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A Home Water Birth Based on Faith and Evidence Based Care

A Home Water Birth Based on Faith and Evidence Based Care

Around my daughter’s first birthday in December, it was placed heavily my heart to have another child. I had just graduated college, and the timing seemed perfect. My husband agreed and we found out we were expecting in January with an estimated due date of around September 17! I immediately started researching home birth midwifery options. I had an all natural, un-medicated hospital birth attended by a midwife with my daughter. I was at the hospital less than an hour before she was born, because I knew I needed to wait as long as possible before going in to be able to stick to the birth plan. It felt weird to not have a care provider with me while I was laboring. The post partum care was disappointing with my hospital midwives. So I knew I wanted to give myself something more with this baby. We deserved the best care possible. I found a homebirth Certified Nurse Midwife in my state, and she took me on as a client.

I was incredibly blessed with an easy pregnancy. I didn’t have HG this time; in fact, I never even threw up once. I was able to work out until the middle of the third trimester as well. This was such a difference than my pregnancy with my daughter, which was great because having a 1 year old and being pregnant at the same time is quite challenging! We had an anatomy scan with the maternal fetal medicine doctor that does the ultrasounds at the birth center and found out we were having a healthy son. I still tear up thinking about that day. I knew God had a plan for us to have a son, and to keep him whole and intact. He was created perfectly, and I would not change that by circumcising him! I felt instantly connected to him the moment I saw him on the screen. I knew at that moment I would do anything to protect him!

maternity shot for birth story

Having my midwife come to my house for all my appointments was so nice. I never had to make childcare arrangements for our daughter, and it was simply convenient! I also had regular chiropractic care during this pregnancy, which alleviated a lot of aches and pains. Also, I treated myself to pedicures with my girlfriends which was fun!

Once September came I had some episodes of prodromal labor. I knew my baby was getting ready to enter the world, but each time the prodromal labor would end without me actually going into labor, it was disappointing. He had been posterior most of the pregnancy, so I figured it was him trying to get into the best position.

The early morning hours of my due date, I started having contractions that I knew weren’t Braxton hicks. I knew Berkley was coming to meet us. I was timing them and getting so excited. I cleaned and lit candles, prayed and told my husband. He needed some convincing that it was time, but once he realized it was, he started blowing up the birth pool. It was around 3:30AM at this point. We called our midwife and told her we believed I was in labor. We also sent text messages to the doula and photographer. We were so excited!

birth pool for story

My midwife called around 6:00AM to let us know she was on her way. She told me my labor may stall a bit once my toddler woke up, and recommended sending her to Grandma and Grandpa’s so I could get on with my labor. In her experience, mothers of small toddlers can get out of the labor when they mother their toddler. And I was so ready, so off she went to Grandma and Grandpa’s. I remember sitting with her on the rocking chair, where I nursed her for her first year of life, telling her mommy loves her so much, and she will always be my baby girl. It was such an intense moment knowing when she would arrive back home she would be a big sister.

My midwife was right. My labor slowed way down once Faith woke up. I went almost 2 hours with no contractions. My midwife still set up all her equipment though. She suggested I take a walk, use the breast pump, take a shower, all to get things moving again. I asked for a cervical check and I was 4 centimeters dilated and 80% effaced and baby was at minus 2 station.

Hours passed with pretty minimal contractions. My midwife went to go eat some lunch around 11:00AM to give us some space. It was so weird having such irregular contractions, yet they were so intense. I was pretty confused about the situation. When my midwife arrived back, I told her I would like an intervention of some sort to get labor moving. Once my doula arrived, I consented to a stripping of the membranes. Literally, once that happened, things picked up so fast. The contractions were coming so quickly. I could barely breathe and talk through them. I noticed all my hypnobirthing techniques weren’t helping to cope. I told my husband to call the photographer, I knew it would be soon that we would be meeting our baby boy!

My midwife didn’t want me getting into the birth pool prematurely. So when I asked her if I could get in and she said yes, I knew it would be close. This was around 2:45PM. I already felt so tired from being up all night with contractions. The pool was very relaxing, I am so glad I got that thing! It was nice being able to stretch out in it. The contractions were coming so quickly. I didn’t know how much more I could handle. I felt like I was loosing it. We put on my hypnobirthing tracks which helped a little. I even said I wanted to transfer to the hospital. Looking back, I know this is a “sign post” that means that the baby is coming soon, but I couldn’t think at that point. I just didn’t know how I could handle any more labor. The photographer walked in and I couldn’t even say hi. I felt so rude! I was sobbing. I was a mess. I felt like I was failing at my peaceful birth.

janet hugging me

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birth story photo 1

 

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I felt nauseated (which again, usually means baby is coming SOON) so my doula did some aromatherapy which did help.  I asked to get out of the pool. I went into my room and was crying some more. My midwife came and gave me a big hug and told me I just needed a little more courage and the baby would be here. I told her she was right, that I was scared. Looking back at my photos of that moment, I realize I definitely picked the right care provider. She hugged me and told me everything I needed to hear.

laboring on ball

Right at that moment, my water broke. My midwife called her assistant in to chart the time. It was clear fluid. I felt so much better once my water broke, but then the contractions kept coming even more frequently. I started having bright red blood drip down my leg. My midwife immediately (yet calmly) figured out I was involuntarily pushing against a cervical lip. I asked if it were too late to get back in the pool. Of course not! So I ran back into the pool. The bleeding stopped just as soon as it started. Everyone was right there with me. I told my midwife I felt like I had to have a bowel movement. Again, a sign the baby is right there. She just told me “poop the baby out”, “it’s okay!”, “you can do this”.

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labor in the pool 3

The pushing was an experience I had not really had before. With my daughter, she came very quickly with no pushing stage, and I had 3 first degree tears. I wanted to be in the water to minimalize tearing. It is amazing how natural it is to push. I didn’t need any directed coaching about how long to push or how to push. If given the opportunity, it comes naturally!

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Within just a few minutes, he was born! I did it! I leaned against the back of the birth pool and he was right on my chest. He had vernix! He was so cute and tiny! It’s amazing how quickly you forget how tiny they are! He got a 9 and a 10 on his APGARs. He was so beautiful and calm. My photographer said when he was born, I was saying “We wanted you so much, We wanted you!”.

group shot at birth

birth of c 2

birth of C

 

after birth of c 2

I felt like I didn’t have a lot of traction sitting in the birth pool with him, so I asked to move to my bed. We went to the bed and just cuddled, hugged, breastfed, everything that should be done in that golden hour. When we were ready, my midwife checked me and I didn’t tear! She weighed our boy and he was 7 pounds 12.5 ounces and 20.5 inches long. There were no hands on him other than mine and my husbands until we consented to his exam. She didn’t even have to draw blood to test his blood type, she collected a sample from his umbilical cord! It was such a private birth, this was the experience I wanted, the experience we deserved. I know God designed me to be able to give birth, and having a midwife with so much experience and evidence-based practices made the home birth decision even more excellent. I know my fast recovery and lack of PPD can be attributed to such a peaceful birth and loving care from my midwife and family.

we did it

kale at birth

Maternity Photo by Brink Street Photography

Birth Photography by Aperture Grrl

Birth of Twins {Baby B-Birth in OR before CS}

Birth of Twins {Baby B-Birth in OR before CS}

A few days after finding out I was having twins, I began mourning the loss of my birth experience. Dramatic? Probably. But as a Doula and at the time, prospective, Childbirth Educator, and someone who’s frankly quite terrified of needles, I knew that medication, needles, scalpels and augmentation were not for me.

Coming to terms with the possibility that my birth was most likely going to be filled with things I didn’t want was very difficult. I agonized, cried and had panic attacks over it for weeks. After seeking the advice of other doulas and doing some serious soul searching, I finally started to feel peace about the possible ways I would birth these babies. However, I was very prepared to make informed decisions and fight for what I wanted and needed during my birth experience.

I knew that in order to have a birth that somewhat resembled the ideal I had envisioned, I would need to have a doctor who was ok and on board with at least some of my desires. Home birth was not an option for me so I chose a practice I was familiar with through both personal experience, and experience as a doula, who I knew would give me the best chance at a vaginal birth of twins in the area. That being said, out of the four doctors in the practice, only two were ok with the fact that I didn’t want an epidural or even want the catheter placed but only one of those two was ok with doing a breech extraction if needed, should baby B turn breech after baby A was born. While I knew I could make the decision to refuse any procedure, I also knew it was probably going to be an uphill journey and one I wasn’t sure I was strong enough to climb.

34 Weeks with twins

On the day I went into labor (around 34/35 weeks gestation), the doctor who didn’t mind if I refused the epidural but wouldn’t deliver a breech baby B was on call, but I felt at ease. We arrived at the hospital when I was 5 cm and 100% effaced. Within an hour, I had progressed to 6 cm and was hardly uncomfortable, despite the air conditioner in L&D being broken, and it being 82 degrees in my room. The rest of the labor progressed quickly, with minimal discomfort, and without any mention of pain meds, or epidurals from the nurses and the doctor.

At 9cm I was not feeling the typical transition-like contractions I had felt with my previous 2 labors and wasn’t quite sure what was happening with my body. I had prepared for something so much more intense! I had also prepared to defend my choices with the medical staff every step of the way, but none of that was necessary as they were in awe that I was completely in control of my contractions and pain management, and was willing to listen to and think about the choices I was presented with and decisions I had to make.

