SOME USEFUL STUFF TO KNOW ABOUT ELECTIVE C-SECTIONS

January 20, 2019

I opted for a c-section in 2018 after an incredibly traumatic natural birth in 2015. Here's what I learned having chosen to embark on this positive path...

Meeting Maisie

Every woman in the UK has the right to request an elective c-section

NICE guidelines advise that women have the right to ask for an elective c-section, even if there is no medical need for one.  

Even so, getting one on the NHS might be hard 

If there are no clear medical reasons for a planned c-section, getting a consultant to agree to your request could prove to be difficult on the NHS. Indeed, research by the Birthrights charity reveals that it's something of a postcode lottery. My own journey to securing a c-section was much harder than I would have liked, despite having been given the green light in writing by a consultant at my previous hospital. In fact, the NHS trust where I ended up having my baby explicitly informs women in their pregnancy notes that their policy is to not agree to elective c-section requests. After some difficult conversations, my consultants eventually agreed to my request due to my previous trauma. Once I'd scaled this huge hurdle, everything became much easier, but I had to work hard to increase my mental resilience with the help of some counselling and the support of a doula.

If you're granted an elective c-section, you’ll likely have to wait until 39 weeks to have your baby

NICE guidelines state that "babies born by planned caesarean section at term but before the due date are at a higher risk of respiratory complications", so they therefore advise that planned c-sections shouldn't take place before 39 weeks. If, like me, you are having an elective c-section partly to avoid the trauma trigger of going into labour, this could result in a nervous period leading up to the c-section, with the constant fear of a natural birth looming over you. My own c-section ended up being performed at 38+5 weeks to enable a certain consultant to perform it, but any date pre-39 weeks is very unlikely on the NHS.

Writing a birth plan for your c-section is well worth it

Birth plans - or birth preferences - aren't just for women who are planning natural births with as little intervention as possible. My doula advised getting all my concerns and wishes out of my head and on to a page, and it made a big difference to my mental wellbeing. It also meant I was taken extremely seriously by all the healthcare professionals I met in the run-up to the birth, As a direct result of my birth plan, in which I stated that I wished to meet the team who would be performing the surgery, we had a wonderful meeting with the consultant anaesthetist who was due to be present on the day. This reassured us that everyone was aware of my unusual medical history, which was hugely helpful. 

The pain of trapped wind 

After my c-section, my stomach was literally undulating as the bubbles of air passed through my system; it felt as if my baby was still inside moving about! Apparently it’s caused by air entering your body during surgery and unfortunately it’s not the kind of pain that goes away with painkillers - the air just needs to work its way out. I'd advise stocking up on peppermint oil and taking it to hospital with you to encourage the wind to pass...and do let it pass - holding it in will make things worse, so parp with pride!

You’ll still bleed down below 

Even though lots of lochia will have escaped during surgery, you’ll still experience postpartum bleeding, so definitely pack some maternity pads and expect to bleed for at least a week. And don't be scared if you experience a bit of a gush when you first stand up after surgery - it's simply gravity doing what it does after you've been lying down for a while.

They bring a whole new meaning to “big pants”

Everyone advises you to buy big granny pants to wear after the surgery, but going one or two sizes up simply doesn’t cut it, especially while you're still in hospital. Go at least three or four sizes up to accommodate your wound and swollen belly, or do what I did and buy the largest disposable incontinence pants you can find which are stretchy yet soft around your tender stomach and perfect for hospital and those first days back home. These also have the added bonus of built-in absorbency so you don’t have to bother with separate pads for postpartum bleeding. 

People recover at different rates 

I got incredibly frustrated with myself the day after surgery as I was unable to stand up without my blood pressure plummeting. Seeing other women on the postnatal ward up and about before me - even though they’d had surgery after me - was very demoralising, but eventually I understood that my body simply wasn’t ready and it needed more time to reset itself. After an extra night in bed with the catheter still in place I was able to finally walk about the next morning, and I was home that evening. 

Don't be a hero

You'll hear it a lot, but a c-section is major abdominal surgery. You'll need help at home and you'll need pain relief - make sure you stock up on paracetamol and ibuprofen for when you get home as the hospital won't provide this. I also took arnica tablets following the c-section, a homeopathic remedy which is supposed to aid healing. I have no idea if these made a difference but I had no issues with my wound and it healed quickly.

Movement begets movement

Striking the right balance between activity and rest is hard, but immediately after surgery even little things like wriggling your toes helps to keep the blood flowing while you're still confined to your bed. One tip I wish I'd known before the surgery was tying a dressing down cord to the foot of the bed to help you pull yourself up for those first few days.

Your dressing will be removed after just a few days 

I presumed the dressing would be changed regularly once I got home, but no: once it’s off - usually by day five - it’s off. To ease removal of the dressing you could rub a little oil around the edge. Sadly I'd not had the foresight to do this so I got a bit of an unscheduled wax....! I couldn’t believe how small and faint my scar was on the day the dressing was removed by the community midwife. In my case you also couldn't see the stitches as they stitched from the inside to knit everything back together, but it might be worth asking what kind of technique they intend to use for your specific wound so it doesn't come as a surprise. 

