Researching Your Pregnancy & Birth Online? Learn How to Find the Most Reliable Resources

As you probably already know, the internet is littered with information about pregnancy, birth, and parenting. But do you know how to evaluate the source of the information you’re reading? Knowing who is behind the advice and statistics provided on any given website will allow you to judge their credibility. Before digging too far into a website, take a few minutes and learn about the source:

1. Who’s behind the website? Typically, you can find this information in the “about” section. Is it a non-profit group or for-profit group? How are they funded? What’s their mission? If you cannot find this information on the website or after doing a quick Google search, it may be a red flag. Your best bet is to keep searching for more trustworthy sources.

2. Who’s the author? So you know who’s behind the site, but what about the person who’s written the blog post/article/review? What are their credentials? Who do they work for? In other words — are they qualified to give evidence-based information and how big/slanted is their bias?

3. How up-to-date is the material? When was the piece written? Women’s bodies have not changed, but a lot of what we know about pregnancy and birth has evolved. That being said, some of the most “old-fashioned” advice and information on how to have a healthy birth is still relevant today.

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!


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 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.

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

Find the Best Care Provider and Hospital through Referrals

When you’re on the hunt for the best midwife or OB and hospital or birth center to have your baby, it can be hard to narrow down the field. Yes, you can schedule interviews. Yes, you can talk to friends and family. Yes, you can even Google search for other moms’ opinions online. But if you want a direct, dependable, and knowledgeable referral, your best bet is to talk to your local birth network or group of doulas and childbirth educators.

It can be tough to find the rates of interventions and cesareans for care providers and hospitals, as they often are not published nor are they readily available. Even doulas who have been practicing for less than a year have the inside scoop on providers in your area, as well as the typical policies and standards found at local hospitals and birth centers. Doulas work in the presence of midwives, doctors, and nurses on a monthly or even weekly basis. They can tell you which care providers regularly practice evidence-based care, which ones have high rates of cesarean, and which ones truly support VBAC. Independently certified childbirth educators not affiliated with a specific hospital (many of whom are also doulas) also have this insight. Talking to doulas and childbirth educators in your area will give you a starting point to finding the best care provider and birth location for you and your baby. With referrals in hand, you can then proceed with scheduling interviews and tours to find the provider who best aligns with your preferences for birth.

Support for Pregnancy and Birth after a Fatal Diagnosis

We have been given the opportunity to interview Amy Kuebelbeck, journalist, author, and founder of, a resource website for parents who make the decision to continue their pregnancy after receiving a diagnosis that their child will die shortly after birth. 


Describe “perinatal hospice and palliative care” and tell us about the resources you provide on your website.

Most pregnancies progress beautifully and end joyfully with the birth of a healthy baby. Sadly, some pregnancies end unexpectedly in miscarriage, stillbirth, or infant death. And in a heartbreaking twist created by prenatal testing, some parents are receiving devastating news before birth that their unborn baby has a condition so serious that the baby is expected to die.

Many families in this situation are choosing to continue their pregnancies and allow their baby’s life to unfold naturally, embracing the time their baby will be able to have, no matter how brief. In response to these families’ needs, the concept of perinatal hospice and palliative care was pioneered in the U.S. and is now spreading around the world. Caregivers are incorporating wisdom from adult hospice and palliative care into the care of these families, treating all involved with respect and compassion and love. Perinatal hospice is not a place. It’s a model of care that can easily be incorporated into ordinary pregnancy and birth care just about anywhere.

This support begins at the time of diagnosis. It can include birth preparation and preliminary medical decision-making before the baby is born; plans for making memories with the baby such as photography (for example, see the beautiful work of Now I Lay Me Down to Sleep, an international network of professional photographers); emotional support; and more-traditional hospice and palliative care at home after birth if the baby lives longer than a few minutes or hours. (Lamaze healthy birth practices can help parents prepare for a labor and delivery that is as natural and peaceful as possible.) Palliative care can also include medical treatments intended to improve the baby’s life. This approach walks with these families on their journey through pregnancy, birth, and death, honoring the baby as well as the baby’s family.

I know it sounds counterintuitive, but even though these parents know that their pregnancy and birth will result in a baby who is not expected to have a long life, this path can bring surprising beauty and joy.

I started the website in 2006 because I wanted to provide a comprehensive site for parents to find support and for caregivers to find information about how to provide this care. The website includes many online support resources for parents; professional resources such as medical journal articles for caregivers; and an international list of hospitals, clinics, hospices, and others that provide perinatal hospice and palliative care support.

