(Yes, that’s CHOCOLATE!) When Pregnant, We’re Just Different: How To Maintain Sanity

Pregnancy brain? Hormonal, x35,000? Feel like a complete MENTAL CASE?

All things pretty common when we’re pregnant.

Thoughts like:

“If I JUST had a big hunk of extra sharp cheddar cheese RIGHT NOW, everything, and I mean EVERYTHING, would be fine!” (And add to that, a few (?) pieces of chocolate, and we’re set!)

“If anyone else calls me on the phone,  I WILL HUNT THEM DOWN, STEAL THEIR PHONE, BREAK IT, AND THROW THE PIECES IN THEIR FACE!”

“I AM NO LONGER HAPPY THAT YOU WILL BE THE FATHER OF THIS CHILD!”

Whoa, Nelly.   What happened? I was fine (well, most of the month, anyway) a month ago, six months ago, nine months ago.

What happened, is, for sure, hormonal changes. What exactly, and why exactly? Not clear. But we need to give ourselves a break.

The whole truth is this: When we are pregnant, we are, in many ways, simply a DIFFERENT PERSON. We have a different makeup.

We could theorize that we are in need of more protection ourselves, as we’re protecting a most fragile being, increasingly growing inside of us.

And modern day culture, which does not encourage a woman to rest for anything,  fuels us an uphill battle.

We feel like we should do it all. Be pregnant, and run a marathon, while keeping a full time job, fully managing the house, and of course, taking care of any children we already have. Not to mention keeping up a good marriage. It’s a lot. Guess what? It’s too much.

Ladies, our priority is to take it easy, however we need to, in our own pregnancies. For some women, this means energy levels aren’t much different (at least perhaps until the end of pregnancy;), and others feel a huge energy drop just after conception.

The most practical tips are simple:

1. EAT.

Eat well. (Whole grains, fruits, veggies, PROTEIN. Did I mention that extra sharp cheddar cheese? I seem to have needed that for weeks one pregnancy.)

EAT FREQUENTLY – you might prefer smaller meals, 6-7 x/s day, including middle of the night. (My husband LOVES to joke about my 3am escapades. Where’d those last two, three, four pieces of gourmet pizza go?)

2. DRINK.

DRINK WELL. (Tea, whole fruit juices, not sugary ones, and water.)

DRINK FREQUENTLY.

3. If you feel up to it, EXERCISE.

Break a sweat, work the muscles. Doesn’t have to be what you did pre-pregnancy, not even close – depends on how you feel. Just follow your body, and you’ll know what feels good during, and afterward. YOU, AND ONLY YOU, KNOW.

4. BLOOD TESTS.

Your prenatal care provider should be sending you for regular blood tests to monitor your health. Iron levels, for example, can affect energy levels.

5. HOMEOPATHY/HERBALIST/DOCTOR.

If you feel like you’re drinking & eating well, exercising to your beat, and you still feel depressed, or overly low on energy, consider a good homeopath and/or herbalist. They will screen you well and determine some good supplements for you, which often do the trick. If you have a history of needing antidepressants, and/or feel that none of the above solutions are working for you, consider speaking with a doctor about medication suitable for pregnancy.

Overall, know that you know yourself. Give yourself your time to yourself. Baths, reading, napping all over the place, hire a maid (the money will come back to you), whatever you need.  (Wanna laugh? Read “The Girlfriend’s Guide to Pregnancy” by Vicki Iovine. A must.)

Relax. Drop your shoulders.

And above all, there’s no need to explain nor apologize. Just do your thing, and those around you will get it. And they’ll ultimately be happier for you, and with you. And hey, you can always remind yourself it’s for your baby.

Feel great, feel healthy,

Chaya

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Attainable Epidural-Free Births

Are you sure I can have a birth without an epidural?