Lactulose is your friend 

You might be given dihydrocodeine pain relief in the hospital, but what they won't tell you is that one of the likely side effects of this is constipation. Sure, they'll give you lactulose to help things stay as 'soft' as possible, but if you continue to take codeine-based pain relief at home be prepared for something like this legendary poogate tale.... I'm reluctant to go into details but all I can say is that I can vouch for the anecdote.

C-sections can be overwhelmingly positive and empowering birth experiences 

Finally, and most importantly, I now know just how positive a birth experience an elective c-section can be. The birth was so calm and peaceful, and has helped me to make peace with the difficult time my family and I went through in 2015. A huge thank you to everyone at St Thomas' Hospital in London for giving us the experience we so painfully missed out on before.

TIMES TWO

THE REALITIES OF PARENTING MORE THAN ONE

Human climbing frame and bed.

Babies change everything. Even if you've organised as much as possible for their arrival, nothing can truly prepare you for how your life is forced to reset once they're actually here. All of a sudden you are no longer in control of your time, your sleep, your personal space. Even if you try and resist it and keep your lives as "normal" as possible, there's not much you can do to prevent your life from suddenly and irrevocably revolving around your tiny human who depends on you for absolutely everything.

But then, that tiny human isn't so tiny anymore. They start to be able to do things for themselves, and while they're still dependent on you, they're not wholly dependent on you. You start to carve out a bit of time for yourself. You can leave them in a room unattended and get on with something else. You get some personal space back. 

You start spending more quality time with your friends, your wider family and your partner again. And, maybe, as your evenings gradually emerge from the milky depths of sleep regressions, night terrors and toilet training (ongoing...), you might finally manage to have a conversation with each other which doesn't resemble a verbal to-do list. And perhaps you start to talk about the possibility of adding another tiny human into the mix. After all, your lives have already changed now, surely another baby wouldn't actually make that much difference to your lives anymore?

Reader, they would.

Getting pregnant with our second baby wasn't straightforward (although, compared to many others' conception journeys, it wasn't difficult). We lost a baby one Christmas, and the next Christmas we thought we'd come close to losing another. But she clung on. And, this August, Maisie arrived.

She arrived in a way that couldn't have been further from the truly terrifying way that Elliott made his appearance nearly four years ago. One day I'll write about Maisie's wonderful birth - it's been on my to-do list for months now - but I simply haven't had the time to sit down and express all of my powerful emotions about her birth in a way that does justice to the experience, the many people who helped me through it and my pride in myself for doing so. And this is why I'm writing this blog post today instead, as the year draws to a close and I reflect back on it. Because what I want to talk about at this moment in time is, well, time itself.

Because I - we - have no time at the moment. I am only able to write this because Maisie is having a rare long nap in her cot, Elliott is watching a(nother) film which involves animated animals and my wonderful husband is preparing dinner while he's off work for the festive period. Yes, he's spending his 'time off' doing housework so I can sit down for an hour. I love him. But I digress.

A lot's been said and written about this 'Twixtmas' period between Christmas and the new year so I won't bang on about it, but it's always been such a precious time of year for me. As an introvert - albeit a confident one (yes, it's complicated) - I depend on having time to myself to rest my mind and re-calibrate. So this time of year has got me written all over it. I don't leave the house much, I like to potter and tidy, I might do a spot of decluttering and I try and reflect as much as possible before the chaos of January kicks in. But, this year, it's been nearly impossible to do any of these things.

Having two children is Hard Work. It is also joyful and lovely and wonderful, but I can put my hand on my heart and say with complete honesty that I have never been so busy in my life. 

The days are full and chaotic from the moment I get up to the moment I go to bed. 

Transitioning from a child-free life to life as a parent was life-changing (here's a beautiful piece of writing about it). But transitioning from a mum of one to a mum of two has utterly floored me. Yes, my life had already changed, but now it's full to the brim. The soup of parenting a young baby and a preschooler is thick with their constant, competing needs which don't overlap in any way. My own needs barely get a look-in, which is why I'm constantly dehydrated and feel like a husk. 

To feed Maisie is all-consuming, but on top of that I have to cook something vaguely nutritious for Elliott as well as trying to feed myself. I currently eat my dinner (fish fingers and chicken nuggets on rotation) at 4.30pm with Elliott because if I don't eat then I don't eat full stop.

The laundry is never-ending by its very nature. But my attempt to reset our washing routine so that we simply do one load every other day was curtailed by my baby's sudden penchant for vomiting.

The cooking, the laundry, the nursery run, feeding Maisie, changing Maisie, household admin, the cooking, the laundry, the nursery run, feeding Maisie, entertaining Elliott. Constant, repetitive and demanding.

