September 21, 2025 • 34 mins
Today on the podcast we chat with Sarah Elliott.
Sarah is a Registered Nurse and Registered Midwife. She has moved in to academia with an interest in midwifery, and in-particular rural and remote midwifery.
We chat about the problems of women who have to travel, due to high risk deliveries of their unborn babies, and the challenges they face.
Sarah discusses the difference around c-section and vaginal deliveries and the impact research is showing this can have on the babies gut health.
This is a broad discussion around birthing and how we as nurses and midwives can help mothers to be, mothers post c-section and their babies.
Sponsored by Nutricia. This episode was created independently by the presenters/speakers and the views expressed herein are those of the presenters/speakers, not of Nutricia. This content is intended for healthcare professionals. Medical professionals should rely on their own skill and assessment of individual patients.
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Episode Transcript
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Speaker 1 (00:05):
Appochia Production.
Speaker 2 (00:10):
Hi everyone, thank you for tuning back into Tenantus for Nurses.
I suspec Woodbine here this season. I am so excited
to announce that the podcast is being supported by Nutritia,
which is a global leader in medical nutrition. They understand
the needs of nurses in the nutrition space and for
over one hundred and twenty five years have provided products
(00:31):
to support child health. Some of Nutrita's pediatric brands include
Neo Kate Junior for children who have food allergies and
apt to Grow for those fussy eaters. And those of
us who have children know many kids who go through
the phases of definite fussiness. For more information and resources,
visit the nutritiona Pediatrics hub at nutritia dot com dot
(00:54):
au forward slash Pediatrics. I just want to say a
huge thank you to Nutritia. Their desire to support nurses
is truly appreciated, and they are allowing me to continue
this podcast so that we can all grow as nurses.
This season, we have some amazing speakers in the pediatric
space which I cannot wait to share with you all. Hi,
(01:14):
my name's Beck Woodbine and welcome to Tenderness for nurses.
Speaker 1 (01:18):
I'm grateful for the person that I have the opportunity
to be.
Speaker 3 (01:23):
So I hit it and parked it for Nellie four years.
Speaker 1 (01:27):
We always have free will, We always get to choose.
Speaker 3 (01:29):
We are autonomous.
Speaker 2 (01:33):
Hi everyone, thank you for tuning back in to Tenderness
for Nurses. We've had a little bit of a hiatus
as I've been working on a few different things with
the podcast and the website and just moving forward with
all the amazing people that I am going to be
bringing to you with the podcast. But today I am
very grateful that Sarah Elliott is with us. She's a
(01:54):
wretched nurse, registered midwife and she's coming on today to
have a chat to us about caesareans or c sections,
and she's part of the amazing group of women that
Nutritia put forward for me to have a chat to,
and their knowledge around food, diet, probiotics, probiotics is remarkable.
Speaker 1 (02:13):
So welcome Sarah.
Speaker 2 (02:15):
Thank you so much for coming on the podcast and
sharing a bit about yourself. So let's get straight into it.
Can you just tell me a little bit about yourself
and how it is that you and I are sitting
here opposite each other with the information you're going to share.
Speaker 3 (02:29):
Okay, So obviously I am a registered nurse. I've worked
in nursing for quite some time before making a bit
of a career change into midw free as most often
some of us will do. And I've worked in mid
with free as well as nursing, particularly around the Blue
Mountains and Lisco area. Moved into community mid with free,
(02:50):
working as a community midwife, and I moved on then
into academia with Childs University. Unfortunately, Mami and We've got
a lot of issues with the university's the budget's constraints
and they're losing money. My contract was cut for now,
so I'm sort of floating around doing some casual work
(03:10):
with other universities. And so this has led me to
Nutritia where I've been picked up and I'm more happy
to share whatever knowledge I can can provide.
Speaker 2 (03:21):
Is your interest in particular around cesarean sea section.
Speaker 3 (03:25):
I have had a bit of an interest with sea
section petically, given that not just as a midwife and
I was working in a hospital, but also as a
community midwife. Quite often I would be caring for women
who have been through sea sections and working in very
much a perib and to rural setting. Often these women
(03:47):
pallyw a higher risk ended up having to go to Nepean.
I'm situated in the Blue Mountains in New South Wales,
so our class is tertiary. Referral hospital is Napelean Hospital
down the Penrith and Western Sydney, and often they get
shipped down there when they're high risk and may end
up having to have a C section, whether it's because
(04:07):
of a real school because labor hasn't gone well. Do
you have your ones that go down there with a
planned caesar? And sometimes when you're looking after these women
post natally, they can have quite a broad range of
feelings about their birth experience and what occurred there, whether
it was planned or unplanned to have a C section.
(04:30):
So high risk pregnancy certainly peaked my curiosity and I
have had a research project that's been going with CSSUME.
It's yet to be finished, but yeah, it's a C
section in particular, and high risk pregnancies has been a
bit of an interest of mine, particularly for real women.
Speaker 1 (04:47):
Is that what this research is about that you're doing not.
Speaker 3 (04:51):
Just on C section, but looking at real women's experience
itself and looking through the literature we have found that
the experiences of real women have not really been explored,
which has been interesting because we have spoken. But there
is a lot of research out there that does look
at women with high risk pregnancies needing to transfer out
(05:14):
to tertiary referral hospitals and city areas. But the problem
is we don't always explore exactly what did they feel around,
you know, their experience, what were the hardships that they faced,
And quite often you find that they're at a considerable disadvantage.
Given that women with low risk pregnancies are able to
access anti enatal care within their communities, often with a
(05:38):
GP obstetrician, or they've got a visiting obstetrician or to
meet Biff they care thereout, high risk pregnant women can
be at a considerable disadvantage because they've got to be
going down to us we've got a birth and this
will increase a lot of stress upon them because they've
got to take time from work. Their partners may need
to take time from work. There's travel. You could be
(05:58):
sitting in a waiting room for hours.
Speaker 1 (06:01):
How far is it from the Blue Mountains to Penrith?
Speaker 3 (06:05):
So where I'm sitting I live in Workberfors, which is
right in the middle of the mountains. It's about a
forty five minute drive, okay when you go out to
lit Go, so we're looking about an hour and a
half they could be driving chair. And then if you
go further out to Bafitt, that's another half out of
forty five minutes on top of that, so you could
be looking at two two and a half hours. And
(06:27):
because that distance milage increases. The third is you go
west or in some cases you go thirty go south north.
There are other hospitals obviously, so further down the coast
you'll have access to Subtlent and Woongong hospitals, and there's
Royal North Shore John Hunter up in Newcastle. But you know,
rural women still have that tyranny of distance that they
(06:50):
need to overcome to access high level care.
Speaker 2 (06:53):
It was interesting I was reading through some of the
information and literature that have been sent through and in
twenty twenty two CEA section rates had gone up to
thirty nine percent, and in twenty ten they were at
thirty two, thirty one, thirty two percent. And it's interesting
because when I was working as a theater nurse in
(07:16):
at the Marta here in Brisbane, and I just did
the caesars. I didn't look after the babies, as I'm
not a midwife. When I first started, we got the
odd one at night time, you know, the odd emergency,
that sort of thing. By the time I left, and
I'd worked there two years, we were pretty much busy
all night with emergency caesars. And there were women, as
(07:37):
you said, that had come in that were rural and
remote that had come into the Marta as you know,
being a primary healthcare setting and tertiary hospital. But some
of those women were down by themselves, and especially if
it was an emergency. You know that is traumatic to
be by yourself when you're giving birth. You know, I
can't even begin to comprehend what that must be like.