There were a few things I did agree to and ask for after making conscious and educated decisions, but they were MY decisions. I did ask for a bag of fluids when I arrived at the hospital, so I had an IV and I did ask for pitocin to be turned on during pushing if it was needed. Staying in the labor room to birth my babies was not an option because of hospital policy, but I was ok with that and we did move to the operating room at 9cm. Though it wasn’t a climate controlled, dimmed room, I was able to maintain my focus and feel at peace with being there.

Immediately after being checked and found “complete” I felt the urge to push, and 5 pound 13 ounce Baby A was born after a few pushes, 5 hours after arriving at the hospital.  Not one nurse counted or yelled or told me how to push, which was exactly what I had asked for.

When Baby A was born I remember thinking she was tiny and had a great cry, but I didn’t get to actually see her face. She was passed to my nurse who started checking her over, who then had to passed her to the NICU nurses because the doctor needed her help. Baby B had flipped transverse as soon as her sister was born and she did it fast too.

Everything I had read about twin births said that the worst pain you would ever feel would take place if you had to have a version during labor without an epidural. And there I was, facing a version without an epidural. When I made the decision not to have an epidural I was very much aware of the possibility of the pain but I figured I would rather endure 5-10 minutes of intense pain than all of the risks and side effects associated with an epidural through a labor.

Somewhere between both the doctor and me “talking” to Baby B and begging her to turn and the doctor and nurses beginning the version, I went into a trance like state. I didn’t feel pain, just a lot of pressure. I spent the last minutes of labor fully aware of everything that was happening, but It felt like  it was happening to someone else and I was just watching.

During the version there were about 5 hands on my belly, some holding the space where baby A had been, others turning baby B. They were able to turn her to be head down, but she then turned transverse again and her heart rate became rocky.  The doctor decided it was best to do an internal version to try to get her into position to be born. He was holding the ultrasound transducer with one hand and internally moving the baby while trying to keep her cord from prolapsing with the other. He was able to move baby B into position to be born but then she moved her hands above her head. So we sat, and waited. Waited for her to move, waited for something, anything that would allow me to push for her birth. And we waited while the doctor still was holding her cord and her in place, internally.

After roughly 13 minutes of waiting, her heart rate plummeted and wasn’t showing any signs of recovering. She needed to be born right then, but that wasn’t going to be possible to do vaginally. I will never forget the look in the doctor’s eyes when he looked at me and told me he had to do a c-section. He knew how much I didn’t want one and how hard I had fought for this birth. I knew that he didn’t want to do a cesarean and had tried everything possible to get Baby B to be born vaginally. There just weren’t any other options.

Because I had chosen not to get an epidural I was going to go under general anesthesia, which I had never been under before. The anesthesiologist who was standing by quickly started preparing the anesthesia while the nurses were racing to put sensors on my chest. The pitocin was turned off, and the room was switched from a birthing room to a fully functioning operating room in less than 45 seconds.

Right before I was put under general anesthesia, the doctor saw on the ultrasound screen that Baby B had moved her hands, and yelled for me to push. And in the confusion and haste of the OR, I pushed twice and our feisty 5 pound 8 ounce Baby B while the doctor guided her into the world, just 17 minutes after her sister was born.

I will forever be grateful to my doctor for trying so hard to give me the birth I wanted and what I needed. He respected me and my knowledge and trusted me and my body to do what it needed to do to birth these babies. Never once did he look down on or question my choices, he never made me feel like naive or pressured into anything. He went well outside his comfort zone and fought for me and fought for birth and in those 17 minutes, admittingly learned a lot.

Edited To Add:

Even though it’s been nearly seven years, the story of the birth of my twins will sometimes hit me and cause me to pause. I’ve never shared this picture before- I wasn’t ready to. I was honestly scared to. This picture captured and froze a moment so personal, and intense. The intensity and emotion are still fresh, even after all this time.

My sweet Baby B, being born into the hands of our extremely patient and incredible doctor. Her umbilical cord coming before her, after a nearly 15 minute internal version (without pain meds), seconds before I was going to be put under for a crash c-section. This moment, with our baby girl halfway between my womb, and the beginning of her life outside, before she’d even taken her first breath, was captured by my husband as he stood next to me, praying desperately for his wife and baby. He will tell you this moment defined and shaped him more than any single moment before, or since. And I don’t doubt that because it did for me too. But I can only imagine what he felt watching our baby’s birth unfold from his vantage point: the unknowns, the joy, the confusion in the chaos. Truly needing to trust, have faith, and let go.

Seven years later my perspective is changing. Instead of the uncertainty and a moment hanging in the balance, I am starting to see a joyous beginning, a triumphant entrance into the world and the perfect start to the life of our feisty Baby B.

twin vaginal birth

The birth of my twins serves as a reminder of strength and courage that I hold within. If I can get through a nearly 15 minute internal version without pain medication, I can handle almost anything. I look back on that day with peace and a sound mind, knowing it went exactly the way it was supposed to go, with nothing to regret.

GGTwins Mom

gg twins 2

GG Twins sleeping

gg twins

Stretch, Open, Breathe {12 Prenatal Yoga Poses To Prepare For Birth}

Stretch, Open, Breathe {12 Prenatal Yoga Poses To Prepare For Birth}

A special thank you to all of the mothers who sent in their prenatal yoga photos for this story. You are all beautifully balanced yoginis! {Guest post by Alisia}

Photos by to Cradled CreationsAmy Leist Photography, and Tammy Bradshaw Photography

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Yoga can be a wonderful and gentle way to keep your body flexible and you mind focused during pregnancy, labour and birth. Most medical and birth professionals recommend yoga as appropriate exercise – even for mums who are limited for whatever reason! Yoga poses can be modified  and a teacher can help you use props and accessories to support your body while practicing. It’s really important to remember that when it comes to yoga, “no pain, no gain” is not the motto!! The aim is not necessarily to ‘get into the poses’ or perform the perfect pose – you need to listen to your own body. It’s not a race, go slow. It’s ok to only push as far as is comfortable, or to stretch a little further to mildy uncomfortable. The aim is NOT pain!

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I personally used yoga throughout both of my pregnancies, although more with my second than my first. Regular practice enabled me to feel more open and free, flexible and aware, both physically and emotionally. I also used HypnoBirthing for my second, so yoga was a really great way to lead into my daily HypnoBirthing meditation. Even if you aren’t using HypnoBirthing, a few short stretches each day followed by a short relaxation or meditation feels great. And I don’t know about you, but for me, any excuse to relax while pregnant was welcomed by me with open arms!

I’ve put together my top 12 poses for pregnancy, which are gentle but helpful. This is not an exhaustive list of poses – there are countless other yoga positions that are great for pregnancy as well (most are, really!) – but these are the ones I personally loved the most. As always (and it goes without saying, but I’ll say it anyway!): caution should always be taken when practicing yoga while pregnant!

Easy Pose (Sukhasana)

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Easy Pose is a nice pose to start and end a yoga session. It doesn’t require a great deal of flexibility, but it can be quite intense to hold. During pregnancy and labour, this pose can be used as a rest and relax pose, and also works to gently open the hips.  Arm and shoulder stretches can be performed in this pose to relieve tension in the shoulders and open the chest. During labour, opening the chest allows deeper breathing; rest in this pose between surges and focus on the breath.

The pose: Sit on the ground, ensuring that your weight is on your sitting bones and not you tailbone. Inhale; cross your legs,  sit up (on the  sitting bones not the tailbone), stretch the spine and straighten the back. Rest your hands on your knees or thighs. If you feel discomfort, you may prefer to use a folded blanket underneath your buttocks to help you sit forward off your tailbone, or to perform this pose up against a wall to prevent slouching.

This can be a meditation position, or you can move into some back, arm, and shoulder stretches or chest openers:

  • Inhale, and reach your arms back and into a prayer position with palms together behind the back. Hold for 4-6 breaths.
  • Inhale; reach one arm up and bend it down behind the head and rest the hand on your back, at the same time reach the other arm down and around your to your lower back. Stretch your arms and shoulders and open your chest until your two hands are clasped  behind your back. Some people might have difficulty clasping hands in this position; that’s fine, just give your arms a great stretch while you try. Hold this position for 2 breaths, release the hands, swap arms and repeat.
  • Inhale, and reach your arms back. Keep them straight, reach them behind you and clasp your hands. Hold for 4-6 breaths.
  • Inhale; stretch your arms back and place your palms on the ground behind you, lengthen the spine and lean back slightly, to gently stretch the abdonmen, chest and back. Hold for 2-4 breaths.
  • Place your right hand behind your right thigh (as demonstrated in the picture above), inhale, stretch the left arm up and lean to the right side. Hold for 2 breaths, come back to centre, and repeat on the other side.

Bound Angle Pose (Badhakonasana)

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Bound Angle Pose, sometimes also called Butterfly Pose, is another hip-opener, and it also gives a nice stretch to the inner thighs, improve posture and help stretch the back and neck. Bound Angle Pose could also help stabilise the pelvis, which is helpful for many women in pregnancy. This was one of my personal favourites to labour in, while leaning over a birth ball.

The pose: Begin seated in Easy Pose, with crossed legs. Inhale; sit up on the  sitting bones (not the tailbone), stretch the spine and straighten the back. Exhale. Inhale; uncross legs, and bring your feet together in front of you, heel to heel, and draw your feet towards your groin. Press the knees towards the ground. If the knees are unable to reach the ground, gently bounce the legs – this will give a deep stretch into the thighs, hips and groin. Hold the position for 4-6 breaths. Inhale; readjust your posture – sit up, stretch the spine and straighten the back. Exhale; keep the spine straight and  bend at the hips, lean forward towards the ground. Once you have gone as far forward as possible while keeping the spine straight and without squishing your belly, bring your chin to your chest and hold the position for 1-2 breaths.