Andy comes home at 7.30pm from a busy day in the office and spends the next two hours trying to coax Elliott to flick his switch from on to off. Eventually, but always after 9pm, he eats. Then he passes out on the sofa. The same sofa I've been pinned to since he returned from work because Maisie won't be put down until she's had at least a couple of hours of fitful kip on her beloved mummy bed. 

We don't talk to each other because that would wake Maisie up. We can't take her upstairs because that would wake Elliott up. And that would wake Maisie up. And so we exist, every evening, together but apart, in a hastily-choreographed routine of busy silence as that's the only way any of us can get anything near to the amount of sleep we need to do it all over again the following day.

Those with more than one child will be reading this and possibly thinking 'duh, what did you think it was going to be like?' But maybe they'll also be thinking 'thank God she finally understands and I can talk to her about it'. Please talk to me about it. Those with no children will be reading this and possibly thinking 'I just don't see how being at home all day can be busy.' And this is how I used to feel, too. 

I remember being at work one day a number of years ago. A colleague had just returned from her second maternity leave to her busy, stressful, high-profile job. She was bouncing around the office with joy and I just couldn't understand why she was so happy to be back. "It's like being on a holiday!" she told me when I asked her how she felt about her return. I smiled and nodded but deep down I just didn't get it. 

Now I do. Because I'd genuinely thought that, on maternity leave, you just got to sit around at home all day watching telly and going out for nice lunches with your baby. How going to work preferable to that?! But parenting is work. And babies aren't babies forever. It's a physical, draining, thankless slog with barely any gaps for (hot) coffee or lunch breaks or pleasant, quiet time sitting to yourself to think and create and listen to podcasts on your commute.

And, of course, this is what it's been like for (mainly) mothers since the dawn of time (with the exception of podcasts), so this entire piece of writing is just me stating the obvious. But until you've lived it, you don't know it. And this is me saying, finally: I know it. I understand it. Bloody hell. And I want to document this moment, because of how hard I'm finding it.

***

After a couple of difficult Christmases we decided to have a slow one this year. No overnight guests, no elaborate decorating or activities, just Christmas stripped back to its simple, meaningful bones with our newly-expanded family unit. We really needed it, but it wasn't without its sacrifices. We've not been able to do nearly as much, or see nearly as many people, as we would have liked. Sometimes it's hard to express to those we love and care about why we are currently less available than we usually are. It's because we are trying our best to survive, day by day. The children's needs fill up every available gap of time. We are constantly exhausted. This is our current reality. It won't last forever but right now we're in the thick of it. 

As the new year approaches and the next term of preschool and its endless nursery runs to and fro, to and fro loom on the horizon, I can feel my blood pressure rising and the dread creeping in at the prospect of doing everything single-handedly again. So writing this is my way of telling myself to STOP. Stop with the dread, Hayley. Stop with the pressure, the worry of what others think of you, the constant fear of something awful happening. Because, right now, everything is lovely. Your daughter is sunshine, your son is astounding and your husband looks after you all in a way that makes your heart sing. Never forget that he needs looking after, too.

And, Hayley, you know all too well that some people will be reading this and wanting you to realise just how amazing your life looks to them. 

Yes, life is busy, but it is so imperfectly beautiful. You'll look back on this time in years to come and weep, because you'll long to live it all over again. 

I'm so lucky, and so thankful.

Here's to 2019.

BRINGING BABY HOME: WHEN COLOURS FADE TO GREY

Disclaimer: I wrote this piece a year ago for a magazine. Sadly it never got used, so I thought I'd dig it out of the archives and publish it here instead.

Our first night at home

We would be knackered for sure. But we would be so happy. Just the three of us, back home. We’d show him each room in turn, spending longer in his little bedroom which we’d decorated in all the colours in the world. I’d sit with him on the nursing chair and drink in every millimetre of him. We’d cuddle on the sofa, bleary eyed, but filled with love. We’d put on a film and, despite not really watching it, forever associate it with the birth of our son, with the blue of his eyes, with the crinkles of his skin.

At some point our parents would arrive and there would be a flurry of activity, advice and photography. And conversations about how to turn the bloody flash off.

It would be the most magical time.

Well, it wasn’t any of that.

The day we came home from hospital with my newborn son was the greyest day of my life.

The birth itself had been straightforward. The afterbirth was a different matter. My placenta decided it quite liked the lining of my uterus and had become rather too attached to it. It’s called placenta accreta and it affects 1 in 500 pregnancies. There was a lot of blood – four litres of the stuff – a lifesaving transfusion, two operations and eight nights in hospital, including three nights away from my baby on the high dependency unit.

Our son, Elliott, was thankfully fine, but I really wasn’t. The physical impact of what I’d been through was one thing, but what I hadn’t anticipated was the massive emotional void that followed.