First, let’s dispel the myth that women giving birth “naturally”, i.e. drug free (which usually means without an epidural), are some sort of heroines. Every woman who has given birth is a heroine, the circumstance of her birth irrelevant to the testimony of her heroism. Women who give birth without drugs can do so by utilizing natural tools which allow us to relieve the pain. It is a myth to think that drug-free births are more heroic, rather, they are usually the result of a myriad number of means of simply feeling the contractions less. Drug-free births still feel the contraction intensity via pressure, a sense of movement, and “highs”. We know we’re in the midst of a contraction, but we can minimize the pain, even not feel it at all at times. And to top it all off, some women even get to a state of pleasure (yes, you read it – pleasure).

So back to the question: Are you sure I can have a birth without an epidural? The answer is: Very. Strong. Likelihood. The reason is that, thankfully, there are TONS of techniques to use to minimize, and even eliminate at times, the feeling of contractions. Here they are:

DISCLAIMER: The below does not apply for women on Pitocin or any other drug which creates artificial contractions.

Achieving Natural Birthing

Here are ways of feeling mostly pressure/intensity with contractions, as opposed to pain. Using these techniques, many women even feel pleasure. (Yes, that kind of pleasure.)

The Three Basics
-Physical state of relaxation, using a relaxation technique
-Physical, emotional, and technical support throughout the labor (partner, doula, parent, supportive medical staff)
-Being in tune with exactly what YOU feel is best for you and your baby.

The Specifics

-Relaxation techniques – always starting with the relaxation points as a focus. You might change which ones help you the most, or you might focus on just one. A key aspect is to drop your shoulders.
-Hot water bottles
-Hot water via the shower (for 2^nd births and beyond, shower only in the place you plan to give birth! The shower can really speed up labor and next thing you know, you’re pushing in the shower.) The shower is often THE PLACE TO BE. Its warmth, massage qualities, and rhythm of water flow help many women dilate easier.
-Direct pressure and/or massage on the place you feel contractions
-Being in the optimal position for YOU (could be on the ball, leaning on a chair, all fours, etc.)
-Visualizations (the “image” you love to look at; it gives you pleasure and makes you feel relaxed)
-Vocalization (moaning, singing). A tip: Avoid screaming, unless it’s at the very end, when things are most intense (9-10 cm) as it might help you to release tension, but otherwise it raises adrenaline. Release with one or two screams, and then, ideally, get back into the relaxation focus.
-Breathing techniques
-Voicing any fears you might have – release them, and you’ll feel free to move on.
-Prayer. Certain verses that speak to you. Make them rhythmic for you – a mantra.
-Music. Many women bring along their audio files with relaxation mantras or music they love, etc.
-Smiling. What? Yes, the act of smiling in itself releases the pleasure hormones endorphins and serotonin. Try it now. Then frown. Which one actually makes you feel good?

In short, any combination above can alleviate most of the feeling of the contraction such that you can get through it without drugs. It is often most intense at the very end (called “transition”). Many women ask for an epidural at transition, but if you’ve gotten that far, most likely you can just keep going when you maintain the Three Basics (see above).

Just have those supporting you trained to not take no for an answer, and to keep supporting you in the ways that you know are best for you, and to remind you of all of the above techniques. It’s great to practice with them beforehand, as a laboring woman is not expected to remember A THING.

And in most cases, once you are fully dilated (around 10cm) and  you feel the urge to push, you won’t need to try to relax anymore, and you’ll have something to channel the contractions into – pushing!

Here’s to using various techniques to achieve easiest birthing, all the while coupled with  tapping into our God-given strengths.

-Chaya

Iron in Pregnancy

Some women are low on iron even when not pregnant. But once we’re pregnant, it becomes even more likely for the masses. Here’s everything you need to know about getting enough iron during pregnancy.

What does iron do in our bodies?

Iron plays such a large role in our bodies that you might end up asking, “What does iron NOT do?!”

Iron is essential for the following:

– Transporting oxygen to cells throughout the body, and CO2 to the lungs.
– Red blood cell production
– Metabolism: Converting blood sugar to energy
– Enzyme production (for hormones, neurotransmitters, amino acids, and cell generation/regeneration)
– Immune system strengthening
– Encouraging optimal physical/mental growth by carrying oxygen for red blood cells. Therefore, iron is crucial for a growing fetus, infant, or child.