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Hero Pose (Virasana)

Hero pose looks simple, but is great for relieving leg and ankle swelling during pregnancy, improve posture, and help stretch the back, shoulders and neck. Also, as your belly grows, it can feel like you aren’t able to get a full breath, and the arm and shoulder stretches you can perform in this pose can help stretch the abdomen and open the chest to restore the breath. During labour, this pose can open the chest to allow deeper breathing, and relieve arm or shoulder tension; rest in this pose between surges and focus on the breath.

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The pose: Begin by getting into a kneeling position – thighs parallel and knees together. If this is uncomfortable on your knees, you can place a cushion or blanket between your thighs and feet, to sit on. Inhale; sit up, stretch the spine and straighten the back. Stretch the arms above the head, interlace the fingers and twist the hands so that palms are facing up. Hold for 4-6 breaths.

Arm and shoulder stretches  can be performed now:

  • Inhale, and reach your arms back and into a prayer position with palms together behind the back. Hold for 4-6 breaths.
  • Inhale; reach one arm up and bend it down behind the head and rest the hand on your back, at the same time reach the other arm down and around your to your lower back. Stretch your arms and shoulders and open your chest until your two hands are clasped behind your back. Some people might have difficulty clasping hands in this position; that’s fine, just give your arms a great stretch while you try. Hold this position for 2 breaths, release the hands, swap arms and repeat.
  • Inhale, and reach your arms back. Keep them straight, reach them behind you and clasp your hands. Hold for 4-6 breaths.

Child Pose (Balasana)

This is a relaxing resting pose that you can use during pregnancy between poses to help stretch the lower back and have a moment of stillness. In labour, Child Pose continues to be a helpful resting pose between surges, taking the pressure off your knees and wrists if you are labouring or pushing on your hands and knees. When practicing this pose, have three or four blankets stacked up ready to lean you chest on so that you can relax forward into this pose.

The pose: Inhale: position your knees apart, and sit back and gently rest on your heels.  Inhale; sit up, straighten your back and stretch your arms up above the head. Exhale. Inhale; lean forward, stretch the back and lift the tail bone, and lower the arms and head towards the ground. Have your stack of blankets ready – they should be set up in such a way that when you lean forward, your chest rest on the blankets and your abdomen is not compressed at all. Let your arms hang down beside the blanket and rest on the ground comfortably. Hold the position for however long is comfortable.

Cat and Cow Pose (Marjaryasana and Bitilasana)

During pregnancy, cat pose and cow pose are both great for lower back pain, and taking the pressure and weight of your baby and belly off your hips and back. It gives a gentle stretch for both the lower back and abdominal muscles. Practing a cat/cow sequence can also help encourage your baby to move into a ‘good’ LOA position for labour.This pose should also be on your labour ‘to do’ list, and a birth ball can be used to lean on to take the pressure of the arms and wrists. This is an especially helpful pose if your baby is posterior – it can help relieve the intensity of ‘back labour’.

The pose: Starting on hands and knees. You might prefer a towel underneath your knees, and as previously mentioned, you could lean your chest on a birth ball if you find it difficult to rest your weight on your arms and wrists. Ensure that your wrists and hands are aligned underneath your shoulders, and that your knees are positioned below your hips.  Your feet should be flexed, soles up, and your toes should not be curled under; palm of the hand should be flat on the ground and fingers should be flat and facing forward. During the poses, be aware of the pressure on your wrists and knees – weight should be equally distributed between all four limbs. Inhale; stretch your neck and lift your head forward and your chest up. Lift your tailbone and drop your belly towards the ground. Exhale; draw your belly in and up, curl your spine out, and roll your tailbone and chin down and towards one another. Repeat 4-6 times. To rest, come into Child Pose. Inhale: keeps the knees apart (or slightly wider, to accommodate your belly), and draw the hips back to rest on the heels while keeping the hands and arms outstretched, lower the head to the ground.

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A variation of Cat Pose is Extended Cat Pose (pictured above): Inhale; stretch your neck and lift your head forward and your chest up. Lift your tailbone and drop your belly towards the ground. Exhale. Inhale; shift your weight to your right leg and stretch your left leg back and up, at the same time shift your weight to your left arm and stretch your right arm forward and up. Stretch the neck and head so that you are looking forward. You can choose to hold this pose for another exhalation and inhalation, or on the next exhalation, bring the arm and leg back to their original position. Inhale, and repeat 2-4 times. Begin again, using the right leg and left arm. To rest, come into Child Pose.

Tree pose (Vrksasana)

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As you progress in pregnancy your centre of gravity changes with your growing belly. Tree Pose is a pose that help regain your balance with your new centre of gravity, as well as improving posture, and building strength and stamina for labour. Tree Pose can also work to stretch and open the hips, and can help with pain and discomfort in the hips. You may need to practice this pose while holding on to a chair, table or wall, until you develop a strong sense of balance in this pose. Always work with your body and find the right place for you – remember, the point is not how high you can force your foot to go, the point is finding your centre of balance, so even just lifting your leg off the ground is fine to start with.

The pose: Begin in Mountain Pose – standing, feet flat on the floor, with arms by your side. Inhale; stand tall, stretch the spine and straighten the back. Lift the right foot and position the sole of your foot on your left leg; some people are able to stretch the foot to the upper thigh, others need the foot lower on the calf or even just lifted in the air slightly. Exhale. Hold on to something steady if necessary, or press the palms together in prayer position: in front of the body (as shown in the picture above and below) or stretched up above the head. Stretch the spine and straighten the back. Hold this position for 4-6 breaths, lower the arms, return the foot to the ground, and repeat using the opposite leg.

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Warrior I Pose (Virabhadrasana I)

Warrior I stretches the thighs, abdomen, back and shoulders. It’s also good for balance, and it tilts and opens the pelvis, which makes is especially useful in labour during surges to encourage baby to engage.

The pose: Begin standing, in Mountain Pose – feet flat on the floor, with arms by your side. Inhale and step your left foot back so the your feet around 3 feet apart. Evenly distribute your weight between your front and back leg. Exhale; stand tall, stretch the spine, straighten the back, and place your hands on your hips. Inhale, turn your back foot 45-90o away from your body. Bend your front knee and bring your thigh parallel to the ground. Ensure that your knee does not bend further than your ankle, and that your hips and shoulders remain square towards the front. Exhale as you reach your arms above your head – let your eyes follow you hands about 3/4 of the way and settle your gaze with your head tilted slightly upwards. Alternatively, you can reach  and clasp your hands behind your back. Hold for a minute, remembering to breathe. Release your arms, straighten your leg and return to Mountain Pose. Repeat using the opposite leg.

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Warrior II Pose (Virabhadrasana II)

Warrior II gives the thighs an intense stretch, strengthens the abdominal muscles, and is extremely helpful if your experiencing tight hips. It can also help stretch the back and shoulders and relieve back aches during pregnancy. This pose can help open the hips and encourage your baby’s head to engage and in labour it can assist by opening the pelvis for baby to descend and put pressure on the cervix to aid in dilation. If you have difficulty balancing, practice this pose next to a wall.

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The pose: Begin by standing with your feet wide apart. Rotate your right leg by turning your right foot away from your body. Keep your hips facing forward in the direction of your left foot. Keep your shoulders in line with your hips, and raise your arms and look in the direction that your right foot is pointing. Bend your right leg until the knee is in line with the ankle – do not bend past that point. Be aware of your posture and do not sway your back to push your belly or hips out towards the front. Hold for 2 breaths, straighten the right leg, return to centre, and then repeat with the left leg.

Low Lunge (Anjaneyasana)

The low lunge is fantastic during pregnancy. This pose is another hip-opener, and also helps strengthen the lower back and abdomens. When practiced with arms up, it gives a deep stretch in the shoulders and back. This pose is excellent during labour, and can be helpful to hold during a surge to open the pelvis and encourage your baby to engage, rotate and descend. This can also be used during labour to encourage dilation.

This can be a really tricky pose, balance-wise. You may like to start with a blanket underneath your knee, to reduce discomfort. The picture below shows Karen (a mum of 7, soon-to-be 8, at 6 months pregnant) extending her arms above her head, and this is quite tricky. Many women need to keep their arms down and position blocks (stool, phone books, bricks etc) beside their hips so they can stretch their back and keep their balance.

karen - 8th baby, 6 months pregnant

The pose: Begin on hands and knees. Inhale; bring your right leg forward and place your foot between your hands, ensuring that your knee does not extend past your ankle. If your foot does not come all the way to your hands, move your hands back and place them on either side of your right foot. Exhale. Inhale, stretch your torso up and extend your spine. You may choose to move your hands to some blocks besides your hips, or stretch them up to rest on your thighs, or reach them up above your head – this depends on your balance and level of comfort. Hold this position for 4-6 breaths, or through 2-4 surges, and then return to centre in the same way you came into the pose, and repeat the lunge using the opposite leg.