The day before I was finally discharged I was as high as a kite. I’d had a flurry of visits from all the lovely people who’d cared for us over the previous week; my midwife, consultant, high dependency unit staff, the maternity ward matron, the breastfeeding counsellor...they’d all heard my discharge was imminent and wanted to wish me well.

“I feel so good!” I told them all honestly, and off they all went with big smiles on their faces thinking they had mended me. And, there and then, I did feel mended.

But that night – my final night in the hospital – was rough. I was dosed up on morphine to ease the pain of the latest operation, yet unable to sleep because Elliott wouldn’t settle.

Morphine and no sleep are not a pleasant combination and, as dawn broke, I knew there had been a shift inside of me. My mind was shrouded in something dark and heavy as it struggled to process everything we’d been through, and everything that lay ahead. It had been over a week since the birth yet I still hadn’t changed a nappy, or dressed him, and breastfeeding wasn’t going brilliantly. How on earth was I going to cope? With all these hormones, fears and uncertainties rushing around my mind, my brain did what it needed to do to protect itself: it shut down.

I genuinely feared that if any of the medical professionals in the hospital had any inkling as to how horrendous I felt there was no way that they would discharge me, so I shakily filled in the forms, pretended to listen to the instructions about all the medication I needed to take, and off I went.

In a series of photos as we carried our baby over the threshold of our home for the first time I look dead behind the eyes. Clinging to my rainbow-tinted visions of what returning home would be like, I slowly climbed the stairs, gingerly perched on the nursing chair in our baby’s mockingly colourful room, and held Elliott. But I didn’t coo or stare lovingly at him, I wailed.

It wasn’t just tiredness. I felt as if my spirit had been sucked out of my body, leaving behind a grey Hayley-shaped shell. I had thoughts inside my head but they were echoey and distant, as if they didn’t belong to me. “Me”? I didn’t even know if there was a “me” anymore, or if there ever would be again.

My parents put my husband and I to bed but how could I sleep if I didn’t exist? After a couple of hours of nothingness a quiet, unrecognisable voice inside of me told me that I had to do something normal, even if I’d never felt less normal in my life. So I wrenched my bruised and swollen body out of bed and forced myself to eat something.

As I got back into bed my body did something that it hadn’t done since giving birth: it stretched. It was a long, deep, recuperative stretch that I had no control over whatsoever.

I didn’t think much of it at the time, but, looking back, I now realise that this stretch was the first step on my long road to physical and emotional recovery. It showed me that the human body really is a wondrous thing and it can sort itself out without you having to tell it to do anything.

That stretch stirred my personality, which was lying dormant somewhere deep inside, (my husband later told me of his incredible relief when I finally made a humorous quip). That stretch told me that I was home, and that I’d be OK.

That evening I finally managed to get a bit of sleep, and when my slumber was disturbed by the cries of my son as my parents tried to settle him, I asked to hold him. He quickly stopped crying, falling peacefully asleep in my arms. I felt – I could feel! – like a mother.

Over the following days I continued to get sleep whenever I could. It often didn’t come easily – I had flashbacks and nightmares to thank for that – and it was often broken due to the needs of our baby, but with each additional hour of sleep I felt more like me.

There was a constant presence of at least one of our parents throughout the first couple of weeks. We needed all the help we could get, and the thought of somehow having to manage on our own was petrifying. But we did eventually manage.

Nine months later and here we are.

“We’re home!” I always exclaim after the latest battle to get the buggy over the doorstep. Elliott grins back at me, his eyes sparkling, his personality already burning in his belly. I carry him through the house, plonk him down as I tidy this and sort that. He chomps his way through a surprisingly large volume of food in the kitchen and bops along to the radio.

We pause at the hallway mirror and make faces at each other. I change his nappy in his little room we decorated in all the colours in the world. He splashes in the bath, and fiddles with the bath mat (fun toy? NO! Edge of bath mat? YES!) as I wrestle him into his nightwear. We sit on the nursing chair, read a book and have a cuddle. He gulps milk, sleepily.

Yes, that day we left hospital was truly horrible. But we are healthy and we are together. And, each day, we come home.

When it hurts to look up

Carving a path through loss

I started writing this towards the end of 2016 as a general rant about the sorry state of the world. But then some sad personal events unfolded and it took a different direction. Trigger warning: miscarriage.

"Aleppo is a place where the children have stopped crying."

Yet another friend had shared this video on social media and, once again, I scrolled passed it without pushing play.

Not through disinterest or ignorance, but as an act of self-preservation.

It all began midway through the year, just before the Brexit vote. I’d been plodding along quite contentedly up until that point. I’d started a nice new job, my lovely baby boy was happily transforming into a cheeky little toddler and, on balance, life was good.

But a week or so before the referendum, around the same time as Jo Cox was brutally murdered in her constituency, my mind started to run away with itself as I found myself imagining what would happen if the UK voted to leave the European Union. The future I foresaw wasn’t nice at all.

As the Brexit vote was confirmed and events unfolded pretty much as I’d predicted, the ground beneath me fell away – ground I hadn’t even really noticed before.

