• Chloe Bernard

Last year, I made this little lexicon to help my clients navigate through their journey in a smoother way. When you are pregnant in Finland, you meet nurses, doctors and midwives who speak Finnish or Swedish. Most of them speak English but you might be confronted to some "lost in translation" moments. I've got your back!





Abortti / raskaudenkeskeytys

Abortion

Termination of the pregnancy. It can be medical (induced with drugs) or surgical.


Akupainanta

Acupressure

Alternative Chinese medicine similar to acupuncture but without needles.


Akupunktio

Acupuncture

Traditional Chinese medicine using the meridians of the body to balance and heal. Very thin needles are screwed in the skin at strategic points. It can be used during pregnancy to alleviate discomfort, pain or to facilitate labour.


Aquarakkulat

Sterile water injection (aqua blisters)

A non-medical pain tricker. Hot feeling that makes diversion. The sterile water is injected just under your skin, in your back or lower belly. You can ask for refills.


B-ryhmän streptokokki

GBS

Group B Streptococcus also known as Group B Strep Infection (GBS) is a type of bacterial infection that can be found in a pregnant woman's vagina or rectum. This bacteria is normally found in the vagina and/or rectum of about 25% of all healthy, adult women. Women who test positive for GBS are said to be colonised.


Ballonki

Foley balloon catheter

This is a tool used as a mechanical induction method. The balloon is inserted in the cervix, then it is inflated with a saline solution and left in place while being taped to the thigh to provide gentle traction. When the balloon falls down, that means the cervix has opened. During this process, contractions usually start and labour follows.


Doula

Doula

A professional who offers you information and unconditional (emotional and physical) support through pregnancy, birth and beyond. There are different types of doulas: birth doulas, yoga doulas, water doulas, bereavement doulas, death doulas, postpartum doulas. Some doulas are even specialised in adoption or surrogacy. Doulas are there to facilitate all types of transitions.


Emätin

Vagina

Magical organ with superpowers that some men fear. It is an elastic, muscular canal with a soft lining which connects the uterus to the outside world.


Epiduraali

Epidural

Injection of anaesthetic and/or analgesic in the epidural space.


Episiotomia / välilihan leikkaus

Episiotomy

A surgical cut made at the opening of the vagina during childbirth, to aid a difficult delivery or to enlarge the vaginal opening during a vacuum-assisted delivery. Traditionally, it used to be practised systematically to avoid tears. Since then, evidence based medicine has refuted the theory and tears, healing faster and better, are preferred to a surgical cut that can lead to further damages and challenge the mother’s quality of life.


Gua sha kampa

Gua sha comb

A traditional Chinese medicine massage tool that looks like a comb, a fish, an heart, made of jade, quartz, bone or wood. It is use to scrap or spoon the skin. A way to relax, release tensions, during pregnancy, birth and after.


Hieronta

Massage

One of the tools we have to relieve pain, relax, and stimulate oxytocin production.


Hypnoosi

Hypnosis

Self induced state of relaxation. Technique to enter and stay in a safe bubble. The mind-body fantastic relationship.


Häpyhuulet

Labia

Lips of the vulva.


Häpykieli / Klitoris

Clitoris

The female organ that focuses on pleasure only. Its full shape has recently been discovered.


Ilokaasu

Laughing gas

Nitrous oxide (nitrox) is used as a pain relief during labour. The birthing person inhales the gas through a mask. The gas formula is N2O.


Imetys

Breastfeeding/Chestfeeding

Gastronomic exchange of oxytocin. Soothes and reassures baby. Helps mummy/parent to get a restorative sleep, bond with their baby and so much more.


Imukuppi

Vacuum extractor

The vacuum device uses a soft cup that attaches to the baby’s head with suction and guides the baby’s expulsion through the birth canal.


Istukka

Placenta

The placenta (a type of cake, in Latin) is a temporary organ that connects the developing fetus via the umbilical cord to the uterine wall to allow nutrient uptake, thermo-regulation, waste elimination, and gas exchange via the mother's blood supply; to fight against internal infection; and to produce hormones which support pregnancy.