Goddess Pose (Utkatakonasana)

This is a ‘half squat’ pose that is really intense on the legs but can help build strength and stamina for labour and birth, as well as stretching the groin and opening the hips. It stretches and elongates the abdomen and allows for more room to breathe. During labour, this is another pose that can help your baby settle down into the pelvis and and put pressure on the cervix to dilate.

molly_maternity (1 of 1)-10-L

The Pose: Stand with your feet slightly wider that your hips. Inhale. As you exhale, bend your knees and lower yourself so that your thighs are straight and parrallel to the ground. Keep your heels on the ground. Bring your arms up so that your upper arms are parallel to the ground and the forearms are vertical. Alternatively, you can bring the hands into prayer pose, or hold on to a chair or wall for support. Hold this pose for a few minutes.

Full Squat Pose (Malasana)

This pose is a excellent pose all round – for pregnancy, labour, and also for birthing. It takes the Goddess pose further, putting This pose opens the hips, and stretches and strengthens the legs. It can be difficult to balance in late pregnancy and during labour, so you can practice this pose against a wall for support, or use a low stool or yoga block to balance on during the squat to help you maintain the pose. If your heels lift, try placing a folded towel underneath them to lean on.

The pose: Stand with your feet slightly wider that your hips. Inhale. As you exhale, bend your knees and lower yourself so that your buttocks are only an inch or two from the ground. Keep your knees wide and your heels on the ground. Bring your hands together in a prayer position, resting your elbows on the inside of your knees to keep the apart. Lean forward slightly for balance, if necessary. Hold this pose for a few minutes.

Corpse Pose (Savasana)

Yes, that’s an unfortunate name, but a very relaxing pose! This is a great on to end your yoga session on, and it can lead into meditation, relaxation or HypnoBirthing practice.

The pose: Copse Pose is a reclining pose, laying reclined on the ground, with arms by your side and palms up. Corpse Pose should be modified into a side-lying pose after 20 weeks, so that you are lying on your right side rather than on your back. For comfort, support yourself with pillows and blankets under your head and body and, if practicing the side-lying pose, between your knees. A soft, dark cloth over your eyes will help you relax into meditation or rest.

 

Disclaimer: This is an informative article and is not intended as medical advice. Always consult your care provider about all exercise and health concerns during pregnancy. Always seek out and consult your personal yoga teacher for any prenatal yoga concerns. If you have never practiced yoga before, it would be beneficial to attend a dedicated prenatal yoga class and seek the advice of a yoga teacher before beginning practice. 

Generally accepted advice among yoga teachers is:

  • you should avoid practicing yoga in the first trimester,
  • supine (laying) poses should be modified after 19-20 weeks, to avoid compressing the superior vena cava and reducing blood flow,
  • deep abdominal stretches, crunches, and spinal twists should be avoided or performed with caution,
  • if you have any additional medical concerns (for example, Symphysis Pubis Dysfunction, Incompetent Cervix or Placenta Previa) you should seek clearance from your heath care provider before beginning any form of exercise.

There is some debate about inversions (hand, head, or shoulder stands) during pregnancy. My personal belief is that inversions come with potential risks during pregnancy due to the deep core muscles involved, the changing centre of balance during pregnancy, as well as the fall risk to inexperienced women. Most people should avoid inversions while pregnant, unless you are very experienced and comfortable with performing inversions prior to pregnancy and have a deep understanding of the safety, anatomy and physiology of pregnancy and yoga inversions. 

Many positions can and should be modified depending to your individual physical limitations. And above all else, always listen to and respect your body – if you feel pain or discomfort during your prenatal yoga practice, stop and rest. If you experience cramping, contractions, bleeding, fluid leakage, dizziness, changes in vision, pitting edema, or persistent headaches, or any other symptom that is concerning for you, contact your health care professional.

ccyoga2

Article written by Alisia Cameron, wife and mum of two.

My Battle With Hyperemesis Gravidarum

My Battle With Hyperemesis Gravidarum

I sit here after my son’s second birthday party with Cars cups, plates and wrapping paper all over my house. Looking over I can see pure joy in my half naked two year old sons eyes and I feel as though it is time to write his survival story down.

This is not necessarily a birth story – but the story of the 9 months prior. You see, with my 5 year old daughter (Charlotte “Charlee”) and Sebastian’s pregnancies were not the glowing, happy pregnancies that every woman wishes for. I had Hyperemesis Gravidarum (HG) for both pregnancies, and with Sebastian it was sever.

HG is severe nausea and vomiting during pregnancy and can lead to many complications to mom, baby and our external relationships with others. The typical saltine crackers and sipping Ginger Ale is not a solution to this (go ahead and suggest this to an HG suffer – I dare ya! haahaa). It is a terrible, terrible disease that makes any pregnant woman affected with it in a debilitated state and can be life threatening.

In July, Chris went to his long-weekend bachelor party out of country and I was at home with Charlee, who had just turned two in April. We had been planning on getting pregnant soon and when he got home from four days away we ‘celebrated’ and three weeks late it was confirmed – we were going to be a family of four!

At first, I believed that I couldn’t be as miserable and sick with my second blessing as I was with my first. That it wouldn’t be fair if I did, so I didn’t expect anything terrible to occur. However by the end of August (approx 6 weeks gestation) I started to get the signs I had experienced with Charlee. It was slow at first, some pretty intense nausea throughout the day which didn’t lead to vomiting but was very uncomfortable. We had our “Buck n Doe” that week and I was able to celebrate and announce our pregnancy to our family and friends.

A week later it all changed – I couldn’t get out of bed, I was vomiting 30-40 times a day (yes! That is not a typo- THIRTY to FORTY times a day). I could not keep down any food or liquid so it was mostly dry heaving with some bile. I popped blood vessels in my face and eyes. I began to loose weight quickly and had chronic constipation.

I wanted this pregnancy – I welcomed it. I did not welcome HG. It was an uninvited friend to what should have been a 9 month long party! Our wedding was coming up on September 25 and I just could not do anything to prepare for it. I went on disability leave from my job and laid in bed all day and all night only getting up to puke – most of the time I just did it in a bucket beside my bed.

My poor sweet, lovable, and perceptive 2.5 year old was feeling negative affects of it as well. All she wanted to do was play with Mommy, but I couldn’t even get out of bed without my husband’s assistance. She was so strong – stronger than I was. She made me food and tea and would bring it up to me in bed, hoping it would help me. As soon as she was gone, I would have to reach beside my bed side table and put it in a garbage bag so at least she would think she was helping me. When she would come up and check on me – I would fake that I was feeling better, that we could play dollies if we could just play them while in my bed.

This continued on for 6 months before I was starting to feel human again. Sure, I had oral anti-nausea medications and I went to the hospital weekly to get hydrated. The doctors would discharge me because I had not thrown up in the last thirty minutes and I wouldn’t even be out of the hospital parking lot begging my husband to pull over because I refused to throw up in our car. Nothing worked. NOTHING. Nothing takes away the nausea, the pain and the loneliness. The worse is the depression. Depression while being pregnant is a terrible beast that I wish no one would ever have to go through.

My depression started the second week of September. I was so sad, I couldn’t be with Charlee, I couldn’t plan my wedding, money was tight and I didn’t deserve this – two pregnancies where I couldn’t move, let alone enjoy it? Even though I never went to the doctor and told them about my depression (I just wasn’t strong enough) I figured that if the HG would let up then the depression would magically go away.

That was a great plan, if HG would have gone away. I was alone every day. Chris would get up with Charlee, take her to daycare then go to work. He would pick her up from daycare. He would make dinner. He would bath her. He would put her to bed. The only thing I was able to give my precious blonde curly haired daughter was a story before bed (of course, laying in my bed). Sometimes I feel as though I should have been strong enough. That I could have done it if I tried a little harder. But I know that in actuality I was battling something my body couldn’t handle. I felt as if I was dead, I regretted getting pregnant and on several occasions considered terminating my pregnancy so Charlee could have her mommy back. I am so glad that I didn’t consider the latter too much.

newborn baby

April 2011 came and it was a joyous month, by then we knew we were having a boy and we were over the moon. Charlee turned 3 on April 1st and I had a huge party for her (also the first time I had seen many family and friends since our wedding in September). It is one of my best memories. She was thrilled, I was relatively healthy and my family was all together again. Sebastian’s due date finally came and nothing – 9 days later I was induced. It wasn’t the way I pictured my birthing experience, but when you have such a terrible pregnancy experience giving birth is the only way to get it to end. I only required the cervix cream to jump start my labor and 9 hours later at 6pm on April 20, 2011 my beautiful 10 pounds 5 ounces 21 inches long co-survivor arrived. He was perfect from his first breath and is still perfect to this breath.

hyperemesis gravidarum

Hyperemesis Gravidarum may have ruined my pregnancy for me but that little chunky baby was worth it all in the end. I survived HG. Sebastian survived HG. Charlee survived HG (twice!). Chris survived HG (twice). We did it together.

To all my fellow HG survivors and sufferers please remember that it will end soon enough. And you will get that amazing and shiny reward at the end. You can survive this!

With much love,
The Osburns

For more information on HG please visit – http://www.helpher.org/

Pregnancy After An Eating Disorder

Pregnancy After An Eating Disorder

I have tried to write this at least a dozen times. It never turns out the way I want. In the beginning I tried to approach it like an informative article, a place people could go to find facts, research and information… but I get caught up in my own experience, and it ends up a jumbled mess… No, I can’t write an informative article. Not yet. Not until I tell my story…

So here it is. I had anorexia for over 7 years. ‘Had’ anorexia is the right way to write it, but the reality is that it had me…

I was 13 when it ‘started’. It was slow; an incessant nag in the back of my mind, slowly wearing me down, like the way a constant water drip smashes into concrete, slowly working a hole through… you’re not good enough, that’s not good enough, you’re not good enough, do it better… like a drip, these thoughts came, slowly, until they wore me down. Eventually I was swimming in them. Or more accurately, drowning in them. Everything was so out of my control, I had no idea where these thoughts were coming from, but they were inside me and they would not stop. Food became the thing I could control. While everything seemed crazy, and out of my control, I could control food. And my weight. Except, of course, that I had lost all control. I was completely and utterly powerless against this disorder.

