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

Product Information

Strategies that promote spontaneous pushing in favour of directed pushing for those with POTS are recommended ( Pezaro et al, 2018). Though for this group, decision making in relation to labour and mode of birth should be based on obstetrical considerations, rather than simply a diagnosis of POTS ( Morgan et al, 2018; Ruzieh and Grubb, 2018). Nevertheless, frequent monitoring of hemodynamic parameters may be advisable during the second stage of labour, as pushing, pain and fluid loss may result in a worsening of symptoms ( Ruzieh and Grubb, 2018). It may also be useful to consider the administration of early analgesia for those with POTS to reduce tachycardia and associated complications ( Morgan et al, 2018). To this effect, birthing environments that promote calm and relaxation will also be highly valuable. Postnatal care considerations As with previous care considerations ( Pezaro et al, 2018), it is recommended that those childbearing with hEDS/HSD should not be discouraged from birthing their babies vaginally. Yet, in one American cohort of 13 881 592, births to women with a variety of EDS subtypes, 910 were found more likely to be via caesarean section (OR 1.61 (95% CI 1.41–1.85)) compared to those without EDS ( Nicholls-Dempsey et al, 2019). Conversely, other evidence suggests that those with joint hypermobility, defined by a Beighton score ≥4 are less likely to birth via caesarean section or vaginally with the aid of instruments after complete cervical dilation [odds ratio (OR)=0.51; 95 % confidence interval (CI):0.27–0.95] compared to those without ( Knoepp et al, 2013). In any case, gentle handling of tissues and meticulous attention to haemostasis will be important in any surgical interventions. Optimal maternal positioning and joint support is also encouraged throughout labour and birth to avoid unnecessary trauma to joints and ligaments ( Pezaro et al, 2018). In cases where episiotomy would otherwise be clinically indicated, birth via caesarean section may be preferred to avoid an increased risk of pelvic organ prolapse ( Wiesmann et al, 2014). In terms of complications for those pregnant with hEDS/HSD, some can experience both high- and low-risk episodes ( Pezaro et al, 2018; 2020). In one study observing 13 881 592 births, pregnancies in those with EDS were found to be more likely to be associated with antepartum haemorrhage (OR 1.79 (95% CI 1.20-2.66)) and placenta previa (OR 2.23 (95% CI 1.29-3.86)) ( Nicholls-Dempsey et al, 2019). Although caution must be taken in interpreting these results, as the types of EDS included were not stated and findings are specific to the US, where the data was collected between 1999–2013.

Mum-of-three Jenny Wonnacott is a Content Editor for Mumsnet, specialising in writing, editing and optimising pregnancy care and child play content. Prepares you for some of the breastfeeding challenges you may encounter and how you can overcome them Not to be confused with hypnosis, hypnobirthing teaches a variety of relaxation and breathing techniques to help mums-to-be work with their body to make their labour a more calm and comfortable experience. With a focus on educating and changing your mindset, away from fear and negativity and towards enablement and empowerment, hypnobirthing has grown hugely in popularity over recent years. It's worth noting, however, that hypnobirthing does not guarantee a natural labour if that's what you want - unfortunately you can’t prepare for every eventuality and medical intervention is sometimes required. That said, using these techniques can help you feel calmer and more prepared about the prospect of giving birth. Filled with month-by-month guidance, information on birth plans and advice on preparing to support labour, this book can help dads feel more prepared and less overwhelmed, helping them navigate through some of their own personal fears or anxieties around parenthood.

There are some great options on this list, but if you’re looking for a great all-rounder that covers your entire pregnancy from conception to birth, The Positive Birth Book is a great choice. From conception through to those first daunting days and weeks at home with your newborn, the informal, friendly writing tone is both relatable and non-judgemental, and is presented in a format that is easy to read and digest.

In what ways are connective tissues affected for those with hEDS/HSD in childbearing, and what may be done to reduce the risk of any 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 Marie Louise has years of labour experience under her belt and a wonderful way of simplifying even the most complicated and overwhelming of pregnancy details into a format that is relatable and easy to understand. There can be a misconception that hypnobirthing can guarantee a natural labour (if that's your preference), but that's not the case