(07:59):
And you would see this all the time because you know,
someone's got to stay home if they've got more than
one child and look after their kids. It's we think about,
you know, c sections just being easy. But you know
when you think about rural and remote women, it's not,
is it.
Speaker 3 (08:13):
No, it's not. You know, these women, like we've mentioned,
i'd have to look at time of work, whether they're partner,
can get time of work families, existing children, you know,
who can look after the kids because not everyone lives
in the same community in terms of family. Some have
moved in from the city, or they may even be
(08:34):
people who have family overseas, and so that's not always
care for other older children. It's not always readily accessible there.
And then you've got the other issues that come with
rural health as well, not just in access of health care,
but we're also looking at, you know, the social determinants
of health. We're looking at health literacy, we're looking at
(08:54):
you know, their education levels, they're health in general, you know,
and all this can really determine sometimes whether or not
they're going to have a high risk pregnancy and if
they're going to need to be shipped as well.
Speaker 1 (09:06):
It's interesting. On Friday, Sammy, who's sitting on.
Speaker 2 (09:10):
My lap, and I visited the Children's hospital here in
Queensland just to do some therapy dog work and I
had the absolute privilege of meeting this beautiful family from Normanton.
And this is where I think, you know, we get
it so right with kids that are in hospital, and
we get it so wrong for the other areas of
(09:32):
healthcare in that they were able to they were First
Nations people, Indigenous.
Speaker 1 (09:38):
They were able to fly the whole.
Speaker 2 (09:39):
Family down from Normanton, so you know, her sister, her mum,
and her dad, and they came out because they missed
their doggies, so they came and have a cuddle with
the dogs, and I got chatting with mum and they
were just the most beautiful, beautiful family, and they were
so grateful that they were able to come as a
(10:02):
family supported by the Children's Foundation, to be there all together.
And we know, in particular First Nations people like their
people around them. You know, they heal better, they recover
better when loved ones and people that they know are
around them. But these two little girls, oh my god,
they were divine and they were so beautiful with the
(10:24):
dogs and so excited to have and then they'll show
me photos of their animals, and I just thought, you know,
it's very different then for a woman giving birth, she's
probably shipped out pretty much, I'm assuming or air backed
out by yourself, and family would come in later if
they can. But imagine if you're a First Nations person
(10:45):
where you know you want your women tribe around you,
and here you are going in to have a c
section or a high risk pregnancy near thereby yourself. It
must be really frightening.
Speaker 3 (10:56):
It would be very, very frightening. And also there's cultural
considerations around. I mean, they like to be able to say,
say birth on country, so they want to be able
to have their babies on their country, their ancestral country leads,
and so where shipping them to another area where they're
not Some hospitals like the Pean to have a good
(11:17):
indigenous cultural environment that they've tried to help create Indigenous women,
but there's still always those cultural issues. We have women
that are able to bring their family in, but it's
not always the case and it can be a very
very difficult experience for them. And also we've also got
the issues that are still left behind from the stolen
(11:39):
generations as well, where we have the inherent mistrust of
the medical system. So you can imagine a woman who
you know, she comes from a family where there's been
so much of that abuse and mistrust within stolen generation mothers, fathers, aunts,
uncles or grandparents, and they're still hurting from that. They've
(12:02):
heard all the stories and if they've been net straight
down to nepaying for an emergency birth because something's not
going well, you can imagine the fear that could be
cropping up in their minds of Indigenous what's going to
happen to my baby? Or how they support people, whether
it be their parents, their partner, partner's family as well,
(12:22):
could be feeling a bit on edges to you know,
whether they can trust this system or not.
Speaker 2 (12:28):
And you find that that has absolutely impacted our First
Nations people moving forward in healthcare, it can.
Speaker 3 (12:36):
We're making head roads, you know, to trying to be
more culturally we're more culturally respectful, and we certainly have
you know, good inroads with things like our Aboriginal midwives.
You know, we have our Aboriginal midwives that are providing
care to Aboriginal women, and of course where we have
(12:57):
non Indigenous midwives that are providing care, we try to
ensure that we've got Aboriginal liaison officers or healthcare work
because they also assist in the care, just to make
that care smooth more trustworthy for them as well. So
we are making some inroys there, but you know, you
can you can expect that these emotional and psychological scars
(13:20):
is going to take so long to heal, and here
is at you'll never heal. Yes, it's very deep and
will never heal. So while we're making some good inroads,
there's still a long way to go, and also the
closing of the gap. As we know, Indigenous people, including
their women, still have lower outcomes, you know, better out
(13:41):
they don't have the good outcomes that non Indigenous people have.
So we're still working to close those gaps as well, which.
Speaker 2 (13:48):
Is wonderful in healthcare and it makes me really proud
to be part of that that you know, people have
recognized this and are trying to change it. It's not
going to happen overnight, but the right people hopefully are
doing the right things, you know, and meeting these.
Speaker 1 (14:06):
This family, I don't know.
Speaker 2 (14:07):
It's funny how one family can impact you so dramatically,
and this family did, and they just, I don't know,
I just felt like they got the hospital and the
foundation got it right for this family. I'm not saying
that happens to all families, but for this family, it
really helped them. And it was so beautiful, beautiful to see,
(14:28):
you know, this little girl that hopefully will get discharged
in a couple of weeks time, and that mom and
dad were there and it was just lovely to see
and to actually help with some of the healing with
you know, Sammy the therapy dog. You know, it's a
little thing I did, but I probably got more out
of it than they did.
Speaker 3 (14:44):
But you know, it is a beautiful story and it's
wonderful to hear. It is great to hear these stories
that are going on with Hill.
Speaker 1 (14:52):
I couldn't agree with you more.
Speaker 2 (14:54):
When we talk about C section and compare it to
a vaginal birth, and then we start talking about gut
health and microbiome and all that sort of thing. What
is the difference between a C section and a vaginal
birth when it comes to gut health.
Speaker 3 (15:12):
So what we're looking at in terms of gut health
and a vaginal birth, as we can appreciate, the vaginal
environment has a lot of microbes in it. So as
a baby is being birth through the vaginal canal or
the passage there, they are exposed to more microds from
mump and those microbes, you know, will infiltrate their respiratory
(15:34):
and their gut system, the gas intestinal system, and create
a microbiome within there. However, when it comes to C section, unfortunately,
and you wouldn't think of it initially, but with C section,
because it's a more sterile environment, they're not being pushed
through the vagina, so to speak. They're coming out through
an incision that's been swopped down, sterilized or sterile drapes,
(15:56):
or the doctors and nurses are stereo for good reason
because you know, you've got to be on infection. Good. No, Unfortunately,
what it means is that the baby isn't getting that
microbe exposure, and so they're not building that gut health
the microbiome in comparison to what a vaginally birthed baby is.
(16:17):
So I guess what that is. So it is well
established that there is a difference in those microbios between
the two types of births, and there may be some
issues around that, particularly around conditions like exma, maybe asthma,
issues with colic diary, and a few other issues that
may be related to that as well.