[2003 – 17 years old: after I was discharged from a hospital stay, and when I graduated from high school]

teenage anorexia

At my worst, I was 39kg (85lbs), and at 156cm (5’2”), and this was a devastating weight to be. I couldn’t see it though. Even at 39kg, I could see extra weight; bulges and bumps that I needed to lose to be better. I lived with other anorexic girls on my many hospital admissions, and felt obese compared to their emaciated figures. Eating disorders are bizarre like that; I never could see myself for what I truly was. I saw these girls and I thought I was not controlling my food enough. Even though at one point I existed on a handful of oats soaked in water (but never cooked, because I wanted my body to burn my energy digesting them) and drinking iced water (because I wanted my body to burn more energy to warm it back up to body temperature). I wondered why my parents worried so much, I was frustrated and angry at people trying to ‘help’, and every single time I walked into the ‘Eating Disorders Clinic’ I felt like a fraud.

Thankfully, after years of suffering, I was given the help I needed and eventually I was ‘weight restored’ to 54kg, and ‘recovered’. Which is a misleading word which just means that you aren’t drowning in self-hatred – but it doesn’t mean that the drip isn’t there, or even the occasional downpour or flash flood of thoughts. My experience with  recovery from anorexia is similar to an alcoholics experience with recovery – we can triumph over it, but never let our guards down and we must always be aware of triggers. I have many triggers, but my biggest trigger was yet to come… but it wasn’t pregnancy.

I met my partner in 2006, and began trying to start a family in 2007. I always wanted to have children, and was excited about being pregnant. But I was nervous. My body was going to grow, in a way that I had absolutely no control over. I would have to surrender control, but keep control. I could not allow myself to be swept away in a flood of thoughts. I could not skip meals. I could not run until my muscles were burning. I had to look after myself, and I had to look after my baby. Could I do it? I was strong, but was I that strong? I was recovered, but… was I *that* recovered? Was I ready? Would I ever be ready?

I was lucky that physically, the years of disordered eating and being malnourished did not affect my fertility or my ability to sustain a pregnancy, although that isn’t the case for everyone.

My first pregnancy came with a wonderful sense of ease; in relation to the eating disorder at least. This was surprising, as I was always acutely self-conscious and self-critical pre-pregnancy, but my growing belly was something I cherished. For once my body was meant to be growing, and I let it grow. I was relaxed. I loved the life and energy flowing from me. I loved that eating was ‘for the baby’, and I could argue with the thoughts in my head. “I must eat”, I would think, “I must eat, for the baby”. And I did. I gained a lot of weight, and I didn’t let myself worry about it. I knew that if I acknowledged the amount of weight I had gained, it would rain-pour-flood, and I would drown. And I could not let that happen. I gained a lot of weight – over 20kg (44lb). Part of this weight gain was because I couldn’t restrict what I ate – if I did, it would just begin a barrage of thoughts that I might not have been able to fight. Another part of this weight gain was like me saying a big f**k you to the thoughts – kind of like, “you’ve controlled me for long enough, look what I am doing now”.

Unfortunately, throughout my first pregnancy I suffered with antenatal depression that extended into postnatal depression and anxiety, mixed in with some PTSD. I was lucky that they eating disorder did not take hold in a negative way. I know that many women react to pregnancy differently – the changes in hormones and body shape can be a huge trigger for eating disordered thoughts and behaviours – and even after recovery they have trouble keeping the thoughts and behaviours at bay. Women need to be aware of their strengths and their limitations when it comes to their recovery, always inform care providers and try to let people know or ask for help when they are struggling.

I birthed my daughter via cesarean in August 2008. It was an emergency cesarean; very unplanned, and very unwanted. Because I had gained so much weight, I did not just ‘bounce back’ to my pre-pregnancy weight. Well, I don’t think many women do just ‘bounce back’, but regardless, I was devastated. My belly is covered in stretch marks, my stomach shrunk down after the cesarean my skin crumpled in a sea of raw pink lines and I had a ‘hang’ on one side of the scar. I was carrying extra weight across my whole body, and I felt like a disgusting puffy crumpled-up mess. Breastfeeding did NOT help me lose weight, despite the belief that it does, and I was wearing maternity clothes for some months while I struggled with whether I would ever get to wear my pre-pregnancy clothes again.

[2009]

mother and daughter after eating disorder

I develop severe postnatal depression and anxiety. Even though I had dealt with depression and anxiety for years, I couldn’t recognise how much I needed help. I struggled, and I had a baby who existed on 2 hour blocks of sleep (if I was lucky!) and constant feeding. I was a mess, and some days were so dark I could barely see a way out. I dealt with it for years, and I fought so hard for the first two years to not relapse or go back into disordered eating. The thoughts were there, and they were strong , and I believed each and every thought that entered my head: they would be better off without you, they don’t need you, you’re nothing, you’re nothing, you’re a bad mother and your daughter knows it… For two years I fought those thoughts, but eventually I was worn.

[August 2010]

mother and baby recovery from anorexia

It was around the end of 2010 when it started again. I don’t really remember it well, but it was a tough time for us all. A multitude of things tumbled together and crashed into me and knocked me off my feet…  I lost all the weight I was carrying, and was back down to me pre-pregnancy weight. I pushed myself to my limits, all the while believing that it was never enough, I was never enough, I could do enough, be good enough, smart enough, strong enough… People told me I was losing weight but I couldn’t see it of course. Each morning I would get up, and cry as I made my coffee, then sob as I said goodbye to my daughter. I’d cry as I drove to work. On the drive to work, I’d pass cars and powerpoles, I’d drive over bridges, I’d take careless risks through roundabouts and traffic lights, wondering if I could just accelerate, lose control, drive into or drive off at the right moment, and it would all be over. I didn’t, of course, and it was probably because I knew I didn’t want to die, but I told myself I wasn’t strong enough, I was too weak, and for being too weak I deserved to keep living in hell. I usually held it together at work, and I’d come home and be angry, and cry myself to sleep.

My partner would be there, sometimes frustrated and angry, sometimes caring, but always there. Despite that, I felt alone. And so powerless and weak. And ashamed that I had let it take me again. And hopeless. She watched as I fell into a pit of despair. I pushed her away, but she stayed anyway. There was one night when she sat down next to me, with a look I’ll never forget, it was fear, she looked at me with fear. She asked me if I was going to be ok, and it broke my heart. She sobbed, and we cried together. She said I needed help. She wanted to help. She didn’t want to lose me. I told her I was strong. I could do this.

I fought and gained some control back. It was hard, but we did it together, my partner and I. She reached in and helped me out again.

[January 2012]

mother and daughter

I was pregnant with our second daughter early 2012.

This pregnancy was difficult. The first 14-15 weeks were full of vomiting and constant nausea. It was difficult to force myself to eat when I knew I would be bringing it back up in half an hour. I couldn’t work for almost 6 weeks. Things quietened down in second trimester, except for a few scares that left me in the birth suite with a fluid leak and infection.

At 28 weeks I was diagnosed with Gestational Diabetes and that was hard. I almost lost it. It was hard for me to keep hold of the eating disorder when I had to engage in the very behaviours that I were so disastrous to me for years. I had to keep track of my food, grams of carbohydrates, balance my meals, and religiously test and keep track of my blood sugar levels and weight. I had to keep it all in check. The obsessive part of me broke out, and I counted carbs to a key. I got to a point where I was 34 weeks pregnant, 62kg (136lb) and I wasn’t gaining weight and it was difficult. In my first pregnancy I found it easy to let my body gain the weight, I let myself eat, and I didn’t let myself think about it. This time, I was surrounded by triggers, and I couldn’t just ignore it, I couldn’t just eat, like in my first pregnancy. I had an acute awareness of my food, the nutritional value of my food, my weight… 

The hardest part was admitting it. I don’t like admitting when there’s something out of my control, I like being able to just take care of myself, and I won’t ask for help. Even when asked, I won’t admit I’m struggling. So telling my partner was tough. She already knew, of course. She knows my triggers, she knew what was happening in my head. We worked through it together, with a lot of support from her. I had a VBAC in November 2012, and with it, I gained a new sense of worth, achievement, and power. 

For me, the hardest part of this whole journey through pregnancy after eating disorders is relinquishing control. Through the years I lived with anorexia, I tried to control, I wanted control. Even through recovery, I hold on to the fact that I am controlling the eating disorder, I am in control of myself. But there’s an element to pregnancy and birth and postpartum that is uncontrollable. It is about trust and faith, it is about letting go and embracing the chaos. It is a fine balance between letting go and riding the wave, but knowing when to hold on again so I don’t start drowning. Even now, I struggle with knowing when I need to be in control and when I need to let go. Having a good support team around me to remind me to hold on or let go is essential.