Joogamatto

Yoga mat

Thick mat with a grip which doesn’t damage the knee caps.


Jumppapallo

Birthing ball (gym ball)

It helps you dance your baby down, sitting. You can also hug it while your doula gently sifts your belly or shakes your apples with her rebozo.


Kaksoset

Twins

Two for the price of one birth. Twice more love and twice more everything.


Kalvojen pyörittely

Membranes sweeping (stripping)

Mechanical labour induction technique. A doctor or midwife will use a gloved hand to sweep the inside of the cervix in a circular motion.


Keisarinleikkaus / sektio

C-section / Belly birth

This is one of the possible entrances for babies into our world. This is a surgery which can be elective (elektiivinen keisarileikkaus), urgent (kiireellinen keisarileikkaus) or emergent (hätäkeisarileikkaus).


Keskenmeno

Miscarriage

When the pregnancy involuntarily stops.


Kivunlievitys

Pain relief

Tools, medical or non-medical, to alleviate the pain.


Kohdunkaula

Cervix

The womb’s turtle neck.


Kotisynnytys

Homebirth

Birth in your own very familiar nest. Your bed, your fridge, your shower, your smell and friendly bacteria.


Kyykky

Squatting

An art and a strategic position for pregnancy and birth. Relaxes the pelvic floor and strengthens the legs. And it doesn’t press your tail bone, making more room for baby’s exit.


Kätilö

Midwife

Midwives are medically trained to assist families during pregnancy and birth. They also deal with female reproductive health and menopause.


Lantionpohja

Pelvic floor

The layer of muscles that support the pelvic organs (uterus, bladder and bowels). It is often referred as a hammock.


Lapsivesi

Amniotic fluid

Protective water contained in the amniotic sac. Not pee. Not discharge. It is slightly shiny and smells sweet like an areola. Coincidence? I don’t think so.


Lääkäri

Doctor

You might meet one if you encounter challenges before or during the birth. If not, you’ll meet one at your post partum check up, about 6 weeks after birth.


Mikrobiomi

Microbiome

The microbiome is the genetic material of all the microbes (bacteria, fungi, protozoa and viruses) that live on the skin and inside the human body.


Nänni

Nipple

The female part of the breast that is too often censured on social media.


Nännien stimulointi

Nipple stimulation

When nipples are stimulated (with the person’s consent) the body might secrete oxytocin, which relaxes or excites the person and can help induce the start of labour if the conditions are present.


Napanuoran myöhäinen katkaisu

Delayed cord clamping

It’s when you wait for your baby’s umbilical cord to be empty of blood (and nutrients, ferritin, oxygen etc.) and stop pulsate, so your baby gets the maximum amount of goodness to thrive. (3-10mn).


Napanuora

Umbilical cord

The conduit connecting the placenta to the navel of the fetus or baby. Contains two arteries and one vein buried in Wharton’s jelly. The average length is 55cm but it can rarely be longer than 1m and in this case the midwife must bake a cake for her colleagues. That’s the tradition.


Närästys

Heartburn

Heartburn is a painful burning feeling in the chest or throat. It happens when stomach acid backs up into the oesophagus. During pregnancy, the hormone progesterone causes the valve to relax, which can increase the frequency of heartburns.


Oksitosiini

Oxytocin

The love hormone involved in love making but also labour progress, breastfeeding and bonding.


Pähkinäpallo

Peanut ball

This is peanut shaped ball created for pilates but used more and more during labour to mobilise the pelvis while lying down. Placed between the legs of the birthing person, the peanut ball can significantly shorten the length of the second phase of labour.


Peräaukko

Anus

The beginning of the end.


Peräpukama

Haemorrhoids

Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels inside or around the rectum and anus. During pregnancy, piles (just like varicose veins) can occur because hormones make the veins relax. Fortunately, they retract once the baby is born.