Speaker 2 (16:40):
Can it increase your risk of getting an autoimmune condition,
because you know, skin conditions tend to be more autoimmune allergies.
Can it increase that risk?
Speaker 3 (16:51):
It appears that some research is pointing to the possibility
that there may be some risks in this direction. I
guess what it is is that it's balancing that way
of evidence. You know, while we have some research it
will say yes, we found a positive correlation, there's evidence
that's saying we didn't find that, So we've got to
(17:14):
look at you know, where is that evidence? Coming back
to one I thought was a bit interesting though it
was sort of I wasn't sure I particularly felt about it.
There's a few research articles around c sections and autism.
You know, does C section delivery increase the instances of autism?
(17:36):
And having a look at the research, it's okay, there
was quite a large cohort, But what did they measure
this against? What might have been just circumstantial or coincidental?
I guess is probably the word that I'm looking at.
What did they measure against? Was it coincidental? And as
even some autism groups are saying, look, correlation doesn't also
(17:59):
equate to causation. We can't really say for sure that
it increases of autism or autism diagnosis. And I think
there's also the issue that with people with autism, we
look at it and say, look, you're saying that we're
people that need to be fixed or a problem as well.
Speaker 2 (18:18):
Yes, So yeah, regardless how you look at it's fraught
conversations and opinions that that sort of research question, isn't it,
You know, like that's one research. I mean, look, you
can look at any research and take from it what
you will, can't.
Speaker 3 (18:35):
You you could? I mean, there's research that is pretty
rock solid. The way of evidence is pretty clear around
you know, mass medications or what physics is, or around
elements and all that kind of stuff. But when you're
looking at research that does have a lot of gray
areas in there, we've got to look at how we
(18:56):
measure that, and you know, it's going to be repeated
research and good methodology and that research it's going to
be inform is better as well.
Speaker 2 (19:08):
What can mums and families do if they do have
to have a cesarean or a sea section? Are there
things dietary wise they can do for their newborn? Now,
obviously breast is best and that would be your number
one choice that you're getting mum's milk, But if it's
been a really traumatic delivery due to that, you know
(19:31):
mum's milk is dried up. What is the next best
thing that they can do?
Speaker 3 (19:36):
Well? From us, what we do you try to do
is provide education around you know verst all. Some even
anti natal expressing if there is an expectation that mum
is going to have a C section birth, or if
we've got a prem baby. Even what we sometimes do
is educate about expressing before delivery because some mums do
(19:56):
you have closterom and we can collect that clossroom to
feed to the baby. Okay, and sometimes that's the case
in a new key. A lot of mid and even
some children's and nic you or special cannursity nurses are
also lactation consultants, so they're going to give mum some
education beforehand as to watch there to try and bring
(20:19):
the breast milk in if it has been particularly traumatic,
especially where we've had quite a loss of blood. Of
mum's had to postpartum fridge, which is quite common. Unfortunately
it's a higher risk with sea section delivery and she's
lost a lot of blood. Sometimes her milk does it.
It takes a bit more to come in, so we
need to maintain that stimulus. But in the meantime we
(20:39):
may need to provide a small amount of formula and
that can be a very fra topic as well. We
do get some people in one corner head be quite
purist about breast is best, and some people that will say, look,
it's a tool. Formula can be used as a tool
to help breastfeed a baby, especially where mum is not
(21:01):
producing the milk, or we've got significant issues with nipple trauma,
mastitis and a range of other issues that are going
on getting that feeding started. Formula it sort of can
be a tool that can just help get that baby fed,
reduced to stressing them, because if you've got a constantly
hungry baby that's just wanting to feed, feed, beet beat
(21:21):
bet beet fed absolutely no sleep, she's got nipple trauma
or a lot of things, and she's thinking, particularly if
it's an emergency see section trying to digest what happened,
you're more likely to lose that breastfeeding. So me personally,
as a midwife, I don't demonize formula for that, and
(21:44):
I certainly don't demonize it for women here end up
exclusively formula feeding, because there are reasons why they are
doing that and they need to be supported to.
Speaker 2 (21:54):
We had a wonderful chat on the podcast about mixed
feeding and the one of the pages on a website,
the number one visited page was about mixed feeding, and
I can tell you from experience, it's the patients of
mind that have come into seeing me in my clinic,
and you know, some of them did mixed feed and
(22:14):
they were worried about even talking about the mixed feeding
side of things, but it allowed them to steal breastfeed
and allowed them to work or for whatever reason, because
you know, it's not my position to judge anybody on
how they choose to feed or breastfeed or that's not
my place or space to do that. My place is
(22:35):
to support the mum, which sometimes I think we forget
to do and I.
Speaker 3 (22:40):
Do feel that we do forget to do that, and
ideas around breastfeeding or infant feeding become very extreme. I
have in my time seen very militant breastfeeding advocates that
they almost gaslight women for not breastfeeding when there are
valid reasons why women can't breastfeed. And mental health of
(23:00):
the mother is just as important when it comes to
raising her bab baby and postnatal depression can be exacerbated
by issues with feeding as well. And I remember when
I had my first baby, well I wasn't a midwife
at the time. I had significant nipple trauma, and I
was absolutely devastating. I had postinnatal depression and devastated the
(23:22):
fact that I couldn't feed, and after two months of
battling that and nipple pain, it was like red hot
pins was very polar and I was just in the
ceiling with it. I ended up exclusively formula feeding, and
I hated every single bottle I had to make because
it psychologically entrenched. And it wasn't until I ended up
(23:43):
going to Tristy and then having around with the counselor there.
I was their psychologists, and she said he got pastinatal depression,
and we ended up talking about the feeding, and because
I was really sort of fixated on the inability to breastfeed,
and because she was saying, She's saying, I get so
upset with this extreme idea about breastfeeding, and you know
(24:04):
you're doing a good job, was a mom when you
have to resort the formula And I tried to carry
that on board even when I became a midwife, but
I found even as a midway three student that push
for breastfeeding was still quite hard. And I remember one
night I was into Postnatal Award as a student midwife
and talking with another midwife. He was talking to a
(24:26):
mother who was making formula and is a mom was
just about in tears and she's saying, why is everyone
making me an awful mum just because I'm making my
baby a bottle? And my heart broke right there and
I thought, what the hell am I doing? This isn't
midw for it, This isn't how you look after a
mom with a baby. And I think from then on
(24:48):
it became a very reflective experience for me to say, Look,
at the end of the day, being a mom isn't
simply about birth, and it's not simply about how you
fed your baby. It's that human being that you raise
and what they become at the end. And that's often
what I've had to say a lot of moms that
have been, you know, upset about their birth experience, if
(25:10):
it ended up in an emergency seas or even an
instrumental vaginal delivery, or if they've been unable to breastfeed
and they've had postnatal depression. It's sometimes being able to
go into that conversation in mind and that the motherhood
journey is still going, it's still continuing. Birth is a moment,
(25:32):
the infant feeding is just a moment.
Speaker 1 (25:34):
That's so true.
