Birth Savvy Bub Savvy

21/02/2026

If parenting advice makes you feel like you have to override your instincts…
pause.

That discomfort might not be weakness.
It might be neurobiology. 🧠✨

When you become a parent, your brain undergoes measurable structural and functional change.
Regions involved in threat detection, reward, empathy and emotional regulation reorganise to prioritise your baby.

This is not sentiment.
It is adaptive design.

And yet many modern parenting frameworks ask parents to suppress responsiveness in the name of “fostering independence.”

But infant brains develop through co-regulation.

Connection is neurological input.

Responsiveness builds brain architecture.

This webinar will focus primarily on the maternal brain, but both parents are absolutely welcome.

We now know that caregiving reshapes both brains. Fathers and non-birthing partners show measurable neural change too.

If you’ve ever felt torn between advice and instinct, this session will give you language, science and clarity.

FREE LIVE WEBINAR
🗓 Saturday 21st March
⏰ 11am–12pm AWST
🎟 Limited spaces
⚠️ Not recorded

In 60 minutes we’ll cover:
• The four core parental brain networks
• Why responsiveness is biologically adaptive
• How infant brain development depends on relational safety
• How to filter modern advice through a neuroscience lens

Live Q&A included. Small group. Real discussion.

This session forms part of my Parental Brain Mastery accreditation assessment, so numbers are intentionally capped.

If you want evidence, not noise,
email pip@birthsavvy.com.au
to reserve your place.

No recording.
Be in the room. 🧠💞

09/02/2026

So I did the caricature thing too. I think that is meant to be a picture of the anatomy of a lactating breast in the background!

22/01/2026

Most OBs and hospitals only focus on actively managing the third stage of birth to prevent postpartum bleeding (PPH)…
But the new WHO 2025 Guidelines say something that might surprise you.

They remind care providers that avoiding induction, augmentation, and episiotomy unless truly necessary also prevents PPH.

So if your OB or midwife is recommending an actively managed third stage, it’s worth asking:

✨ Are they also following the other WHO advice to
• Only perform episiotomies selectively and restrictively (not routinely and liberally)?
• Avoid induction or augmentation where not clinically indicated?
• Support your body’s natural physiology wherever possible?

Because true PPH prevention isn’t just about managing the end of birth.

It’s about protecting the whole process.

The WHO even acknowledged “the lack of evidence on the effectiveness of episiotomy in general.”

Yet in 2023, 22% of first-time mums in Australia who had a normal vaginal birth still had one (AIHW 2025).

It’s okay to ask questions.
It’s okay to want care that’s based on evidence, not habit.

💬 What do you think?
Did your care provider talk to you about avoiding unnecessary interventions to lower your risk of PPH?

21/01/2026

Infant sleep, “responsive” approaches, and why definitions matter

This post is shared to support informed decision-making for parents and to call for greater accountability in how infant sleep programs are promoted.

In Australia, many families are referred to infant sleep approaches described as responsive, gentle, or relationship-based. These terms sound reassuring and often suggest care that aligns with babies’ emotional and developmental needs.

From an infant mental health perspective, however, what matters is not the label used, but the mechanism.

AAIMH’s position – Extinction Based Behavioral Sleep Interventions:

“AAIMH is concerned that extinction based behavioural sleep interventions are not consistent with the infant’s needs for optimal emotional and psychological health and may have unintended negative consequences.

Extinction based behavioural sleep interventions have not been rigorously assessed in terms of the impact on the infant’s emotional development.
While arguably there is evidence to suggest these techniques do not harm infants, this does not mean there is evidence of no harm.

These type of sleep interventions are at odds with the overwhelming body of evidence that shows that the foundations for lifelong physical and psychological health are laid down in infancy when distress is responded to in a prompt and reliable way (National Scientific Council on the Developing Child 2020).

Although extinction based behavioural sleep interventions may reduce infant crying and increase caregiver perceived infant sleep time, they may also have the unintended effect of
teaching infants not to seek or expect support when distressed (Blunden, Thompson, & Dawson, 2011; Etherton et al., 2016). A lack of response to infant cries at night, and an inconsistent approach in responding to day and night distress signals may lead to increased infant stress (Porter, 2007).”

