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Perhaps you haven’t been able to keep your eyes open over the last week? Maybe you’re even feeling the beginning of breast tenderness, or hints of nausea?

You pluck up the courage to take a test, and as you see those two blue lines appear, the realisation hits you – you’re pregnant! 

Congratulations! Here begins one of life’s most wonderful adventures!

Early pregnancy can be a time of real excitement and joy, but it can also be a time of anxiety and of constantly analysing what you are – or are not – feeling.

At Juno we’d love to take the worry out of the early weeks of pregnancy for you, so that you know exactly what to expect, and can fully embrace the beauty of the experience!

Once you have a positive pregnancy test it’s important to get in touch with a Midwife. 

Some will choose to access a Midwife via their GP, however you can make a self-referral to your local midwives, just by dropping them a text or email! 

Your GP surgery or local children’s centre will be able to advise you of the relevant contact details. Alternatively you should be able to access a self-referral form via the website of your chosen hospital.

There are many symptoms associated with early pregnancy, here we’ll take you through the most common.

Tiredness 
This is not your average tiredness. This is an exhaustion which can make it difficult to get out of bed in the morning, and to complete even your normal daily routine. You may find your eyelis closing as soon as you sit on the sofa, and in fact this is a common prompt for women to begin to consider that they might be pregnant. There is a huge amount happening in your body in early pregnancy, and all of that takes a lot of energy. Do only what you have to, and rest whenever you can, it’s the perfect excuse to leave the household chores to someone else – you’re already working hard growing your baby!

Nausea & vomiting
Often called ‘morning sickness’ which is a misleading title because some find that the nausea lasts all. day. long. Some women will experience nausea only, others may regularly vomit.

This typically begins at around 6 weeks of pregnancy and will generally last until around week 12. It can be a tough time both physically and emotionally, especially as people may not even know that you are pregnant and so you may be trying to carry on as ‘normal’.

Focus on managing symptoms day by day and do ask for help from loved ones if you’re struggling.

This is a fairly common symptom and is not a cause for concern unless the vomiting is severe enough to mean that you cannot tolerate water, which can lead to dehydration. 

In this instance you should see your GP for advice.

Breast tenderness
This is another very common symptom of early pregnancy. Some will notice that their breasts grow noticeably even in the early weeks, or that their nipples may darken, and veins in the breast become more prominent. These are all signs of your body responding to the hormones of pregnancy, and the beginning of preparation for breastfeeding. Make sure to wear a soft supportive bra, and avoid underwires which can increase discomfort.

Needing to wee – a lot!
Even in the very early days and weeks there are enormous changes happening in your womb and so its quite common to feel that you need to pass urine more frequently, as the womb grows and pressure on the bladder increases. You’ll get some relief from this at about 12 weeks, as your womb moves up out of your pelvis – although I’m afraid that symptom makes definite return in the 3rd trimester!

Changes to your sense of smell & taste
Scents that you would normally love or not even notice may now seem overpowering to you. You might spray on your favourite perfume as you usually would and then find yourself running straight to the bathroom to wash it off again!

Equally you may find that foods you enjoy just wont taste the same, or even that you have a continual strange taste in your mouth. It can be unsettling to feel that everything is changing but bear in mind that this is just a stage, nothing permanent, and before long you’ll be enjoying all of your favourite things once again. 

Your first appointment with a Midwife is known as your ‘booking appointment’ and should ideally happen before you are 10 weeks pregnant.

This will likely be the most in depth appointment of your entire pregnancy and your Midwife will ask a huge number of questions about you, your partner, your own medical history as well as that of your family. You may need to brush up on any family medical history ahead of that appointment! 

Midwives offer holistic care and that means they’re not just interested in the physical aspects of your pregnancy, but also how you’re feeling emotionally, and what kind of support network you have around you. Some of the questions are of a very personal and sensitive nature, so while you’re welcome to have someone accompany you to the appointment, it’s wise to carefully consider who.

Your Midwife will also spend time discussing diet, vitamin supplements, as well as screening and diagnostic tests that are recommended in pregnancy, It’s important you have a good understanding of any tests that you are offered before they are carried out.

Whatever the early weeks of pregnancy bring your way, remember that Midwives at Juno are just a text away to answer any questions that you may have.

