60 Tips for Healthy Birth: Part 3 – Bring a Loved One, Friend or Doula for Continuous Support

In this six-part series, we are sharing 10 tips for each of the Lamaze six Healthy Birth Practices that help guide women toward a safe and healthy birth. The Lamaze Healthy Birth Practices are supported by research studies that examine the benefits and risks of maternity care practices. Learn more about each practice, including short, informative videos at Lamaze.com. To read the rest of the 60 tips, check out the other posts in this series.

 

10 Ways to Have the Best Continuous Support During Labor and Birth

1. Learn why bringing a loved one, friend, or doula for continuous support is important for you and your baby.

2. Encourage your designated labor support person(s) to read The Birth Partner by Penny Simkin.

3. Curious about professional labor support? Find out why a doula can be a wonderful asset to your support team.

4. Learn about the many ways you can find comfort in labor by taking a good childbirth class.

5. Choose a care provider and place of birth that encourages bringing a doula to your birth.

6. Create a birth plan/preferences sheet and share it with your birth support person to make sure that she knows your wishes.

7. Spend time connecting with your birth support person prior to going into labor — get to know each other (if you don’t already), share your feelings about the upcoming birth, and talk about what you envision as the best labor support.

8. Pack a hospital or birth center bag with items you imagine will be useful to the person who supports you during labor — nourishment, scents, favorite lotion, focal point, etc.

9. Be sure that your support team — all of the members present with you during labor and those actively supporting you — are people you actually want by your side. You only get to birth this baby once!

10. If your spouse, family member, or friend is the one who will be your labor support person, be sure they know it is not their job to “save” you from the hard work of labor, but rather to support and comfort throughout your labor, as best as they possibly can.

 

How Did You Know You Were Pregnant – Real Women Share

As a follow-up to last week’s post about the most common early pregnancy signs, this week we hear from real moms who share their early pregnancy signs and how they just knew they were pregnant.

It was most evident with my third, and I don’t remember it being so pleasant. I was tired, had to pee CONSTANTLY, couldn’t poop for the life of me, and my pants were suspiciously not fitting quit right as though my uterus knew something I didn’t. That and I just ‘didn’t feel right.’ No romantic glow here…vomiting started one week later.

-Chelsea W.

 

I had cravings — nothing too random (chocolate milkshake & fries were always on my mind) — but the intensity of the cravings was incredible! I really HAD to have whatever it was, and now! And heartburn, heartburn, heartburn! Smells also seemed to intensify. I had a linen-scented candle and I had to throw it out because it seemed to smell so horrible at the time! 

-Amanda R.

 

My boobs told me the first time. They were crazy tender. Also, my pee smelled different. The second time I had bronchitis and a double ear infection, so I missed my pregnancy symptoms. I was just miserable all over. At some point, I realized I didn’t start my period and took a test.

-Richee E.

 

When I became pregnant with our 3rd child, I knew before I missed my period. We lost our second child as a 40-week stillbirth the previous year, and I had become very aware of my body and cycles during my grief. It was definitely fun to show friends and family a positive test result, but my husband and I knew without a doubt before any tests.

-Sherri W.

 

As soon as implantation happens, I go from having no dreams (that I remember) to having very vivid, realistic dreams. Some stressful, some intense.

-Marisa H.

 

I knew by my boobs. Getting in the shower was quite painful on them. Then, I realized I was supposed to be on my period and I wasn’t. Soon after that, the nose swelling began — and it continued the whole pregnancy. I had nose swelling which followed with a sinus infection… nose swelled the whole pregnancy. 

Gina G.

 

I felt the overwhelming urge to go and take a nap in the middle of the day — and I never nap. In fact, one day, I actually went out to my car during my lunch break and fell asleep for 20 minutes!

-Shelly B.

 

Apparently, my husband knew before I did. He told me I became really moody with him and snapped at everything he said, lol! Since we were trying to get pregnant, he thought it was because I was pregnant. Thankfully, I wasn’t quite as hormonal the rest of my pregnancy as I was in the beginning.

-Avery F.

 

Before I was ever got a positive pregnancy test, I started having round ligament pains when I rolled over in bed. I thought it was impossible to feel those pains that early in a pregnancy, but this was my third, so maybe? As it turned out, I was actually pregnant!

