Long-acting reversible contraception or ‘LARC’ describes contraceptive methods that you don’t need to use every day. This includes the copper intrauterine device (also known as the ‘coil’), progestogen-only intrauterine system (also known as the ‘hormonal coil’), progestogen-only injectable contraceptives (‘depo’) and subdermal implants (‘implant’). I recently mentioned another group conducting research on provision of long acting contraceptives. Looks like it’s a hot topic this year!
LARC is popular as it’s a highly effective method of preventing pregnancy. For some people it can be a positive option, but there are concerns that some may experience pressure to use LARC, or may find it difficult to get removed. Researchers from Lancaster University, working with the British Pregnancy Advice Service (BPAS), are studying LARC in the UK.
If you’ve been encouraged to use LARC, are over 13 and living in the UK, the researchers would love to talk to you!
For more information, please read the attached documents:
Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI
I took part in the Big Birthas Parenting Science Gang as a Parent Scientist. I helped to decide the research question, design the methods we would use, and undertake some of the analysis.
When the project ended, we Parent Scientists had the data and the findings, but needed to decide what to do with them. My day job is a doula and researcher, and I’m passionate about choices in birth for all, regardless of BMI. Some of the stories women had shared with us were heartbreaking; stories of choice and power taken away, and of upset and trauma as a result.
Some of the stories were also uplifting, when women took power back; asserting their rights to make choices and decisions about themselves, their bodies, and their babies. Women had shared so much, giving time and investing themselves by telling their stories. I want to make sure we do justice to that.
One way I can do that is to present our findings to a diverse range of audiences. In my day job, I frequently present research to conferences of academics, so I applied to the Medical Sociology Conference. Hosted by the British Sociological Association, it is a brilliant event which focuses not on what we do within health care, but how we do things, why we do things, and how we could do health care better.
My talk was accepted, in a format called Pecha Kucha. These presentations allow you to present 20 slides, and talk about each one for 20 seconds. It’s a challenging format because it makes you really focus on the key points you want to make. There is no room for waffle!
I wrote the both the initial application and the presentation collaboratively with Big Birthas and several of the other Parent Scientists, using the Facebook group to refine ideas and try things out, in the same way we had used it during the Parenting Science Gang project. It was lovely to have that very supportive and equal way of working. This is quite different from the creation of most other academic and medical presentations.
The high BMI ‘box’
I chose to focus on one of our findings, the idea of the ‘high BMI box’. Many women explained how, once in this category, BMI was the only thing anyone seemed interested in. They described having serious medical conditions ignored. One woman explained how the difference between her starting weight in her two pregnancies was objectively only 7 pounds, but in one this was ‘normal BMI’, while the other saw her put into the ‘high BMI box’. She eloquently described the differences this made to her care.
Programme excerpt about our research at the Medical Sociology Conference:
Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI
What does it mean to be labelled as having a high-BMI whilst pregnant? How does this label affect women’s experiences of navigating maternity services?
This presentation is based on a novel user-led Citizen Science collaboration between Big Birthas (peer information and support service) and Parenting Science Gang (Wellcome Trust funded user-led citizen science project).
The results described complex journeys, where interactions with healthcare professionals revolved around conversations of BMI-related risks to the exclusion of other factors, and ignored other events of the pregnancies.
Women also reported disrespectful and shaming language from healthcare professionals, and conflict if they asserted a decision that was not in line with the healthcare professional’s views.
This led some women to decline care that they actually wanted, or avoid attending appointments, to avoid conflict or denial of choice; a consequence which was particularly apparent when we examined how those women chose to approach their second pregnancies.
The presentation and our research at the Medical Sociology Conference was well received. Questions after the talk asked about both the Parenting Science Gang methodology, our methodology, and our findings. People spoke about how our research overlaps with work they are doing.
The Parenting Science Gang’s project is over, but the journey of the stories we collected is not. Next, I am hoping to work with some of the other Parent Scientists to turn our findings into a piece that can be published in a midwifery journal. Watch this space…
Dr Mari Greenfield
Academic researcher in maternity care, doula, birth activist. Special interests in traumatic birth and LGBTQ experiences.
Huge thanks to Mari for bringing our research to a wider audience, and for writing up the experience too!
Would you like to write a guest post for Big Birthas? Have you got experiences or a perspective that the Big Birthas audience might be interested in? Do you have a birth story you want to share? Please get in touch via the Contact Big Birtha page.
(If you are unfamiliar with the term, an IBCLC is a breastfeeding expert. Highly experienced, trained and qualified to help mothers and babies to breastfeed, they can help with both basic and complex breastfeeding challenges. What they don’t know about boobs, breastfeeding and milk isn’t worth knowing! Find out more at the Lactation Consultants of Great Britain website.)
“Christmastitis – Did you know that rates of mastitis go up around holiday periods?
Why? Well, loads of reasons to be honest. Let’s picture it shall we?
It’s your first Christmas with your baby. You’re mega excited and so is everyone else to have this gorgeous bundle in their lives. Christmas is going to be AWESOME. Lots of travelling around in the car visiting friends and family, making the most of maternity leave to see everyone and proudly show off this little person, taking up offers to go over and be cooked for! And that is genuinely fabulous.