There are so many new things we need to learn as parents. You have to become an expert on all sorts, including the array of coughs, cold, and bugs that your child will inevitably pick up in their early years. In this situation, knowledge is power; knowing how to care for your child when they feel unwell and what signs mean medical support is needed, is invaluable. Here, I outline the 5 illnesses that sound more sinister than they actually are and outline what you need to know about them. 

Hand, foot and mouth disease

This ominous sounding disease can often conjure up thoughts of foot and mouth disease – a completely different, much more serious condition that occurs in farm animals. In contrast, hand, foot and mouth is an extremely common childhood illness that many little ones catch. Whilst it’s not very pleasant, it normally clears up on its own within 7 to 10 days. 

The first signs of this disease might be a sore throat, a temperature above 38C, and a lack of appetite. This then develops into ulcers or sores in the mouth and a rash or blisters on the hands and feet. It can be uncomfortable for children and can also be passed on to adults, (whose symptoms can be more serious – my toenails fell out after my son got hand foot and mouth!). The mainstay of treatment is to drink plenty of fluids to stay hydrated, whilst your child’s immune system fights off the virus. Cool drinks, soft foods, and liquid paracetamol can all help ease discomfort. 

You only need to seek help from a doctor if: symptoms don’t improve after 10 days, your child appears dehydrated, or if they present other symptoms that don’t fit the normal description. If you’re pregnant there are some additional risks, so you could also consult your GP if that’s the case. 

Febrile convulsions

Febrile means a fever (anything above 38 degrees) and convulsion means to have a seizure or fit. When some children between the ages of roughly 6 months to 5 years get a sudden, high fever it can cause some of them (about 1 in 20) to have a seizure. The cause of this is still unknown.  A febrile convulsion can be extremely scary, but try not to panic. 

How should you manage this? 

If your child has been running a high temperature and starts to seize (which typically sees their limbs go stiff and the body jerk), place them in the recovery position on the floor, stay with them, and don’t try to put anything in their mouth. If safe and possible for you to do so – time how long the seizure lasts, and take a video recording of it, as this can be helpful for doctors.. Most stop within 5 minutes.  It will then be normal for your child to be sleepy for a while after the seizure 20-60mins (on average).

  1. If it’s your child’s first seizure or it looks like it’s lasting more than 5 minutes, I’d advise calling 999 and going to your local A&E.
  2. Don’t try and bring your child’s temperature down quickly (such as by putting them in a cold bath). If your child is going to have a febrile convulsion, you cannot prevent it.
  3. They should only have one in a 24hr period, so if they have more, then once again please go to your local A&E

The vast majority of febrile seizures aren’t a cause for long-term concern and are actually caused by things like viral upper airway infections and ear infections, which don’t normally need antibiotics. However, a small portion may be caused by things like urine infections which will need antibiotics. So, if your child has a febrile convulsion and it’s not clear that they have a sore throat, ear infection, runny nose, etc. then I’d advocate seeing your doctor for a urine test and general check up. 

Only 50% of one year olds go on to have any more febrile convulsions after their first. Having a febrile convulsion in itself does not mean your child has epilepsy.

Viral exanthem

It might sound like something from Dr Who, but a viral exanthem is simply a rash caused by a virus. They are incredibly common in kids. There are a huge number of viruses that cause rashes to appear, but most are fairly benign and will go away on their own.  

A liquid antihistamine can be used if the rash is causing irritation. If the symptoms don’t clear up naturally within 72 hours, get significantly worse, or it appears to be another, more serious form of rash (such as those associated with meningitis), it’s important that you contact a medical professional.  Remember to perform the glass test – press the side of a clear glass firmly against your child’s rash.  If the rash does not fade under pressure, be sure to seek urgent medical assessment.

If you’re unsure if the rash is a cause for concern, but you’re keen to speak to a professional, I’d recommend intermediary services. These include NHS 111 or apps like Juno, where you can speak to a trained professional quickly and get advice on next steps.

Gastroenteritis

Incredibly common in adults, children and babies, gastroenteritis is a bout of vomiting and diarrhoea  which is often caused by a viral infection or stomach bug. Although unpleasant, it’s typically not serious and shouldn’t last longer than a few days. 

Aim to keep your child hydrated, encourage lots of rest, and let them eat what food they fancy (dry toast or crackers tend to be a good place to start). If you’re concerned about your child becoming dehydrated, a pharmacist can help you find oral hydration solutions (such as dioralyte) that might help. 