I tried really hard to build it up again. To become a more active citizen and at least try to make some modicum of difference. I tried to broaden my horizons and gain alternative perspectives. I even registered a domain with a view to somehow enabling those with contrasting views to connect with each other and find common ground.

But it got too much. All the information. All the vitriol. All the question marks. The blatant incompetence on display from our government and its so-called opposition. My growing sense of disillusionment upon realising that that every single person, organisation and movement – especially those who profess the loudest to know what they're doing – is making it up as they go along (and things like this - which call for some kind of undefined "action" instead of justifiable despair – just made me feel even worse). No strategies. No foresight. No experts.

And I realised that there really wasn’t a single damn thing I could do to alter the course that humanity seems to have set for itself beyond donating to charities, signing petitions and sending supplies to those in need.

I could see no hope.

So, eventually, instead of leaning in and trying to make my voice heard, and listen to the voices of others, I found myself doing the exact opposite: leaning out from the world and all of its uncertainties. *** "It's not a problem if you don't look up."

I never would have predicted that this line, used by the heroine in Rogue One to sum up her approach to ignoring the the rise of the Empire, would so clearly reflect my new approach to life for the second half of 2016.

I practically stopped watching and reading the news. My phone's breaking news alerts – switched off for the US election – remain deactivated. And I scrolled past the helpless children in the heartbreaking videos.

Instead, I hunkered down and tried to focus on the pleasant minutiae of my life in an attempt to fill my brain with nice little things so I'd be prevented from entering another whirlwind of existential anxiety by thinking about the horrible big things.

And 2016 was on track to end with a particularly nice little thing. A unique collection of cells quietly multiplied inside of me, providing me with a renewed focus and – dare I say it – hope. But deep down I think I always knew that the cells were behaving a little too quietly. And after 12 weeks the sonographer's screen was filled with a dark void instead of twitches of light and feet and a swooshing raisin heart. There was no baby anymore. The cells – our unique mishmash of cells – had gone. And only their protective bubble resolutely remained, still determined to do its job, going nowhere fast.

The blank space on that screen enveloped me in a way that somehow felt inevitable after the events of the previous six months. The plans we'd laid out for our lives for the months – and years – ahead crumbled away. The first feeling I felt in that sonographer’s room was stupidity, for daring to believe that things could have ever turned out differently.

And, over Christmas, it suddenly hurt just as much to look down as it did to look up. To see my tummy, swollen but empty. To see the residue of surgical tape dotted over my body. To find my hands subconsciously clutching the ‘baby on board’ badge lying unused in my coat pocket.

Constant reminders of what we’d lost.

If there was one word I had to choose to sum up 2016 it would be ‘loss’. The year was so full of it for so many people.

Sadly 2017 isn't magically going to get better. Our "leaders" will keep spewing hate. Websites will keep pumping out lies, lapped up by the hungry masses. Our cultural icons will keep dying.

Our budding baby will be lost forever.

But from loss comes experience. From experience comes strength. And from strength comes resolve. And my resolution for this year – and for all years going forward – is to recognise that I do already make a difference.

We all make a difference to each other. And I make a difference to my son, by holding him close. By making him feel safe, loved and fulfilled as the structures around us appear to spin out of control. By helping him to see joy, wonder and kindness in the world and its people.

I resolve to value what I have, whilst never forgetting what I've lost. To live for now, rather than dwell on what might or might not be in the future.

And, more than anything – and trying to find one iota of positivity from what has undoubtedly been the most sorrowful period of my life so far – I resolve to be my son’s very own unpoppable bubble.

Further reading and information

While I don’t envisage I’ll be able to write more about the experience of miscarriage, I found the following sources of information helpful during this difficult time:

What is a missed miscarriage?

The Miscarriage Association

Recovering from surgical management of a miscarriage

The Happy Baby Project’s blog post on what she’s learned about miscarriage (with a particular nod to point 6).

LOSING BABY WEIGHT: LET'S CHEW THE FAT

"FEED YOURSELF WHAT YOU WOULD FEED YOUR BABY"

This is the best nutritional advice I have ever received. And, by following it over the last six months, I've lost two stone (over 12 kg) since Elliott was born...and counting.

And it's particularly relevant today in light of a report just published by the National Obesity Forum and the Public Health Collaboration, which calls for a “major overhaul” of current dietary guidelines.

But let's rewind a bit. Last autumn I wrote about my post-birth wobbly bits. There were lots of them. I'd reached the point where I didn't know what changes to make to get me where I wanted to be in terms of my health, fitness and weight. Elliott was over five months old but I looked five months pregnant. I was still wearing maternity clothes, my joints ached and my knees strained, my wedding and engagement rings didn't even reach the halfway point of my ring finger and my weight had well and truly plateaued. I generally didn't feel too good about myself.

A few weeks after writing the post things still hadn't changed, so I took the plunge and approached a local nutritional coach for advice. It was the best £49 I've ever spent.

