The Modern Midwife's Guide to Pregnancy, Birth and Beyond

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In relation to the management of poor wound healing and anaesthetic coverage along with the additional risk of wound dehiscence in the postnatal period, our previous care considerations advocated the use of non-tension, non-dissolvable, deep double sutures, left in for at least 14 days in line with Chetty and Norton (2017), and individualised assessments of pain ( Pezaro et al, 2018). Frequent joint dislocations, along with difficulties in holding, caring for, bonding with, and breastfeeding can also further complicate parenthood for those with hEDS/HSD ( Pezaro et al, 2020). People with hEDS/HSD are at a greater risk of experiencing shoulder symptoms, which early findings indicate may be improved with strengthening exercises ( Liaghat et al, 2020). As such, there may be a heightened need to provide more bespoke, and practical postnatal care for those recovering from birth and engaged in early parenting with hEDS/HSD. Covers postpartum advice and support only, so you’ll want a different book when preparing for birth Breastfeeding for the first time can be incredibly daunting. Whether you’re worrying about feeding positions, the quality of your baby's latch, engorgement or simply if your baby is getting enough milk, establishing a breastfeeding routine can be really overwhelming, particularly when met with well-meaning but conflicting advice from friends and family. Area of focus: Are you looking for one book that covers everything from conception to childbirth, or are you happy to read a book focused on a specific area such as nutrition, breastfeeding or labour? Whilst empowering women to choose what’s right for them, it’s important to remember that labours don’t always go to plan and that interventions are, at times, an important part of childbirth

I highly recommend reading a book called The Positive Breastfeeding Book... It made me feel so prepared and also diminishes what I now deem to be stupid beliefs that you can't enjoy a glass of wine without pumping and dumping!” (Vetted by Mumsnet user sleepsuit) Our verdictMilli Hill is the founder of The Positive Birth Movement, a global network of antenatal discussion groups that championed positive births for all women. The groups aimed to create spaces for women to consider what they really wanted from their childbirth experience and to challenge any fears or negative expectations they might have. Additionally, hyperemesis gravidarum, carpal tunnel syndrome and fatigue can be particularly challenging for those pregnant with hEDS/HSD ( Pezaro et al, 2020). In one case study, bladder diverticulum has reportedly developed without any obstruction of the urinary bladder during pregnancy ( Pradhan et al, 2020). This may be because of the growing fetus pressing over the bladder where connective tissues may be compromised. Consequently, in such instances, herniation and diverticulum can formulate and increase as the pregnancy progresses. Such cases may be managed conservatively unless chronic symptoms and complications arise in which case surgery may be required ( Pradhan et al, 2020). 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). She has worked with all ages, supported thousands of women and girls in their understanding and integration of menstrual awareness. Her widely loved online course, the Cyclical Living Immersion, has been received and celebrated by participants from around the world. Most recently, she has started an online container called ‘Altered’, a 4 week course exploring the liminal dimensions of menstruation. She is always tending budding projects as well as serving weekly tea ceremonies, continuing her deep studies and exploring under the guidance of her mentors Dr. Lara Owen and Moana Pearl. I loved [Milli Hill's] positive birth book. It covered loads of stuff I didn’t come across anywhere else, in particular about informed consent and how to advocate for yourself. Really recommend it to anyone who’s pregnant. It’s really accessible and easy to read, you can dip in and out of it."(Vetted by Mumsnet user AnneLovesGilbert) Our verdict