Vomiting normally only lasts 1-2 days, on average, but the diarrhoea can last up to 1-2 weeks. If either lasts for longer, or your child is unable to keep down any fluid or is showing signs of dehydration (you will know this because they won’t be weeing much or at all), it’s time to speak to a doctor. 

Oral allergy syndrome (OAS)

Oral allergy syndrome (OAS) is what happens when your child experiences irritation in their mouth after eating certain types of fruit or fresh vegetables (tomatoes are a very common cause of this). Whilst certain allergies can be extremely serious and sometimes life threatening, this is very rarely the case in oral allergy syndrome. 

OAS happens because the child’s immune system is mistaking the proteins in the food for pollen, triggering a mild allergic reaction. This can cause itchiness, discomfort and redness in and around the mouth and throat (children often say it makes their mouths feel ‘furry’ or ‘fuzzy’) that should dissipate soon after eating. Cooking the same fruit and vegetables before eating often stops this reaction.

If the rash and itching bothers them, you give your child a non-sedating antihistamine (always check the label). However, if your child’s face, lips or tongue starts to swell, they feel dizzy, look or feel unwell, or they have any difficulty breathing, call 999 immediately as they may be suffering from anaphylaxis which is much more serious. 

If you have been following a healthy exercise programme before you became pregnant then it is usually safe to continue with it throughout your pregnancy.  Your midwife, at booking, will discuss lifestyle and exercise with you.  However, if you have been attending a gym or classes then you should let your instructor know that you are pregnant now so that modifications can be made.

One exercise you can safely take up is Tai Chi (gentle moving meditation) and its’s sister Chi Kung (Chinese yoga or the art of energy cultivation).  Both of these ancient Chinese practices promote deep relaxation and improved mental focus. The movements are adaptable and can be practised while walking, standing or sitting.  Tai Chi is a martial art and a form of Kung Fu but do not let this put you off. 

What is it?

The type of Tai Chi I learned focused on energy management and improving health and wellbeing.   It used repeated flowing circular movements and visualisations to harmonise body and mind.  The emphasis was on balance and using the breath to create a sense of calm within.  As a student my Chinese Teacher used to say that in learning the form (i.e., the series of steps and sequence of hand and foot co-ordinations, that the hardest part was learning the transitions, when one flow of movement changes to another flow or form.   I believe it is the same with the birth process.  Very often, it is just before the birth that mother’s to be want to stop and give up.  The sensations within the body can become intense and we become aware of a change being imminent.  Tai Chi helps us recognise that even when there is intensity there is also calm and flow.

Why do it?

Exercise does not have to be intensive to be beneficial, it can be something gentle that you do for you and your baby for twenty minutes each day.  As you nourish and take care of your body, you are doing the same for your baby.  The gentle swaying motions of Tai Chi and circular movements, encourage good posture and deep connection to your body’s energy system or chi.  Tai Chi makes you aware of your surroundings but it also encourages you to dive deeply within and connect with your body and its’ own healing mechanisms.

In pregnancy, your centre of gravity changes and both Tai Chi and Chi Kung can help build core strength and balance.  Care is taken to warm up all parts of the body in turn, so that optimum circulation is achieved.  This can help improve swelling and lymph drainage. The gentle circular pelvic rotations promote mobility, thus helping prevent backache and teaching you to tune into your body for labour.    Breathing in a slow gentle rhythm in time to a series of gentle repeated movements stills the mind.  There is evidence to suggest that Tai Chi and Yoga combined can help prevent depression in the antenatal period.

Birth is a time when we need our strength and to be able to draw on our inner mental focus and intuition.  The guided relaxations and moving mediations within Tai Chi encourage a calm gentle contemplation and teach a sensitivity as to when to move and when to rest.  I was not pregnant when I first discovered Tai Chi and Chi Kung but both these practices helped me through an extremely stressful time in my life. 

They became a way for me to access inner resources and balance.  

What will I learn?

In Tai Chi and Chi Kung, we learn to focus on an area called the “dantian”, which is approximately three finger widths below the belly button.  Known as the “golden stove” in ancient Taoist texts, the dantian in Chinese medicine is regarded as being the foundation of balance, breathing and full body awareness.  

I like the fact that in focusing on this area, you are also focusing on where your baby is.  It can be a lovely way to connect with him or her, if you imagine them inside floating in their own ocean of stillness, as you move about your busy day.  One simple visualisation is to picture them safe and warm and relaxed, smile at them and see them smiling back at you.  Don’t worry about how it is done.  Just know that it is done.  You may even feel a nudge or a kick in response from your baby. Exercises like Tai Chi and Chi Kung promote the production of endorphins and endorphins provide us with a sense of happiness and wellbeing.  