How infant mental health defines extinction-based sleep interventions:

The Australian Association for Infant Mental Health (AAIMH) groups the following approaches under the umbrella of extinction-based sleep interventions, because they share the same underlying mechanism:

changing infant behaviour by withholding or limiting responses to distress.

This classification is not about intent or tone.

It is about what the infant experiences.

How these approaches are defined:

·Unmodified extinction
Often referred to as “cry it out”.

In this approach, the baby is placed in bed and the caregiver does not respond to crying until a set wake time. All distress signals are ignored.

·Graduated extinction
Such as controlled crying, controlled comforting, The Ferber Method or quite a few 'gentle' sleep training methods.

Caregivers delay responding to crying for set periods of time (for example, every 2, 4, or 6 minutes), briefly return using limited settling techniques, and repeat the process until the baby falls asleep.

While responses occur intermittently, the baby continues to experience repeated periods of unresponded distress.

·Extinction with caregiver presence
Such as caregiver presence, camping out, fading, the chair method, hands-on settling, and comfort settling.

The caregiver remains in the room while the baby cries but intentionally limits comforting. Physical proximity is gradually reduced over time, even if the baby remains distressed.

Although the caregiver is present, responsiveness is still withdrawn or limited to things such as patting and shushing.

Why AAIMH classifies all of these as extinction:

AAIMH’s classification is based on the infant’s experience, not the caregiver’s intention or the language used to describe the approach.

Across all three methods:

·crying is not responded to promptly

·comfort is delayed, minimised, or withdrawn

·distress is tolerated as part of the process

·behavioural change is achieved through reduced signalling, not through co-regulation

From an infant mental health lens, this constitutes extinction, regardless of whether:

·responses are gradual

·the caregiver stays in the room

·the approach is described as gentle or responsive

Presence without responsiveness does not meet the definition of responsive care.

What this post is, and is not, about:·

This is not about blaming parents. Parents act with love and with the information available to them at the time.

It is also not an attack on frontline practitioners, many of whom work with care and integrity within complex systems and constraints.

It is a call for:

✔️clear and honest use of language

✔️alignment with infant mental health and neurodevelopmental evidence

✔️due diligence when sleep programs are promoted or publicly endorsed

When advice is described as responsive, it should reflect what responsiveness means for a baby’s nervous system: support that continues until the baby is calm and regulated, not simply acknowledged.

Clear definitions matter.

Transparency matters.

And accountability matters, especially when guidance is delivered with the authority of public health or professional endorsement.

Parents deserve informed choices.

Babies deserve care aligned with their developmental needs.

https://www.aaimh.org.au/media/website_pages/resources/position-statements-and-guidelines/sleep-position-statement-AAIMH_final-March-2022.pdf

08/01/2026

Caesarean rates are rising, but this isn’t about women’s bodies.

This large international review looked at why caesarean section rates keep climbing, even when guidelines aim to reduce unnecessary surgery.

What it found was clear:
• The rise can’t be explained by biology alone
• It’s happening even in low-risk, first-time births
• And it varies hugely between systems caring for similar women

The strongest drivers weren’t age or BMI.

They were:
• system pressures
• financial and legal incentives
• fear of litigation
• convenience and scheduling
• media narratives
• and women protecting themselves from poor or disrespectful care

In other words
Not a body problem. A system problem.

Caesareans can be life-saving when they’re needed.

But when they become the default, we need to ask why, and who the system is really designed to serve.

✨ Informed consent matters
✨ Respectful care matters
✨ How maternity care is organised matters

Reference:
Ojong SA, Temmerman M, Nsahlai CJF, Gidion D, Kihara A.
Why do cesarean delivery rates persistently rise despite evidence-based efforts to reduce them?
American Journal of Obstetrics & Gynecology. 2026; 234(Suppl): S569–S580.
https://doi.org/10.1016/j.ajog.2025.08.014

07/01/2026

Why do caesarean rates keep rising, despite evidence-based efforts to reduce them?