Why do we need to consume iron?

Our bodies do not produce iron on their own, therefore we must consume it via food or drink, mineral supplement, herbs, or homeopathy.

Symptoms of Low Iron

If iron stores are low, normal hemoglobin production slows down, which means the transport of oxygen is diminished. Possible symptoms include:

-Fatigue
-Lower energy
-Dizziness
-Lower immunity
-Low blood pressure
-Paleness
-Increased heart rate due to less oxygen (the heart overcompensates by trying to pump more)

What do the blood test numbers mean?

A blood test determines if you have iron deficiencies in your blood, which could lead to anemia (too few red blood cells).  The test usually shows results for hemoglobin,  hematocrit, and iron stores (ferritin).  Note that percentages/ratios are slightly lower in pregnancy due to the 30-50% increase in blood volume, and therefor numbers might be lower than when not pregnant, yet still be within range for pregnancy.

Hemoglobin, Hematocrit and Ferritin

1.      Hemoglobin Levels: Hemoglobin (Hb) is the oxygen-carrying protein in your red blood cells. The expected level is between 10.5 to 15 grams/deciliter (a deciliter is 1/10 of a liter).

NOTE: Hemoglobin can be written without the decimal point. For example, 11.2 gm% is the same as 112 g/L. Your blood test results list it in either or both formats.

2.      Hematocrit Levels

Hematocrit is the percentage of red blood cells in your blood.  In pregnancy, a healthy range is around 30-35%.

 3.      Ferritin (iron stores):  If this number is low, but your hemoglobin and hematocrit levels are fine, it stands to reason that you are simply using up your stores quickly.

How do we lose iron in the body?

Iron is lost via these processes:

-Eliminations
-Sweat
-Exfoliating (dead skin cells)
-Bleeding. Since we women bleed regularly during our monthly cycles, we are more at risk than men for low stores of iron. During pregnancy, both babies and mothers need extra iron: Babies need enough iron for growth in-utero, and mothers need enough iron in general, and specifically in case of excessive blood loss after the birth.

How can I increase my iron levels?

The main issue with iron intake is to ensure proper absorption.  Consume iron with vitamin C and NOT with calcium nor caffeine, within an hour before/after.

If your Hb levels are 11g or lower,  you need to supplement. Use any of these methods continually through the pregnancy:

1. Chlorophyll: 1-2 Tb/day
2. An herbal tincture of yellow dock, nettles, dandelion, and black strap molasses
3. A commercial supplement such as SpaTone.

If your levels are stable:

Cool! You obviously have the nutrition to provide enough iron. Keep it going with the following nutritional guidelines:

1. Heme Iron (easier to absorb) comes from red meat, poultry, and fish.
2. Non-heme iron is less easily absorbed, but is still healthy, and is suitable for non-meat eaters. Non-heme iron comes from:

-Seaweed (especially Nori)

-Legumes

-Dark green leafy vegetables

-Apricots

-Prunes

-Wheat Germ/Wheat Grass juiced drinks

-Tofu

-Seeds: Pumpkin, Sesame, Squash

In Summary

Iron in pregnancy affects both mother and baby. To ensure proper iron levels, use the instructions above. As always, feel confident to tailor instructions for your lifestyle, in order to make iron consumption as easy for you as possible.

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Before Labor Begins: What to Pack for the Hospital + Practical Tips

What to Pack in “The Bag”

–Pregnancy medical papers

–Three – hot water bottles (any drug store)

-Money, including small change for food/drink machines in middle of night

-Almond oil, unopened (any drug store). Midwives use this for birthing (“pushing”) stage.

-Plug-in tea kettle for  refilling hot water bottles in the delivery room (and making your own tea, why not?)

-Red Raspberry Leaves (for tea)*

-White grape juice (as in real grape juice) – one bottle.