-Cara T.

 

I remember cramping early on — just like I was going to get my period, but it never came. It was like a dull aching feeling in my pelvis and lower back. It lasted for quite a while in the early part of my pregnancy and I remember noticing it most in the middle of the night. 

-Karin L.

 

We want to know — how did you know you were pregnant? Chime in with your experience in the comments!

 

60 Tips for Healthy Birth: Part 2 – Walk, Move Around and Change Positions Throughout Labor

In this six-part series, we are sharing 10 tips for each of the Lamaze six Healthy Birth Practices that help guide women toward a safe and healthy birth. The Lamaze Healthy Birth Practices are supported by research studies that examine the benefits and risks of maternity care practices. Learn more about each practice, including short, informative videos at Lamaze.com. To read the rest of the 60 tips, check out the other posts in this series.

10 Ways to Walk, Move Around and Change Positions Throughout Labor

1. Learn why walking, moving around, and changing positions throughout labor is important for you and your baby during labor.

2. Limit interventions, like epidural and routine IV fluids, both of which can restrict your ability to move during labor.

3. Bring a trusted friend, family member, your partner, or doula to serve as your birth support person who will be in charge of reminding you to change positions and offer suggestions for movement that keeps labor progressing, facilitates baby’s positioning, or allows you to rest in between contractions.

4. Find a care provider who supports evidence-based practices for a healthy birth, including remaining mobile during labor.

5. Make sure your place of birth is one that encourages women to move around and change positions during labor.

6. Request intermittent fetal monitoring (usually 20 minutes out of every hour) instead of continuous fetal monitoring, which is more restrictive for movement and has been shown to increase the risk of more interventions.

7. Labor as long as possible at home, where you are free to move around as much as you like.

8. If you need to have an epidural, ask your care provider and anesthesiologist about having a lower dose epidural to be able to move and change positions easily, and possibly get up and walk short distances (though many hospitals do not permit this).

9. If you must be monitored continuously or hooked up to an IV (like you would during an induction), you can still get out of the bed! Enlist the help of your support person(s) to help you move around with wires in tow.

10. Familiarize yourself with the many different labor positions you can use to help promote comfort and facilitate labor and birth.

Common Early Pregnancy Symptoms

Many women report knowing they were pregnant before they tested positive on a pregnancy test, and some recall early pregnancy symptoms only in hindsight after getting their long-awaited “BFP” (big fat positive). But most ALL women who are trying to conceive will hit the internet to Google possible pregnancy symptoms before they pee on a stick. It’s just so hard to wait! Of course, there’s no precise way to determine pregnancy by symptoms alone, but you can make an educated guess based on some of the most common early pregnancy symptoms.

Think you might be pregnant? Take a look at this list and see if any of your symptoms match up.

Implantation spotting (bleeding) – At about 6 to 12 days after fertilization, the egg will implant in the lining of your uterus which can cause light spotting.

Late period – Perhaps one of the most obvious sign, but only if you have regular cycles and/or are charting your basal body temperature to detect ovulation and pregnancy.

Tender breasts – Thanks to pregnancy hormones, tender breasts may be one of your first noticeable symptoms of pregnancy. But it could also be a sign of menstruation about to begin.

Nausea – Again, another symptom caused by hormones. While most women don’t report feeling nauseous until week 6 or 8 of their pregnancy, others report feeling queasy earlier.

Unusual tiredness – Hormones are also responsible for a feeling of intense tiredness that washes over you, making you feel like napping anytime, anywhere.

Cramping – As your uterus begins to change and grow — especially if this is your first pregnancy — you may experience cramping that feels similar to menstrual cramps.

Back ache – Often a result of the above symptom or due to a normal loosening of ligaments that occurs during pregnancy.

Frequent urination – Yes, this begins early on. Not due to baby’s growing size (as is the reason for late-in-pregnancy frequent urination), but an increase in fluids that your body produces.

Sensitivity to smells & food aversions – This is often part of the fun little early pregnancy “morning sickness” package.

