through, but a lot of it involves resigning to absolute trust in oneself and letting go or going with the flow of birth in its rawest form for each self.  

Cultivating Self Trust And Self Belief For Better Birth

Changes that occur on a physical level during labour and birth are indeed vast. They are often obvious or can be observed or kept track of, and are seemingly more reliable in terms of ‘monitoring’ birth as a textbook process, something we have come to do so readily. All too often the birthing person has not been empowered to trust in themself, or to recognise they are able to birth however birth happens for them. The next best thing for this person is to instead place this trust in the professional who is caring for them. The professional who has their best interest in mind, who can stay level headed at a time when they cannot, and who has been present at or assisted at many births so must surely be trusted. They resign and hand over a lot of power and control and seemingly rightly so. They then go with the flow of birth but under very different circumstances, and with different expectations and often consequences.

But What About The Physical Changes Of Birth?

Many of the physical changes along this universal journey of birth, does make each birth unique and it seems that this is what we should focus on when looking back and reflecting. But, there are so many more significant and powerful parts to birth, especially those that are spiritual, or transitions of the mind and soul, that if we focus on, most will find uniting, empowering and maybe even healing.

REframing Birth

Focusing on birth as a powerful transformation and rite of passage rather than a vaginal birth or a caesarean section for example, where their baby seen to be delivered or handed to them safely, or where they could not have done it without the help of a health professional or someone more experienced than them.  Reframing birth this way brings the truly miraculous and special feel of birth to the forefront.

Birth as a rite of passage…

Viewing Birth as a period of transformation or rite of passage between significant life stages, that is beyond our conscious control, encourages a pressure free and universalised visualisation and experience of birth.  It also encourages us to embrace the biological elements of the incredible transformation that are beyond any person’s control, rather than attempt to control, manipulate or predict them.

REclaiming Birth

Instead of trying to influence or manage women / birthing people, we should instead guide them, support them, lift them up, empower them and witness them. We should focus on the amazing things that happen, the powerful feelings felt and the often inconceivable limits pushed through in order to achieve the miracle that is birth. Coming away from the nitty gritty details of how a birth was achieved, the steps or stages, procedures and all the ‘mechanics’ involved in order to safely ‘deliver’ a baby to the mother or birthing person, and what or who helped it happen, is birth-changing.

mother centred birth

Birth will be birth no matter what…

Humans have birthed, birth their babies and will continue to do so, no matter what inventions, interventions or different means of birth arise or may be needed. Birth is in the least part a physical process and in the most part a powerful spiritual transformation that no one can touch or change.

I shall end this blog post with a quote I wrote, that I think summarises things nicely, thanks for reading!

 

 ‘Know yourself, Trust yourself

  Know your body and baby, trust your body and baby

  Know your strength, trust your strength ’.

 

– Sophie Robinson – Founder of The Nurture Mama Ltd –

 

For more info on this topic, why not visit any of the following website pages:

 

Additionally, I highly recommend reading this book yourself, it really is every bit amazing that I make it out to be!

Reclaiming Childbirth as a Right of Passage by Rachel Reed

Did you enjoy or find this blog post useful? Why not share it on your social media.

The Nurture Mama Ltd is a fully insured (through ZEST Health Innovation Consultancy Ltd), independent midwife service that offers Antenatal, Postnatal, Combined and Complete packages. Caring, supporting and empowering people throughout pregnancy, labour, childbirth and after birth – giving families complete continuity of care. 

 

What Is The Golden Hour After Birth?

Birth Is Birth However It Happens

What Is The Golden Hour After Birth?

The golden hour after birth is a way of referring to the precious time immediately after birth where incredulous, important and some long-awaited transitions are starting, continuing and completing.

Consider life inside the womb, warm and soft in feel, dark and soothing, comforting and very familiar after the time spent safely tucked away.

Depending on the birth environment, life outside the womb, after birth, is potentially very harsh in comparison and intensely different. SKIN TO SKIN, is the sturdy foundation of the golden hour after birth, it is a wonderful form of compensation and an investment, gently soothing baby and mother, and quietly nurturing the mother-infant dyad.

So the golden hour – skin to skin after birth, is something that can be done to ease babies transitions to the outside world, it therefore makes sense for it to be done as soon as possible after birth, and as naturally and peacefully as possible*.

skin to skin immediately after birth

When Is Best To Have The Golden Hour After Birth?

Achieving a golden hour as soon as possible after birth not only protects the baby but it also protects the mother, her birth preferences or choices such as mother infant bonding, delayed / optimal cord clamping, breastfeeding to name a few.