There can be a misconception that hypnobirthing can guarantee a natural labour (if that's your preference), but that's not the case Those left with chronic pelvic girdle pain (PGP) are at a significantly increased risk of suffering from anxiety and depression ( Siqueira-Campos et al, 2019). The management of this can be further complicated by emotional and behavioural responses to PGP ( Alappattu and Bishop, 2011), and fear avoidance beliefs, which may lead to worsening levels of pain tolerance ( Chang et al, 2007; Quartana et al, 2009; Alappattu and Bishop, 2011; Rashidi Fakari et al, 2018). Accordingly, multidisciplinary working with clinical psychology, psychiatry, pain management, physiotherapy, and rheumatology teams in line with summarised recommendations may be useful in the management of PGP ( Vleeming et al, 2008; Ali et al, 2020). Where PGP persists, last-line treatments may include intra-pelvic corticosteroid injection treatments ( Lindgren, 2020), and joint fusion ( Vleeming et al, 2008). Jacqui Lewis is a meditation teacher, mentor, an author of four books, a Tedx Speaker, and hosts leadership programs globally. She co-founded The Broad Place, a global school sharing ancient knowledge and modern neuroscience, tools and experiences for higher grade living with Arran Russell. She focuses on philosophy and tools for greater clarity, creativity and consciousness and bringing a grounded, innovative and resilient approach into the lives of her students and clients. A student of Eastern wisdom, neuroscience and psychology, she continues to study and integrate these teachings into her work. This book also includes lots of practical tips and guidance for dads and birthing partners, making it a great option for couples to share. The Eating for Pregnancy Month by Month Nutrition Guide (clue is in the title), contains 150 recipes that are tailored to meet the nutritional needs of both you and your baby at every stage of your pregnancy, including postpartum.

We researched the pros and cons of each pregnancy book, including its format, the complexity of the information and the reputations of the authors. Finally we looked at which pregnancy books worked best for each scenario to bring you our final list of recommendations. About the author The functional state of the autonomic nervous system plays an important role throughout pregnancy, childbirth and in the newborn condition ( Atallah et al, 1999; Egliston et al, 2007; Dmitrieva et al, 2011). Postural orthostatic tachycardia syndrome (POTS) is a form of autonomic dysfunction that can cause orthostatic intolerance, with up to 78% of women with hEDS/HSD potentially affected ( Gazit et al, 2003). Significantly, in one study of pregnant women diagnosed with autonomic dysfunction, where autonomic dysfunction was present in 55% before pregnancy, this figure rose to 100% during pregnancy ( Taitubayeva et al, 2020). Those with POTS may also experience symptoms such as trouble concentrating, light-headedness, palpitations, fatigue, exercise intolerance, and in severe cases, syncope (fainting) ( Fedorowski et al, 2021). The authors of a recent review of the literature have determined that there is inadequate published evidence to confirm any relationship between hEDS, POTS and mast cell activation syndrome ( Kohn and Chang, 2019). However, others have argued that the overlapping symptoms of these conditions and their under-diagnosis means that the potential link should not be ignored, as clinical experts find these three conditions together commonly in practice ( Roma et al, 2018; Afrin et al, 2020). Such academic debates highlight the need for further inquiry. How many pregnancies are affected globally by hEDS/HSD per year and how might midwives prepare for this newly highlighted reality? Motherhood Your Way, by renowned birth and parenting coach Hollie de Cruz, covers month-by-month what you can expect during your baby's first year. Helping new mums understand more about your baby's needs and how to meet them, this book also comes with an important reminder about self-care and avoiding comparisons. In one study of 13 881 592 births occurring in the US, women with EDS were found to stay longer than seven days in the hospital setting following the birth of their babies (OR 3.10 (95% CI 2.34-4.09)) ( Nicholls-Dempsey et al, 2019). Similar data has also associated EDS with increased maternal mortality in the US (OR 9.04 (95% CI 1.27-64.27)) ( Spiegel et al, 2020). The authors of these works suggest that such findings certify EDS in pregnancy as a high-risk condition. However, because the findings did not distinguish which of the 14 subtypes of EDS this included, caution should be taken. This is because people with vascular EDS would endure a high-risk pregnancy as opposed to the risks associated with pregnancy and hEDS/HSD, which should be determined in relation to individual symptoms. Findings in relation to other geographical areas outside of the US remain absent, and one must consider the fact that despite spending more on childbirth than any other country in the world, the US already has worse outcomes in maternity services than any other high-resource countries ( National Academies of Sciences et al, 2020). Accordingly, further evidence in relation to outcomes, best practice in postnatal care and length of hospital stay for those with hEDS/HSD is required, especially as some with hEDS/HSD can experience an uncomplicated postnatal recovery ( Pezaro et al, 2020). Neonatal care considerations