Light-headedness or fainting – Fainting isn’t just for Hollywood, folks — it can be a real symptom early on in pregnancy, caused by the major changes in blood volume in your body. It can also be caused by low blood sugar.

Mood swings – If you’ve noticed unusual spells of weepiness or irritability, you might just be pregnant! This is caused by — you guessed it — an increase in hormones brought on by pregnancy.

 

Did you experience any of these common symptoms early on in your pregnancy? What would you add to the list?

 

 

National Birth Defects Prevention Awareness Month

National Birth Defects Prevention NetworkJanuary is National Birth Defects Prevention Awareness Month. As a woman who is pregnant, trying to get pregnant, or will one day get pregnant, it’s important to know what current research says about preventing birth defects. According to the National Birth Defects Prevention Network (NBDPN), birth defects are the leading cause of infant mortality. The good news, however, is that you can take steps before and during your pregnancy to prevent birth defects. NBDPN advises women who are pregnant or who are planning to become pregnant to take the following steps to prevent birth defects:

  • Consume 400 micrograms of folic acid daily
  • Manage chronic maternal illnesses such as diabetes, seizure disorders, or phenylketonuria (PKU)
  • Reach and maintain a healthy weight
  • Talk to a health care provider about taking any medications, both prescription and over-the-counter
  • Avoid alcohol, smoking, and illicit drugs
  • See a health care provider regularly
  • Avoid toxic substances at work or at home
  • Ensure protection against domestic violence
  • Know their family history and seek reproductive genetic counseling, if appropriate

Patricia Olney, MS, a certified genetic counselor and pregnancy risk specialist at MotherToBaby (the pregnancy and breastfeeding medications and toxins exposure specialist organization)  informs parents about the importance of taking folic acid:

Since one-half of U.S. pregnancies are unplanned and because birth defects occur very early in pregnancy (3-4 weeks after conception), the United States Centers for Disease Control recommends all women of childbearing age consume folic acid daily.  CDC estimates that most of these birth defects could be prevented if this recommendation were followed before and during early pregnancy.

Folic acid can be found naturally in dark leafy greens (spinach, kale, collard greens, romaine lettuce), asparagus, broccoli, brussels sprouts, cauliflower, celery, carrots, squash, beets, oranges, papayas, grapefruit, strawberries,  fruits (bananas, melons, and lemons), beans (with lentils yielding the highest amount), seeds and nuts, avocado, yeast, mushrooms, and beef. To ensure that you are receiving sufficient folic acid on a daily basis, CDC advises taking a synthetic supplement (vitamin) of folic acid that delivers at least 400 micrograms of folic acid.

To learn more about prevention or find a support group, NBDPN has created a comprehensive list of birth defect internet resources for parents and families.

60 Tips for Healthy Birth: Part 1 – Let Labor Begin on Its Own

In this six-part series, we will share 10 tips for each of the Lamaze six Healthy Birth Practices that help guide women toward a safe and healthy birth. The Lamaze Healthy Birth Practices are supported by research studies that examine the benefits and risks of maternity care practices. Learn more about each practice, including short, informative videos at Lamaze.com. To read the rest of the 60 tips, check out the other posts in this series.

 

10 Ways to Let Labor Begin on Its Own

1. Learn why letting labor begin on its own is important for you and your baby.

2. Choose a doctor or midwife who has a low rate of induction and who is comfortable with a pregnancy that lasts 42 weeks.

3. Know that your “due” date is not an expiration date. Only about 5 percent of moms give birth on their due date. Instead of a day, think of it as your due “month.”

4.  Learn about induction — when it’s needed for medical reasons and when it’s used for reasons of convenience. A good childbirth class will cover this topic in detail, as well as give you the tools you need to ask the best questions and make an informed decision.

5. If your care provider suggests an induction, ask questions. Is it an emergency? What’s the risk in waiting? What are the alternatives?

6. Unsure of your care provider’s recommendations? Consider seeking a second opinion.

7. Want to avoid the barrage of calls, texts, and emails around your due date? Keep your due date a secret. Tell friends and family you’re due “sometime in April,” or whatever month your predicted due date is in.