At the time I started the website, I had been collecting notes literally on scraps of paper about the few perinatal hospice programs in existence. It seemed to me that someone ought to keep track of the programs and make a list available online, so I decided to go ahead and do it myself. It’s been inspiring to see the growth in programs across the U.S. and around the world. As of this writing, the number of perinatal hospice and palliative care programs listed on my website is 193, and the number is growing all the time. (Recent additions include hospitals in California, Ireland, and Chile, as well as an independent program in Hawaii.) Ultimately, my goal is that the list will become unnecessary — that it will be as redundant as keeping a list of hospitals that provide emergency care or obstetricians who can perform C-sections. I hope perinatal hospice and palliative care will become a standard model of care available to any pregnant woman whose baby is diagnosed prenatally with a life-limiting condition.


How/why did you get involved in this line of work?

I needed this kind of support back in 1999, and there was nothing like it. My husband and I had learned through prenatal testing that our son, Gabriel, had an incurable heart defect. I searched for websites, books — anything — for reassurance that someone else had gone through this experience of continuing a pregnancy and simultaneously preparing for birth and death. There was virtually nothing. The idea of perinatal hospice had not yet spread. Fortunately, we had an empathetic nurse who affirmed for us that we still had a profound opportunity to parent our baby. We created a sort of perinatal hospice experience for ourselves, even though we didn’t have those words for it at the time. I eventually wrote a memoir, Waiting with Gabriel, which was the kind of story I had been searching for while I was pregnant. A few years later, I put my journalistic hat back on and collected stories from more than 100 parents for A Gift of Time: Continuing Your Pregnancy When Your Baby’s Life Is Expected to Be Brief. It’s like “What to Expect” when this isn’t what you were expecting at all. I invited developmental psychologist Deborah L. Davis Ph.D., who is now my friend, to co-author the second book with me because I had been helped greatly by her books Empty Cradle, Broken Heart: Surviving the Death of Your Baby and Loving and Letting Go. When Debbie and I were writing A Gift of Time, sometimes people would assume that the subject was depressing. It wasn’t, because every story in it is a love story. Parents’ descriptions of saying hello to their babies through tears of joy still give me goosebumps. My hope is that these books and my website will help at least one other parent feel more empowered and less alone.


What do you find that parents need most after they’ve received a fatal diagnosis for their child?

Judging from my own experience and what I’ve heard from hundreds of other families, parents first of all want to be acknowledged as parents and want assurance that their baby’s life is valued by others, even though that life may be very brief or “imperfect.” They need to hear that they will not be abandoned and instead will receive excellent care from their caregivers during the remainder of the pregnancy, during birth, and beyond. They need reassurance that life-limiting conditions generally do not cause the baby to suffer, and if pain is a possibility, it can be treated aggressively and effectively. They need to know that life-limiting conditions in the baby generally do not pose any greater physical risk to the mom than the normal risks of pregnancy. (For medical references, see They need to hear that others who have traveled this path have found that it’s not just a journey of grief but also a journey of love. Continuing the pregnancy can be beautiful, profoundly meaningful, and healing.


When parents receive a fatal diagnosis, what the first thing they should do/first step they should take?

The first thing I would gently encourage parents to do is to take a deep breath and not make any decisions immediately. Typically, the baby is snug and safe right where he/she is and is not in any distress. It’s not an emergency. Take the time to research your options and imagine what each path might look like, both for you and for the baby. Parents who are considering terminating the pregnancy usually still have time to make that choice. (Most states allow abortion for any reason through about 24 weeks of pregnancy and also allow exceptions after that, and nine states and the District of Columbia have no time limit at all.) A diagnosis like this leaves parents reeling. Many parents have said that they benefited from taking time to process their initial shock and grief before being able to make a clear decision about how to proceed.


In what ways can extended family members help?

This is a difficult experience for extended family too. They may be mourning for an already-loved grandchild, niece, or nephew. They may feel helpless watching the parents grieve and wish that something could make the situation go away. The sad truth is that nothing can erase the fact that this baby is very sick, and there is no shortcut through grief. What often helps both the parents and extended family is to offer support just like you would to anyone experiencing a terminal illness or loss. That could mean practical help with food, babysitting, and household tasks, as well as simply being present and listening if the parents want to talk. (Not just the mom; ask the dad how he’s doing too!) And there are ways to show your support for this unique situation. If the baby has been given a name, use it. This honors the baby and honors the parents’ gift of the name, one of the few and precious gifts they will be able to give to this little one. If invited to be present at the hospital to welcome the baby, or if there’s a funeral or memorial service, go — even if you’re afraid or think you’ll be uncomfortable. Google for lists of things not to say to parents whose baby has died. (“At least you didn’t really know the baby” is one example that many parents find deeply hurtful.) But do say something, even a heartfelt “I’m so sorry” or a simple “I don’t know what to say.” For more ideas, Share Pregnancy & Infant Loss Support has a helpful brochure, “Ways to Support a Parent Whose Baby Has Died.”