While we often hear from OBs that it is because birthing women are now older or have higher BMIs, the evidence tells a much more complex and important story.

A large international review just published in the American Journal of Obstetrics & Gynecology looked at 144 studies from around the world asking a simple question:

👉 Why do caesarean rates keep rising, even when we have clear evidence and guidelines aimed at reducing unnecessary surgery?

The answer was clear.

This is not about women’s bodies failing.
It’s about how maternity systems are designed and how care is delivered.

The review found that rising caesarean rates:
• can’t be explained by biology alone
• are happening even in low-risk, first-time births
• vary dramatically between systems caring for very similar women

If age and BMI were the main drivers, we wouldn’t see such stark differences between public and private hospitals, between regions, or between countries with similar populations.

Instead, the strongest drivers identified were non-clinical.

The review identified five main non-medical reasons why caesarean births are overused:

1. Fear of being sued
Many doctors feel safer legally performing a caesarean “just in case,” even when evidence supports waiting or supporting labour. This leads to defensive medicine, especially in countries with high litigation risk.

2. Financial incentives
In many health systems, caesareans:
• Pay more
• Take less time
• Are easier to schedule

This is especially clear in private hospitals, where caesarean rates are often much higher than in public systems.

3. Cultural beliefs and social pressure
In some places, caesareans are seen as:
• More modern
• Less painful
• More controlled
• Better for the body

These beliefs are often shaped by class, media portrayals of birth, and poor experiences of labour care.

4. Health system problems
Short staffing, lack of continuity of care, busy labour wards, and poor support for physiological birth make caesareans the “easier” option for overstretched systems.

5. Violations of informed consent
In many parts of the world, women report:
• Not being fully informed
• Feeling pressured or rushed
• Having surgery without genuine consent

The authors describe this as part of a broader pattern of obstetric violence, particularly affecting marginalised women.

The review also found three important but less talked-about influences:

1. Media and social media, which often portray caesareans as safer or more predictable than vaginal birth, without showing the downsides or recovery.

2. Provider convenience, with caesareans clustering around weekdays and office hours rather than labour patterns.

3. Mistrust of maternity care, where women choose caesareans to avoid fear, neglect, or disrespect during labour.

The paper also highlighted a global imbalance.

In some countries (like parts of Latin America and Australia), almost half of babies are born by caesarean, often without medical need.

In others (especially parts of Africa), women can’t access life-saving caesareans when they actually need them.

So the problem isn’t “too many or too few caesareans”... it’s the wrong women, at the wrong time, for the wrong reasons.

A really confronting finding is that some women don’t choose caesarean birth because they want surgery, but because it feels safer emotionally within a system they don’t trust.

That matters.

Because caesareans can be life-saving when they’re genuinely needed.

But they also carry short- and long-term risks for both mothers and babies, especially when they become the default rather than the exception.

The authors are very clear:
Rising caesarean rates are a structural and systems issue, not a failure of women’s bodies.

If we truly want to see safer, more balanced birth outcomes, we need to look beyond individual women and ask bigger questions about:
• how maternity care is organised
• how clinicians are supported (or pressured)
• how informed consent is practised
• and whose needs the system is designed to serve

👉 Not a body problem. A system problem.

What needs to change?

The paper calls for:
• Stronger informed consent and respectful care
• Payment systems that don’t reward surgery
• Better support for VBAC
• Legal systems that protect both families and clinicians
• Regulation of misleading birth information online

Women deserve respectful, evidence-informed care that supports physiological birth and surgical birth when it’s genuinely needed.

Reference:
Ojong SA, Temmerman M, Nsahlai CJF, Gidion D, Kihara A.
Why do cesarean delivery rates persistently rise despite evidence-based efforts to reduce them?
American Journal of Obstetrics & Gynecology. 2026; 234(Suppl): S569–S580.
https://doi.org/10.1016/j.ajog.2025.08.014

05/01/2026

✨ Been told you might need an induction? ✨
Feeling unsure, overwhelmed… or quietly disappointed?