Where can I practice?

Tai Chi and Chi Kung can be practised anywhere.  You can practice it at home with your shoes on.  However, my favourite thing to do is to find a quiet place outside.  Perhaps in your garden, at the beach or in a park. 

Kick-off your shoes and sink your bare feet into the ground.  Allow your knees to soften and relax, imagine a ball of sunlight under each armpit and that you are sitting on a large golden sun.  (Something like your birthing/labour ball if you have sat on this and bounced about.). If you are tired, you can use the ball to sit on or a chair. 

Just make sure that you are comfortable, have a snack to hand and stay well hydrated.  

Then without rushing and in your own time, imagine you can breathe in the gentle sunlight all around. 

Imagine that the sunlight flows all the way from the top of your head, right down through your body and out the soles of your feet.  Spend as long as you wish doing this and towards the end, connect with your baby again and picture them breathing in and out this gentle light in harmony with you. 

Don’t forget that smile.  

Typically if your pregnancy is low risk then you can usually expect spontaneous labour to occur when you are between 37-42 weeks pregnant. 

You may have seen that a TV labour usually starts with a dramatic gush of water in the middle of a shop and then contractions follow immediately after. But actually in real life, early labour (known as the latent phase) it is very normal for either waters to break or contractions to start spontaneously. There is no set way for labour to start. You may even notice your mucus plug coming away, although this could happen a good few weeks before labour, backache, or period like discomfort.

Pop!

For most of your pregnancy, your baby has been protected and surrounded by a fluid filled sac called the amniotic sac. The amniotic sac is made up of amniotic fluid and two thin, but tough, layers called the membranes. Towards the end of pregnancy when labour is ready to start, membranes can rupture and spring a leak – commonly known as waters breaking.

When waters / membranes break they can go with a gush or sometimes just a trickle. It is important to observe for signs of this towards the end of your pregnancy as your maternity unit needs to know when your waters break. 

*Please take note of the colour of your waters if they go as this is good information to pass onto your Midwife*

Contractions

You may have heard lots about contractions. Contractions are the name used to describe the tightening and shortening of the uterine muscles. 

Contractions have two purposes:

  1. To help the baby to move down into the birth canal.
  2. To assist the cervix in thinning out and dilating.

In early labour, contractions often start as quite irregular, infrequent and uncomfortable tightenings. You might notice that the contractions may stop and start, this is all part of the latent phase and it could last hours or sometimes days. Timing contractions is a really good idea in early labour. Time from the start of the contraction to the end and record how many contractions you are experiencing in each ten minute period. By recording the duration and frequency you are able to recognise when you may need to contact your local maternity unit.

What can I do?

At first you may be unsure if you are in early labour or not. It is always a good idea to:

Monitor. Record frequency and duration of contractions, watery loss and/or symptoms. Also monitor fetal movements as your baby should remain active through labour.

Bathe. Water is brilliant for relaxing and helping with discomfort.

Hydrate. Drink plenty of fluids to keep hydrated, you could also drink isotonic liquids to keep energy levels up.

Snack. Labour requires a lot of energy, so snacking little and often throughout the latent phase will help.

Mobilise. Remaining mobile during the early stages will help to get the baby into an optimal position for birth.

Analgesia. Paracetamol is safe and effective to take during labour if you have no recognised allergies / contra-indications.

Lighting. Keep lighting to a minimum. Dimming lights encourages relaxation and reduces stress hormones whilst increasing oxytocin (the hormone needed for effective contractions).

Massage. Asking your birth partner to massage you through this time will encourage relaxation.

Birthing ball. Gently rocking side to side can help baby settle into an optimal position for labour.

Rest. Use meditation or breathing techniques to help rest through early labour. Preserve your energy as your baby will be here before you know it.

Call. If you are experiencing any symptoms other than the ones described here or you would like to be assessed, please call your local maternity unit.

Please do not hesitate to contact one of our Midwives here at Juno if you require support advice or assistance regarding all things early labour related.

Unfortunately, feeling nauseous and queasy often go hand in hand with pregnancy. Often termed ‘morning sickness’, it’s important to note that the queasiness doesn’t always happen in the morning and can appear at any given time of day and night. 

