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Anxious Mums author, Dr Jodi Richardson, offers advice for mothers and children experiencing anxiety.

One in four people will experience anxiety within their lifetime, making it the most prevalent mental health condition in Australia. Statistics determine it is twice as common in women, with one in three, compared with one in five men, diagnosed on average.

Having lived and studied anxiety, Dr Jodi Richardson  is an expert in her field, with more than 25 years of practice. In addition to her professional background, it was ultimately her personal experiences and journey in becoming a mother that shaped the work she is passionate about. 

Jodi’s books, Anxious Kids; How Children Can Turn Their Anxiety Into Resilience,  co-written with Michael Grose (2019), and her latest release, Anxious Mums; How Mums Can Turn Their Anxiety Into Strength (2020), offer parents, in particular mothers, advice on how to manage and minimalise anxiety, so they can maximise their potential, elevate their health and maintain their wellbeing.

The more I learned about anxiety, the more important it was to share what I was learning.”

Jodi’s first-hand experiences have inspired her work today, stating, “The more I learned about anxiety, the more important it was to share what I was learning.”

Jodi’s first signs of experiencing anxiety appeared at the early age of four. Her first symptoms began in prep, experiencing an upset stomach each day. Her class of 52 students, managed by two teachers, was stressful enough, on top of her everyday battles. Jodi recalls, “There was a lot of yelling and it wasn’t a very relaxing or peaceful environment, it obviously triggered anxiety in me, I have a genetic predisposition towards it, as it runs in my family.”

Twenty years later, the death of a family member triggered a major clinical depression for Jodi. She began seeking treatment however, it was in finding an amazing psychologist, that helped her to identify she was battling an underlying anxiety disorder. Jodi discloses, “It was recognised that I had undiagnosed anxiety. I didn’t really know that what I had experienced all my life up until that point had been any sort of disorder, that was just my temperament and personality.” 

After many years of seeing her psychologist, Jodi eventually weaned off her medication and managed her anxiety with exercise and meditation. Offering advice on finding the right psychologist Jodi states, “For me it was my third that was the right fit. I really encourage anyone if the psychologist you were referred to doesn’t feel like the right fit, then they’re not and it’s time to go back to your GP. Having the right professional that you’re talking to and having a good relationship with is really important for the therapeutic relationship.”

Jodi highlights the importance of prioritising mental wellbeing, affirming, “The more we can open up and talk about our journeys, the more we encourage other people to do the same and normalise the experience.”

Anxious Mums came into fruition after a mum in the audience of one of Jodi’s speaking engagements emailed Jodi’s publisher stating, “Jodi has to write a book, all mums have to hear what she has to say.”

Everyday efforts new mothers face, consign extra pressure on wellbeing and showcase the need to counteract anxiety before it subordinates everyday lifestyles. While Jodi’s children are now early adolescents, she reflects upon the early stages of new motherhood, “Ultimately when I became a mum with all the extra uncertainty and responsibility, as well as lack of sleep, my mental health really declined to a point where I ended up deciding to take medication, which was ultimately life changing.”

When I became a mum with all the extra uncertainty and responsibility, as well as lack of sleep, my mental health really declined to a point where I ended up deciding to take medication, which was ultimately life changing.”

New mothers experience heightened anxiety as they approach multiple challenges of parenthood; from conceiving, through the journey of pregnancy, birth and perpetually, thereafter. Becoming a mother provided Jodi with insight into new challenges, in particular struggles with breastfeeding and lack of sleep. She shares, “It’s something that we don’t have much control over, particularly as new parents. We just kind of get used to operating on a lot less sleep and it doesn’t serve us well in terms of our mental health, particularly if there have been challenges in the past or a pre-existing disorder.

Research suggests women’s brains process stress differently to men, with testosterone also said to be somewhat protective against anxiety. This, along with different coping mechanisms of women, highlight statistic disparity between gender. For early mothers in particular, it is a time of immense change, as their everyday lives are turned upside down. New schedules, accountability and hormonal changes increase the likelihood of anxiety and depression, which are also commonly triggered in the postpartum period.

Jodi elaborates on important hormonal timeframes that shift women’s mental wellbeing stating, “Anxiety is heightened during times of hormonal changes as well as in the key points in our reproductive lives. Through having children and menopause and alike. It’s more disabling in that it impacts our lives in different ways to men, particularly I think, because we’re usually the main carers. There are stay at home dads, but predominantly that’s what women tend to do.”

Normal anxiety is infrequent and settles down, but when someone suffers a disorder, they can have incessant worry and avoidance. This can include anxiety around not wanting to participate, attend a function, for example, try something new or step up in a work role. Anxiety disorders can be crippling, leaving sufferers feeling as though they are unable to live their best life.

There’s no harm in going and asking the question because the gap between the first symptoms of anxiety and seeking help is still eight years in Australia.”

There are many telling physical signs and symptoms of an anxiety disorder. Some indicative signs to look out for include a racing heart, trembling, sick stomach, frequent perspiration and dizziness that accompanies shortness of breath. Jodi says, “If you think that your anxiety might be a problem, that’s absolutely the time to go and make an appointment to see your GP. There’s no harm in going and asking the question because the gap between the first symptoms of anxiety and seeking help is still eight years in Australia.”