Breasts Not Being Regularly and Fully Emptied
But all that travelling leads to lots of time in the car seat, and for most babies the car seat sends them to sleep. And long sleeps mean long gaps between feeds, which leads to full breasts with potential for blockages…
Then the parties, the gatherings, celebrations! Lovely right?! Yes! Except everyone wants a hold of little baby Rupert and once again he has longer stretches between feeds. And when he does come back to you he’s over stimulated and over tired and only takes two minutes on the breast before he falls asleep leaving you with, you guessed it, full breasts….
Or the guests seem to think they know better than you do about baby Josie’s feeding cues and tell you she doesn’t need feeding, they can settle her for you. They talk about how ‘when they had babies you only fed every four hours and it didn’t do them any harm’. You’re then stuck between a rock and a hard place, because you would like to feed your baby, but you don’t want to upset family or the way they did things, and maybe they’re right?
Feeds are often cut short around celebrations, because you have lots of people offering to help and hold the baby so your dinner doesn’t go cold, or guests arrive, or you’re due somewhere, or you’re upstairs feeding and want to get back down to the party…the list goes on. So your breasts don’t get ’emptied’ like usual and can you guess what happens next? Yep….
Restricted Milk Flow?
Maybe you don’t feel comfortable feeding around Auntie Ethel and Uncle Bernard, so you don’t quite expose your breast as much as you might normally, and your clothes/bra are digging in a little and restricting milk flow and cause a blockage…
Maybe you’re sleeping somewhere different, the bed is different, you can’t quite get the angle of the feed right on this squishy mattress and the latch goes a bit dodgy, but you put up with it because you don’t want the baby to cry and wake everyone. Dodgy latch leads to breast not emptying efficiently…and you know the rest.
Christmas is lovely, but for a huge amount of people it’s also very stressful. Stress hormones can impact on oxytocin, which is the hormone needed to let your milk flow. So stress can temporarily inhibit milk flow leading to those full/blocked breasts again.
I might be coming across as a bit Bah, Humbug! but I’ve been around enough mothers with mastitis to know its REALLY not what you want to be dealing with at any point. It is not to be messed with, it is a serious condition and you can potentially end up very poorly.
What I’m saying is, take it EASY. Plan ahead now to make sure this holiday season is one where you can feed whenever and wherever you need to. Be led by your baby. Don’t stretch out or cut short feeds. Listen to your body, not Auntie Denise.”
If you’re finding you’re struggling with breastfeeding, don’t battle on alone. People often stop breastfeeding in the first month when they experience problems such as sore nipples, inadequate milk production (real or perceived), and difficulties getting the baby feeding. These problems can almost always be overcome with the correct support – and getting help sooner rather than later is definitely the best advice.
You can find a Baby Café near you: https://www.thebabycafe.org/ who offer free drop-in sessions for info, support and advice (part of the National Childbirth Trust, and often run by IBCLCs)
You can employ the services (if you have the funds) of an IBCLC to come to your home: https://www.lcgb.org/find-an-ibclc/ Usually about £60-£90 for an initial consultation, but if money is a concern, many offer instalment payment options, and while it’s not really a financial decision, when weighed against the cost of months of formula, it can be an excellent investment if it helps you to begin/maintain the breastfeeding relationship with your baby that you want.
Finding fashionable plus-size maternity wear can be a bit of a problem at the best of times, but it’s a nightmare before Christmas! So here are Big Birtha’s picks for festive fashion if you’re plus-size & pregnant.
One of the pluses of being pregnant and plus size is that you often don’t have to restrict yourself just to maternity ranges (whole article on this here). If it’s a loose style with plenty of fabric, give it a try, with the additional bonus that you’ll be able to use it after pregnancy too. Most of the clothes featured here aren’t from the maternity section, so don’t forget to check out the non-maternity lines!
The Killer Christmas Dress
I think this holly print vintage style dress by HellBunny is my favourite of everything I’ve found.
It’s not a maternity dress, but because the style flares out just under the bust line, there’s plenty of fabric at the front. Depending on the size and position of your bump it could be an option. It’s being sold by high street retailer Yours, so with free click and collect and free returns, you can just try it on when you collect and if it’s no good, return it!
Not one, but two options here! I have a slight reservation with the Yours one, in that it’s described as a ‘novelty’ dress. This makes me question the quality, but both reviewers have given it 5 stars. The Shein dress is significantly cheaper, but it does say the fabric has no stretch, and it doesn’t appear to be as full as the Yours dress, so if you’re quite far along, it may not be the option for you…
There’s a plethora of gorgeous shimmery dresses this season, and with plenty of fabric in the pleats, could be perfect for the office Christmas party this year with a bump, and still wearable next year.
(I’d say next year, without a bump, but let’s be realistic!)
I think the glittery gold dress from Shein looks really opulent. It also comes in silver. Just steer clear of that one if you’re planning on wearing it for Christmas lunch, unless you want to invite comparisons with a foil-wrapped turkey!
As well as glorious shimmery sparkle, it seems to all be about the sequins this Christmas!
For many people, Christmas is all about being snuggly in a cosy pair of pyjamas. If so, fear not – there are some festive maternity options which should see you comfy as you open your presents on Christmas morning.