Speaker 2 (25:36):
It is but a moment, a magnificent moment and a
very special moment. But I was reflecting with a friend
on my two kids. And you know, I've got a
daughter in America she's twenty six, and a son here
in Brisbane who's twenty four. One was breastfed, one wasn't breastfed.
One was an absolute nightmare of a child. You know,
(25:59):
in hindsight, I probably did have postnatal depression with Jacob.
He was fed with a now's a gastric tube, wouldn't
take a bottle, nothing was It was horrendous time. But
both those kids are really nice humans, you know. And
we can beat ourselves up that we didn't breastfeed, or
we didn't do this, or we didn't do that. But
(26:21):
I think you're right when you say it's the beginning
of the magnificent journey. And at the end of the day,
we just want to make good humans, good people that
are good to other people, you know. And does it
matter that Jacob didn't breastfeed. Now at the time, it did.
I spent a lot of money on lactation consultants and
(26:43):
hospitals and you name it.
Speaker 3 (26:45):
It's surprisingly expensive.
Speaker 2 (26:47):
But I also wanted to give him that opportunity that,
you know, if he wanted to start breastfeeding again and
nuzzling that, you know, I could. But it just it
didn't work out, and so be it. And I moved
on pretty quick because I was more stressed about the
fact that the kid didn't eat and he didn't sleep,
so you know, whether he was bottled or not sort
of went out the window. It was a matter of
(27:08):
coping day to day with the child. That was hard work. Yeah, yeah,
you know, and I had plenty of people willing to
offer me advice, but in the end, I just had
to do what was right by my family, me, my husband,
my daughter, and Jacob exactly.
Speaker 3 (27:25):
And that's it at the end of the day, is
that it can be given all the advice in the world,
but it's got to work for you. And what worked
for one person isn't necessarily going to work for you.
And that's another conversation often have with particularly first time parents,
who you know, they got the world of advice coming
at them. When the mother is pregnant, they got the
(27:48):
world of advice coming is that baby arise. But what
was great for one person isn't necessarily great for another.
And you know my experience from my orders, I did
manage to go on and breastfeeding other and I did
a bit of mixed feeding as I went along. But
as he's seventeen now, he's finishing year eleven, going into
(28:09):
year twelve, andles he gets a mechanic apprenticeship which he
might be getting. And he's a great kid, and I
love him dearly. You know, I've enjoy him. I've enjoyed
him at each state of his life. I wouldn't change it.
Foot well, he's a great kid and I'm so proud
of him, and I appreciate that while I can say
that birth is but the moment, the feeding is at
the moment, I can appreciate the impact for some women.
(28:32):
I was lucky I hadn't had a hugely traumatic birth experience,
and remembering that traumatic birth experiences do happen with vaginal
verse as much as I do see and I'm lucky
I didn't have a traumatic birth experience. It was a
surprisingly vast one for the first time, but it was
that journey afterwards, the passontal depression, having this baby that
(28:56):
just didn't want to sleep, trying to breastfeed and it
just wasn't working and just being unable to absorb information
because I was just totally The lack.
Speaker 2 (29:06):
Of sleep, I would have to say, profoundly affected me
being able to cope day to day.
Speaker 3 (29:14):
Yeah, as one of my child and family health colleagues said,
you know full well, while they use it as a
torture tool, it's horrible. It's horrible, and you're just not
yourself at the end of it. And this is I
think why it's so important for women to be able
to have family and also to care. You know, that
(29:35):
stage in hospital when they're recovering, particularly they've had a
sea section, remembering we've still got a mom. She's recovering
from a surgery, but she's still just become a mum,
So we need to go that extra mile for her
to treat it for the surgical word her host operative needs,
but we need to treat it for her mid referee
needs and the fact that she's a mum that's just
(29:55):
had a babe and we need to go to extra
mild to make sure she's got support.
Speaker 2 (30:00):
I have utmost respect for moms that have had sea because,
let's be honest, it's major abdominal surgery. Absolutely, those women
are up and at them so fast, and they must
be so sore, and you know, I.
Speaker 1 (30:18):
Just think, oh, you poor things.
Speaker 2 (30:21):
I think it's wonderful because the baby's safe and mum
safe and for whatever reason they had a c section.
But I sometimes also think we forget you know, major
abdominal surgery usually takes a good six weeks to get over,
oh minimum.
Speaker 3 (30:34):
Absolutely, and it's got those other issues. You know that
we warn them against driving as well, because you know,
if something word to happen, because it's face that it
is a surgical awareness, an abdominal warn it could become infected,
or it could to hiss. There could be a range
of issues. They could bleed, being a c section and
a high risk of PPH R in the secondary PPH.
(30:57):
There's always there's possibilities that these things could happen while
they're driving and cause an accident. Their insurance won't cover it,
which puts me in a bit of a j lam or.
If they need to drive kids to school, so and
having to pick up the washing basket, someone like, well,
I've got no choice here. We're going to have to
pick up that washing basket where anyone's going to tell
me I can't or not.
Speaker 2 (31:18):
You just got to get on and do it, don't you.
And interesting, I'll keep this vague. A lovely client of mine,
I hadn't seen her for a while, and she brought
her little daughter in. And this will explain the damage's
seat belt can do. They're in a terrible car accident,
the daughter, and it shredded her bow. Now she now
(31:40):
has a nelios to me, and you know, moving forward,
you know things are progressing. However, that was from a
seat belt. So if you've got a Caesar scar which
is lovely and low mm hm, and you've got that's
exactly where the seat belt sits, if there was an
accident or you did have to stop suddenly, the thought
is actually really scary.
Speaker 1 (32:00):
It's really scary, right.
Speaker 2 (32:03):
I Mean, you hear about seatbelt saving lives, but it
just about costs that little girl hers, you know. So
I say to all my patients that have had anesthetic
or do not drive for twenty four hours if you've
had like a scope done or something like that. If
you've had post surgery, big surgery, you've got to get
the okay from clearance from your doctor. But there's the
(32:24):
other side of the coin where that mom might be
on her own, doesn't have any support, How the kid's
going to get to school, how is she going to
get shopping? She might be remote. There's so many other
issues around that as well. Yeah, I don't know the answer.
Speaker 3 (32:39):
No, I mean, I guess the thing we do is
that we're never going to force anyone, as we know,
whether a nurse or we're a midwife, we know we're
never going to force anyone to adhere to what we
advocate or educate them on. But at the end of
the day, they're going to do what they have to do.
(33:00):
Absolutely I think we just give them education, we give
them the full warning, and I do what they've got
to do in the end because they've got to live.
Speaker 2 (33:08):
To Absolutely well, Sarah, we have to wrap this up.
Thank you so much. I just want to ask one question.
I'd love to get you back on I to do
a little bit of a chat about personatal depression but
also birthing trauma. Do you have a lot of experience
in that area with your research.
Speaker 3 (33:28):
A little bit. I haven't directly researched I do yet,
but I am familiar with birth and trauma being a midwife,
we do come across birth in trauma and it's a
huge spectrum what trauma can be. And of course down
here in New South Wales we have had a recent
inquiry parliamentary inquiry into birth trauma and those findings are
(33:50):
quite interesting as well. So i'd be happy to Oh my.
Speaker 1 (33:53):
God, I would love it.