8. Prepare yourself for the mental mind game that occurs with nearly every mom who reaches 39-40 weeks. Schedule mini celebrations for each passing day or days — lunch with a friend, pedicure, ice cream, movie, bliss out to your favorite tunes. Do whatever it takes to relax and take your mind off of having a baby!

9. Remind yourself that every day your baby is still on the inside is one more day she needs to grow and develop. Healthy babies are worth the wait.

10. If you end up needing an induction, learn how you can keep your labor as normal and healthy as possible. If you are induced through the use of Pitocin, consider asking if your care provider can turn down or turn off the Pitocin once your body has established a good contraction pattern.

Five Fun Ways to Document Your Pregnancy

Liz Abbene, one of our contributors, waiting for her belly cast to dry during her 4th pregnancy.

Newly pregnant? Documenting your pregnancy is a fun way to preserve the memory of your growing baby and changing body, and your child will one day love looking at the images, notes, or letters where she was in your “tummy.” Below are five fun ways to document your pregnancy.

1. Weekly belly photos. This can be done in SO many ways. It can be as simple as taking a profile photo of your belly in the same spot and same shirt every week of your pregnancy, or as elaborate as putting your images into a video, or creating a hard bound or digital book. You can keep your images simple, or add a note, message, or comparison item (“your baby is the size of a lemon…”) for fun. For some inspiration, check out this weekly belly shots board on Pinterest.

2. Keep a pregnancy journal. Your journal can include photos, mementos, notes about your pregnancy, doctors’ visits information, sonogram pictures, letters to your baby — anything you want to preserve and share about your pregnancy. You can create your own, or you can purchase one of the many available online or at a major bookstore.

3. Weekly letters to your baby. This is not only a wonderful way to preserve the memories from your pregnancy, but also an amazing gift that your child will always treasure. You can write hand-written letters, you can set up an email account and email your baby, or your can blog your letters.

4. Professional maternity photo shoot. If you can swing it, professional maternity photos are a wonderful way to capture a moment in time during your pregnancy. You can have them taken solo or with your partner. Be sure to research different poses and shots before going to your shoot so that you get just the look you were hoping for (Google “maternity photo poses”).

5. Belly cast. For a more three dimensional documentation of your pregnancy, you can have your belly cast so that you can preserve your shape forever. You can purchase a kit online or find someone locally who will come to your house and do it for you. Once your cast is dry, you can decorate or paint it as you like. Some moms also use their cast to pose their newborn for the first set of baby photos.

 

How did you document your pregnancy? If you have a link, please share it with us! 

Enjoy the Holidays, Safe, Sane & Sound During Pregnancy

By Dr. Kecia Gaither

Deck the halls and hark the herald! Well ladies, the holiday season is upon us again.  Time for family and friends, shopping and travel, New Year’s resolutions and my personal favorite—cooking and eating.  So let’s  discuss a few things, from a medical  perspective, that will keep you and your precious cargo well and whole for the holiday season.

Travel: Recommendations for travel will vary depending on your destination, mode of transportation and the length of time spent traveling. Basic rules: being pregnant increases your risk of blood clots in the legs; long hours of sedentary travel further increases that risk—it’s important during your excursions to wear comfortable clothes, support stockings and to get up and stretch at least every two hours to get that blood pumping.  If you are going to an exotic destination, try to avoid those locales where vaccinations are needed; if you must go, consult your physician to verify which vaccinations are safe during pregnancy.  Be extra cautious about consuming the water in foreign countries to avoid stomach upset/traveler’s diarrhea—err on the side of drinking bottled water in these circumstances.

Flying during pregnancy, pending your medical status, is considered safe in the first and second trimesters.  Prior to making your reservation, it would be prudent to contact your airline carrier for their travel policies concerning  pregnant women as restrictions may vary.  Due to a lack of oxygen, it may be wise to avoid flying in small, unpressurized planes while pregnant.