The dramatic increase in hormones, especially in the first trimester is to blame for this. Unfortunately it can sometimes diminish the excitement you’re feeling of being a parent to be. However, There is an abundance of natural remedies that can help alleviate and ways to cope if you’re experiencing these symptoms. 

So what is ‘morning sickness’? Well It tends to start around 6 weeks gestation when the hormones increase, in particular; human chorionic gonadotropin (hCG). Typically the sickness peaks at around 12 weeks gestation and then begins to subside. However it’s important to remember every pregnancy is different, with some women experiencing it into the second and third trimester. 

Additional factors that can have a part to play in how severe you may be feeling are: 

Most women do experience some type of nausea feeling when pregnant (8 out of 10 women). The majority of the time it is manageable with certain adaptations that you can implement yourselves, for example: 

If the home remedies aren’t helping at you feel like it’s becoming severe, you may be experiencing hyperemesis gravidarum. This is a serious form of ‘sickness’ and can feel debilitating. It is vital to assess how you’re feeling and to get in contact with a medical professional if you have any concerns. Remember that we’re here to help you. There are other forms of treatment that can be provided such as ‘anti-emetics’. These are anti sickness medications that can be prescribed by your GP if the natural remedies do not help. 

If you feel like you’re unable to keep food and fluids down, you’re losing weight and have signs of dehydration, please seek medical advice.

I would suggest you aim to have your bag packed by the time you are 36/37 weeks pregnant.

If possible take a bag for you and a bag for baby, when you are in labour it makes it much easier to get something you need quickly, rather than rummaging around amongst baby’s things!

Mum’s bag.

Clothes for labour – you don’t need to buy anything new, think of an old nightie or baggy T Shirt that you don’t mind getting dirty. Lots of women I have looked after have thrown them away after birth!

If you are going to use the birthing pool, think about what you would feel most comfy in. Some women don’t wear anything and some cover up – there is no right or wrong! Try not to use anything too loose as it will stick to your body when wet – I would advise a bikini or tankini top, or a dark coloured vest top. 

Some women find a cold flannel on their forehead useful in labour, or if you have one a hand held fan.

If you have longer hair, hair bands or scrunchies.

Snacks and drinks – think of non-fizzy energy drinks, water or juice. Simple snacks such as plain biscuits or cereal bars are good, and hard boiled sweets or jelly babies for a quick energy boost. Think also of snacks for your partner as labour can be a long process!

Plan a playlist on your phone or tablet, music can be a great distraction in labour.

After birth – 1 or 2 pairs of pyjamas or nighties, if you are planning to breastfeed front opening ones can be useful. 

A dressing gown and slippers.

Big knickers! I wouldn’t advise the disposable ones as they tend to be too small and uncomfortable. Instead buy a pack of cheap comfy knickers.

Maternity pads – the proper thick ones rather than your usual thin sanitary pads – I would suggest 2 packs as you get through them quite quickly.

Comfy bras, and a small quantity of breast pads if planning to breastfeed.

Washbag – the usual things, shower gel, shampoo, toothpaste and brush, face cloth, deodorant, hairbrush.

Make up – not needed but can make you feel more human!

Comfy clothes for going home.

At the end, don’t forget to add your maternity notes and birth plan, phone and charger – you would be amazed how many people forget these things!

Baby’s bag.

Nappies and cotton wool for cleaning – we don’t advise baby wipes in the early days.

Muslin squares – 3 or 4.

Cotton hat x 3.

Vests x 3.

Sleepsuits x 3.

Outfit for going home.

Blanket for going home.

If planning to bottle feed, most hospitals will expect you to bring in bottles and formula.

Don’t forget the car seat, but this can stay in your car until ready to go home.

For more advice on birth planning and pregnancy download Juno for IOS or Android and talk to one of friendly midwives.

Most doctors have a bugbear or something that makes them cringe. Some of these can be most unexpected though usually they are things like toenails or eyes or something. Mine is sunburn. It makes me so ill that nursing staff direct me away from any cases (or even any parents attending with a child who themselves have sunburn. I feel nauseous, go pale and then faint.

Some of that is my own memories of my very Scottish skin turning salmon pink after alabaster and very quickly back again. Some of it is knowing the damage it does (I worked for 3 years in Oz and suncare was indoctrinated. I also developed temporary wrinkles which later vanished – phew!). It is 100% preventable and families often have no idea just how dangerous it is and that one sunburn doubles the risk of skin cancer and this only increases with each additional burn.