“Half of all mental illness comes on by around the ages of fourteen. Most adults who have anxiety can track it back to when they were teenagers or children.”

Just as anxiety is common for mothers, it’s also important to observe and be aware of in children. Jodi reveals, “For parents it’s important to know that half of all mental illness comes on by around the age of fourteen. Most adults who have anxiety can track it back to when they were teenagers or children. 75 percent of all mental illness comes on by about the age of 25, with one in seven children [4-17 years old] being diagnosed with a mental illness, and half of those have anxiety.”

“75 percent of all mental illness comes on by about the age of 25, with one in seven children [4-17 years old] being diagnosed with a mental illness, and half of those have anxiety

These pre-covid statistics highlight significant numbers of anxiety in adolescents. However, with the current climate prevalent of immense loss of control, many are facing new heightened emotions and increased numbers of anxiety. Early research coming out of Monash University is showcasing significant growth of adults with depression and anxiety, including statistics of children in the early ages of one to five experiencing symptoms.

Similar research has given light to evidence portraying children mirroring stress responses of their parents. Jodi further explains, “They can pick up the changes in our own heart rate, in our stress response — we are told that as new mums aren’t we, that our babies can pick up on how we are feeling but the science proves that to be true as well.” Parenting is a consequential way in which children receive cognitive biases and behaviours, “Just the tone of our voice, the expressions on our face, the way that we speak, what we say, certainly can be picked up on by kids and mirrored back.”

Noticing these early signs in your children is essential to alleviating anxiety before it progresses, Jodi lists some signs to be aware of, “Avoidance is a hallmark sign of anxiety — I don’t want to go, I don’t want to participate, I don’t want to deliver that oral presentation in class, I don’t want to go to camp and so watching out for that sort of thing. Other signs and symptoms to look out for include big emotions. If your children seem more teary or angry than usual, are feeling worried or avoidant, can’t concentrate, having trouble remembering or difficulty sleeping.” It’s important to be aware and help counteract anxiety when you see it. 

Jodi offers parents, who are struggling coping with their children’s anxiety some advice stating, “It’s an age old question, how much do we push and when do we hold back; I think as parents we are constantly answering that question. We don’t always get it right, but the thing about avoidance is it only makes anxiety worse. So for the child who is anxious about going to school, the more they stay home, the harder it will be to front up on another day. Sometimes, we need to nudge them forward in small steps and that’s a technique called step-laddering. It’s about making a step in that direction.”

Jodi encourages parents to observe their children’s symptoms and to never feel ashamed to go see a GP.  She urges, “Sometimes we get that reassurance from a GP, it might just be developmental, but the sooner kids are getting the help they need, the better, and it’s the same for us as mums.”

There are simple everyday steps we can take to combat anxiety. When someone is anxious a threat has been detected within the brain, this part of the brain is called the amygdala, one of the most powerful strategies for managing this stress detection is regulant meditation. 

Jodi explains, “What meditation does is it brings our attention to the present, so we are paying attention to what’s happening in the moment.” Meditation recognises deliberate breathing with a focus equally on exhalation as inhalation, proven to be calming to the anxious brain, using the relaxation response. 

Commending the importance of the practice and its effect on functioning, Jodi describes, “Meditation is more that sort of seated and formal practice of focusing the breath. What we know this will do over time, is it reduces the size and sensitivity of the amygdala, so it’s less sensitive to threat which reduces long-term anxiety. For the average person, our minds wander around 50 percent of the time, when we can bring our attention back to the present we are much more likely to be able to settle our anxiety, and feel happier as well.”

Another everyday strategy for combatting anxiety is exercise. Jodi shares her experience and routine stating, “Exercise is something I’ve used my whole life to calm my anxiety. Even now, I do cross-fit, karate and walks every week. I think naturally I was managing my health and wellbeing without really understanding why, I just knew that it made me feel good.”

The fight or flight response tied to anxiety powers us up to fight physically to save our lives or to flee. So often, when someone is anxious, they are powered up in this way, but not doing anything about it. Jodi shares, “When we move, it’s the natural end to the fight or flight response. Not only that, when we exercise we release serotonin, which is a feel good neural transmitter, among with gamma aminobutyric acid, a neural transmitter that puts the breaks on our anxiety response helping to calm us down.” 

Jodi’s practice in physiology, working with clients using exercise to help them with their mental and physical health has led her to her understandings, “One of the things I can 100 percent tell you is that it’s best not to wait until you feel motivated — the motivation will come once you get into the routine of it.

Dr Jodi Richardson, anxiety & wellbeing speaker, bestselling author & consultant

I’d just like to say, anxiety isn’t something we need to get rid of to really be able to thrive, to do what we need to do and accomplish what’s important to us. But I really encourage to anyone, that there are lots of ways to dial it back. I think it’s very easy for us to wait until we feel 100 percent to do something, but doing anything meaningful is hard.

So don’t wait until your anxiety is gone because you might be waiting a long time.”

 

 

 

 

Anxious Kids Penguin Books Australia, Author: Michael Grose, Dr Jodi Richardson RRP: $34.99 Anxious Mums Penguin Books Australia , Author: Dr Jodi Richardson  RRP: $34.99

 

 

 

 

 

 

 

 

 

 

If you or someone you know is in crisis and needs help now, call triple zero (000)

Lifeline:  Provides 24-hour crisis counselling, support groups and suicide prevention services. Call 13 11 14, text on 0477 13 11 14 (12pm to midnight AEST) or chat online.