Perätila

Breech

When your baby is ready to enter the world bum/feet/foot first.


Pre-eklampsia

Pre-eclampsia

Pre-eclampsia is a serious condition. Symptoms might be: high blood pressure, blurred vision, headaches, swelling.


Prostaglandiini

Prostaglandins

They are synthesised within the human foetal membranes (amnion and chorion) and decidua and act to ripen the cervix, change membrane structure and contract the myometrium (middle layer of the uterine wall).


Raskaus

Pregnancy

A pregnant woman's placenta produces hCG (human chorionic gonadotropin), also called the pregnancy hormone. If you're pregnant, an urine pregnancy test can detect this hormone in your urine from about 1 day after your first missed period.


Raskausdiabetes

Gestational diabetes

Too much sugar in the blood during pregnancy. The condition disappears after childbirth.


Rebozo

Rebozo

A beautiful shawl traditionally made in Mexico or Guatemala to carry merchandise and children. It is also a piece of fashion. Traditional midwives use the shawl to massage pregnant women and new mothers. They also use this tool to help the baby rotate and descend in the birth canal in an optimal position.


Repeytyminen

Tearing

When pressure and pushes lacerates the perineum, vulva or vagina. Some tears require stitches, others don’t. A tear heals faster than a straight cut (episiotomy) because it follows the fibres of your skin tissue.


Sikiökalvojen puhkaisu

Rupture of membranes

Rupture of membranes (ROM) or amniorrhexis is a term used during pregnancy to describe a rupture of the amniotic sac. Normally, it occurs spontaneously at full term during labour. Rarely, it doesn’t happen and the baby is born “en caul”. Rupture of the membranes is known colloquially as "breaking the water”. Membranes are sometimes artificially broken to kick start or accelerate labour.


Spinaali

Spinal

Single dose anaesthetic injection in the spinal fluid. Acts quickly in numbing the saddle area. The risks are hypotension, difficulty to push, severe itching, headache, medication crosses the baby bloodstream, challenged breastfeeding.


Supistus

Contractions

Oh, the c-word. Call them “surges” just like Ina May Gaskin does. Suddenly these waves are more pleasurable.


Synnytyksen käynnistys

Birth induction

When nature is assisted by the human’s touch.


Synnytys

Birth

A new beginning.


Synnytys laskettu aika

Due date

Are babies just like industrial pizzas? Let’s talk about an approximate due month, shall we?


Synnytysosasto

Delivery ward

This is the ward dedicated to birth.


Syntymärefleksi

Fetal ejection reflex (FER)

This is a natural process happening during an undisturbed birth. High levels of adrenaline can trigger the foetal ejection reflex. The surge triggers strong, rapid contractions which move the baby from the uterus and into the birth canal. The pressure of the baby in the vagina stimulates the Ferguson reflex, which is the uncontrollable expulsion of the baby, which happens when nerves in the pelvis are stimulated as the baby descends through the birth canal. This biofeedback sends messages to the brain to release even more oxytocin, resulting in two or three strong contractions. The baby is born quickly and easily without voluntary pushing from the mother. More about FER.


Testi

Test

Like in ovulation test, pregnancy test, amniotic fluid test, GBS+ test.


Tens-laite

Tens machine / Tens unit

Transcutaneous Electrical Nerve Stimulation. Electrodes are sticked on your skin and you press a button to deliver an electric shock. It feels like thousands needles. Another pain tricker that makes endorphins kick in.


Ultraääni

Ultrasound

Type of imagery that uses sound waves to produces pictures of the inside of the body. It helps dating the pregnancy and the child’s healthy development. In Finland there are 2 routine ultrasounds: the early pregnancy ultrasound scan, (week 10+0 – 13+6) and the structural ultrasound scan (week 19–21).


Vyöterapia

Reflexology

Similar to acupressure but specialised in hands and feet. Each spot is linked to an organ or system.