Speaker 2 (33:54):
So I will shoot your message and we will do
a part B, I think, and maybe a part C
because I love this information and I love what you've disseminated,
and I also love that it's common sense and there's
just not enough common sense.
Speaker 1 (34:12):
I don't think no world anymore.
Speaker 2 (34:15):
And it's really great to hear someone in your position
that you research, you educate, is just wanting the best
for women.
Speaker 1 (34:25):
And I love it.
Speaker 3 (34:26):
So thank you, thank you, thank you very much for
having me on
Appochia Production.
Speaker 2 (00:10):
Hi everyone, thank you for tuning back into Tenantus for Nurses.
I suspec Woodbine here this season. I am so excited
to announce that the podcast is being supported by Nutritia,
which is a global leader in medical nutrition. They understand
the needs of nurses in the nutrition space and for
over one hundred and twenty five years have provided products
(00:31):
to support child health. Some of Nutrita's pediatric brands include
Neo Kate Junior for children who have food allergies and
apt to Grow for those fussy eaters. And those of
us who have children know many kids who go through
the phases of definite fussiness. For more information and resources,
visit the nutritiona Pediatrics hub at nutritia dot com dot
(00:54):
au forward slash Pediatrics. I just want to say a
huge thank you to Nutritia. Their desire to support nurses
is truly appreciated, and they are allowing me to continue
this podcast so that we can all grow as nurses.
This season, we have some amazing speakers in the pediatric
space which I cannot wait to share with you all. Hi,
(01:14):
my name's Beck Woodbine and welcome to Tenderness for nurses.
Speaker 1 (01:18):
I'm grateful for the person that I have the opportunity
to be.
Speaker 3 (01:23):
So I hit it and parked it for Nellie four years.
Speaker 1 (01:27):
We always have free will, We always get to choose.
Speaker 3 (01:29):
We are autonomous.
Speaker 2 (01:33):
Hi everyone, thank you for tuning back in to Tenderness
for Nurses. We've had a little bit of a hiatus
as I've been working on a few different things with
the podcast and the website and just moving forward with
all the amazing people that I am going to be
bringing to you with the podcast. But today I am
very grateful that Sarah Elliott is with us. She's a
(01:54):
wretched nurse, registered midwife and she's coming on today to
have a chat to us about caesareans or c sections,
and she's part of the amazing group of women that
Nutritia put forward for me to have a chat to,
and their knowledge around food, diet, probiotics, probiotics is remarkable.
Speaker 1 (02:13):
So welcome Sarah.
Speaker 2 (02:15):
Thank you so much for coming on the podcast and
sharing a bit about yourself. So let's get straight into it.
Can you just tell me a little bit about yourself
and how it is that you and I are sitting
here opposite each other with the information you're going to share.
Speaker 3 (02:29):
Okay, So obviously I am a registered nurse. I've worked
in nursing for quite some time before making a bit
of a career change into midw free as most often
some of us will do. And I've worked in mid
with free as well as nursing, particularly around the Blue
Mountains and Lisco area. Moved into community mid with free,
(02:50):
working as a community midwife, and I moved on then
into academia with Childs University. Unfortunately, Mami and We've got
a lot of issues with the university's the budget's constraints
and they're losing money. My contract was cut for now,
so I'm sort of floating around doing some casual work
(03:10):
with other universities. And so this has led me to
Nutritia where I've been picked up and I'm more happy
to share whatever knowledge I can can provide.
Speaker 2 (03:21):
Is your interest in particular around cesarean sea section.
Speaker 3 (03:25):
I have had a bit of an interest with sea
section petically, given that not just as a midwife and
I was working in a hospital, but also as a
community midwife. Quite often I would be caring for women
who have been through sea sections and working in very
much a perib and to rural setting. Often these women
(03:47):
pallyw a higher risk ended up having to go to Nepean.
I'm situated in the Blue Mountains in New South Wales,
so our class is tertiary. Referral hospital is Napelean Hospital
down the Penrith and Western Sydney, and often they get
shipped down there when they're high risk and may end
up having to have a C section, whether it's because
(04:07):
of a real school because labor hasn't gone well. Do
you have your ones that go down there with a
planned caesar? And sometimes when you're looking after these women
post natally, they can have quite a broad range of
feelings about their birth experience and what occurred there, whether
it was planned or unplanned to have a C section.
(04:30):
So high risk pregnancy certainly peaked my curiosity and I
have had a research project that's been going with CSSUME.
It's yet to be finished, but yeah, it's a C
section in particular, and high risk pregnancies has been a
bit of an interest of mine, particularly for real women.
Speaker 1 (04:47):
Is that what this research is about that you're doing not.
Speaker 3 (04:51):
Just on C section, but looking at real women's experience
itself and looking through the literature we have found that
the experiences of real women have not really been explored,
which has been interesting because we have spoken. But there
is a lot of research out there that does look
at women with high risk pregnancies needing to transfer out
(05:14):
to tertiary referral hospitals and city areas. But the problem
is we don't always explore exactly what did they feel around,
you know, their experience, what were the hardships that they faced,
And quite often you find that they're at a considerable disadvantage.
Given that women with low risk pregnancies are able to
access anti enatal care within their communities, often with a
(05:38):
GP obstetrician, or they've got a visiting obstetrician or to
meet Biff they care thereout, high risk pregnant women can
be at a considerable disadvantage because they've got to be
going down to us we've got a birth and this
will increase a lot of stress upon them because they've
got to take time from work. Their partners may need
to take time from work. There's travel. You could be
(05:58):
sitting in a waiting room for hours.
Speaker 1 (06:01):
How far is it from the Blue Mountains to Penrith?
Speaker 3 (06:05):
So where I'm sitting I live in Workberfors, which is
right in the middle of the mountains. It's about a
forty five minute drive, okay when you go out to
lit Go, so we're looking about an hour and a
half they could be driving chair. And then if you
go further out to Bafitt, that's another half out of
forty five minutes on top of that, so you could
be looking at two two and a half hours. And
(06:27):
because that distance milage increases. The third is you go
west or in some cases you go thirty go south north.
There are other hospitals obviously, so further down the coast
you'll have access to Subtlent and Woongong hospitals, and there's
Royal North Shore John Hunter up in Newcastle. But you know,
rural women still have that tyranny of distance that they
(06:50):
need to overcome to access high level care.
Speaker 2 (06:53):
It was interesting I was reading through some of the
information and literature that have been sent through and in
twenty twenty two CEA section rates had gone up to
thirty nine percent, and in twenty ten they were at
thirty two, thirty one, thirty two percent. And it's interesting
because when I was working as a theater nurse in
(07:16):
at the Marta here in Brisbane, and I just did
the caesars. I didn't look after the babies, as I'm
not a midwife. When I first started, we got the
odd one at night time, you know, the odd emergency,
that sort of thing. By the time I left, and
I'd worked there two years, we were pretty much busy
all night with emergency caesars. And there were women, as
(07:37):
you said, that had come in that were rural and
remote that had come into the Marta as you know,
being a primary healthcare setting and tertiary hospital. But some
of those women were down by themselves, and especially if
it was an emergency. You know that is traumatic to
be by yourself when you're giving birth. You know, I
can't even begin to comprehend what that must be like.