We might think that children look ‘healthy’ with a suntan and a crop of freckles. While they well might, each and every freckle is a marker of sun damage. The earlier children’s delicate skin is exposed to the sun, the more damage it does and they the longer they live with that damage. Cancer (melanoma in the case of skin) is caused primarily by how much damage (how severe and how often) and how long it’s been present. We used to see skin cancers in older people. It’s more and more common to see it in young women particularly. Sunbeds are certainly a part of this and there is at least some regulation of the industry now. Skin cancer occurs when tumour cells grow quickly – the body generally suppresses these. The more there are the harder that is.

The science of suncare.

You don’t even need a ’sunny’ day to get damage. 80% of harmful rays go straight through clouds. There are 2 types of ultraviolet rays (natural energy from the sun) which cause damage. You can’t see them – your skin sure can feel them. Delicate childrens’ (especially baby skin) is even more sat risk. We buy special gentle bubble baths and creams and then encourage sun exposure! We know how delicate and sensitive their skin is!

UVA and UVB are the two main wavelengths involved. UVA is said to largely cause ageing, where UVB largely causes burning. SPF numbers are based on how much longer we can sit in the sun before burning vs with no sunscreen. They are a multiple of the amount of time it would take with no sunscreen. U|VA causes tanning and when sunscreen offers protection against them they are called ‘broad-spectrum’. Originally sunscreen only protected against UVB. They are less intense though they penetrate more deeply to the lowest layer of the skin where skin cancers start. Tanning is the body’s attempt to protect itself from any more damage – not really such a sign of health!

Those years in Oz drummed good sun protection care into me. We have good advice here in the uk – it isn’t presented in such an accessible way though. They have Sid who used to Slip, Slop, Slap. He has got smarter now and now it’s Slip, Slop, Slap, Seek, Slide.

So what are these?

SLIP: Slip on some clothes. Ideally densely woven (some will have an SPF on them). Have a collar and longer arms and legs if possible.

SLOP: Slop own sunscreen. SPF 30+ in the UK (50+ in Oz) Broad spectrum and particularly focusing on areas often missed – backs of ears, backs of necks, behind knees. It should be applied 30 mins before going into the sun and allowed to dry in. It should be reapplied frequently and particularly after swimming

SLAP: Slap on a hat. A wide brimmed one which covers the face and neck. Some hats even have neck extensions to protect the neck.

SEEK: Seek some shade – especially in the middle of the day. Have lunch in the shade for example.

SLIDE: Slide on some shades. These should fully cover they eyes and have UV protection.

On top of this advice, we should remember that babies under 6 months should not be in direct sunlight and that in the middle of the day the sun is much stronger and where possible should be avoided.

Prevention is ALWAYS better than cure so don’t panic, just start now. 

Download Juno on IOS or Android and talk to one of our specialists for more sun safety advice.

Have you ever wondered what the Placenta is and what it does?

If you had a baby before or have attended a birth you might have been aware of a midwife in the corner carefully examining the placenta and membranes. Perhaps your midwife invited you or your partner to examine it with her? 

It may be that you chose not to look then, however, you might be fascinated by what you see.  

What Does the Placenta Look Like? 

The word placenta derives from the Latin for cake and the Greek for “flat or slab-like” and this is how it appears. Placentas vary but they are approximately the size of a dinner plate. Roughly 15 – 20 cm in diameter, 2 – 3 cm in thickness, and 500g in weight.

If you look at it immediately following birth, you will see that it has two surfaces, a fetal surface and a maternal surface. The fetal surface or baby’s surface is smooth, shiny and blue/purple in colour and covered in a double layer of membranes. The umbilical cord is inserted into it (more about the cord and insertion types in a moment). The maternal surface has a cobblestone appearance due to the cotyledons (or lobes of the placenta) and looks like raw liver. It may sound gross, but as a piece of engineering, it is miraculous.

What Does the Placenta Do?

For nine months your baby has been swimming in a pool of amniotic fluid, warm and safe inside your womb. What maintains the pregnancy? How does your baby manage to take in oxygen? Their lungs were not operating yet. How do they manage to receive nutrients and how do they dispose of waste like carbon dioxide? The answer is the temporary organ called the placenta and you and your baby’s co-operation at a cellular level.

How it Works on the Mother’s Side.

The maternal side of the placenta or basal plate which is made of the mother’s tissue allows for maternal blood vessels such as arteries and veins to create a lake of blood rich in oxygen and nutrients. This is easily available to your baby. However, there is no direct contact between maternal and fetal blood vessels due to a semipermeable layer of tissue in the placenta called the placental barrier.  