It was also hard to get used to my new body. Things changed. A lot. Even being back to pre-pregnancy weight I am not the same as I once was. I’m softer and squishier, and I never expected that. And oh the stretch marks, so many stretch marks everywhere. No one told me my thighs would get stretchmarks, and yet as my hips widened, they did! My breasts are marked as well. And as my body shrunk back down my skin did not follow, and there is loose skin and dimples and crinkles… And I am one of the ones who don’t lose weight while breastfeeding, so that was a little disappointing as well!


post partum belly

I am 4 months postpartum now, and things seem clearer second time around. I am more confident, and I like my body. Some days I love my body. I know it deserves to be loved all the time, and I do my best. I am happier. Brighter. I still struggle with control – hold on, let go, hold on, let go…? The thoughts are there, although I wish I could say they weren’t, and they get to me sometimes. I can’t see this as something I will ever ‘get over’. Every now and then the thoughts get quieter and I live more freely, and sometimes they are deafening, and every minute is a struggle. I have to be aware of my triggers. We don’t own scales, and I don’t think there will ever be a time where I can have a set of scales in the house full-time – I can barely walk past scales on the shelf at a department store without wanting to stand on it. I can say with confidence that I will never be able to ‘diet’ or engage in any kind of radical detox program without having to fights the thoughts to take “one step further”, which is the path the leads to disordered eating. Exercise is difficult – I love running but have a tendency to push myself too far. I joined a gym once, a few months into an attempt at recovery, in an attempt to exercise in moderate and be ‘healthy’, but that didn’t end well.

But right now I am strong, and I am ok.

Written by Alisia, wife and mum to two kids in Australia.

post partum belly and baby

I Am Strong {Young Mom with Hyperemesis Gravidarum}

I Am Strong {Young Mom with Hyperemesis Gravidarum}

This is daily living for me.

I’m currently 7 months pregnant, 19 and proud to soon be a mommy. My fiancé and I found out very early on this wasn’t going to be an easy pregnancy . When I was barely 6 weeks along the complications started coming and I was diagnosed with HG. Which is short for hyperemesis gravidarum. I went from 97lbs to 82 in a few weeks. I couldn’t eat, be in light, smell, be in heat, or tolerate any sort of stimulation without becoming sick.

Around my fifth month of pregnancy I had to get a picc line in my arm; it’s a long flexible tube that goes into my arm and drains near the heart. I had to have all my meds and fluids and nutrients through the picc daily.

I’m strong because even through all of this I’m still going and I’ve never regretted anything. Never became resentful. Never loved my child less.

New New2

The Truth About Gestational Diabetes {And Why It’s Not Your Fault!}

The Truth About Gestational Diabetes {And Why It’s Not Your Fault!}

So you’ve had the Glucose Tolerance Test, or maybe you’ve been monitoring you’re blood sugar levels at home, and your blood sugar readings were high. You have been given a diagnosis of Gestational Diabetes. If your experience was anything like mine, an Obstetrician or midwife gave you a pamphlet on ‘Diabetes and Pregnancy’, referred you to a dietician and endocrinologist for management, and then sent on your way. And now you’re at home, and all the questions you didn’t think to ask are flooding in…  What the heck is it? And what does it mean? Will my baby be alright? Do I need a caesarean? Will I need to be on insulin? What can I eat? Do I have to stop eating CHOCOLATE?!?!?!

There is some debate against the use of routine testing to diagnose Gestational Diabetes, and also questioning about giving the diagnosis of Gestational Diabetes as a label on pregnant women. Dr. Sarah Buckley recommends avoiding routine testing for Gestational Diabetes for most women. Henci Goer and Dr Michael Odent are among many pregnancy and childbirth professionals who argue against diagnosing women with gestational diabetes, citing unnecessary stress and interventions as one of the risks of the Gestational Diabetes diagnosis. Nevertheless, whether you want to call it Gestational Diabetes or Pregnancy-Induced Insulin Resistance, or just high blood sugar levels in pregnancy, some women do have elevated blood sugar levels and need some extra help.

Gestational Diabetes Mellitus (GDM or GD) is described as a form of diabetes that develops during pregnancy, and usually goes away 4-6 weeks postpartum. In a pregnant woman without Gestational Diabetes, the body works ‘as usual’. You eat, your stomach breaks down your food, you start to digest it, and the glucose from the carbohydrates in your food enters the blood stream. The pancreas gets the signal to secrete more insulin into the blood stream to help the cells absorb the glucose and convert the glucose into energy. The blood glucose level increases straight after a meal but as the glucose is absorbed from the blood and into the cells, the blood glucose levels decrease. The blood glucose readings fluctuate as normal, but remain within the ‘prescribed levels’.

In a pregnant woman with Gestational Diabetes, the cells become ‘insulin resistant’. The pancreas makes ‘the usual’ amount of insulin to enable the cells to absorb the glucose, but because the cells have become ‘resistant’ to the insulin, the amount of insulin needed increases. When the pancreas makes as much insulin as it can, and the cells continue to struggle to absorb the glucose, this is Gestational Diabetes. The blood glucose levels in a woman with GDM rise as normal after a meal, but stay elevated due to the cell’s inability to absorb the glucose.

diabetes blood sugar test

So what can you do to prevent or stop insulin resistance and GDM from developing? There seems to be this myth floating around that fit and healthy women don’t get GDM, and unfit or unhealthy women are probably going to have GDM. It’s false. In pregnancy, insulin resistance is mostly caused by an increase in pregnancy hormones (hormones produced by the placenta). The hormones are thought to reduce the effect of insulin on the cell, as well as reducing the response of the cell to insulin. While keeping yourself healthy can reduce your risk, there is nothing that can stop your cells developing insulin resistance from the hormones made by the placenta. Although there appear to be some risk factors which could increase the chance developing Gestational Diabetes (for example, age, ethnicity, weight, personal or family history of diabetes,  or some hormone-related conditions such as PCOS), there are many women who develop insulin resistance and GDM who do not show any risk factors. In short, you just can’t control how your cells respond to your pregnancy hormones. There is a lot of research to suggest the most pregnant women will develop some insulin resistance during the pregnancy because of the increase in pregnancy hormones, but for many women the pancreas is able to produce enough insulin to maintain stable blood sugar levels and so it does not develop into diabetes.

There is also this idea that women with GDM can control it. Women are told “You just need to keep your diabetes under control.”, like it’s just that easy. Unfortunately, no one can explain how to control a cells response to the pregnancy hormones. You can’t control Gestational Diabetes. It happens sometimes. But telling a women that she should be able to control it really put unnecessary shame and blame on mothers who are frustrated and disappointed enough as it is. So if you’ve ever said this then, please, never say it again!

You can’t control Gestational Diabetes. It happens sometimes. But there are ways to help your body deal with it. Monitoring diet and engaging in regular exercise really can be the key for women who have low-to-medium level insulin resistance. The aim of monitoring your diet is to balance the amount of carbohydrate in your meals. The general consensus from dietitians and endocrinologists seems to be that having 3 meals and 2-3 snacks per day (but please follow the advice of your personal care provider). It does make sense that it’s easier on your body if you spread out the carbohydrates into 3 balanced meals and 2-3 snacks instead of packing them into three carb-heavy meals per day. Another way to manage high blood sugar levels can be regular exercise, like walking. Going for a walk 30 and 90 minutes after eating to can help lower blood sugar levels by using up the excess glucose in the blood stream. Every person responds differently though, so if you do have Gestational Diabetes, please work with your care provider in finding the management plan right for you.

Some women develop a high level of insulin resistance, despite eating balanced and spaced out meals and snacks, and exercising regularly. These women continue to have consistently elevated blood glucose levels. I was one of those women.

When my hormones peaked at 32 weeks, I would not be able to eat a chicken and salad sandwich of barely 30g of carbohydrates without my blood sugar spiking well above the ‘allowed’ limits. People kept telling me to “control” my diabetes. I thought I was doing something wrong because my blood sugar levels were so high, so I reduced my carbohydrate intake drastically. The dietician put me on insulin when I started losing weight (and I was only 140lbs at 32 weeks, so didn’t have much to lose!), I had no energy and I was and spilling ketones into my urine.

If, like me, you are doing all you can and you still need insulin, please be kind of yourself – it’s not your fault. Remember, you can’t control this. You have a medical condition. You are insulin resistant. Your body just needs some help. Injecting insulin is very easy (I found it virtually painless, and nowhere near as unpleasant as the finger-prick tests!). It helps your body by giving it the extra insulin it needs when your pancreas is producing as much insulin as possible but your body is still unable to lower your blood sugar level.