How Can I help?

There are lots of ways to help. If you know someone who is expecting a baby and needs this support or who is currently researching options for her pregnancy, send her to to find a program closest to where she lives. (Even if there’s no program nearby, she and her caregivers can work together to create this kind of care for her and her baby.) If you would like to make sure your own caregivers know about this concept, please tell them about the website and about the professional training and resources available. You can follow perinatal hospice news on Facebook. And if you’d like more people to know about this beautiful and compassionate model of care, please share information about it with your friends and on social media. Maybe someone out there needs this help right now and will find it because of you.


Amy Kuebelbeck is a freelance journalist and former reporter and editor for The Associated Press and other news organizations. She is author of A Gift of Time: Continuing Your Pregnancy When Your Baby’s Life Is Expected to Be Brief (Johns Hopkins University Press, 2011), along with Deborah L. Davis Ph.D. Kuebelbeck described her own experience of continuing a pregnancy with a life-limiting prenatal diagnosis in her memoir, Waiting with Gabriel: A Story of Cherishing a Baby’s Brief Life (Loyola Press, 2003), which is used by many hospitals and clinics as a resource for patients. She edits the website and its companion Facebook page and is a frequent speaker at medical conferences across the U.S. and Canada. She moderates an e-mail group for caregivers interested in perinatal hospice, a group begun in 2006 that now has grown to more than 300 members. She also has been quoted by media including The New York Times and in stories about perinatal hospice and related issues. 


photo credit: seyed mostafa zamani via photopin cc

Pregnancy and the Holiday Dinner


This week, millions of people across the United States will gather together to enjoy the Thanksgiving tradition of reuniting with friends and family, giving thanks, and eating. A lot. When you’re pregnant, eating a lot of food (or any food at all) in one sitting may not sit well with your body. With this in mind, there are things you can do to stay comfortable, ward off the antacids, and enjoy your holiday feast.


BYO crackers – If you’re in your first trimester and experiencing nausea, consider bringing your own side dish to dinner — crackers. No one will care that you can’t partake in Grandma’s favorite casserole or pumpkin pie — more for them!

Drink up – Well, not those kinds of drinks. It’s easy to get caught up in conversation, cooking, and merry-making when among friends and family during the holidays — if you’re not remembering to drink, you can become dehydrated. Be sure to keep your glass filled.

Have seconds – And thirds, and fourths. If you’re in your third trimester, eating a large meal in one sitting may push you past your comfort level. Instead, eat small portions of your holiday meal throughout the afternoon and evening.

Take a break – The holidays are the perfect time to “pull the pregnancy card.” Feel free to retreat, take a seat, put your feet up — growing new life is hard work!

Smile & nod – A growing bump and a family gathering prompts lots of advice, suggestions, and birthing war stories. Some women find it easier to just smile and nod, instead of engaging with the back-and-forth. Or, you can reply with, “My doctor/midwife has advised us to ______.” It’s hard to argue with medical advice! If people feel the need to share a negative birth story, say, “Shhh! No scary birth stories — the baby is listening!”

Butterfly Confessions: How Writer, Advocate and Mother A’Driane Nieves Gives Birth With Confidence


I am excited to introduce A’Driane Nieves to the Giving Birth with Confidence community. A’Driane is a well-known blogger and maternal mental health advocate. Her artwork inspires, and her chronicle of her pregnancy is a testament to self-advocacy in prenatal care. By sharing her journey through pregnancy and motherhood with bipolar II disorder, A’Driane gives courage to all women to give birth with confidence.


Tell us a little about this pregnancy.

 This pregnancy, my third has been…physically overwhelming. It’s honestly been one for the books! Every symptom the first trimester was far more intense than what I’d experienced previously, especially my morning sickness and the withdrawal symptoms I was experiencing from having to stop my mood stabilizer (Lamictal) until my second trimester. I also struggled with hypotension, migraines, and severe symphysis pubis, which rendered me immobile most days and landed me on bed rest quite often these past 9 months. Since the beginning of my third trimester I’ve had fairly strong contractions daily-ones that are usually 3-4 minutes apart most of the day and force me to stop and breathe through. I ended up in labor and delivery twice and given various medications to try and stop them, often to no avail, which led to stricter bed rest and having to be put on a monitor every appointment. Like I said, this has definitely been one for books…


How do you approach giving birth with confidence with this birth?

This is the first birth that I feel like I actually prepared for mentally in terms of actually learning about the labor process, birthing methods, pain management, etc. With my previous two births, the bulk of my preparation was external, ensuring everything I needed to care for my sons after they were born was purchased and at the ready. I simply didn’t place much value or emphasis on the experience-I solely cared about the end result.