It would have been easy for me to have titled this blog post "how I lost weight by switching to full fat milk" but a) clickbait headlines annoy the hell out of me and b) this change is obviously just one part of it. But...it's totally true.

June 2015 | May 2016 (gotta love a stripy dress)

Kirsty, the coach, explained to me that your body needs fat, but it doesn't need sugar or any other chemicals which are present in processed foods, including those which have had the fat stripped out of them and replaced with rubbish. As long as the fat is coming from good, natural sources - and is balanced with plenty of vegetables and protein - you can pretty much eat as much of it as you want (with the all-important caveat that you should obviously only eat if you're truly hungry). No calorie counting, no fasting, no juices or other short-term weightloss fads which will leave you hungry and with unsustainable results. Just sensible planning, buying, portion control at mealtimes and ensuring you have "good" snacks to hand when the hunger strikes.

And this is completely in line with today's headlines.

Lots of people may recognise this approach as the paleo diet (which is based on the notion that we should only eat the types of foods presumed to have been consumed by early humans) and effectively that's what it is, though I prefer not to use the word "diet". Instead, I see my new way of eating as a sensible relationship with food which follows basic paleo principles, but without being completely obsessive about it.

Using this approach, I've completely cut out pasta (which is a huge deal given this was my go-to staple meal), got rid of most other gluten-based foods (after all, wheat and other grains weren't widely available until the 19th century), stopped eating my beloved (but nutritionless) breakfast cereals (I have porridge or Bircher muesli instead), dramatically reduced my sugar intake and, as previously mentioned, switched from low fat dairy products to their yummy - and more nutritious - full-fat equivalents. Milk chocolate is (mostly) out, but dark chocolate is very much in.

Eating out has taken on a new dimension. Previously I would naturally choose the creamiest, stodgiest option on the menu, ideally encrusted in pastry. But now I look for the gluten-free options and end up trying something completely new and different (and without the subsequent food coma).

Kirsty's advice really resonated with me, but my issue was finding the time, and inclination, for cooking and meal preparation, especially when I had a young child to feed as well. And that's when she uttered those monumental words: "feed yourself what you would feed your baby". Up until that point I'd only heard the opposite mantra - feed your baby from your own plate. But when your own plate is full of crap it quickly shines a light on how terrible your own diet is. So I switched my mindset and haven't looked back.

Over the months, and alongside one spinning class a week and lots of walking, I've lost a pound or two a week - nothing dramatic but a steady and healthy decline. My clothes gradually got looser, my knees stopped aching and, eventually, I could get my wedding ring back on again. But, more importantly than what the scales show, I feel great. I've got loads more energy, I feel strong and I have a new-found respect for my body and its ever-present wobbly bits.

Today's report into dietary guidelines is long overdue. But sadly it's not been warmly received by everyone. Crucially, though, when you look closely at where the dissenting voices originate from, you'll eventually see that that many of them, one way or another, have links with food manufacturers (just one example here), who are producing the very types of food that we should all actually be avoiding. Sadly it will probably take years and years for official guidelines to change. But I, for one, will definitely be proudly sticking to those milk bottles with the blue lids. After all, we don't give our babies semi-skimmed milk, do we?

TEN THINGS I WISH I'D LEARNED IN ANTENATAL CLASSES

MY MIXED FEELINGS ABOUT THE NCT

You're here! Umm, now what?

I picked up the phone and left a shaky voicemail message in a voice I barely recognised. 

It was about two weeks after giving birth and I was a mess. After a difficult birth and an eight-night stay in hospital, I had barely changed any of my baby's nappies, breastfeeding was a struggle and my mind was shrouded in something dark that I hadn't experienced before. I felt numb and was struggling to see how things would ever get better. 

After a bit of Googling I discovered the existence of the NCT shared experiences helpline, which endeavours to put women in touch someone from their roster of volunteers who have been through something similar. So, one evening, I plucked up the courage to dial the number and leave that message. I'm so glad I did. After about 24 hours I was referred to a lovely lady with whom I had a tearful chat for a couple of hours who helped me to see - and hear in her kind yet confident voice - that the fog would lift. But this support was nothing at all to do with the NCT antenatal classes I had attended whilst pregnant, and I would have had access to the same support had I not forked out to attend them.

Since having Elliott I've been asked numerous times by parents-to-be whether or not the NCT classes are worth the money. And it's a lot of money (the course we did in 2015 was around £300, though prices vary depending on the type of course you do and by region). I always say yes. But primarily for the network of almost instant friends you're likely to accumulate. Beyond this, I'm truly torn.

Founded in 1956, the NCT (the 'National Childbirth Trust' name was scrapped a few years ago) aims to support parents through what they believe to be the crucial "first 1,000 days" of a child's life after conception. Which begs the question, why do their phenomenally popular antenatal classes place so much emphasis on the birth, rather than the 700 days that follow?