Beyond Blue: Aims to increase awareness of depression and anxiety and reduce stigma. Call 1300 22 4636, 24 hours/7 days a week, chat online or email.

Kids Helpline: : Is Australia’s only free 24/7 confidential and private counselling service specifically for children and young people aged 5 – 25. Call 1800 55 1800

To learn more about Dr Jodi Richardson’s work, watch the full interview below or on our YouTube channel.

 

 

A brief guide to some of the most common foods women crave during a nine-month pregnancy cycle. 

Pickles, grapefruit, and ice cream. A sub-par combination for most, but a delicacy for one with pregnancy cravings. Although women will often experience some type of food cravings or aversions throughout the first, second, and third trimesters of their nine month cycle, little is known as to why women crave certain flavors, textures, and food combinations when expecting but not post-partum.

Top food cravings during pregnancy:

  1. Chili Peppers. Spicy foods are a popular craving among pregnant women. One theory suggests this is because the body is often in need of cooling down during pregnancy. Eating spice generates the effect of cooling down on the body, triggering a craving for a particularly distinct taste.
  2. Dark Chocolate. Both rich with antioxidants and flavour, dark chocolate satisfies pregnancy’s increased caloric needs.

    Woman enjoying a slice of chocolate cake.
  3. Vanilla Ice Cream. Also in line with the idea that the body is always looking to cool down, some suggest ice cream not only satisfies a sweet tooth, but is also high in calcium and iron. This rich ingredient is a popular craving for these nutrients. There are however, other, healthier options available to satiate a craving for calcium or iron (i.e. kale, almonds, fish).

    Woman in sunglasses enjoying a cup of vanilla ice-cream.
  4. Pickles. Along with the usual salty suspects, foods like potato crisps and pickles are a response to an increase in blood volume because they are high in sodium.
  5. Grapefruit. Sour citrus fruits such as lemons, and others such as grapefruit are low in natural sugar and high in vitamins and nutrients like vitamin C. This craving supports the popular hypothesis that the body craves food in which it is deficient.

    Sliced grapefruit on chopping board and plates.
  6. Rice. Starchy foods such as potatoes, pasta, and bread are popular cravings. Rice is a particularly interesting one because some research suggests it is culturally dependent. For instance, women in the Untied States are more likely to crave highly palatable foods such as chocolate, while women in Japan tend to crave rice. This suggests something to do with country specific cultural expectations about food and pregnancy.
  7. Dirt and clay. Yes, sometimes pregnant women crave non-food items such as ice, dirt, clay, soap, or chalk. These are unsafe to consume and may hint towards an iron deficiency. In more extreme cases, where the body cannot obtain certain vitamins or minerals from food substances, the body can develop Pica.

Why do pregnant women get food cravings? 

Woman eating a serving of hot noodles.

Pregnant women with food cravings or aversions does not last post-partum. This begs the question as to why pregnant women have a tendency to change their appetite for certain foods during pregnancy. Here a few hypotheses:

  • A popular suggestion is that pregnant women crave foods they themselves, or the fetus, have a deficiency in. The body craves what it lacks. For instance, a rare craving for citrus fruit such as Oranges might be a lack in Vitamin C, etc. An obvious link is the body increases a need for certain vitamins and minerals during pregnancy and expresses their absence in diet through cravings.
  • Others have suggested cravings and aversions to specific foods also have something to do with the manner in which pregnancy hormones can affect senses such as taste or smell.
Woman enjoying a meal of tacos with chillies.
  • Some scientific research has also suggested that although popular belief looks at biochemical justification for food cravings during pregnancy, they differ from country to country. Women in Japan for instance, had a higher reporting of craving starchy food like rice, whereas women in the United States had a higher case of craving for highly palatable foods such as fries, chocolate, and sweets. Indeed, this suggests cravings may have something to do with physiological factors or culture. This hypothesis challenges the idea that hormone levels influence food cravings.
Woman in pink enjoying ice-cream in a cone.
  • Some old wives tales suggest the baby’s gender has an influence on the types of cravings their mothers have. For instance, citrus cravings have often been associated to girls. Others suggest craving salty foods means the baby is a boy, whereas craving sweet foods means the baby is a girl.
Woman taking a bike into a sour lemon.

Side note: The only legitimate way of predicting a baby’s gender is through a skilled sonographer recommended by your doctor.

Whether a craving for ice cream means the body needs to cool down, or one for lemonade means one is having a baby girl, we still do not know enough about why women crave certain foods when they’re expecting. What is for sure, is that some foods are just not meant to be consumed at the rate some pregnant women crave during their cycle.

A happy couple presenting their sonogram.

 

After an early miscarriage and PCOS diagnosis, Chantell Davis experiences an “unbelievable” double pregnancy.

I trust that this story will bring hope to those who have struggled with infertility and know that miracles do happen…

Kevin and I got married in 2008, and we were excited to start a family. A year later, I was pregnant with our firstborn son. It was a wonderful experience, and our healthy boy, Evan, was born early 2010.