This barrier acts as a selective membrane to substances passing from maternal to fetal blood. It is a protection mechanism to keep both circulation systems separate. However, certain drugs can cross this barrier and affect your baby which is why morphine injections, for instance, are not given if birth is imminent.

How it Works on the Baby’s Side.

To explain what is happening it is easiest to start with the umbilical cord. The umbilical cord has two veins and one artery within it, all encased in a jelly-like substance called Wharton’s Jelly.  When the cord is cut, all three vessels are visible and it resembles a smile emoticon ☺. The large vein forming the lips at the bottom and the two smaller arteries forming the eyes.  

If you have never seen umbilical cords, I recommend you look at photography sites online showing their intricate spirals and colours (shades of blue and creamy white). One of my favourite births was when a baby girl emerged with her hand holding onto her cord.  She seemed particularly relaxed.  Nowadays it is common practice to allow the cord to stop pulsing before it is cut. Your midwife will ask you if you wish this as part of your Birth Plan. 

The whole placenta looks like a drawing of the Tree of Life on the baby’s side of the surface. If you trace the cord back from your baby’s umbilicus (belly button) you will discover that the three vessels within the umbilical cord eventually branch out and split up inside the chorionic plate (or baby’s placental tissue) creating a tree-like network of branches and roots that protrude into the maternal lake of blood described above. This allows for your baby to receive oxygen and nutrients from you and for your system to take away carbon dioxide on behalf of your baby.  Cool isn’t it?

The Placental Examination or What Your Midwife is checking for?

Firstly, the appearance and size of the placenta which indicates how well the placenta has been functioning. We also check that there is no unusual smell and that it is in good condition. A bad smell may indicate an infection has been present and perhaps that you and or your baby may need antibiotics. 

We check that there are two membranes present. You may see us rubbing the membranes between our gloved fingers or peeling the membranes back and we check that there are no ragged edges on the maternal side of the placenta.  Nor any missing lobes or (cotyledons).  

If the membranes or part of the placenta is left inside, this may lead to infection or make it difficult for the uterus to contract properly and stop the bleeding from your womb. Midwives also check the umbilical cord to ensure the three blood vessels described above are present.

We also note how and where the cord is inserted and if there have been any knots in the cord. The umbilical cord insertion site to the placenta can be described as central, lateral, marginal (battledore) and velamentous insertions (where the cord is inserted into the membranes instead of the placenta). Central and lateral insertions are the most common types.

All the findings are documented and you may see the following written on your discharge paperwork – “placenta and membranes complete” or “placenta and membranes doubtful”. This information is useful for your GP or Community Midwife in helping to assess your risk for excessive postnatal bleeding and or infection.

How long can it take for me to deliver my Placenta?

Delivery times for the placenta vary, but if you are having a natural birth usually you will deliver your placenta within an hour. If your bleeding is heavy or if you have decided to have an oxytocin injection (a drug to help your uterus contract and shear away the placenta) then delivery of the placenta can take 5 or 10 minutes. Your midwife will discuss delivery options with you as part of your birth plan.  

Cutting the Umbilical Cord

Some parents wish to cut the cord themselves, but be warned the cord can feel quite resistant to cut through. Imagine cutting into a thick rubber band with a none too sharp scissors. Parents usually look at me horrified when I describe the sensation of cutting the cord as “being chewy”. I promise no midwife to my knowledge has ever yet bitten into one. 

Occasionally, parents opt for a “Lotus birth” where the umbilical cord is left uncut after childbirth. This means the baby remains attached to the placenta until the cord naturally separates at the belly button. This usually happens within 3–10 to days after delivery. It is often done to honour the shared life between baby and placenta.

Cultural Beliefs and Customs

Many societies give particular significance to the placenta, seeing it as a twin, grandparent or guardian to the newborn. In the Maori tradition, the word “Whenua” is used for both the placenta and land. The placenta is buried on tribal land. It is thought that the placenta creates a bond between the child and tribe. Often a tree, signifying new life, is planted during the ceremony and its burial is viewed as a gift to Mother Earth. In Malay culture following birth, a ritual cleansing of the placenta and the umbilical cord takes place. Both of these are then buried in the doorway of the familial home, alongside books and pencils to encourage the child to be studious.  

