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The Benefit of Cloth Diapers For You and Baby

on by Guest Blogger

By Jennifer Buchanan CNM, WHNP-BC, IBCLC

Cloth diapers…I know what you’re thinking! But continue reading and you may consider switching to cloth diapers for your bundle of joy.

Before I read the many reviews and searched the Internet for information about cloth diapers, I was riding the disposable diaper wave. Something in me changed when I learned of the health and potty training benefits. I’d like to share what I learned with you! Please note that this this is a personal opinion and you should make a decision based on what works best for your family and lifestyle.

Reasons to Consider Cloth Diapers for Your Infant

You may end up with more laundry, but you may find the benefits outweigh the extra work.

Cloth diapers:

  • Contain no chemicals such as chlorine, perfumes or polyacrylate (a chemical used for absorbency). Chlorine and other chemicals can strip away good protective bacteria on the skin and change the pH balance of your infant, which can cause dryness and skin irritations. One report found an increase in childhood asthma and respiratory problems in babies wearing disposable diapers. In more critical cases from exposure to these chemicals, your infant can develop severe skin irritations, a fever, vomiting, and staph infections. Also, these chemicals have been found to be carcinogenic.
  • Allow for more breathe-ability. They are made from cotton and result in less skin irritation and rashes. Many of the cloth diaper companies are using organic cotton for their diapers. The reason for this is that farmers of non-organic cotton may spray their plants with chemicals and pesticides that can find their way into the cotton that is placed next to your infant’s skin. To avoid the skin irritation and other effects of harsh chemicals it is better to look towards the organic cotton brands.
  • Lead to earlier potty training for your infant. Using a cloth diaper allows your infant to feel the wet sensation against their skin and become more aware of when they have gone potty. Disposable diapers wick away the wetness, keeping your infant unaware of a wet diaper for longer periods of time.
  • Save money. The initial investment in cloth diapers is more expensive, but once you own cloth diapers you have them for life. No need to be constantly buying disposables!
  • Produce less waste – and waste that sticks around a long time. It’s been predicted that it could take 250 to 500 years for a single disposable diaper to decompose.
  • Allow convenience. If the store is closed, you always have a diaper on hand (as long as you have a washing machine accessible).

A Diaper Service vs Owning Your Own Cloth Diapers

Using a diaper service

This means you don’t need to wash your infant’s dirty nappies! Using a diaper service can save you the time and effort it takes to wash dirty diapers. After talking with a representative from a local diaper company, I learned there is a $10 introductory fee followed by an average cost of $83 per month. This cost includes a laundry hamper with liners, no rinsing needed for 80 diapers per week plus weekly pick-up and delivery. I then found out this cost is very similar to other cloth diaper services in Los Angeles. A select few companies exclusively use organic cloth diapers. If you’re looking for a cloth diaper service, I recommend searching on Yelp or Google.

Owning cloth diapers

When it comes to buying your own cloth diapers, there are many options to choose from. You can easily find a list of companies by searching for “cloth diapers” in your preferred search engine.

Individual cloth diapers range from $13.79 to $20.99 per diaper. When I spoke with some companies, the suggestion they made was to have a minimum of 12 diapers and to work your way up to a total of 24 diapers so that you are only washing them every other day.

Owning your own diapers has the highest initial costs, but after you purchase your 12-24 diapers you will never need to buy more. Most of these companies have single-size diapers that will last up to the potty training period. I feel this option is the most economical in the long run and most ecological for the environment. Additionally, it’s the best option for your infant and their sensitive bottom..

Looking for reviews of cloth diaper companies? I found this blog helpful.

Will You Really Save Money by Using Cloth Diapers?

The answer is yes. If you are following an organic and natural lifestyle for your infant, it is more economical to use cloth diapers. I’ve broken down the cost for you below.