Once Evan was a year old, we hoped to conceive again; to have our children close together. I noticed various alarming symptoms, like hair loss, adult acne, weight gain, and no monthly cycle. We decided to consult the Gynaecologist, who confirmed after a series of tests that I have PCOS (Polycystic Ovarian Syndrome). PCOS is one of the leading causes of infertility in women, and the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation).

This news was such a shock and certainly unexpected, since I was in the prime of my life. We immediately reached to the Lord and have a firm belief in Christ’s healing power. We were convinced that miracles do happen. The doctor advised that I use fertility treatment to aid ovulation, but Kevin stated that he would prefer we don’t use any medication.

Kevin said: “If we are going to have another baby, God will do a miracle in your womb.”

We stood on the Word and feasted on every scripture regarding children and multiplication. A lady gave me a prophetic word, stating that “the fruit of your womb will be fruitful.” The Lord in His mercy provides all kinds of promises which one can hold on to when you are going through a journey of uncertainty. (Psalm 23:4)

While we were trusting to get pregnant, I recall Kevin having a vivid dream where he saw two cribs and two babies wrapped in blue blankets.

Around August I had a chemical pregnancy (an early miscarriage) which was very emotional. Two weeks later, I felt under the weather, and when the symptoms did not subside, we opted to visit Pathcare for a blood test. The staff knew us by name at that stage. I truly did not want to see the results since I was afraid of another disappointment. Low and behold, Kevin brought back a positive lab result sheet, stating that according to the HCG count, I was pregnant.

We were over the moon and made an appointment with the Gynaecologist, Dr Seton. During the scan, he detected a single yolk sac and strong heartbeat and after doing the necessary measurements; congratulated us on the new baby that is on the way.

This miracle overjoyed us… I recall sitting in the car after our appointment, Kevin and I both teary, yet thrilled to finally be pregnant.

We studied every little part of the sonar picture – falling in love with the tiny baby.

Kevin reminded me of the “blue-blanket dream,” and we chuckled as we knew it was merely a dream

1st Ultrasound Scan

Around 11 weeks, I had severe back pain due to a pinched nerve and visited my G.P, for an injection. I was so keen to see our baby’s growth and asked him to do a scan for me since he had a sonar machine in the consultation room.

His eyes widened as he took my file, and started asking questions about the pregnancy. I was getting worried, when he smiled and turned the screen to show me what he saw. Right there, in black and white, were two active little babies.

This was almost “unbelievable.” In absolute shock, I broke the news to Kevin.

The following day, my gynaecologist confirmed that we are carrying twins and that it was a rare case where the smaller twin was conceived more than a week after the other. Hence the single heartbeat detected initially and the difference in size between the two.

11 Week Ultrasound Scan

This is an extremely rare case, called “double pregnancy,” also known as Superfetation.

A recent article in the U.K (Mail Online) mentioned that chances are “1 in 600 million” for this to happen. There have been less than 20 cases recorded globally, mostly after using fertility medication. It was unusual in our case however, since I was not on fertility medication.

Our boys were born on 2 May 2012 via C-section. They look entirely different. One is tall, dark-haired and has a large build; the other shorter, blonde and distinct in personality and temperament.

In 2016, God again blessed us with another baby boy, Chad.

Our household is extremely busy, very loud and competitive, but full of love.

The twins are currently 8 years old. Colin is 5cm taller than Nathan, their personalities differ completely, and even in their build, they have a 12kg weight difference.

I trust that this story will bring hope to those who have struggled with infertility and know that miracles do happen…

Chantell Davis and Family

 

 

 

Recent years have seen an increase in the number of women freezing their eggs for future use, establishing a trend that can be seen across every state in Australia. Over this time clinics themselves have also made information regarding the processes behind egg freezing and IVF more accessible to the wider general public.

In the two years from 2016 to 2018, national Australian IVF clinics have seen a 48% increase in the number of women freezing their eggs. This incredible increase of nearly double that of previous years has been the result of a number of social and economic factors, as well as the increasing knowledge of the methods behind the process of freezing eggs.

What is egg-freezing?

Originally, freezing eggs was an option available for oncology patients who were about to undergo cancer treatment, designed to protect their chances of fertility in the future. However, over the last 20 years there has been an increased interest in egg freezing by the general population. Treatment is now available to anyone, regardless of health conditions or potential future fertility problems. As women have a finite number of eggs, which decreases dramatically after the age of 40, egg freezing has become popular for those choosing to start families later.

Frozen eggs can be stored for many years; in some cases, a pregnancy has even occurred after the eggs have been frozen for 14 years.  When women are ready to use frozen eggs, the eggs are warmed, fertilised with sperm and then if an embryo develops it will be transferred to the woman’s uterus through IVF processes.

Why are so many women considering freezing their eggs?

In times gone by, the majority of women were married and had started a family by their twenties, with only 23% of the female population in 1991 having their first child over the age of 30. This figure has since increased to 48% by 2016. While the prime fertility age for most women being on average between the ages of 20 and 35, some women are not ready to become mothers at this age.

There are a number of reasons for this. Some women have not met the right person who they would like to start a family with, others have chosen to focus on careers and establish themselves in businesses which (depending on the individual) they feel leaves them little time for both dating and motherhood. Other women who would consider having children may have experienced a change in relationship status or the ending of a long-term relationship, and are re-assessing when they will meet someone new who they might want to have children with.