An induction doesn’t have to mean a birth that happens to you.

I created my Positive Induction Online Course to help parents understand what’s really going on, feel confident in their decisions, and walk into an induction feeling calm, prepared, and supported, not rushed or powerless.

Inside the course, you’ll learn how to:

✔️Understand why induction is suggested and the different ways it can be done
✔️Learn how induced labour differs from spontaneous labour — and why that matters
✔️Make sense of timing (because when induction happens really matters)
✔️Sort fact from fiction around “natural” induction techniques
✔️Feel confident in your decisions, without pressure, fear, or confusion
✔️Create a personalised birth plan that reflects your values, even within an induction
✔️Communicate clearly with your care providers and advocate for what matters to you
✔️Work with your body and your brain to support a positive induction experience
✔️Understand how your partner can actively support you and advocate alongside you

🎁 Bonus modules included:
✨ Practical relaxation tools to help you stay calm and grounded (these are even more important with an induction)
✨ How to get breastfeeding off to the best possible start after an induction

This course is about informed consent, clarity, and helping you feel proud of your birth, whatever path it takes.

👉 Learn more or enrol here:
https://birthsavvy.com.au/positive-induction/

You deserve information you can trust.
You deserve choice.
And you deserve support. 💛

Positive Induction Online Course to gain confidence and knowledge for your birth plan. Empower yourself with expert guidance and support. Buy now!

04/01/2026

So many women are still told they need to start pushing as soon as they’re fully dilated, in the belief it will shorten labour, avoid exhaustion, protect the pelvic floor, and keep babies safe.

But…

This large new study helps clarify how second stage of labour actually works and where the risk sits.

The second stage isn’t one single block of time.

It has distinct phases:
• a passive phase, where the cervix is fully open but the body and baby are doing the work of moving down, softening and opening
• an active phase, when the mother is actively pushing

This new AJOG paper followed over 10,000 births using a delayed pushing approach. Even when there was a longer pause before pushing began (up to 3 hours), the time spent actively pushing was usually very short, often under 15 minutes.

This matters.

Growing evidence suggests that many outcomes we worry about, like maternal exhaustion, pelvic floor injury, heavy bleeding, and stress on the baby, are more closely linked to how long someone actively pushes rather than how long they are fully dilated.

The authors also note that:
• active pushing is the time of highest stress for babies
• shorter pushing is associated with less perineal trauma and lower rates of postpartum haemorrhage
• allowing time before pushing helps babies rotate and move into better positions, making pushing easier once it starts

Importantly, babies in this study were born in good condition, with reassuring Apgar scores, normal cord gases, and very low NICU admission rates, even with delayed pushing up to 3 hours.

But the takeaway isn’t about "delaying" pushing.

It’s about trusting the process, not watching the clock.

And trusting women to know when and how to push, which leads to a shorter, gentler, and safer active pushing phase.

📄 Reference:
Montfort E et al. Active Second Stage Duration Under 15 Minutes in Spontaneous Vaginal Deliveries with Delayed Pushing.
American Journal of Obstetrics & Gynecology, 2026.

29/12/2025

Such a great service from Justine.

When I visited Maymom in October they told me that they would be releasing a 'Goldi Pack' of fl**ges - 3 different sizes for you to test out. As in 'Goldilocks and the 3 bears - 1 too small, 1 too big, and 1 just right, or so you hope...

Here's a reminder that I've been selling a fl**ge trial pack (the 'Fl**ge Lending Service') - which is 3 fl**ges in any sizes of your choosing - for over 5 years!

You get 3 sizes to test for $40, including free postage. PLUS you get $20 refunded if you return them.

Yes, they might be previously used fl**ges (that have been washed and sterilised, using an at home sterlising system), but they are a trial pack - so not intended for long term use. You can then by the correct size/s and not waste money on items you don't need.