Whilst thinking about this blog post I asked mums from my local Facebook parenting community - Mummy's Gin Fund - for their thoughts. The volume of responses and took me by surprise, and almost all of them centred around a few key themes which were in line with my own thinking.

It would be unfair of me to suggest that it would be possible for the NCT to encompass all of the below in their classes. After all, there will never be an ultimate instruction manual for having a baby. And I did ultimately enjoy the classes - the teacher was friendly and a group trip to the pub at the end of the final one went down a treat. However, with the benefit of sleep-deprived, poo-stained and vomit-soaked hindsight, here are the ten things that I wish I'd been told...

1. How to actually look after a baby

Learning about the biology of the birth itself is undoubtedly fascinating, but I wish we'd learned more about the realities of day-to-day parenting. I do understand the NCT's probable thinking behind this. After all, different people "parent" in very different ways and the NCT course leaders try hard not to be seen to impose a certain style or method over others. In an attempt to overcome this their classes focus on evidence-based guidance as opposed to the teachers' own experiences. But it does result in a total lack of practical advice from someone who has been there, done that. Emma, a mum from the local Facebook group, summed it up by saying: "In retrospect it seems crazy to spend hours discussing the element of becoming a parent that we had the least control over. In our group we all had wildly different birth experiences - but the unifying factor was that we all had these tiny new humans to get to grips with at the end of it. A more practical focus on first aid*, winding, feeding (breast, bottle and the almost never discussed combination feeding), after care, child development, sex after baby etc would have been infinitely more useful."

2. Accepting medical intervention doesn't mean you've failed

Above everything else in the classes, I came away from them thinking that I should strive for as natural a birth as possible. You are steered towards the belief that natural births are good and anything involving intervention is bad, and to always question medical advice whilst in labour. Emma felt the same: "I felt totally unprepared for any scenario that was not a drug-free labour, healthy baby and a smooth breastfeeding journey and it took me a while to shake off that (irrational) sense of failure of not achieving that." And I think that point about failure is a crucial one. Another woman from the Mummy's Gin Fund, Claire, hits the nail on the head, by expressing that she wished the NCT would "empower the women, so they know that they can do it, whatever the scenario. And let them know they and their babies are a success and miracle however they come into the world." Sadly I didn't feel empowered after the classes. Instead, I came away thinking there was a "right way" and a "wrong way" to have a baby. So when my birth quickly went from a very natural scenario to a highly medicalised one, I felt an enormous sense of guilt for having fallen at the first hurdle as a mum. Which is ridiculous, given that the medical intervention, which I was in no fit state to question, saved my life.

3. Your body - and your mind - will take a while to recover after the birth. Let it, and accept help.

Giving birth is bloody tough for everyone, regardless of how it ends up happening. And all women need to be given the chance to recover from that, physically and emotionally. I'm not saying that the NCT told me to crack on with things once the baby was born - I think western society as a whole has more to answer for on that front - but I really wish I'd been told that's it's OK to give yourself a break and, crucially, to accept help rather than try and be some high-achieving supermum from the outset. This blog post is a fascinating read in this regard, and makes some really strong points about the importance of mothers getting enough sleep when they return home, letting others care for them and their new baby, and not being made to feel as if they have to immediately carry on their lives as normal.

4. The realities of breastfeeding

There was an entire half-day session dedicated to breastfeeding in the NCT course I signed up to and I came away thinking my baby would climb up my chest once he was born and latch on to my boob straight away. It would also be painless and, if it did hurt, I was doing something wrong. Many women I spoke to reported that they had been told the same so, when they did experience pain, they thought they had failed (there's that word again). I've written more extensively about breastfeeding previously, but in terms of the antenatal session, a more truthful picture of some of the common obstacles you're likely to encounter to begin with - letdown pain, potential tongue tie issues, the symptoms of mastitis, cluster feeding, inevitable (and often unfounded) doubts about your milk supply - and how to overcome them would have been a more productive use of everyone's time. Instead, you are presented with a rose-tinted view of what it will be like, meaning that - as I've written before - many women probably give up breastfeeding because they believe their perfectly normal difficulties are unique to them. It's such a wasted opportunity. 

5. Formula: the basics

I think it's fair to say that most women intend to give breastfeeding a go if they can, but despite asking to find out about formula in our antenatal class we came away with no tips or insights beyond an acknowledgement of its existence. Understandably the NCT don't want to be seen to be promoting formula given their evidence-based approach, but there's a difference between talking about the practicalities of formula and promoting it. After all, some new mums don't even get the chance to try breastfeeding if they are separated from their baby in the beginning, as I was. I also think failing to discuss combination feeding as a perfectly sensible option for feeding your baby - especially if you end up having to recover from a traumatic birth - is a real shame, given that combination-fed babies still get all the advantages of breastfed babies in addition to being able to take a bottle, meaning you can share feeds. It's worth pointing out, however, that there is information about formula, bottle feeding and combination feeding on the NCT website but, in my case, this was something I had to seek out for myself. 