Äitiysloma

Maternity leave

In Finland, you get a maternity allowance for 105 working days minimum (4 months). After the maternity leave, there is the parental leave to share as you agree with the partner. More info on Kela’s website.

  • Chloe Bernard

Last Summer, Sophie Messager had a message for all of us, explained in a 9 chapter-book called Why Postnatal Recovery Matters (Pinter & Martin).


"A doula is like a Sherpa. If you were going to climb Everest, you would take your partner, but you would also hire someone to help you navigate the mountain."

The author, Sophie Messager, is a birth and postpartum doula based in Cambridge, United Kingdom. This is how she describes the profession: "A doula is like a Sherpa. If you were going to climb Everest, you would take your partner, but you would also hire someone to help you navigate the mountain."


She starts her book by recalling ancient wisdom and traditional postpartum practices from all over the world. As a doula, I knew more about Chinese, Indonesian or Mexican traditions rather than European ones. It was refreshing, here, to learn a little bit more about old English postpartum rituals and recipes (such as the recipe of the Groaning cake). This gives me hope to rediscover and restore some old French or Celtic postnatal traditions, as long as they provide comfort and support the new parents.



Cover by Blok Graphic, illustration by Lucy Davey

Sophie presents these four keys to a successful recovery:

  1. Rest: Extreme tiredness can be avoided if you have the right support.

  2. Food and drinks: Comforting and nourishing foods and drinks are necessary to repair damaged tissues and promote milk production.

  3. Social support: Loneliness is met by 80% of new mothers. First months can be monotonous and isolating. Adult interaction is essential.

  4. Body work: After a wonderful job, the rather amazing postpartum body needs nurturing (closing the bones, wrapping the hips, massaging...). This has been forgotten in Western countries. What else? Pelvic floor re-education is offered to all new mothers in France. Why isn't that a priority in other countries? Why does society focus on your mom bod, your stretch marks, your saggy breasts and expect you to bounce back in the twinkle of an eye?

So you read this list and you wonder, how is it possible? What are people going to think of me if I don't manage on my own? Isn't that a luxury? This is well explained and it is when the village intervenes.

There are all these limitative thoughts that prevent us from asking for support. There are also polite habits pushed on us. In some cases, there is no free support available: no family, no friends around. It is then suggested to hire professional help such as postpartum doulas, lactation consultants, cleaners, housekeepers etc.


On the other hand... This is ultra complicated for first time parents to set up boundaries, to limit visits in the hospital, to refuse to host well-meaning guests who bring (sometimes useless) token-gifts and want to pass the baby from hand to hand, expect to get served, offered refreshments and leave the dishes undone. The book gives tips on how to set up boundaries and ask for much needed help (laundry, dishes, cooking, walking the dog) in a diplomatic way.


We tend to forget about postpartum. It is often relegated as the prologue of birth, instead of being invested and recognised as the epilogue of a strong bond between a mother (a parent) and a child, a united family. This vulnerable time can affect (negatively or positively) the family for months, years, decades or even generations.


Sophie mentions how it is complicated to explain to a future mother/parent what they will need before they can even experience it.


There are heartfelt testimonials of women who went through postpartum (the good, but also the bad and the ugly) which will help future parents better visualise, feel and prepare what is coming.

These postpartum stories are filled with gratefulness, regrets, envy, hopes and wishes for an empowering postnatal experience, a better care for new mothers, new parents, in our countries, a real desire for a re-focus on the person who just gave birth.


New babies don't care about clothes and stuffed toys: what they need most are parents who feel strong enough to support them

As an ex-biologist and researcher, Sophie always shares studies, statistics and references to back up her findings.

One conclusion is shattering to me: According to a survey, new parents spend a lot of money on a new baby, splashing out an average of 1600£ on equipment alone and 10000£ on the first year (about 1783€ on equipment and 11143€ in total, on the first year). So much pressure from marketers that parents feel the urge to give in. 90% of parents admitted having overspent on baby equipment, with an average of 5567£ (6203€) wasted . Babies certainly don't need that much; a place to sleep, some clothes and nappies and a sling could be enough. Second-hands items are also great, for your budget and for the planet.