Plus, you are welcome to buy 3 new fl**ges - which for Spectra (or anything other than Medela) actually works out cheaper than these new Goldi Packs, because you get the whole fl**ge (the Goldi Packs are just the 'half' fl**ges) and a valve.

Keep in mind I also offer a free fl**ge sizing service - if you are in Perth you can come see, if not you can send me a video

02/12/2025

What doulas do goes far beyond comfort measures; the research just keeps showing how powerful continuous support can be.

A huge 2025 study of 17,831 births
(published in the American Journal of Obstetrics & Gynecology) found that when parents had doula support (both prenatally and at birth):
✨ VBAC rates were higher
✨ Exclusive breastfeeding rates were higher
✨ Preterm birth rates were lower
✨ More parents made it to their postpartum check-up

And what really stood out in this study is that these benefits weren’t limited to one group of families. They showed up no matter a woman’s background, postcode, or insurance status.

There is decades of research, from the US and UK, that show social and racial disadvantage are linked with higher rates of preterm birth, lower breastfeeding rates, more birth interventions, and poorer maternal outcomes overall. Not because of anything women do wrong, but because the system doesn’t support all families equally.

So the fact that doula care consistently narrowed those gaps is incredibly powerful. It suggests that having someone who understands birth, who protects your physiology, and who stands beside you with continuous emotional and practical support can create a buffer against the very inequalities that usually lead to worse outcomes.

Doulas don’t replace partners or maternity care providers… they help everyone work together so women feel safer, more supported, and more connected to their choices.

Reference:
Lemon LS, Quinn B, Young M, et al. Quantifying the association between doula care and maternal and neonatal outcomes. American Journal of Obstetrics & Gynecology. 2025;232:387.e1–387.e43.

01/12/2025

Vaginal breech birth in Western Australia, by Raya Tangchai

Original story here: https://www.breechwithoutborders.org/l/raya-wa/

At 34 weeks pregnant we discovered that our baby was breech, I believe she had been in this position for a while, this was my second pregnancy and my first was relatively easy and straight forward. I had an anterior placenta and felt that the two pregnancies were quite different, I could feel the kicks and movements of my son a lot more. My midwife at Fiona Stanley Birthing Centre warned me that the OBs would strongly recommend a c section but I can still have my baby vaginally if that's what I wanted, however the hospital itself was apparently very inexperienced with this and usually referred breech births to another hospital who it seems had recently stopped taking these referrals as they felt Fiona Stanley needed to gain the experience themselves being a tertiary hospital.

So with that in mind we tried everything to turn our baby, moxibustion, spinning babies, acupuncture, and I had an ECV booked in, hopeful that we wouldn't have to make that decision. The ECV at 37 and 2 was unsuccessful, and straight away the doctor told me that now they book me in for an elective c section, to which I replied "well that's not my only option?", I recall the doctor looked taken aback that I would even suggest a vaginal birth.

Anyway, I felt they clearly did not support it and said if I was adamant I wanted that they'd like to book me in to speak to a senior consultant which I agreed to, and they never even actually organised. I also booked in for a c section at 39 and 2 but still felt like this was not the route we were meant to take, just felt pressured into it. And on top of that when I tried to push this back a week the hospital told me I couldn't do that as their waitlist was full. We knew this hospital was not for us for this birth.

I did a deep dive into breech births because I wanted to make sure I was making the right decision for both of us and I was fully informed about all of my options. I was not going to be pushed into anything just for the convenience of the doctors or by them projecting their fears onto me. However, I wanted to make that choice for the right reasons too and knew that if anything went wrong it would be fully on me, and as so many people were unsupportive, I needed to be at peace with that. I spoke to many midwives, read many studies and listened to podcasts that really cemented my decision. Breech is just a variation of the norm and what the medical world did after TBT2000 was infuriating.

Anyway, my partner and I decided to change hospitals as that was the recommendation from everyone we had spoken to and we would both feel more comfortable in the hands of people who we felt actually had experience with breech babies. I had no doubt in myself but so much doubt in the people around me.