The process of freezing eggs

Women undergo a self-administered hormonal stimulation for 10 to 12 days which enables 6 to 15 eggs to mature. Stimulation comes in the form of an injection which can be done at home after instruction from the clinic. The only currently known side effect from the stimulation is cases of mild bloating.

The eggs themselves are then collected from the ovaries using a probe guided by ultrasound. This part of the procedure is carried out under light-to-general anaesthetic, with the patient usually allowed to go home one to two hours afterwards.

Once the eggs are in the laboratory, they are frozen through a procedure called vitrification. Vitrification involves the rapid freezing and extraction of all fluids to prevent damaging ice forming on the eggs. Once this is completed, the eggs can be stored for many years.

 

Pregnancy rate after freezing

Success depends on the quality of the egg at the time of freezing. The health of eggs can be negatively affected by:

  • Age and individual genetic makeup.
  • Smoking, poor diet and obesity.
  • Chronic medical conditions (including diabetes and high blood pressure).

On average, for every 10 to 15 eggs that are frozen by someone under the age of 35, 1 pregnancy could be expected. For women 35 years old and under, 1 stimulation cycle (collection of 12-15 eggs) will produce between seven and nine eggs suitable for freezing and storage

  • Approximately 80-90% of these eggs survive the warming process.
  • Approximately 50-80% of those surviving eggs would fertilise.
  • Approximately 80-90% of fertilised eggs develop into an embryo.
  • 1 single embryo has a 20-30% chance of developing into a pregnancy.

A simple blood test can be done when a woman is in her thirties to assess her fertility before undergoing egg freezing. However, IVF Australia reminds us, don’t leave it too late!

Financial Costs

Medicare and other government subsidies are available, but they will only pay for fertility treatment when there is a medical indication. Individual cycle costs vary according to circumstance as well as clinics across the country.

Mahsa Fatantoni of NewsDaily did an investigation into the costs of the procedure in 2018. Her figures indicate the following:

  • Between 2016 and 2018 there was a 48% increase in the number of women freezing their eggs.
  • In Melbourne clinics their patient numbers doubled in the space of two years.
  • IVF Australia in 2018 cost $6885 per cycle of freezing.
    • This did not cover the cost of the hormonal stimulation which can run into the $1000s.
    • There is an additional $500 per year storage cost for the eggs
    • The cost for thawing, fertilising and transplanting the eggs (IVF) is $3650.

These figures vary from clinic to clinic, with Melbourne IVF costing nearly $2000 more for the egg cycle than IVF Australia, but with a lower per year storage cost.

 

IVF Australia’s medical director, Associate Professor Peter Illingworth, says,

If women wish to freeze their eggs, they should regard it as a backup and not as the main plan.”

Dr Rozen of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists says that it is not usually necessary for young women, particularly those in their early twenties, to freeze their eggs as they usually fall pregnant naturally.

 

Precautions taken by medical staff left new mum, Jess Bowen, feeling traumatised, “diseased” and excluded during her first birthing experience.

 “I felt like I was diseased. The doctor would whisper to the nurse that I should have my mask on like I had the Corona Virus. It felt awful.”

Credit: Jess Bowen

Melbourne mum and hairdresser, Jess Bowen, gave birth to her first baby on the 28th of March this year, when the pandemic was beginning.

“My pregnancy was wonderful. I didn’t have any complications and I was excited to give birth,” shares Jess.

At Jess’s final appointment with her midwife, protein was found in the urine indicating pre-eclampsia, whereupon she was admitted into the hospital and immediately induced.

Jess laughs about not having enough time to gather her things, pack a bag or worst of all, “put on fake tan”.

Being a new mum is stressful without the added pressures of a global crisis. Jess describes her experience at the hospital as “traumatic”. She says the nurses were cold and “on edge with Covid happening. This made them short and abrupt.”

Once admitted, Jess was induced using a Foley Bulb induction, commonly known as the “Balloon Method”, where a Foley catheter is inserted into the cervix and is inflated, with sterilised water or air, over a period of time to help the cervix dilate for birth.

The nurses monitored her during the process by checking her dilation using their fingers. “It felt awful,” Jess recalls. “There’d be no warning. Just enter the room, stick their fingers in and would be disappointed because I wasn’t dilating fast enough. They weren’t reassuring me so it would just make me feel anxious.”

Credit: danielledobson_photographer

Eventually, the doctor arrived to examine her.

“He was really quite abrupt and rude. He basically told me that I had a disease (referencing her pre-eclampsia). I’m a new mum and it’s not really something that I want to hear. He just said I have a disease and we have to get this baby out.”

Jess says at one point she coughed to clear her throat, and the doctor immediately pulled the nurse aside and whispered, “she should have a mask on”.

“It was horrible to hear that. I felt so excluded and was already feeling disgusting from when the doctor called me diseased earlier.”

Jess can’t help but think how her experience may have differed if she wasn’t giving birth during these unprecedented times.

Jess rarely saw the doctor after this. Any interactions from the medical staff were limited until she was ready to deliver. After a day of the Balloon, she had only dilated one centimetre and needed to try another method.