Food: Food is the mainstay of any holiday celebration — however, there are some foods pregnant women should avoid due to the bacteria, viruses or parasites which may be present.  These critters can cross the placenta and not only affect mom, but baby as well.  Listeria, a bacteria, is top on the list of germs that can cause severe food borne illness, miscarriage, and stillbirth.  Foods such as unpasteurized cheese/milk, and poorly cooked hot dogs may contain this bacteria, so be vigilant in their consumption.  Foods with raw eggs,  (like eggnog), or  uncooked vegetables (particularly sprouts), or under-cooked poultry may contain E.coli and Salmonella, both of which can cause sickness for mom. Undercooked pork products  may contain a parasite which can cause trichinosis — this one can also cross the placenta and affect the fetus, causing stillbirth, so be sure that all pork is thoroughly cooked. Proper refrigeration of cooked food also is important. The USDA recommends pregnant women avoid foods which have been left out for more than 2 hours.

New Years’ Resolutions

When you’re pregnant, there are a few resolutions that are certainly worth thinking about, and that are attainable and maintainable.

  1.  Cut the mama drama – decrease the stress in your life.  Stress for anyone, but particularly pregnant women, affects both mother and fetus—presents with an increased risk of preterm labor/delivery, low birth weight infants.  Stress also contributes to the development of hypertension.  Anecdotally, mothers who are under immense stress tend to have crankier babies.  Stress busters—meditation, yoga, aromatherapy, professional counseling and therapy—all are safe, natural ways to de-stress.
  2. Open wide and say AAH! – pay attention to your dental health.  Infection is thought to play a major role, among other things, in the genesis of preterm labor and heart disease. Periodontal disease, is, in effect, a lingering oral infection.  A trip to the dentist for cleaning of plaque/attention to any gum disease decreases your incidence of preterm labor and delivery.  Make sure to schedule routine visits for maintenance of your oral health throughout the year.
  3. An apple a day keeps the doctor away– the old adage is true; nutrition contributes to great health. Pay attention to your nutritional choices with the new year—focus on increasing your fruit, vegetable, beans, and whole grains intake—cut down on fatty high cholesterol containing foods/processed foods. Lean meats like chicken and turkey are great. Increase your water consumption and eliminate drinks containing high fructose corn syrup.  Good nutrition contributes to a healthy growing fetus, and post delivery, helps with good milk production and keeping mom in a positive nutritional balance.

With those thoughts in mind, enjoy your holiday season, ladies!

 

Dr. Kecia Gaither serves as the Vice Chairman and the Director of Maternal Fetal Medicine in the Department of Obstetrics &
Gynecology at Brookdale University Hospital and Medical Center located in Brooklyn, N.Y. – one of the region’s largest and busiest nonprofit teaching hospitals. In her current position, Dr. Gaither oversees the hospital’s OB/GYN’s Ultrasound Unit and the Maternal Fetal Medicine Division. With more than 20 years of professional experience, Gaither’s expertise is grounded in the
research and care for women with diabetes, HIV and obesity in pregnancy.

A New York City native, Gaither’s mission as a medical professional is to offer exemplary prenatal care to those often
underserved and overlooked. The women who enter Dr. Gaither’s office are typically without the financial means nor the emotional support needed to receive the proper care needed while carrying a high-risk pregnancy.

photo credit: richiebits via photopin cc

A New Mom’s Last-Minute Gift Wishlist

1. Sleep

2. Sleep

3. Sleep

4. Breakfast, lunch, and dinner in bed. (You know, in case I want more sleep.)

5. Sign on door that says: Welcome Visitors! Unless you are sick. And only if you bring a meal. And only if you promise to stay for less than an hour. And only if you don’t expect to be fed or entertained in any way.

6. Time for sleep again!

7. Magic powers to know exactly why my baby is crying at any given moment.

8. A shower. Every day would be preferable.

9. An invisible shield that prevents leakage from diapers and breasts.

10. To never, ever forget these precious moments when my baby was small enough to fit in the crook of my arm and fall asleep on my chest.

Unlabored Breathing

By June Connell, ICCE, CD(DONA)

The breath is the link between the body and the mind.  In the yogic philosophy, how we breathe – long and deep or short and shallow – can affect and determine our overall emotional, physical and spiritual well-being.

Every time we breathe, messages are sent to the nervous system about the emotional state we are in at that particular moment.  The breath lets the nervous system know if we are feeling stress or fear, or if we are feeling safe and relaxed.  As soon as the nervous system picks up the emotional cues from the breath, it signals the glandular system to produce and disperse the appropriate hormones to the parts of the body that need them.