(07:59):
And you would see this all the time because you know,
someone's got to stay home if they've got more than
one child and look after their kids. It's we think about,
you know, c sections just being easy. But you know
when you think about rural and remote women, it's not,
is it.
Speaker 3 (08:13):
No, it's not. You know, these women, like we've mentioned,
i'd have to look at time of work, whether they're partner,
can get time of work families, existing children, you know,
who can look after the kids because not everyone lives
in the same community in terms of family. Some have
moved in from the city, or they may even be
(08:34):
people who have family overseas, and so that's not always
care for other older children. It's not always readily accessible there.
And then you've got the other issues that come with
rural health as well, not just in access of health care,
but we're also looking at, you know, the social determinants
of health. We're looking at health literacy, we're looking at
(08:54):
you know, their education levels, they're health in general, you know,
and all this can really determine sometimes whether or not
they're going to have a high risk pregnancy and if
they're going to need to be shipped as well.
Speaker 1 (09:06):
It's interesting. On Friday, Sammy, who's sitting on.
Speaker 2 (09:10):
My lap, and I visited the Children's hospital here in
Queensland just to do some therapy dog work and I
had the absolute privilege of meeting this beautiful family from Normanton.
And this is where I think, you know, we get
it so right with kids that are in hospital, and
we get it so wrong for the other areas of
(09:32):
healthcare in that they were able to they were First
Nations people, Indigenous.
Speaker 1 (09:38):
They were able to fly the whole.
Speaker 2 (09:39):
Family down from Normanton, so you know, her sister, her mum,
and her dad, and they came out because they missed
their doggies, so they came and have a cuddle with
the dogs, and I got chatting with mum and they
were just the most beautiful, beautiful family, and they were
so grateful that they were able to come as a
(10:02):
family supported by the Children's Foundation, to be there all together.
And we know, in particular First Nations people like their
people around them. You know, they heal better, they recover
better when loved ones and people that they know are
around them. But these two little girls, oh my god,
they were divine and they were so beautiful with the
(10:24):
dogs and so excited to have and then they'll show
me photos of their animals, and I just thought, you know,
it's very different then for a woman giving birth, she's
probably shipped out pretty much, I'm assuming or air backed
out by yourself, and family would come in later if
they can. But imagine if you're a First Nations person
(10:45):
where you know you want your women tribe around you,
and here you are going in to have a c
section or a high risk pregnancy near thereby yourself. It
must be really frightening.
Speaker 3 (10:56):
It would be very, very frightening. And also there's cultural
considerations around. I mean, they like to be able to say,
say birth on country, so they want to be able
to have their babies on their country, their ancestral country leads,
and so where shipping them to another area where they're
not Some hospitals like the Pean to have a good
(11:17):
indigenous cultural environment that they've tried to help create Indigenous women,
but there's still always those cultural issues. We have women
that are able to bring their family in, but it's
not always the case and it can be a very
very difficult experience for them. And also we've also got
the issues that are still left behind from the stolen
(11:39):
generations as well, where we have the inherent mistrust of
the medical system. So you can imagine a woman who
you know, she comes from a family where there's been
so much of that abuse and mistrust within stolen generation mothers, fathers, aunts,
uncles or grandparents, and they're still hurting from that. They've
(12:02):
heard all the stories and if they've been net straight
down to nepaying for an emergency birth because something's not
going well, you can imagine the fear that could be
cropping up in their minds of Indigenous what's going to
happen to my baby? Or how they support people, whether
it be their parents, their partner, partner's family as well,
(12:22):
could be feeling a bit on edges to you know,
whether they can trust this system or not.
Speaker 2 (12:28):
And you find that that has absolutely impacted our First
Nations people moving forward in healthcare, it can.
Speaker 3 (12:36):
We're making head roads, you know, to trying to be
more culturally we're more culturally respectful, and we certainly have
you know, good inroads with things like our Aboriginal midwives.
You know, we have our Aboriginal midwives that are providing
care to Aboriginal women, and of course where we have
(12:57):
non Indigenous midwives that are providing care, we try to
ensure that we've got Aboriginal liaison officers or healthcare work
because they also assist in the care, just to make
that care smooth more trustworthy for them as well. So
we are making some inroys there, but you know, you
can you can expect that these emotional and psychological scars
(13:20):
is going to take so long to heal, and here
is at you'll never heal. Yes, it's very deep and
will never heal. So while we're making some good inroads,
there's still a long way to go, and also the
closing of the gap. As we know, Indigenous people, including
their women, still have lower outcomes, you know, better out
(13:41):
they don't have the good outcomes that non Indigenous people have.
So we're still working to close those gaps as well, which.
Speaker 2 (13:48):
Is wonderful in healthcare and it makes me really proud
to be part of that that you know, people have
recognized this and are trying to change it. It's not
going to happen overnight, but the right people hopefully are
doing the right things, you know, and meeting these.
Speaker 1 (14:06):
This family, I don't know.
Speaker 2 (14:07):
It's funny how one family can impact you so dramatically,
and this family did, and they just, I don't know,
I just felt like they got the hospital and the
foundation got it right for this family. I'm not saying
that happens to all families, but for this family, it
really helped them. And it was so beautiful, beautiful to see,
(14:28):
you know, this little girl that hopefully will get discharged
in a couple of weeks time, and that mom and
dad were there and it was just lovely to see
and to actually help with some of the healing with
you know, Sammy the therapy dog. You know, it's a
little thing I did, but I probably got more out
of it than they did.
Speaker 3 (14:44):
But you know, it is a beautiful story and it's
wonderful to hear. It is great to hear these stories
that are going on with Hill.
Speaker 1 (14:52):
I couldn't agree with you more.
Speaker 2 (14:54):
When we talk about C section and compare it to
a vaginal birth, and then we start talking about gut
health and microbiome and all that sort of thing. What
is the difference between a C section and a vaginal
birth when it comes to gut health.
Speaker 3 (15:12):
So what we're looking at in terms of gut health
and a vaginal birth, as we can appreciate, the vaginal
environment has a lot of microbes in it. So as
a baby is being birth through the vaginal canal or
the passage there, they are exposed to more microds from
mump and those microbes, you know, will infiltrate their respiratory
(15:34):
and their gut system, the gas intestinal system, and create
a microbiome within there. However, when it comes to C section, unfortunately,
and you wouldn't think of it initially, but with C section,
because it's a more sterile environment, they're not being pushed
through the vagina, so to speak. They're coming out through
an incision that's been swopped down, sterilized or sterile drapes,
(15:56):
or the doctors and nurses are stereo for good reason
because you know, you've got to be on infection. Good. No, Unfortunately,
what it means is that the baby isn't getting that
microbe exposure, and so they're not building that gut health
the microbiome in comparison to what a vaginally birthed baby is.
(16:17):
So I guess what that is. So it is well
established that there is a difference in those microbios between
the two types of births, and there may be some
issues around that, particularly around conditions like exma, maybe asthma,
issues with colic diary, and a few other issues that
may be related to that as well.
Speaker 2 (16:40):
Can it increase your risk of getting an autoimmune condition,
because you know, skin conditions tend to be more autoimmune allergies.
Can it increase that risk?