Credit: danielledobson_photographer

 

Jess speaks highly of her head midwife, Jenny, throughout this process saying, “She was out of this world amazing, overall an experience from having that doctor, she made it so much better.”

She was then induced through the use of Oxytocin, which is a synthetic hormone that is administered through a drip in the arm to start the contractions.

Jess describes these contractions to be the most painful thing she’s ever experienced before.

 

“Immediately I felt anxious. I felt really depressed. They basically said to me that I needed to try, because at this point, I was feeling deflated and wanted to have a C-section.”

A few hours after starting the Oxytocin, Jess felt a sharp pain to the right of her stomach and had the urge to go to the toilet. The head midwife checked her and told her that she was three centimetres dilated. Jess immediately asked for an epidural, which was a 15-minute wait. During that time, Jess says she dilated 10 centimetres and was ready to deliver.

Jess went into shock and was crying through “the worst pain of her life”.

“Throughout the pushing process, I didn’t opt for any gas or pain relief because I was in such shock. It was a traumatic experience for me with everything that was going on and the treatment of the staff with Covid-19. It was frightening.”

Jess finally gave birth to her beautiful girl, Isla. Fortunately, she had her partner with her through this process.

Credit: danielledobson_photographer

“No one else was allowed to visit me in the hospital and my partner was only allowed during a small time-frame in the day, so during the inducing process and after giving birth, I didn’t have support from my family to get me through this. I just wanted my mum there.”

Hours after Jess gave birth, the nurses continued to monitor her bleeding through a weighing process to ensure there weren’t any further complications. Jess explains being “on a high with adrenaline” throughout this and wasn’t paying attention to the rising concern from the nurses as she surpassed a litre of blood.

After 20 minutes from her last check-up, Jess had sat up and explained the sensation of her “water breaking”. Jess lost 1.8 litres of blood and the head midwife called the surgeon. She recalled nurses accidentally dropping blood on the ground and described her room to be a “murder scene”.

During emergency surgery, Jess says they put a plastic box over her head. “It made me feel really small. The surgeon felt bad about it and was trying to reassure me that it was just protocol with Covid-19.”

After this, Jess was relatively okay. She had spent the last remaining hours after surgery with her partner and her new baby girl, but at 5 AM, her partner was told to leave.

“My partner was annoyed but I was still running on adrenaline, so I was less upset. I was happy and messaging my family about the good news and it was just one of those situations where ‘it is what it is’.”

Credit: Jess Bowen

When Jess was finally able to go home, Victoria’s first round of lockdown’s was in full effect and she spent her first weeks as a mother trapped in her home alone with her partner. Jess was suffering from the baby blues and wasn’t able to lean on her family for help.

“It felt like everything I was doing was wrong. I was barely sleeping, could barely walk because of the blood loss. I just didn’t know what to do. There wasn’t a single day during the six-week lockdown where I didn’t cry.”

Jess speaks about the importance of seeking help. The moment lockdown ended, she went to her psychiatrist and was put on anti-depressant medication.

“No one ever warns you about the way you feel after you give birth. I felt like it was unusual to be experiencing this level of sadness and anxiety when I have the most perfectly healthy baby girl who was gaining weight. Everyone else seemed so happy after their birth that it was hard not to compare myself to them.”

Isla is now five months old and Jess is feeling tremendously better. The lockdown had lifted so that gave her time to introduce her new baby to her family and friends.

“The medication is really helping. I’m starting to feel like myself again and my partner is seeing the improvements too.”

Even though Melbourne has gone back into lockdown again, she’s sad that her family don’t get to see Isla during some significant milestones, she feels much more prepared and stable to tackle what comes next.

Burnet Institute’s Healthy Mothers, Healthy Babies is an important collabrative program designed to respond to the unfinished work of addressing the high rate of maternal and newborn deaths in Papua New Guinea.

When women in Australia ponder their pregnancy and the upcoming birth of their child to be, they often think of the joys (and sleepless nights) they’re likely to face. We’re lucky that it’s rare to ever hear of a mother dying in childbirth, and whilst some families do face the horrendous tragedy of stillbirth or newborn death, it’s thankfully uncommon. We’re so fortunate to have excellent prenatal care and ready access to quality and timely healthcare throughout pregnancy and birth. But this is not the case in Papua New Guinea (PNG) where the maternal mortality rate is one of the highest in the world.

PNG is our nearest neighbour and so it is astonishing that the risks facing mothers and their babies there is so profoundly different to those we face here, just a hundred or so kilometres away. Around 1,500 mothers lose their lives as a consequence of pregnancy or childbirth per year in PNG, and more than 5,000 babies die in their first month of life. This is a devastating reality for families in PNG.

The good news is that one of Australia’s leading medical research organisations, the Melbourne-based Burnet Institute is working hard to change this. The Burnet has been working in PNG for close to 20 years. The cornerstone of their work in PNG is Healthy Mothers, Healthy Babies research program (HMHB), which is designed to help women and their babies have the best chance of surviving childbirth and give babies the best start possible to then thrive through childhood.

PNG is our nearest neighbour and so it is astonishing that the risks facing mothers and their babies there is so profoundly different to those we face here, just a hundred or so kilometres away.