The pituitary gland, known in the yogic tradition as the “master gland” because it controls the entire hormonal system, is located below the hypothalamus, just outside the brain and behind the nose.  It has two lobes, the anterior and the posterior.  It produces a variety of hormones, many of them linked to reproduction.  But it is in the posterior pituitary gland where oxytocin, produced by the hypothalamus, is stored and ready to be released when the hypothalamus gives the signal.

Oxytocin, a Greek word that means “sudden delivery,” is called the love hormone because it is one of the key hormones that helps us find a mate, get pregnant, stay pregnant, go into labor, labor effectively, and ultimately birth a baby.  Immediately after birth, oxytocin is present at its highest levels ever so that a new mother can deeply bond with her new baby.  Without oxytocin, some scientists say, we might cease to behave in ways that “facilitate the propagation of the species.”

So the question is:  How can a woman in labor produce the most oxytocin possible to help her labor progress?  The consensus is that it is through her breath.  Study after study points to how conscious breathing can lower blood pressure, slow the heart rate and decrease stress.  It is also clear that yoga and meditation have direct and positive effects on both mother and baby.

In her book Mindful Birthing, Nancy Bardacke, CNM, teaches an “Awareness of Breath” meditation, a simple exercise where the participant focuses all of her attention on the breath, how it feels moving in and out of the body, and how to use the breath to quiet a wandering mind.  Bardacke says it is breath awareness that creates the foundation for a mindfulness practice that is key for childbirth.

“The conditions that encourage your body to produce lots of oxytocin include both the external birthing environment, and your inner birthing environment, which is deeply influenced by the state of your mind,” says Bardacke.  She adds that when we are in a state of stress during childbirth, we inadvertently trigger the fight or flight response and inhibit production of oxytocin just when it is needed most.   But a mindfulness practice can help a women let go of her “thinking mind” in labor, and instead create a positive internal environment where she can access her more primal state, release more oxytocin and help her hormones reach their fullest levels.

Another way to access that primal state during labor is by repeating a sound or mantra to help keep the mind focused, in the case of labor, on something other than the pain of a contraction.  One of the easiest sounds to make is “hmmmmmmm.”  This is the first conscious breath exercise I share in my birth classes, and I often use it as a warm-up in my prenatal yoga classes.  Some women are very self-conscious about making noises, so it’s good to practice during pregnancy.  Try it right where you are.  Close your eyes, place one hand on your belly, the other hand on your heart, inhale deeply, and hum on a long, deep exhale.  Hum on a low note, and feel the vibration it creates in the chest, in the nasal area, and behind the eyes.

According to Dharma Singh Khalsa, MD, in his book Meditation as Medicine, these vibrations can stimulate the glands, in particular, those located in the head, such as the pituitary and the hypothalamus which produce oxytocin.

“Sound currents also strongly influence the chakras by vibrating the upper palate of the mouth, which has 84 points connected to the body’s ethereal energy system,” says Dr. Khalsa.  “Some of these points carry energy directly to the hypothalamus and to the pituitary.”

Ina May Gaskin agrees that deep abdominal breathing is a positive practice in labor.  “It causes a general relaxation of the muscles of the body, especially muscles of the pelvic floor,” she states in her book Ina May’s Guide to Childbirth.  She says that when a woman is tense in her mouth and jaw, it can inhibit the cervix from opening, so she encourages women to relax their mouth and throat muscles “make a sound pitched low enough to vibrate your chest.”

The ultimate enlightenment in yoga is to develop a neutral mind, to be present in every moment, to become stillness in motion and to find peace during action.  It is hard to imagine that in the very active state of labor, a woman could be any of these, yet with good support, a positive external environment, a conscious breath and a focused sound, a laboring woman can produce the oxytocin she needs for her labor to progress without the need for external interventions, and find peace and calm in the internal stillness.

 

June Connell, ICCE, CD(DONA), is a Happy Birth Way professional childbirth educator.  She integrates her knowledge of the birth process in her roles as a birth doula and a yoga teacher (Yoga Alliance).  She teaches birth and yoga classes throughout Pinellas County and supports women in labor at hospitals and birth centers through the county.