-Snacks for husband, and whomever else is accompanying  you (like chewy granola bars, or sandwiches easy to make). (Note: You don’t have to bring for the doula – she’s responsible for her own;)

-Snacks for YOU- grapes or other non-citrus fruits, crackers (preferably whole grain, yet easy-to-digest), and a few juice bottles or juice boxes with straws*

-Bottled water – 3 bottles

-Two – bath towels

-Plastic Trash Bags for Wet Towels

-Shower shoes/Crocs

-A pillow

-Plastic cups

-Straws

-Hairbands which are very comfortable

-Comfortable nightgown with wide sleeves, that you like, and yet you don’t mind throwing out after the birth. Otherwise you can wear the hospital’s garments.

-Warm socks for after birth

-Music player with speakers, with  mantras/hypnotic birthing files/other music

-Inspirational texts/prayers/poems

And anything else that will make you feel most comfortable.

TIPS FOR INITIAL CONTRACTIONS

A site for tracking contractions – it’s free (and husbands often love it):

http://www.contractionmaster.com/

If you feel initial contractions and/or heavy Braxton Hicks, drink a glass of WHITE wine. If it’s the “real thing”, the contractions will continue. If it’s just “preparatory contractions” (I prefer that term to “false labor”), they will likely go away after the wine.

And assuming your water has not broken, you can also try taking a warm bath to see if the contractions are alleviated. (ONLY FOR FIRST BIRTHS – NEVER TAKE A BATH/GO INTO THE SHOWER FOR SECOND BIRTHS AND BEYOND, UNLESS YOU PREFER TO RISK GIVING BIRTH AT HOME:)

Best to you,
Chaya

* One very effective trick is to take along a zippy bag of “labor cubes” to the hospital, storing them in her room fridge. “Labor Cubes” are ice cubes made out of very strong raspberry leaf tea (perhaps one cup herb to one quart water, simmered down to half and strained) that is heavily sweetened with honey. If the laboring mother begins to fade, energy petering out or contractions waning due to lack of nutrition, she can chomp on these satisfying slushy cubes, which usually will perk her up and kick in some great contractions in a matter of minutes.
— Beth Barbeau
Excerpted from “Tricks of the Trade: Liquids Only,” Midwifery Today, Issue 81

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Your true due date: The low-down on when to really expect baby

The term “due date” is a misnomer. 

Your library book has a due date, your final paper has a due date, your status report for work has a due date.

But a baby? No such thing. The “due date” is the middle date of the four week time period (38-42 weeks) during which most women give birth. I prefer to refer to it as the “40^th week” date.

Tip: Did you know that for 1^st births, the “due date” can be on average a week later than for consequent births? (See Heart and Hands, by Elizabeth Davis.)

This date is often miscalculated when:

1. You don’t know the first day of your last menstrual period (LMP), or
2. You know your LMP, but your menstrual cycle was not 28 days.

Why does this matter?

1. We want to know the right window of “when to expect.” It is empowering to know that, with a healthy pregnancy, you will likely give birth during the 38-42 week window. With inaccurate dating, women are often disappointed, thinking their baby “should have come already” when it’s perfectly normal for baby to keep growing inside of you.
2. Avoiding unnecessary inductions. Women might be geared toward inductions based solely on the date, such as 41 weeks. But oftentimes this date is miscalculated, so they might be trying to induce you at an even earlier date. Knowing this date can help you plan with your care provider.
3. Knowing if it’s a preemie. A baby born before 36/37 weeks is defined as a preemie, and will likely need special care after birth.

HOW TO FIGURE

I) Most Accurate of All:

• EARLY ULTRASOUND
  If you had an ultrasound before week 11, you can use the estimated due date (EDD) from the ultrasound. This is considered extremely accurate – the earlier, the more accurate. Ultrasound dating after week 11 is not reliable, because by that point the embryo’s too big to be statistically accurate for everyone – like comparing the average body size of an Asian with an average Swede – hello?
• 28-DAY MENSTRUAL CYCLE
  If your menstrual cycle prior to pregnancy was usually 28 days, calculate using the first day of your Last Menstrual Period (LMP) with any “Due Date Calculator” online.