Despite the myths floating around, a diagnosis of Gestational Diabetes does NOT mean you will automatically have a big baby. It does NOT mean you automatically need to have a cesarean. It does NOT mean you cannot VBAC. It does not mean your baby will definitely need to go to the Special Care Nursery… You have options, and a gentle, calm and intervention-free vaginal birth with gestational diabetes is possible for most women.

diabetes insulin pen

References:

Australian Diabetes Council. (2013). What is Gestational Diabetes. Retrieved on February 28, 2013, from http://www.australiandiabetescouncil.com/About-Diabetes/Gestational-diabetes

Buckley, S. J. (2008). ‘Gestational Diabetes Testing’. In Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Retrieved on March 31, 2013, from http://www.fullcirclemidwifery.com/2009/02/gestational-diabetes-information/

Goer, H. (1996). Gestational Diabetes: The Emperor Has No Clothes. The Birth Gazette, 12(2). Retrieved on April 1, 2013, from http://www.gentlebirth.org/archives/gdhgoer.html

National Diabetes Service Scheme. (2013). Gestational Diabetes. Retrieved on February 20, 2013, from http://www.ndss.com.au/en/Diabetes-Information-Sheets/Gestational-diabetes/

National Diabetes Information Clearinghouse. (2013). What I need to know about Gestational Diabetes. Retrieved on March 1, 2013, from http://diabetes.niddk.nih.gov/dm/pubs/gestational/

National Institute for Health and Clinical Excellence [NICE]. (2008). Diabetes in pregnancy: Management of diabetes and its complications from pre-conception to the postnatal period. Clinical Guideline 63. Retrieved on April 1, 2013, from http://www.nice.org.uk/nicemedia/pdf/CG063Guidance.pdf

Odent, M. (2004). Gestational Diabetes: A Diagnosis Still Looking For a Disease? Primal Health Research: A New Era in Health Research, 12(1). Retrieved on April 1, 2013, from http://www.bellybeginnings.com/Handouts/GestationalDiabetes-Odent.pdf

Journey to a Peaceful Planned C-section {Twin Girls}

Journey to a Peaceful Planned C-section {Twin Girls}

My story begins when I was just a child. Ever since I can remember, the one thing I wanted to be was a mother. Sure, I had other dreams and aspirations as well – but, while my idea of the perfect career and life was constantly changing, my goal of becoming a mother never once faltered or waned. That dream, however, would come true too soon when I became pregnant at the age of nineteen by a man I’d only been dating for a month. It was bad timing, and there were a lot of struggles – but in my heart I was overwhelmed with happiness. I was growing life! What could possibly be better than that? But, as time wore on, my happiness began to be whittled away by the stress and terror of being a young mom in a new relationship. I spent the majority of my pregnancy alone while my partner worked out of town. I had no vehicle, no friends – I didn’t even have cable TV or the internet to help me pass the time. I was constantly lonely and afraid. And, during the times that my partner was at home, he was cold and aloof – dealing with the stress of the pregnancy in the only way he knew how.

I became bitter; angry. I’d always suffered from anxiety and depression, but now it was out of control. I went days without getting out of bed. I had always wanted to have a baby, but my fairy tale was turning into a nightmare. I felt useless, unwanted, ugly, and broken. Weren’t pregnant women supposed to feel gorgeous and glowing? Weren’t their partners supposed to adore them, support them, and tell them how amazing they were? I felt cheated out of something I had looked forward to since childhood. I was terrified that my child would become tainted in my womb, malformed because of all the fear and hate that I held in my heart.

And then there was the traumatic birth. The only research I had done while I was pregnant included reading a book that my mother gave me and watching reruns of “A Baby Story” on TLC. I had no idea what birth really was – I truly believed that the doctor and nurses had my best interest in mind and would take good care of me. I went into “preterm labor” three times the month before my due date – each time my labor was stopped and I was sent home after one night’s stay in the hospital. Looking back, I am certain that my child and my body knew that we were ready to deliver at that time.

May 14, 2006 – Mother’s Day. My water broke as I was getting ready to go to bed for the night. We immediately went to the hospital, and I was given pitocin to “help things along.” I wasn’t contracting at all, and still didn’t even after they began the pitocin. I slept that night, with my partner and my mom taking shifts watching me. In the morning I was beginning to have some contractions, but nothing regular or painful. Months after my birth, we found out that the hospital had received a “faulty” batch of pitocin at the time of my delivery, so it’s definitely possible that I was given bad drugs.

Later on, sometime early afternoon, my contractions finally started to kick in – but they were far from normal. I would have four or five contractions back to back, and then I would have ten or fifteen minutes of nothing in between. It only took a few hours of this before I became exhausted. I’d previously requested to not have an epidural – but after some “convincing” from the nurses, I finally agreed to have one put in. By the time the anesthesiologist made it to my room, however, I was past the point of being able to have one. At that point, in the middle of a cluster of contractions, the nurses convinced me it’d be best if they gave me a dose of stadol. I don’t remember agreeing, but I must have – because the next thing I knew I was woozy and out of it and I didn’t even know my own name. The next few hours were a blurry haze. I remember being told to push. I remember pushing, and being yelled at to push harder, and crying, and being yelled at, and feeling like I wasn’t good enough or strong enough to have this baby. At one point I looked over at my partner and my mom and begged them to make it stop. Shortly after, consent forms for a C-section were being shoved in my face. I signed them. I just wanted it to be over.

The C-section was probably very normal, as far as sections go. I was terrified of being cut open, but after the spinal took the pain away I was in such a state of relieved bliss (part of this was probably the drugs) that I didn’t mind. My partner stayed by my head while our baby was being delivered – a baby that was so stuck in my pelvis that the doctor was out of breath after tugging and yanking and pushing him out. I remember the doctor saying, “Well, no wonder. This baby is way too big; he never would have come naturally.”

It was late at night, and by the time I went into recovery most of the hospital was shut down. So I lay in a bed, by myself, in near darkness (apparently they didn’t want to turn on more lights than they had to), for over an hour. I remember hearing the doctors and nurses complain about having to come in at 7pm on a Monday to perform an emergency section. I felt like a failure and inconvenience. I ended up shaking more than the nurses were comfortable with, so they gave me a drug to help, which also meant I had to wait longer to see my baby. By the time I got out of recovery, the nurses had convinced my partner and mom that they should go against my wishes to exclusively breastfeed my baby because I was “taking too long to recover” and my baby would “starve” if they didn’t give him formula.

But then I saw my son, and got to hold him for the first time, and suddenly everything else didn’t seem so bad. I was elated and giddy with happiness – I had a son! He was perfect and gorgeous and the most amazing thing I had ever seen. Unfortunately, that feeling of peace and happiness was extremely short lived.

When my mom and partner left for the night, I was left alone with a newborn who didn’t want to latch on because he’d already experienced the easiness of eating from a bottle. He cried, I cried, and we continued on this way for nine months. He was an extremely colicky baby, and I had no idea how to handle it. I remember staring at him and feeling like the worst mother on the face of the planet – because I didn’t know how to make my son stop screaming. He screamed nearly every second he was awake, and every time he screamed I cried. That, along with the PPD that kicked in about a week after he was born, made my life as a new mom worse than any hell I could possibly imagine. I hated myself. I couldn’t bond with my son – and I hated myself even more because of it. And so began my three year stretch of just barely scraping by on a day to day basis.

When my son was three, I made the hard choice to leave my boyfriend and start a new life on my own. I didn’t have a job, a place to stay, and no money – but I knew in my heart that I needed a fresh start. I built myself up from nothing and, with the help of my parents; I succeeded in securing a decent life for me and my son. It wasn’t ideal – but it worked for us. I finally faced my issues with depression and anxiety, and for the first time in forever I felt like I was regaining some control over my life.

Fast forward a couple years – a couple jobs, a couple boyfriends, and a couple stressful situations later. I’d grown remarkably as a person, as a woman, and as a mother. I felt in control and happy. I had a great job and a new boyfriend that I adored. I wasn’t on birth control because my previous partner had a vasectomy, and I was looking into getting an IUD. And then I found out I was pregnant.

Fear. Panic. Denial. Was this really happening to me again? How could I be so reckless and stupid? I was terrified of going through another traumatic pregnancy and birth. Luckily, my boyfriend turned out to be an amazing source of support – he showered me with love and affection from the moment the test came up positive, and every time I panicked and tried to push him away he would stand strong and stay by my side. But I was still scared of everything to come – what if I had another child that I couldn’t bond with? What if I lost everything I’d worked so hard to achieve? I couldn’t stand the thought of going through what I went through with my son, even if everything did turn out okay in the end.

But then, the most amazing thing happened. When I was ten weeks along, I went in with a bit of spotting and had a precautionary ultrasound. What we found was a completely healthy TWIN pregnancy. I was having two babies! I don’t know why, but as soon as I saw my two little angels on that ultrasound screen, everything suddenly clicked into place. I was at peace with myself and this pregnancy. A couple months later we found out that we were having girls, and the joy grew even more. I was having daughters. I felt like everything was finally falling into place. This is what I was MEANT to do – this was the life I was meant to have.

But, slowly, a new type of fear kicked in. The internet is a wonderful thing, but it can be terrifying for a pregnant woman – especially a woman with a “high risk” pregnancy. I read horror stories about TTTS and Vanishing Twin Syndrome. I’d never worried about my son while I was pregnant with him. I didn’t realize how many things could go wrong. So, while I was finally enjoying a joyful pregnancy with a wonderfully supportive partner, I was constantly terrified of something horrible happening. When we found out that our twins were sharing a placenta, the fear got worse. And when I showed signs of my cervix shortening and was put on bed rest at home, the panic truly reached its peak. I spent every waking moment terrified that my water would break and my babies would die, that something beyond my control would come and take my precious girls away.

When I was put on bed rest, a friend of mine who was training to be a doula sent me some information about the effects of bed rest on pregnant mothers. I began to realize that women had been birthing babies since the beginning of time, and that a mother has the ability to know her own body better than any doctor ever could. I did more research – and that’s when I found your blog.

I spent days going through your site. It opened my eyes to a whole new world of babies and birth. It all made so much sense. I read countless stories about beautiful, brave mothers who listened to their own bodies and had wonderful, peaceful births. The new awareness that dawned on me changed me in ways I can’t even begin to explain. For the first time I began to realize how much damage my first pregnancy and birth had done. I began to understand the resentment and guilt that I still carried from it. I began to acknowledge the fear and pain I’d been holding onto since then. I realized that I had spent the last seven years feeling like a failure as a mother, and I saw how that negativity had infected every aspect of my life. And, even more remarkably, I began to forgive and let go. I cried for days. Afterward, I felt like a new person. I felt strong, capable, and informed. I felt peace. I felt joy. I felt the beauty of the lives growing inside of me, and for the first time in my life I felt capable of being the mother my son and girls deserved.