Speaker 3 (16:51):
It appears that some research is pointing to the possibility
that there may be some risks in this direction. I
guess what it is is that it's balancing that way
of evidence. You know, while we have some research it
will say yes, we found a positive correlation, there's evidence
that's saying we didn't find that, So we've got to
(17:14):
look at you know, where is that evidence? Coming back
to one I thought was a bit interesting though it
was sort of I wasn't sure I particularly felt about it.
There's a few research articles around c sections and autism.
You know, does C section delivery increase the instances of autism?
(17:36):
And having a look at the research, it's okay, there
was quite a large cohort, But what did they measure
this against? What might have been just circumstantial or coincidental?
I guess is probably the word that I'm looking at.
What did they measure against? Was it coincidental? And as
even some autism groups are saying, look, correlation doesn't also
(17:59):
equate to causation. We can't really say for sure that
it increases of autism or autism diagnosis. And I think
there's also the issue that with people with autism, we
look at it and say, look, you're saying that we're
people that need to be fixed or a problem as well.
Speaker 2 (18:18):
Yes, So yeah, regardless how you look at it's fraught
conversations and opinions that that sort of research question, isn't it,
You know, like that's one research. I mean, look, you
can look at any research and take from it what
you will, can't.
Speaker 3 (18:35):
You you could? I mean, there's research that is pretty
rock solid. The way of evidence is pretty clear around
you know, mass medications or what physics is, or around
elements and all that kind of stuff. But when you're
looking at research that does have a lot of gray
areas in there, we've got to look at how we
(18:56):
measure that, and you know, it's going to be repeated
research and good methodology and that research it's going to
be inform is better as well.
Speaker 2 (19:08):
What can mums and families do if they do have
to have a cesarean or a sea section? Are there
things dietary wise they can do for their newborn? Now,
obviously breast is best and that would be your number
one choice that you're getting mum's milk, But if it's
been a really traumatic delivery due to that, you know
(19:31):
mum's milk is dried up. What is the next best
thing that they can do?
Speaker 3 (19:36):
Well? From us, what we do you try to do
is provide education around you know verst all. Some even
anti natal expressing if there is an expectation that mum
is going to have a C section birth, or if
we've got a prem baby. Even what we sometimes do
is educate about expressing before delivery because some mums do
(19:56):
you have closterom and we can collect that clossroom to
feed to the baby. Okay, and sometimes that's the case
in a new key. A lot of mid and even
some children's and nic you or special cannursity nurses are
also lactation consultants, so they're going to give mum some
education beforehand as to watch there to try and bring
(20:19):
the breast milk in if it has been particularly traumatic,
especially where we've had quite a loss of blood. Of
mum's had to postpartum fridge, which is quite common. Unfortunately
it's a higher risk with sea section delivery and she's
lost a lot of blood. Sometimes her milk does it.
It takes a bit more to come in, so we
need to maintain that stimulus. But in the meantime we
(20:39):
may need to provide a small amount of formula and
that can be a very fra topic as well. We
do get some people in one corner head be quite
purist about breast is best, and some people that will say, look,
it's a tool. Formula can be used as a tool
to help breastfeed a baby, especially where mum is not
(21:01):
producing the milk, or we've got significant issues with nipple trauma,
mastitis and a range of other issues that are going
on getting that feeding started. Formula it sort of can
be a tool that can just help get that baby fed,
reduced to stressing them, because if you've got a constantly
hungry baby that's just wanting to feed, feed, beet beat
(21:21):
bet beet fed absolutely no sleep, she's got nipple trauma
or a lot of things, and she's thinking, particularly if
it's an emergency see section trying to digest what happened,
you're more likely to lose that breastfeeding. So me personally,
as a midwife, I don't demonize formula for that, and
(21:44):
I certainly don't demonize it for women here end up
exclusively formula feeding, because there are reasons why they are
doing that and they need to be supported to.
Speaker 2 (21:54):
We had a wonderful chat on the podcast about mixed
feeding and the one of the pages on a website,
the number one visited page was about mixed feeding, and
I can tell you from experience, it's the patients of
mind that have come into seeing me in my clinic,
and you know, some of them did mixed feed and
(22:14):
they were worried about even talking about the mixed feeding
side of things, but it allowed them to steal breastfeed
and allowed them to work or for whatever reason, because
you know, it's not my position to judge anybody on
how they choose to feed or breastfeed or that's not
my place or space to do that. My place is
(22:35):
to support the mum, which sometimes I think we forget
to do and I.
Speaker 3 (22:40):
Do feel that we do forget to do that, and
ideas around breastfeeding or infant feeding become very extreme. I
have in my time seen very militant breastfeeding advocates that
they almost gaslight women for not breastfeeding when there are
valid reasons why women can't breastfeed. And mental health of
(23:00):
the mother is just as important when it comes to
raising her bab baby and postnatal depression can be exacerbated
by issues with feeding as well. And I remember when
I had my first baby, well I wasn't a midwife
at the time. I had significant nipple trauma, and I
was absolutely devastating. I had postinnatal depression and devastated the
(23:22):
fact that I couldn't feed, and after two months of
battling that and nipple pain, it was like red hot
pins was very polar and I was just in the
ceiling with it. I ended up exclusively formula feeding, and
I hated every single bottle I had to make because
it psychologically entrenched. And it wasn't until I ended up
(23:43):
going to Tristy and then having around with the counselor there.
I was their psychologists, and she said he got pastinatal depression,
and we ended up talking about the feeding, and because
I was really sort of fixated on the inability to breastfeed,
and because she was saying, She's saying, I get so
upset with this extreme idea about breastfeeding, and you know
(24:04):
you're doing a good job, was a mom when you
have to resort the formula And I tried to carry
that on board even when I became a midwife, but
I found even as a midway three student that push
for breastfeeding was still quite hard. And I remember one
night I was into Postnatal Award as a student midwife
and talking with another midwife. He was talking to a
(24:26):
mother who was making formula and is a mom was
just about in tears and she's saying, why is everyone
making me an awful mum just because I'm making my
baby a bottle? And my heart broke right there and
I thought, what the hell am I doing? This isn't
midw for it, This isn't how you look after a
mom with a baby. And I think from then on
(24:48):
it became a very reflective experience for me to say, Look,
at the end of the day, being a mom isn't
simply about birth, and it's not simply about how you
fed your baby. It's that human being that you raise
and what they become at the end. And that's often
what I've had to say a lot of moms that
have been, you know, upset about their birth experience, if
(25:10):
it ended up in an emergency seas or even an
instrumental vaginal delivery, or if they've been unable to breastfeed
and they've had postnatal depression. It's sometimes being able to
go into that conversation in mind and that the motherhood
journey is still going, it's still continuing. Birth is a moment,
(25:32):
the infant feeding is just a moment.
Speaker 1 (25:34):
That's so true.
Speaker 2 (25:36):
It is but a moment, a magnificent moment and a
very special moment. But I was reflecting with a friend
on my two kids. And you know, I've got a
daughter in America she's twenty six, and a son here
in Brisbane who's twenty four. One was breastfed, one wasn't breastfed.
One was an absolute nightmare of a child. You know,
(25:59):
in hindsight, I probably did have postnatal depression with Jacob.