2) Pretty Darn Accurate:

• MENSTRUAL CYCLE NOT 28 DAYS
  Since due dates are based on a 28-day menstrual cycle, WWYD if your cycle was not 28 days? No problem: Just add or subtract the number of days’ difference to calculate accordingly.  For example, if your cycle was 35 days, add 7 days to the first day of your last period (LMP).  If your cycle was 25 days, subtract 3 days from LMP,.  Any due date calculator online calculates using the First Day of Last Menstrual Period (LMP), so use your adjusted LMP to get the most accurate “due date” (40th week day) for your baby.

3) So-So Accuracy:

• Date of Positive Pregnancy Test. A pregnancy blood test will register positive by one week after conception, and a home pregnancy test (via urine on a stick) will show a positive two weeks after conception, if not earlier.
• “Love” Dates: If you wrote down your “love” dates, and you know when you were expecting your period, this might give you better insight. Usually, conception happens 14 days before your next period would have arrived. This will not provide you a precise date, but will likely give you the week. Remember, sperm can survive up to 5 days waiting for that egg, but the egg can survive 12-24 hours. Yep!

I wish all of you the most healthy pregnancy, however long or short it may be. The true due date for healthy pregnancies is whenever your baby is ready.

-Chaya

NATURES CLOCK
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Week 36: “Rounding Out” the Pregnancy

LATE PREGNANCY

In our final weeks of pregnancy we long for relief – physical, mental, and emotional.

By week 36/37, our baby is considered “term” – the lungs are developed, and if born today, is past the point of being a preemie. That’s a relief in and of itself,  and we can congratulate ourselves and be ever so grateful.  Still, since it’s likely that the baby will not be born for another 2-6 weeks, here are some thoughts on getting other types of relief for the next few weeks.

To start, what might we be feeling?

Physically

-Heavy, off-balance. The Late Pregnancy Waddle. We sometimes fall to the side, due to lack of balance, and the hormone relaxin (great name, huh?) helping our joints to relax in preparation for birth.
–Hard to move (baby pushing “down there”)
–Hard to breathe (baby crowding lungs)

Mentally

-Checking things off list. Your brain is full of what-needs-to-get-done-before-I-can-allow-myself-to-have-this-baby.

-Pregnancy Brain: Forgetting to even write the above to-do list.

-Pressured: If employed, needing to arrange for maternity leave cover and tie up all loose ends. Wondering if this will be done before birth – don’t want anyone calling me during contractions or screaming diaper changing!

-Needing to arrange for other children during birth.

-Finalizing birth plan

Emotionally

-Fear of the birth.

-Hormonal – crying at drop of hat!

-Apprehension – when will this baby come? Wanting to plan, but can’t. Sometimes the dating is off – to be sure, check out dating accuracy.

What helps you deal with all this? Often times it’s just taking time for ourselves. Writing it all down. Especially the fears.  A birth professional colleague, Miriam Maslin, suggests writing out all fears and then numbering them from worst fear to least. It gives us a sense of control, which then allows us to let it go. I’ve done this – even though it was hard to get started, once I did it I felt a huge sense of tension completely lifted. It allowed me to then go about my business of getting things done before the birth.

Additionally, harboring fear leads to tension, which leads to pain during contractions (see Childbirth Without Fear by Grantly Dick-Read). The ideal state is to be free of tensions, so that means releasing our fears. I know, easier said then done, and yet, possible. For more about relaxing during birth, read here.

So now’s the time of treating ourselves with fun and ease, while getting stuff done, huh? I wish you well with the balance of the final weeks,  health for you and baby, and the easiest birth possible.

Warm regards,
Chaya

© Photographer: Liz Van Steenburgh | Agency: Dreamstime.com