As Sophie writes it: "New babies don't care about clothes and stuffed toys: what they need most are parents who feel strong enough to support them."

I appreciate very much that Sophie adds a chapter dedicated to special circumstances and suggests adaptations or integrations to a postpartum plan. Solo-mums, NICU babies, complications at birth, still births, miscarriages or other pregnancy losses. She shares her own very personal and touching experience with miscarriages and invites the grieving hearts to a postpartum treatment. Why would you be treated differently? Your body and your soul went through the same journey as if your baby was alive. Keep warm, eat well, rest, wrap your pelvis and surround yourself with lovely people. You don't deserve any less.


Sophie's dear wish is to shift the mindset of many people who wrongly think that the sooner the new mother "bounces back", the better. They value independence as the ultimate asset, instead of appreciating interdependence or what collective effort brings to the game. She hopes, just as I do, that the more mothers experience a supported postpartum, the more it will become the norm.


Just like Michel Odent shares the view that a respected birth can change the society, Sophie Messager shares the view that a nurtured postpartum can also transform the world. That is powerful, and it is a power we all have.


I recommend this useful little guide for future parents (and their parents). It contains a precious bibliography, some nutritious and delicious recipes, contacts of different British associations, and lots of tips. 150 pages of wisdom that fits in your pocket and only costs about 10€. A good investment.

Updated: Nov 14



Cervical dilation: a modern obsession


In a technical hospital setting, cervical dilation is often at the center of the staff's preoccupations. While it can give serious information about the progression of labour, it is not the only criterium that predicts the imminence of the baby's crowning.

If you are at all familiar with Spinning Babies®, you know how the position of the baby has a great importance and how focusing on the cervical opening only is counterproductive.


Normal labour progress assessment used to be dictated by Friedman's curve. This "gold standard" is outdated and should no longer be a reference for assessing what is normal or abnormal labour. Too many labours labelled "failure to progress" consequently led to unnecessary C-sections and birth traumas.

Each birthing person labours on a different pattern, each birth follows a different scheme. Labour can pause in a totally healthy and normal way and resume on its own.

Labour often stalls when it is disturbed: induction, epidural, lack of privacy, stress, pressure, restricted movements, incessant vaginal exams.


What do you need to know about vaginal exams?


Vaginal exams have been used to assess the cervical ripening, effacement and dilatation, as well as to check for the baby's station and an eventual cervical lip at the time of "pushing". Some birthing people can feel encouraged to know that they are already reaching 8 cm. It can help them to distribute their remnant efforts. These could be considered as the benefits of such an internal exploration.


What are the risks? Once the water has broken, each vaginal exam carries a risk of infection, even if sterile gloves are used. Indeed, bacteria at the border of the cervix can be accidentally pushed inside. Another risk is discouraging the labouring person. If, after long hours of labour, the midwife announces 5 cm, this can be welcomed with a lot of disappointment. There is also a small risk of a "wrong" assessment. It happens that a first midwife says the cervix is 7cm dilated and a second midwife coming one hour later finds out 6-6,5 cm. How disturbing and confusing for the birthing person! These different assessments are understandable. People have different finger size or position can affect the evaluation.

So the question is: What are the alternatives?


Gentle alternatives to "fingers in the cervix" or non-invasive ways to know your labour is progressing


I found a lot of information while reading The Doula Guide to Birth: Secrets Every Pregnant Woman Should Know by Ananda Lowe and Rachel Zimmerman. I recommend this book written by two dedicated doulas, with all my heart.


1. Change in contraction Contractions are regular, become closer to each other or contractions become more intense. The behaviour and moves of the birthing person can change in function of the intensity or phase of labour. Different sounds, chants or moans can as well indicate the progress of labour.