It was a very stressful week after going in and speaking to one of the consultants who said I couldn't have our baby at the alternative hospital due to my postcode, but we eventually managed to get a referral and was able to have a planned breech birth at King Eddie's. We also booked in a c section as back up on 25th Sept where I would have been 40 and 2.

The morning of 24th Sept my husband, myself, our son and dog made our way to a park near a blood bank so I could do bloods for the cesarean the next day, as by this point I had accepted the fact that this was probably the route we were now going to go down. As we pulled up at around 9:45am, I felt like I was starting to get contractions. I started timing it as I wasn't sure, we'd had a few false alarms and my labour with Caspian went in a different order with my waters breaking first. The blood bank was full of people waiting and I decided I was in labour and there's no need to wait in that line now!

We walked around for half an hour and then headed back home, certain that I was in labour and organised for my mother in law to come over to look after our son. Once she arrived we made our way to the hospital, getting there at 12pm by which point my contractions, that started at 1 in 10, was at 1 in 7.

At 12:35pm we were seen by an OB who checked the position of our girl, confirming that she was still in a complete breech position, and I was 4cm dilated. Within minutes my contractions ramped up to 1 in 2 and I knew she was ready. They were putting a cannula in my hand as a precaution and once that was done I said we needed to go, she's coming! As I swung my legs off the bed to get into the wheelchair my waters dramatically broke everywhere. I felt what I thought was a leg dangling out or the sensation of it and we rushed to the delivery room.

When we got there I just got out of the wheelchair and climbed onto the bed. The midwife who wheeled me over was still turning on the monitors, and my husband was catching up to us because he was grabbing our stuff when we rushed out. The room was not quite ready yet, but I didn't have time to wait, I knew I needed to push so as soon as I got on the bed, I got on my knees, held onto the back of the bed and starting pushing at 1:05pm, before the consultant and OB and midwives even got there.

I could hear people slowly arriving with someone shouting "A leg's already out!" but I was just solely focused on what I needed to do. I told my husband he had two jobs: make sure I don't try to change positions and don't let anyone try to interfere with the baby during the birth. I was lucky to have a wonderful consultant whose calming presence really put me at ease. Apparently he was very experienced with breech births and even supports it!

As I pushed I could feel every part of her coming out, this was such a different experience in comparison to my first, there were no contractions in between pushes, it was just constant pushing with big breaths whenever I could get one in. The most intense thing I've ever gone through! Especially as we got to her neck, the midwife was commenting as each part was coming out and I could hear her saying ok there's no chin yet, and the consultant saying in his tranquil tone come on now the biggest push of your life. Our baby was born at 1:13pm, after 8 minutes of pushing, and I knew my instincts were right, she wanted to come the way she wanted which was feet first. Our baby's apgar scores were 8 & 9, she's perfect and healthy, born into a room full of applause and high spirits.

The more I looked into breech births the angrier I got at the medical model and system in general. I believe Western Australia is meant to be one of the worst places when it comes to supporting breech births and the lack of education around it. They should be looking at each individual case, present you with your options and give reasons as to why you would be a good or bad candidate for it. It's disappointing the lack of knowledge around breech birthdays and I hope that these doctors start to try and make a change.

30/11/2025

This is very interesting.

The impact of parity on uterine rupture in patients with and without a previous cesarean delivery: a retrospective analysis of risk variation in women with and without a previous cesarean delivery - Probability of uterine rupture by number of previous VBACs
This graph illustrates the probability of uterine rupture during vaginal delivery attempts in women with 1 previous cesarean delivery, stratified by the number of previous VBACs. The x axis represents the number of previous VBACs (0 to≥5), and the y axis shows the corresponding rupture rate. Women with no previous VBAC had a uterine rupture risk of 0.64%. This risk decreased to 0.28% after 1 previous VBAC and continued to decline with additional VBACs, reaching 0.18% among those with 4 VBACs. Notably, no cases of uterine rupture were observed in women with 5 or more previous VBACs. A logistic regression analysis demonstrated a statistically significant inverse association between the number of previous VBACs and the risk for uterine rupture (P