However, with this pregnancy, I took time to really reflect on my previous labor experiences and came to realize that I hated both of them. I found that because external circumstances had me living in survival mode, I went into both of my labors anxious, stressed out, and uneducated about the labor process and mentally unprepared to manage what I was experiencing physically during each one; back labor with my first, and five days of prodromal and early labor with my second. With this pregnancy I decided that while the end result (healthy baby) was still what mattered most to me, I did want to enjoy my labor and delivery as best I could.

To help facilitate this goal, I’ve read several books, articles, and blog posts on various birthing methods, and have pulled different aspects from each to use that I found appealing. I’ve researched & practiced breathing & relaxation techniques I could employ to manage not just the pains of labor but any anxiety I will most likely experience. I explored the idea of hiring a doula, and talked at great length with my husband about what kind of role he felt comfortable fulfilling during my labor and what kind of atmosphere he’d like us to have during the process. This was a first for me, because with my first labor, I was a single mom, and on my own. With my second, my husband and I were together, but we never discussed anything about labor or what “kind” of birth experience we could have. This time I’ve made sure to include him, which has helped us bond in a way we didn’t my last pregnancy.

Taking the time to inform myself of my options, and actually read what happens during labor has definitely helped me approach my upcoming birth with a sense of vigor and enthusiasm I haven’t experienced before. I’ve been able to communicate more with my OB confidently, and feel far more empowered as a patient…


How has taking care of mental health played a role in that?

While being prepared and informed mentally for the birthing process has been important to me this pregnancy, my top priority from the moment I saw the plus sign on the test has been to take care of myself mentally. As a woman with a history of PPD and currently living with rapid cycling bipolar II, anxiety & OCD, I’ve worked hard this pregnancy to ensure I have what I need to do that. From finding an OB with experience treating pregnant women with mood disorders, to finding new psychiatrist who is knowledgeable and up to date with treatment methods, to educating myself on what treatment and medication options are available to me, to attending talk therapy, I’ve fought hard this pregnancy to advocate for my mental health both during pregnancy and in the postpartum period. I’ve asked both my husband and closest friends to help me be aware to any shifts in mood they may notice that I don’t, and to tell me if they notice anything that concerns them during this time or in the days and months to come. I’ve read up on my risk for postpartum psychosis and have talked with other mothers who have experienced it to gain their insight and support. I have also made it a point to ramp up on my self-care, even during periods of depression this pregnancy. Painting, watching a favorite show, listening to music, reading, and even some days just forcing myself to shower-these are all things that have helped me manage my illness aside from medication and therapy these past nine months.

Reflecting on my previous birth experiences and how they impacted me mentally-especially my last where I experienced prodromal and early labor that went nowhere without augmentation-also empowered me this time to talk at great length with my OB about what my options are this time. I’ve expressed how triggering the physical strain of this pregnancy has been on me, and how triggering the end of my last pregnancy and labor was on my mentally. I stressed my desire to not go into this labor exhausted and drained mentally, and my fear that doing so would increase my chances of struggling in the postpartum period. After two weeks of cervical checks that saw no change in my cervix despite having regular, moderate-severe contractions, and other early labor symptoms, we decided last week that scheduling an induction would be best, as I expressed I was already starting to cycle between moods-mostly depressive, and had reached my limit physically. I love my OB because he heard me and took my mental health into account and not just that of the baby’s at this stage. I’m grateful that he was able to look at my maternal health, the baby’s health, and my mental health, and come to a decision that benefitted all three. Very grateful for that.


How has the blogging and online community offer you support?

I’m also incredibly grateful this pregnancy for the online support system I have this time around. I found my online tribe and place in the blogging community three years ago while battling PPD, and both my tribe and the blogging community at large have become a lifeline for me. Thanks to the blogging, I’ve met strangers who have become my sisters and confidants, and I’ve found my voice as an advocate. They help me stay informed, encourage me, hold me accountable to taking care of myself, and are there to listen and sit with me when needed. They’ve enabled me to have a strength and confidence this pregnancy that I didn’t previously and even though I know being a mother of 3 with a mental illness such as mine will be a challenge, it’s one I know I’m capable of succeeding at.

I go in for my induction on Tuesday 11/12 at 6am….and I can barely contain my excitement and relief :)



I know I speak for everyone in wishing A’Driane well as she welcomes this beautiful baby into the world!


A’Driane Nieves is a writer, painter, mental health advocate, and speaker. She blogs at She also is a contributer at Postpartum Progress. You can follow A’Driane on Twitter @addyeB.