There are many factors that contribute to PNG’s very high mortality rates, rugged geography and poor infrastructure, especially in rural and remote areas, can mean access to health care is very difficult. There can be a lack of understanding around the importance of antenatal care with many women attending clinics late in pregnancy or not at all. There can also be small but significant financial constraints on families, which add to the burden of travel or the cost of accessing care, or there could also be the lack of partner support, or a preference for traditional birthing practices within villages.

All these issues can be further complicated by the complexity surrounding common diseases that are often present such as malaria, undiagnosed sexually transmissible infections, tuberculosis as well as malnutrition and high levels of anaemia, all of which can contribute to poor maternal and newborn outcomes.

 

Healthy Mothers, Healthy Babies is working towards a healthier PNG, focusing on improving outcomes for women and babies in order to save lives. It is a broad research program examining medical causes and behavioural risk factors for poor health, and also looking at social factors influencing health, the provision of health services, and how to encourage effective uptake of services.

Our team of researchers is working alongside local facilities and communities to better understand some of the difficult issues that contribute to poor health outcomes for women and babies in PNG. HMHB is aiming to identify what the main drivers are for poor maternal and newborn health, especially for babies being born too small. Babies born too small, either because they haven’t been able to grow adequately in pregnancy or because they’re born too soon, face a much higher risk of dying in childbirth or early infancy. For those babies who make it through, they face a higher risk of poor growth and development in childhood, often referred to as stunting.

Around 1,500 mothers lose their lives as a consequence of pregnancy or childbirth per year in PNG, and more than 5,000 babies die in their first month of life.

Burnet’s Senior Researcher, Dr Michelle Scoullar, has been working on the Healthy Mothers, Healthy Babies program since 2014, and having lived and worked in Papua New Guinea, understands just how difficult it can be to improve a system that is so complex.

“There are many gaps in our understanding, but through our Healthy Mothers, Healthy Babies program we are already identifying some of the key issues that are impacting on mothers and babies that can be targeted to improve their health,” Dr Scoullar says.

“As part of our first study, we have recruited 700 pregnant women in East New Britain Province and we’re following them from their first antenatal clinic visit, through to their labour, and then also seeing them and their baby at one month, six months and at 12 months.

“At each visit we’re taking a whole series of blood tests and swabs, and growth measurements to identify any issues such as infectious diseases, anaemia, nutritional deficiencies and stunting.”

Photo: Some of Burnet’s Healthy Mothers, Healthy Babies research team including (right to left) Rose Suruka, Lucy Au and Elizabeth Walep together with Sr. Jacklyn Telo.

We’re also interviewing families and healthcare workers identifying barriers to families accessing available health care, and looking at ways to improve the quality of services currently provided, all factors that ultimately influence outcomes for mothers and babies.

One key issue that has arisen from our study is the significant lack of knowledge about family planning.

“Only one in four women interviewed as part of this study had used a modern method of contraception and we’ve found there is a huge demand for these methods of contraception but less than half of the demand is being met,” Dr Scoullar says.

“Supporting women and couples to plan for healthy timing and spacing of births is a cost-effective approach to reducing maternal and infant mortality and has proven benefits not just in preventing death, but also for gender equality, educational attainment and poverty reduction.”

“Were only part-way through the Healthy Mothers, Healthy Babies program and very limited by funding, so any additional support from the Australian or Papua New Guinea community will help us make a huge difference to women and children in Papua New Guinea.”

Dr Michelle Scoullar is a paediatric doctor who is also completing her PhD as part of the Healthy Mothers, Healthy Babies program.

For more information about the Burnet Institute and Healthy Mothers, Healthy Babies or to make a donation go to burnet.edu.au or call (03) 9282 2111

 

Choosing where to give birth is one of the biggest decisions you will make during your pregnancy. Whether you are contemplating public or private care, there are several important factors, as well as possible alternatives, to consider when choosing the best maternity care option for you and your family.

Finding out you are going to be a parent is a very exciting time, but making decisions about the right maternity care for you and your new baby can be a bit overwhelming. We take a look at some of the maternity care options available.

Private Care

If you have maternity care included in your private health package, you may wish to choose private care for you and your baby. If you receive care through the private system, you choose a private obstetrician, who will care for you from your antenatal appointments, right through to the birth and postnatal check-up.

Dr Stephen Lane, president of the National Association of Specialist Obstetricians and Gynaecologists (NASOG), says in the private system, the baby is delivered by very experienced caregivers, with obstetricians going through six or more years of specialist training, on top of their five or six-year medical degree.

He says the most common reason many people choose to have a private obstetrician is continuity of care.

Dr Lane says some considerations expectant parents think about when choosing an obstetrician include:

Gender (for some women, choosing a female obstetrician is important)

Location (“Is there a suitable carpark that is accessible? Are the rooms easy to get to? I think these things are important to consider,” says Dr Lane)

The obstetrician’s desk staff (“If the desk staff are friendly and approachable that is a good sign,” Dr Lane says. “It gives a good feel that they are a mirror of the person you will be seeing.”)

Cost (Dr Lane says the majority of obstetricians and gynaecologists in Australia charge well below the Australian Medical Association’s rates, with the average out-of-pocket cost for delivering a baby throughout Australia around $2000).