Who Might Benefit From The Golden Hour After Birth?

The benefits of the golden hour after birth are many, and that applies to both baby and mother. Labour and birth are orchestrated by hormones, adrenaline and cortisol are amongst these and when it comes to peaceful, this pair are not sought after. Oxytocin is the main hormone associated with the golden hour after birth and it has the added benefit of promoting maternal behaviour when uninterrupted.

Why The Golden Hour After Birth?

During the golden hour after birth we want to see a drive in the parasympathetic nervous systems of mother and baby. The parasympathetic nervous system is the network of nerves that encourages your mind and body to rest, leaving you feeling calm, settled and secure and allowing life sustaining body systems such as digestion to work effectively. This drive will allow the baby to better maintain a safe and comfortable body temperature but also heart rate, breathing rate and in turn blood sugars.

skin to skin whilst breastfeeding after birth

How Is It Best To Achieve The Golden Hour After Birth?

Skin to skin is by far the best way to promote and ensure these favourable conditions for a newborn baby. Skin to skin is best achieved by placing the baby on their front, completely naked, with the maximum amount of their skin against their mother’s skin. Placing babies head up on mum’s chest, in between her breasts has the added benefit of the baby being able to hear mother’s heartbeat and feel her warmth at the same time, in order to closely emulate the womb environment.

So How Does The Mother In Particular Benefit From The Golden Hour After Birth?

The mother can also benefit from the peaceful feel of skin to skin during the golden hour after birth, and the impacts it can have on the immediate environment. Secure and calm surroundings encourage natural physiology and important protective hormonal changes to occur in the mother setting her up well for her early postpartum transition.

As mentioned previously skin to skin encourages delayed optimum cord clamping, ensuring important components such as stem cells, iron and immunoglobulins, in the blood remaining in the placenta after birth, are transferred to the baby.

Skin to skin also protects breastfeeding, it assists with its initiation and builds a sturdy foundation for connected/responsive feeding and the recognition of feeding cues. Breastfeeding that was initiated early after birth tends to result in longer breastfeeding duration which brings with it even more benefits. In addition, if one was ever to experience or witness a beautiful ‘breast crawl’, (when a baby crawls to their mother’s breast themself and latches all by themself), a most likely extended golden hour after birth would be the time for this.

skin to skin after birth helps mother too

Natural hormonal changes, bonding, sniffing baby’s head, baby’s limbs naturally massaging their mother’s womb through the abdomen/from the outside, nuzzling or suckling at the breast, all are (if wished for) likely to occur during an extended and uninterrupted golden hour after birth and all assist in the natural expulsion of the placenta and reduce the risk of excessive bleeding after birth.

*It is important to mention that for some babies it may be recommended that they receive additional support or care, that in certain birth environments, may be difficult for the birth attendant to achieve with baby skin to skin.

Is The Golden Hour After Birth Enough?

An extended and uninterrupted golden hour after birth is absolutely something to think about during pregnancy and when considering your after birth preferences or ‘My ABC’s – beyond’.

Learn more about postnatal midwifery care and support and what is available to you through The Nurture Mama Ltd, by clicking on the following link https://thenurturemama.co.uk/postnatal/.

To summarise, if skin to skin after birth is something that you wish to do and you value its importance to you and your baby, then do consider unlimited GOLDEN TIME, it does not need to be any particular length of time, just the amount that you BOTH need to get the best and most from it. See it as a fantastic way of protecting your postnatal period in the same way that you protected your birth and you would protect anything of value to you.

I wish to draw your attention to a great quote by Sarah Buckley (Author of Gentle Birth, Gentle Mothering) who summarises the power of the GOLDEN TIME after birth perfectly…

‘Contact with you activates your baby’s parasympathetic nervous system – that switches off stress; enhances digestion, healing and growth, and imprints calm and connection’.

– Sarah Buckley

Your Golden Hour Inspiration

  • Why not take 4, 5 or more golden hours after birth?
  • Some uninterrupted and unlimited GOLDEN TIME after birth…
  • How do you wish your GOLDEN TIME to happen?
  • Did you do skin to skin?
  • Was your GOLDEN TIME magical?
  • How long was your GOLDEN TIME?
  • What things did you do to protect your GOLDEN TIME?
  • Did you start your breastfeeding journey with some golden time after birth?

Lastly, I wish to leave you with this very moving video by Waterwipes UK, which highlights some of the wonderful benefits of skin to skin after birth that I have covered in this blog post.