Placentophagy (eating part or all of the placenta) became popular in the United States in the 1960s and 1970s. Although there is little clinical support for doing this practice, traditional Chinese medicine believes that ingesting the placenta after birth ensures a quick recovery, improved lactation, and prevents postnatal depression. The first recorded practice of this took place 2000 years ago in China.

Perhaps you feel differently about the placenta now? In any case, you should realise that the placenta belongs to you and that how you choose to dispose of it is entirely up to you. 

It’s a magical experience seeing your baby grow and develop, watching as they learn to form words and begin to crawl and walk. It’s less magical when their temperature is running high and you’re online frantically searching for solutions. 

A fever in a child at any age can be scary for a caregiver. High temperatures are very common in young children and will usually pass within 3 to 4 days – most can be safely managed at home. 

However, there are times when they signal the need for urgent medical attention. It’s important to know the facts and what to do in different situations. 

Caring for your child at home.

If your child has a high temperature, it is possible to care for them yourself by keeping them at home if appropriate, giving them plenty of fluids, food if they want it, and checking on them regularly in the night.

Depending on their age you can give them paracetamol if they’re distressed or unwell but you should be cautious. Don’t give paracetamol to your child if they are under 2 months and check the NHS website for other age and health condition restrictions.

It may be tempting to undress your child or sponge them down to try and cool their fever but you should avoid this – a high temperature is simply a natural and healthy response to an infection. Covering them up in layers upon layers of clothes or bedclothes, even if they’re shivering, also isn’t effective.

When to seek medical advice.

However, there are times when it’s important to seek outside medical help. You should call 111 or your GP surgery if:

When to go to A&E.

It’s time to call 999 or go to A&E if your child displays any of the following signs: they have a fit, have a stiff neck, are bothered by the light, find it hard to breathe (and suck their stomach in under their ribs), have unusually cold hands and feet, have blue, pale or blotchy skin, lips or tongue, are drowsy and hard to wake, are extremely agitated (they don’t stop crying) or are confused, have a weak, high-pitched cry unlike their normal cry, aren’t responding as they usually do, or aren’t interested in feeding or normal activities.

You should especially look out for a rash that doesn’t fade after applying pressure. Check this by doing a ‘glass test’ – press a clear glass firmly against your child’s skin and see if the spots or rash fade after you stop. If they don’t, it’s time to seek urgent medical attention.

For more medical advice on fevers and other childhood conditions, speak to a paediatrician now and download Juno on IOS or Android.

On Wednesday May 12th, Juno’s Paediatric service will become a paid subscription costing £9.99 per month. Before you flip the table or throw your phone into a hedge, let us explain what the changes are, why we are making them and how it will improve your service with Juno.

What are the changes?

From Wednesday May 12th, parents will need to subscribe £9.99 a month to start a conversation and share a concern with one of our paediatricians. However, you will now be able to access our midwives AND paediatricians with the same, simple subscription. This means we can offer the very best advice and support throughout your pregnancy and into parenthood.

All existing midwifery subscribers:

You can now speak to a paediatrician with the same subscription and will not be prompted to resubscribe. Your subscription now covers both specialists. Bonus!

All existing subscribers without a midwifery subscription:

All your existing conversations with a paediatrician will remain free.

If you start a new conversation or set up a child profile, you will have to subscribe.

If you choose to subscribe, you will still get a free two-week trial.

What hasn’t changed?

The app remains completely free to download.

You will not be asked to subscribe until you have created a bump or child profile.

If you subscribe you will still get a free two-week trial.

Why are the prices changing?

Good question. The answer is – Juno has BIG plans for the future. And as we all know from life, big plans require a bit more money. With our new subscription plan we will reinvest it into our service, making it more effective and efficient. 

What does this mean for you, the parent, though? 

We are going to make Juno more comprehensive, opening up the doors to potential 24hr, 7 days a week service. It is proven that anxiety hits us most during the night and we are working hard to alleviate that issue. 

We also plan to offer more for every parent and parent-to-be: 

More practical and personal medical content straight from our specialists. 

One-on-one consultations to address and pre-empt common childhood concerns. 

Different ways to interact with our specialist: video, zoom sessions, regular check-ins, etc.

Watch this space for updates as there will be plenty to come to improve your Juno journey soon. Get in touch if you have any ideas to change your experience for the better, we would love to hear from you. 

And thank you for taking care with Juno.
You can download Juno now for IOS or Android and start your two week-free trial.