Note: Ask about your chosen obstetrician’s fee schedule and check with your health cover provider to find out exactly what is covered so you can be prepared for any out-of-pocket expenses.
“Australia is recognised as one of the safest countries in the world to have a baby, and this is a reflection of the world class education our specialist obstetricians and gynaecologists undertake, with many completing more than 12 years of study and training,” he says. “NASOG believes that the care provided by specialist obstetricians and gynaecologists is worth every cent to the patients who enjoy improved health outcomes as a result of our professional care.”

Katie Lavercombe says she chose a private hospital because she wanted to be able to access any pain relief that she wanted during childbirth and was afraid her wishes might not be respected at a public hospital.

“I loved giving birth at a private hospital, the care was great, it was never too busy, and the staff were attentive,” she says. “We loved being able to stay together as a couple and have time to bond with each new baby.”

Katie is currently pregnant with her fourth child and does not have the right level of cover to choose a private hospital this time, so is receiving care through the public system.

“We are utilising the public system, and while it is full of hard working doctors and midwives, there are long wait times at each appointment, meaning a large chunk of my time is taken up by waiting for medical appointments,” she says.

Crystal Henderson decided to have her daughter at a public hospital because her GP recommended it. “We had planned to go Private, but when he recommended it, along with many of our friends, who shared their very positive birth stories after giving birth in public hospitals, we thought we should at least look at it,” she says. “When we went to the public hospital, and they took us through the rooms and birth suites, we were blown away.”

Ms Henderson says she was very happy with the care she received. “There (were) some minor complications during the labour and I needed extra medical assistance, however I felt very safe, in control and informed of everything the whole time,” she says

Shared Antenatal Care

If you have a great relationship with your trusted family GP, then shared antenatal care might be an option to consider. In a nutshell, antenatal shared care involves a woman’s appointments being shared between maternity care providers (usually GPs, midwives and obstetricians), and is most commonly between a GP and maternity staff in a public hospital.

Dr Wendy Burton, chair of The Royal Australian College of General Practitioners’ antenatal/postnatal care specific interest group, says women choose to have shared antenatal care with their GP for a number of reasons.

“They may have a good relationship with their GP and are confident that they will be well taken care of,” she says. “The GP’s rooms may be closer or more convenient than the hospital/obstetrician or GPs may work extended hours, making appointments easier to plan around work commitments.


“Antenatal shared care involves a woman’s appointments being shared between maternity care providers – usually GPs, midwives and obstetricians.”

“The best models of shared antenatal care involve a collaborative team effort with well-informed GPs communicating effectively and efficiently with the other providers of care,” she adds. “If your usual GP is not up-to-date with current best practice for antenatal care, they may be able to recommend another GP who is better placed to provide care for you.

Work is currently underway to create digital records and an app for women, which will give additional options for the sharing of the pregnancy health record.”

Your Support

Who will be your support person when you welcome your baby into the world?

Many women will choose a partner, family member (such as their Mum) or a close friend to be their support person. However, there are some options to consider.

For example, a midwifery student is a good choice. They will attend antenatal appointments with you and, if you consent, can also attend the birth.

Another support option is a doula (a professional, non-medical birth and/or postnatal companion who is able to provide continuity of care, and emotional and physical support during pregnancy, birth and the postpartum period).

Michelle Perkins, chairperson of Australian Doulas, says many women hire a doula after experiencing a negative or traumatic previous birth experience.

“Some hire a doula to help them understand the maternity/obstetric systems. Some hire a doula to provide emotional and physical support if they do not have a partner, or if they believe their partner may also need support and guidance.”

Home Birth

Do you want to have your baby at home?

Grace Sweeney, coordinator at Homebirth Australia, says a woman who chooses to birth at home is guaranteed to receive continuity of care from a known midwife.

Ms Sweeney says the most important thing that a woman considering homebirth needs to do is to seek out a midwife as soon as possible.

“Nearly a decade of a sustained witch hunt against homebirth midwives has meant that midwives in private practice are scarce, and book out early,” she says. “It’s worth doing research on midwives in your area before you’re pregnant and making a booking as soon as your pregnancy is confirmed.”

Dr Lane says NASOG does not support home births in Australia.

Sarah Purvey decided she wanted a homebirth for her first child. “I had two private midwives,” Sarah says, when asked about her care. “A primary midwife came to my house regularly in pregnancy, so I built a very close relationship with her in that time and all the options for tests and injections were managed by her, with my consent and our discussions about them first. My primary midwife was there during the birth and then I had a second midwife attend shortly before my babies were born. For my first birth, I was also supported by a private obstetrician. I saw her a few times during pregnancy and she was open to supporting me, if I needed to transfer to hospital, if I needed more medical support from home.”

She says her experiences were wonderful and empowering.

“My first birth was very tough, long and in the end, I did transfer to the private hospital with my obstetrician, as I had a long second stage. In the end, I had an episiotomy, which couldn’t be done at home. This was handled beautifully by my midwives and by my obstetrician. I spent about 30 minutes continuing to labour in the private hospital, once I arrived, then we all discussed the option to do an episiotomy. I consented and this was done well. I felt wonderful when my baby arrived, despite 18 hours of active labour and a previous night of no labour.”

“Second time was much easier – four hours of active labour and my baby was born in to the water, straight into my arms and onto my chest.”