2. Belly is higher With labour progressing, the fundus goes higher. In the beginning of labour, you can place a full hand between your plexus (bra line) and your fundus (belly top). The more the labour progresses and the less fingers you can fit. At 3 fingers, you are about 5 cm dilated. At one finger you are probably fully dilated.



3. Bloody show What is tenderly named "bloody show" is actually a small tinted (pinkish, red or brownish) vaginal discharge. All birthing folks are different, of course, but some experts tend to notice two types of bloody shows. One bloody show would appear before the onset of labour (one week, 24-hours, or on the D day) when the cervix is about 2 cm dilated, and a second bloody show would appear in the heat of labour when the cervix is about 8cm dilated. These are general notes.


Just a tiny amount of bloody discharge, although the smallest amount might seem scary at first. If it's more than a little, consult immediately.


4. The Purple Line I never meant to cause you any sorrow I never meant to cause you any pain I only wanted one time to see you birthing I only wanted to see you birthing with a purple line Purple Line, Purple Line...

Just like the "linea nigra" growing on the pregnant belly, the "linea purpura" grows habitually between your butt cheeks during labour. The colour varies from red in pale skin tones to purple or even silvery in darker skin tones. Some call it the "bottom line" and the bottom line is that it can indicate your labour progress.

The appearance of the purple line is caused by the vasocongestion in the sacrum resulting from the baby's head putting pressure on the cervix. The first mention of the purple line goes back to 1990 with Byrne and Edmonds who sent a letter to The Lancet. They attributed the first observation of the purple line to Sister H. Lake. Their little study focused on 48 women. 89% of them had a visible "purple" line. Some had no line at all. Fast forward to 1998: This is the turn of Lesley Hobbs, a British independent midwife, to write about the phenomenon. Last update about the mysterious line dates from 2010 when Shepherd et al published the results of their research study. They observed 144 women in labour and noticed the presence of the line in 76% of them. Their findings showed a medium positive correlation between the length of the purple line, the dilation of the woman’s cervix and the station of the baby’s head.





5. Descent of the baby through external palpation Experienced midwives can palpate the abdomen with their hands and identify the baby's station in the pelvis.





6. Descent of the baby through external foetal monitoring When the baby goes down, their heartbeat can be caught lower on the birther's abdomen.


Photo by Sharon McCutcheon on Unsplash

7. Spontaneous Rupture Of Membranes (SROM)

SROM is the spontaneous rupture of membranes. When "the water breaks". This term describes the normal, spontaneous rupture of the membranes at full term (after 37 weeks). The rupture usually causes a gush of fluid. This gush may be quite small or significantly large depending on the amount of fluid in the amniotic sac, and to what extent the foetal head is plugging the hole and retaining fluid in the sac.

The membranes don't always rupture. Sometimes, rarely, the baby is born delicately in its little amniotic cushion, "en-caul".


Not that Niagaresque IRL. Is that the Parliament House?


8. Ultrasound

For twins or other multiples, ultrasounds are used during birth to identify the position of the babies. For singletons, ultrasounds are used with more parsimony.


9. Rectal pressure

With the baby's head descending in the pelvis, a significant pressure will be felt, followed soon enough by an irresistible urge to push and the famous "ring of fire" next door (burning sensation in the vagina when the baby is crowning).



10. Involuntary bowel movement Yes, we talk about "uncontrolled poop". The baby's head is pressing like a thumb on an almost empty toothpaste tube. Such a beautiful omen.


11. Opening of the back The tail bone sticks out. Sometimes the rhombus of Michaelis (a kite-shaped/diamond-shaped area in the lower back) is visible if the birthing person is in an upright position or on all-four. This opening enables extra space for the baby's passage, which is impossible if the birthing person is lying on the back.




12. Seeing the head! (Or the bum or the feet of the baby)

No kidding?!



© Ilmatar Doula 2020. 

Ilmatar

Doula

Tel: 040 145 9457

Contact me
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