For more info on the golden hour after birth, why not visit any of the following website pages:

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The Nurture Mama Ltd is a fully insured (through ZEST Health Innovation Consultancy Ltd), independent midwife service that offers Antenatal, Postnatal, Combined and Complete packages. Caring, supporting and empowering people throughout pregnancy, labour, childbirth and after birth – giving families complete continuity of care. 

Why Choose Us As Your Independent Midwife

Why Choose Us As Your Independent Midwife

Are you curious about what an independent midwife does? Perhaps you’re thinking what an independent midwife can offer you that is different or better to what the NHS already offers. Or maybe you already know that you want and need an independent midwife; in that case, let me to explain why choosing me to be your independent midwife will be a wonderful journey for you. In this article, I will explain the need for independent midwives and what you can expect from The Nurture Mama.

Sophie Robinson is an independent midwife. She used to work for the NHS and then founded The Nurture Mama. She delivers the project to enable pregnant women and newborn mums to have full access to advice, guidance and support. She provides this service to enable pregnant people and fresh or new parents to have full access to evidence based, mindful and sincere guidance and support.

What is an independent midwife?

Sophie Robinson: “An Independent midwife like an NHS midwife, is there to be with woman, pregnant person, birthing person and parent. Provided, they are safe and effective, that they adhere to all aspects of the midwifery code of conduct, most significantly, independent midwives practise truly autonomously.”

the nurture mama

Why did you create The Nurture Mama project?

Sophie Robinson: “This is the primary reason I decided to change careers after working in the NHS for almost 12 years. The key to fully appreciating and empowering an individual’s autonomy, in my opinion, is practising truly autonomously, which is defined as taking responsibility for one’s own actions. You automatically respect everyone’s autonomy when you are aware of and grateful for the power of your own actions.”

She adds: “Being an independent midwife has meant everything to me. I can finally practise the kind of heart and soul midwifery that I have long yearned to. I have spent many years learning about, participating in, and respecting the NHS midwifery, yet I won’t miss it. When necessary, I am happy to collaborate with it, help improve an experience, and liaise with it, but when I work as The Nurture Mama, my whole focus is on ensuring people realise their incredibleness and develop their confidence – ensuring people trust in the power within themselves.”

How can I book your independent midwife services?

Sophie Robinson: “Firstly, Congratulations! In order to identify whether The Nurture Mama is the independent midwifery service for you, I recommend we have a relaxed chit chat and hopefully we will establish that we are compatible. My goal is to understand your needs first, then hopefully you will decide we’re right for one another.”

I completely understand this is a very important part of your life thus far, which means we must get to know each other to develop trust and understanding. My goal is to ensure that you are 100% comfortable and confident that I am the right independent midwife for you – we need to be at one and at ease with one another!”

What makes The Nurture Mama different?

Sophie Robinson: “Pregnancy, birth and beyond are all equally and incredibly significant. You may already feel quite strongly about what you need during these times and who you would like as your midwife in terms of personality and passions, I will endeavour to align with these. I truly believe that a strong and sincere relationship with one another is key to ensuring high standard of midwifery care, but most importantly the pregnant, birthing or postnatal person’s experience and satisfaction. Together, you can shape your pregnancy, birth and beyond (yes I meant you). I will be there to lift you up and guide you if needed, to witness you unleash your power and materialise your potential. At The Nurture Mama we value heart and soul midwifery.”

the nurture mama

Anything else?

“As with any relationship, things need to resonate, and all people present and a part of a relationship and journey need to be on the same wavelength to truly feel at ease. I believe that a strong foundation for harmony with all this is trust. Trust is also key to unlocking an empowering, positive and blissful bump, birth and beyond experience. Our values at The Nurture Mama are trust, kindness, patience and unity.”

Sophie Robinson concludes: “It’s important for me to get to know you, but you also need to feel as though you know me too – to develop a genuine and strong sense of trust between us. Therefore, in order to establish this solid foundation of trust, I would encourage you to feel at ease getting to know me as well. I pledge to be open and honest with you. It would be an absolute honour to travel beside you on this wonderful journey, and along the way, doing my best to nurture your self-trust is the least I can do.”

Did you enjoy or find this article useful? Why not share it on your social media!

The Nurture Mama is an independent midwife service that offers Antenatal, Postnatal, Combined and Complete packages. Supporting mothers and surrogates throughout pregnancy, childbirth and after birth – giving families complete continuity of care.