6. Wind

Oh those pesky bubbles of trapped air. They will cause most new parents such anguish, and their little babies such discomfort, yet the entire concept of wind wasn't, as far as I can remember, even mentioned. I do wonder if this is related to the strange myth that breastfed babies don't need burping after feeds, which isn't the case at all. 

7. *If* you have a tough birth, help is out there

It would be impossible - and pretty scary for parents-to-be - for the NCT to outline the many ways that giving birth can go awry, or how babies can get sick. I get that. But briefly touching upon the various sources of help that are out there, including the NCT's very own helpline, if you need any emotional support would have been so useful for me, and would have saved hours of Googling when I should have been sleeping. 

8. You'll never feel such extreme emotion

I think we learned more about hormones in the NCT classes than we did about anything else, but what we didn't learn was how those hormones would make you actually feel. For about a fortnight after the birth, my husband and I were flooded with oxytocin, except at the time we didn't realise that. We were in awe of everything and everyone, especially each other, and the world seemed hyper-real and about ten times as intense and beautiful as normal. Familiar songs took on deep, new meanings and average animation films were suddenly the most inspiring things we had ever seen. And, of-course, our baby was the loveliest baby in the world, without a shadow of doubt. We thought this was because of the dramatic birth and its aftermath, but looking back I think this is actually a pretty normal way to feel after having a baby. Oxytocin heightens all your emotions - good and bad - so be prepared for highs and lows like you've never experienced before, especially if you're just starting out breastfeeding, which gets the hormones whizzing around even more.

9. Love feels different for everyone

My hypnobirthing CD subconsciously gave me the expectation that I would feel a huge "rush of love" for my baby when he was given to me following the birth, and the NCT placed a big emphasis on the importance of skin-to-skin contact in the first hours to help you bond with your baby. None of this happened to me. Perhaps if I'd had a less complicated birth it would have done - I'll regrettably never know. But in the days and weeks that followed I did feel as if there must be something wrong with me because I didn't feel like I was expecting to feel, and I believed I'd never get the chance to fix it because I'd missed out on that important skin-to-skin time. I wish I'd been told that everyone feels differently after giving birth and there's no right or wrong way to feel. For me, it was simply as if Elliott had always been there (when I look back at pictures of me from a few years ago I wonder why Elliott isn't in them!), and over time that sense grew and intensified.

10. And finally...don't stress too much if there's no poo

I couldn't write this post without talking about poo. We were told in the NCT classes that as long as they are producing lots of wet and dirty nappies your baby is, in all likelihood, fine. And you are given a useful leaflet showing you what the poo will look like and when. But when our baby took days to have his first proper poo we panicked, and we continued to worry when he often went a week (or more!) between bowel movements**. These days he has many, MANY poos a day. Every baby is different, and their nappies will produce many different types of surprises as the weeks and months go on. A heads-up about this would have gone a long way. 

In fairness to the NCT, it's important to note that they do ask attendees to provide feedback after they have attended the sessions. Crucially, however, they send out these surveys before you're likely to have had your baby, so any feedback you provide at that stage is from the perspective of someone who can't even begin to grasp what being a parent is actually like, and what you wish you'd learned. 

There are numerous other antenatal options out there beyond the NCT. The NHS run free classes, though they are often very large groups, and there are also other private providers (some of my local options in London include Doctor and Daughter at £380 per couple, and Within You, cheaper at £200 for a total of eight hours). But, the reality is, unless you attend a class within your immediate vicinity, you're sadly unlikely to see your newly-acquired friends very often once you have a baby, especially if you don't have a car. And because the NCT have such a firm grasp on the market, it's simply the best class to do if making friends is your priority.

My husband and I were lucky enough to meet six other couples who all live within streets of us. Throughout our maternity leave, the six other mums and I saw each other three or four times a week on average, sometimes more, in various permutations. And over the months our friendships became about more than just babies and parenting, although that's obviously a good starting point.

We've been through loads together over the last year. There's been so much laughter, as well as many tears. Not one of us had a "straightforward" birth without some kind of intervention. Sleepless nights were made bearable by Whatsapp banter and the amount of coffee we have collectively consumed could probably fill a larger than average lake. 

As everyone in the group begins to drift back to work, and the pool of local friends and babies I can pop out to see at a moment's notice gets smaller by the day, it's made me appreciate just how lucky I've been to have these amazing people in my life. We jokingly refer to each other as "bought friends" but, for me, this ready-made local support network of amazing women, and their partners, has been life-changing and truly priceless, and, despite the many improvements that could unquestionably be made to their antenatal offering, I will always have the NCT to thank for that.

* Regarding first aid it's worth acknowledging that this is a huge, specialist subject that could never be comprehensively covered in any antenatal class. However, a pointer to take a look at the excellent British Red Cross baby and child first aid app would have been helpful.
** Always speak to a medical professional if you're worried about lack of number twos.