And that’s how I ended up here, 30w2d along with my Mo/Di girls, and confident in my own strength as a woman and a mother. I’ll be having a repeat C-section this pregnancy – the hospital here doesn’t even consider VBAC and pushes for sections with every case of twins. But I’m at peace with it, and I don’t feel forced or taken advantage of in any way. I feel informed, capable, and like I’m choosing the option that’s best for me and my babies – not like I’m a passenger along on a ride that I can’t control. So, even though I’ll never get the dream birth that I’ve always wanted, I know in my heart that the resentment and guilt I felt with my first C-section won’t be an issue this time around. I feel beautiful, strong, and calm. And I feel immensely grateful to you and the wonderful women of BWF for opening my eyes and sparking my healing process. Thank you, you beautiful souls.

The first picture is of me and my son, who is now seven. The next three are me and my girls at fourteen weeks, twenty-eight weeks, and thirty weeks. Hopefully in a couple months I’ll have more pictures and a second, happier birth story to share.

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Alternative Methods of Checking Dilation {The Purple Line and More}

Alternative Methods of Checking Dilation {The Purple Line and More}

Through several years of being a part of the birth world I have noticed a trend. Dilation is *the* birth topic. No matter how a mother plans to birth, when the time draws near, dilation is the one thing on her mind. Why? Cervical dilation tells us one thing and one thing only – where you are right that second. It tells you nothing about what came before that check (when you compare to other labors or women) and it tells you nothing about what is to come. It only tells you about the here and now.

cervical check

The news of little or a lot of dilation can either help or hurt a mother’s mental state in labor. If the mother has been in early labor for days (which is normal), the news of a only 1 or 2cm of “progress” can completely take her out of a peaceful state of mind. If the mother has only been in labor for a few hours and finds out she is already at say, 7cm, she may think her time is nigh…only to find out that she has many more hours of work ahead. Basically – the information can back fire on you.

But there are times when the information can be of use. For instance, a mother may plan to wait to get an epidural until “x” dilation. Or she may be waiting to call her family until she is sure things are really cooking. So what are the ways of getting this information? The first thought that comes to mind (and the only thought usually) is that you must have a vaginal exam.

Guess what? You don’t! That’s right – no one has to put their hands in your vagina to give you this information. Vaginal checks come with their own set of risks, from accidental rupture of membranes (or not so accidental – some care providers have used it as a good time to break mother’s water without asking) to increased risk of infection.

Studies also show that vaginal exams are not really accurate. When checking for exact dilation, studies show the accuracy to be around 48-56%. When allowing a margin of 1cm (which is a large margin of error when this information is used to time interventions or labor “cut-offs”) the accuracy is around 89-91%. [One such study abstract from real women in labor. And another study abstract which was done on models.] When you add in multiple people checking, the accuracy gets even worse. Yet, vaginal exams are considered the “gold standard” of assessing labor progress. And lets not forget that vaginal exams are just plain uncomfortable at the best of times – in labor they can be downright hellish.

So what are some ways of figuring out your dilation without actually touching the cervix?

The Purple Line or Bottom Line

This is a purple/dark line that shows up and extends well, to put it delicately, along your natal cleft. Or rather – your butt crack. The line starts at the anus and moves up the cleft. When it is all the way to the top, you are 10cm. Normally – you do have a bit of a line there. But this Purple Line or Bottom Line is not he line that is normally there (which is usually pink). This is a dark purple line. My suggestion is to check out your bum in early pregnancy so that you know the difference.

A study was done in 2010, and published by BMC Pregnancy & Childbirth, that proves the existence and accuracy of the purple line for many women. In this study, the line itself was present at some point in labor for 76% of women. The line was more apt to show in women with spontaneous labor than in those with induced labor (80% vs. 59%). The further dilated a woman was, the more likely she was to have the line show up. The line showed up most when women were around 7-8cm dilated, and seemed to fade in some women at almost complete dilation. And according to this study sample, the line seems to first show for most women around 3-4cm.

An earlier study was done in 1990 and published in the Lancet which also proved the existence and accuracy of the line, though the sample size was smaller. In this study, the line was seen about 89% of the time and was only completely absent in 10% of women. They noticed a significant correlation between the station of the baby’s head and the length of the line.

The reason for the Purple Line is believed to be due to the increased pressure on the veins around the sacrum. This pressure on the veins creates the dark line where the thin skin of the cleft can show it. This pressure from the head creating the line also means that you can reasonably assess the station of the baby’s head as it moves down. Lower head = more pressure = higher line.

Here is a great example of the Purple Line from a wonderful mother in our support group. Obviously – she is complete in this photo, and baby is on its way out! But you can see the Purple Line so clearly (though I did take the liberty of highlighting it for you). Thank you Sara for sharing this moment with us!

purple line

With the relative accuracy of this method, and especially considering the inaccuracy of vaginal checks, this is a great way for women to check themselves without “checking”. This would also be a pretty accurate way of judging when to head to the hospital (if that is your plan) if you are one of the 76% of women this line shows up for.

The photo below is from Jackie, who was so excited when her purple line showed up around 8cm she actually asked her photographer to snap a photo!

Purple LIne

Sounds of Birth

The sounds a woman makes in labor can tell a care provider (or partner) much about where the woman is in labor. Obviously, this will not work the same for all women. Some women are noisy all the way through – which is fine. Some women are quiet until the very end – also fine and normal. However, there does seem to be a pattern for most women in the way they vocalize in labor.

In early labor (0 to 4cm) a women can normally converse easily or with little effort during contractions. She does not feel the need to rest between them very much, and will most likely continue or pick the conversation right back up after each contraction. In active labor (4 – 6 or 7 cm) the woman usually has to do some breathing or vocalizing during contractions, and normally stops speaking during them. She may have to rest more between them.

In transition (7 – 9cm) the woman tends to really need labor noises – groaning, moaning, and sometimes repetitive mantras or noises. At full dilation the women may really retreat within and become quiet. She may not want to speak at all, even between contractions. Pushing of course has its own set of noises. And just a note on noises – low and open noises seem to help women dilate. Keeping the jaw slack and not clenching helps the pelvic area to open and not clench as well.

Smell

This is something that birth workers will talk about and recognize. Just before the start of transition, the woman emits an earthy and very “birthy” smell. Musky and deep, it speaks to some inner part of our being and psyche.

Fundal Height

This is a documented way of measuring dilation externally. When not in labor and full term the fundal height is normally 5 finger-breadths between the fundus (top of the uterus) to the bottom of the breast bone. As labor progresses, the uterus pulls up on the bottom of the uterus (which is the cervical opening) and this is what creates dilation. Think of it as the uterus “bunching up” at the top in order to pull the bottom up and open.

As dilation progresses, the finger-breadths between the fundus and the breast bone becomes smaller and smaller – at full dilation, you can normally no longer find the gap between the two. This measurement must be done at the height of the contraction, and while mother is on her back. This means it will not be the most comfortable way of assessing progress – but it does work.

Emotions

Basically – as a mother gets more serious, her dilation is increasing. Naturally (like with noise/vocalizations) this is not true for all women. However, in reading birth story after birth story (and watching video after video) I do see this trend. Mothers start out chatty and light hearted. As the harder work sets in, mothers retreat inside and tend to ignore those around them or get serious in other ways.

This seems to be a very accurate sign of transition for most women. Transition is typically the last stage of dilation and is normally the most intense. It is during this stage that mom may get irrational or scared. Usually this is when women feel the “I can’t do this” emotions and may express sudden fear or want of pain medication. When women are prepared for this stage they can be reassured that this means labor is almost over and baby is near.

Bloody Show

Many women hear about the bloody show at the start of labor. Not all women have this, but it is the “mucus plug”…basically, it looks like a large wad (or wads) of well – snot. I know, not the nicest way of saying it, but it is true. The mucus plug is probably one of the weirdest looking parts of labor and birth. However, around 6cm or so, most women get another (or first) bloody show. This usually comes out during contractions, and may be a gush of fluids and mucus and blood. If a woman’s membranes were broken before this point, she may have another gush of fluid at this point.

Estimate Without Fear

All of these methods can be used to assess progress in laboring women. Some may be more accurate than others, but perhaps we should ask ourselves about why we want to know dilation in general. In some situations the information can be very useful, for instance if a mother does not want to head to the hospital too early or if she is negotiating for more time in labor but does not want a vaginal exam at the moment (or at all).

However, my suggestion is that for the average laboring woman we learn to not equate cervical dilation with progress or lack of progress. As I stated at the start, dilation is only a snapshot of where you are right now and tells you nothing about where you will be an hour from now or even 30 minutes from now. Long labors with slow dilation can suddenly speed up and reach full dilation (and baby in arms) in mere minutes or hours compared to the slow dilation of the previous hours or days. Women who are not dilated or effaced at all during a prenatal appointment can suddenly have a baby in arms an hour later. [Though, prenatal dilation checks are another subject that will need a separate post.] Dilation is simply not a crystal ball.

If you are a mother who wants to avoid cervical checks completely, or wants to know how to assess dilation before your care provider comes (or you go to them), then these methods can serve you well. As always, continue your own research and talk to other supportive women.

Further Reading

Bellies and Babies Blog on Dilation

Science and Sensibility post on the Purple Line

A Midwife’s Perspective on Cervical Exams

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