He was fed with a now's a gastric tube, wouldn't
take a bottle, nothing was It was horrendous time. But
both those kids are really nice humans, you know. And
we can beat ourselves up that we didn't breastfeed, or
we didn't do this, or we didn't do that. But
(26:21):
I think you're right when you say it's the beginning
of the magnificent journey. And at the end of the day,
we just want to make good humans, good people that
are good to other people, you know. And does it
matter that Jacob didn't breastfeed. Now at the time, it did.
I spent a lot of money on lactation consultants and
(26:43):
hospitals and you name it.
Speaker 3 (26:45):
It's surprisingly expensive.
Speaker 2 (26:47):
But I also wanted to give him that opportunity that,
you know, if he wanted to start breastfeeding again and
nuzzling that, you know, I could. But it just it
didn't work out, and so be it. And I moved
on pretty quick because I was more stressed about the
fact that the kid didn't eat and he didn't sleep,
so you know, whether he was bottled or not sort
of went out the window. It was a matter of
(27:08):
coping day to day with the child. That was hard work. Yeah, yeah,
you know, and I had plenty of people willing to
offer me advice, but in the end, I just had
to do what was right by my family, me, my husband,
my daughter, and Jacob exactly.
Speaker 3 (27:25):
And that's it at the end of the day, is
that it can be given all the advice in the world,
but it's got to work for you. And what worked
for one person isn't necessarily going to work for you.
And that's another conversation often have with particularly first time parents,
who you know, they got the world of advice coming
at them. When the mother is pregnant, they got the
(27:48):
world of advice coming is that baby arise. But what
was great for one person isn't necessarily great for another.
And you know my experience from my orders, I did
manage to go on and breastfeeding other and I did
a bit of mixed feeding as I went along. But
as he's seventeen now, he's finishing year eleven, going into
(28:09):
year twelve, andles he gets a mechanic apprenticeship which he
might be getting. And he's a great kid, and I
love him dearly. You know, I've enjoy him. I've enjoyed
him at each state of his life. I wouldn't change it.
Foot well, he's a great kid and I'm so proud
of him, and I appreciate that while I can say
that birth is but the moment, the feeding is at
the moment, I can appreciate the impact for some women.
(28:32):
I was lucky I hadn't had a hugely traumatic birth experience,
and remembering that traumatic birth experiences do happen with vaginal
verse as much as I do see and I'm lucky
I didn't have a traumatic birth experience. It was a
surprisingly vast one for the first time, but it was
that journey afterwards, the passontal depression, having this baby that
(28:56):
just didn't want to sleep, trying to breastfeed and it
just wasn't working and just being unable to absorb information
because I was just totally The lack.
Speaker 2 (29:06):
Of sleep, I would have to say, profoundly affected me
being able to cope day to day.
Speaker 3 (29:14):
Yeah, as one of my child and family health colleagues said,
you know full well, while they use it as a
torture tool, it's horrible. It's horrible, and you're just not
yourself at the end of it. And this is I
think why it's so important for women to be able
to have family and also to care. You know, that
(29:35):
stage in hospital when they're recovering, particularly they've had a
sea section, remembering we've still got a mom. She's recovering
from a surgery, but she's still just become a mum,
So we need to go that extra mile for her
to treat it for the surgical word her host operative needs,
but we need to treat it for her mid referee
needs and the fact that she's a mum that's just
(29:55):
had a babe and we need to go to extra
mild to make sure she's got support.
Speaker 2 (30:00):
I have utmost respect for moms that have had sea because,
let's be honest, it's major abdominal surgery. Absolutely, those women
are up and at them so fast, and they must
be so sore, and you know, I.
Speaker 1 (30:18):
Just think, oh, you poor things.
Speaker 2 (30:21):
I think it's wonderful because the baby's safe and mum
safe and for whatever reason they had a c section.
But I sometimes also think we forget you know, major
abdominal surgery usually takes a good six weeks to get over,
oh minimum.
Speaker 3 (30:34):
Absolutely, and it's got those other issues. You know that
we warn them against driving as well, because you know,
if something word to happen, because it's face that it
is a surgical awareness, an abdominal warn it could become infected,
or it could to hiss. There could be a range
of issues. They could bleed, being a c section and
a high risk of PPH R in the secondary PPH.
(30:57):
There's always there's possibilities that these things could happen while
they're driving and cause an accident. Their insurance won't cover it,
which puts me in a bit of a j lam or.
If they need to drive kids to school, so and
having to pick up the washing basket, someone like, well,
I've got no choice here. We're going to have to
pick up that washing basket where anyone's going to tell
me I can't or not.
Speaker 2 (31:18):
You just got to get on and do it, don't you.
And interesting, I'll keep this vague. A lovely client of mine,
I hadn't seen her for a while, and she brought
her little daughter in. And this will explain the damage's
seat belt can do. They're in a terrible car accident,
the daughter, and it shredded her bow. Now she now
(31:40):
has a nelios to me, and you know, moving forward,
you know things are progressing. However, that was from a
seat belt. So if you've got a Caesar scar which
is lovely and low mm hm, and you've got that's
exactly where the seat belt sits, if there was an
accident or you did have to stop suddenly, the thought
is actually really scary.
Speaker 1 (32:00):
It's really scary, right.
Speaker 2 (32:03):
I Mean, you hear about seatbelt saving lives, but it
just about costs that little girl hers, you know. So
I say to all my patients that have had anesthetic
or do not drive for twenty four hours if you've
had like a scope done or something like that. If
you've had post surgery, big surgery, you've got to get
the okay from clearance from your doctor. But there's the
(32:24):
other side of the coin where that mom might be
on her own, doesn't have any support, How the kid's
going to get to school, how is she going to
get shopping? She might be remote. There's so many other
issues around that as well. Yeah, I don't know the answer.
Speaker 3 (32:39):
No, I mean, I guess the thing we do is
that we're never going to force anyone, as we know,
whether a nurse or we're a midwife, we know we're
never going to force anyone to adhere to what we
advocate or educate them on. But at the end of
the day, they're going to do what they have to do.
(33:00):
Absolutely I think we just give them education, we give
them the full warning, and I do what they've got
to do in the end because they've got to live.
Speaker 2 (33:08):
To Absolutely well, Sarah, we have to wrap this up.
Thank you so much. I just want to ask one question.
I'd love to get you back on I to do
a little bit of a chat about personatal depression but
also birthing trauma. Do you have a lot of experience
in that area with your research.
Speaker 3 (33:28):
A little bit. I haven't directly researched I do yet,
but I am familiar with birth and trauma being a midwife,
we do come across birth in trauma and it's a
huge spectrum what trauma can be. And of course down
here in New South Wales we have had a recent
inquiry parliamentary inquiry into birth trauma and those findings are
(33:50):
quite interesting as well. So i'd be happy to Oh my.
Speaker 1 (33:53):
God, I would love it.
Speaker 2 (33:54):
So I will shoot your message and we will do
a part B, I think, and maybe a part C
because I love this information and I love what you've disseminated,
and I also love that it's common sense and there's
just not enough common sense.
Speaker 1 (34:12):
I don't think no world anymore.
Speaker 2 (34:15):
And it's really great to hear someone in your position
that you research, you educate, is just wanting the best
for women.
Speaker 1 (34:25):
And I love it.
Speaker 3 (34:26):
So thank you, thank you, thank you very much for
having me on
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