Cloth Diaper Service Owning Cloth Diapers  Disposable Diapers-Natural and Eco-Friendly  Disposable Diapers-Basic 
Costs about $80 per month. Total cost about $250. Costs about $100-$150 per month. Costs about $55 per month.
Receive 80 diapers per week. Set of 12 diapers.    
Time saver! No other expenses.   May contain chemicals such as chlorine, perfumes or polyacrylate.

Secondary to the health and potty training benefits of cloth diapers, this along inspired me to consider going cloth, “Buying cloth diapers instead of disposables can save $1,200 per year and prevent up to one ton of landfill waste.”

Cloth diapering is not for everyone, but if you are considering it I would give it a try knowing you will be potentially saving money, time spent potty training and the environment in the long run.

Right Sided Babies

on by Guest Blogger

By Hayley Oakes LM, CPM

One of the things I loved most about co-teaching Two Doulas Birth (an LA-based childbirth preparation series) was their curriculum and emphasis on optimal fetal positioning. As once a doula and now a licensed midwife, I have seen many births in these past seven years and believe that a baby in utero intuitively knows the path of how to be born through his or her mother’s body without a lot of intervention. However, there are external factors that can make the path a bit trickier, and a natural labor more difficult.

The National Institute of Health published a study in 2012 showing a nearly 3-hour increase in the total length of labor of women today compared to women of our grandmother’s generation. What!? Why? Nothing has changed in a woman’s anatomy? Or has it?

While the study correlates a few contributing factors to this increase in length of labor, think about how we, the average American adult female, live in our bodies today: In a car or on some form of public transportation sitting, commuting to work, sitting at a desk at work all day, then sitting on the commute home to then plopping on the couch after work to kick back and relax. That’s a lot of time sitting to promote “C”-curved spines, lousy posture and a pelvis that tucks under itself (rather than straight). Then think about the women of Grandma’s generation: cars with upright seats, a lot more women at home which meant day in and day out up on her feet cooking, cleaning, gardening, taking care of little ones and then of course sitting with a straight back and “lady like posture” for that 5 o’clock cocktail… you get the picture.

How you live in your body is going to affect how your baby lives in your body. Wherever most of the woman’s weight is centered is going to be where the baby hangs out as well. The back of the baby’s head, called the occiput, is the heaviest part of the baby. When a woman spends most of her time leaning back or slouched, the heaviest part of the baby’s head is going to be in the woman’s back. Conversely, when a woman is consciously aware of hanging out in more forward leaning positions i.e. hands and knees, squatting etc., the heaviest part of the baby’s head is going to be in the front. You may ask yourself, so what does it matter where the back of my baby’s head is…

The position of the baby’s head greatly affects your labor pattern and possibly mode of delivery. You may have heard of ‘back labor’, or a baby born ‘sunny side up’? These are two indications of a baby in a posterior position, which causes a longer labor due a dysfunctional contraction pattern and more pain.

When a baby is in a posterior position, the back of the baby’s head is up against the mother’s sacrum, causing the head to be somewhat extended (rather than flexed) increasing the diameter of the head while not applying itself well to the cervix. As a result, there is slow dilation after hours of contractions and this is one reason some women’s labors are labeled as ‘failure to progress’, which is typically the start of the use of interventions.

This position also causes a lot of back pain, not only during a contraction but in between as well. The pain felt with back labor is not normal labor pain. The latter is characterized by intense sensation located in the lower part of your uterus, in the front of your body, where one would feel menstrual cramps for the duration of the contraction (60-90 seconds) and then when the contraction is over so is the pain or intensity of it as well. Then there is a break anywhere from 2-5 minutes when you feel nothing at all until the next contraction comes. Your body is designed to last and cope with labor, giving you intermittent breaks in between contractions so you can rest and endure the rest of the labor and birth. It’s a beautiful and unique design!

But with posterior babies or ‘back labor’, there is no break in between contractions, only searing back pain. This is a hard labor pattern to cope with naturally and a woman is much more likely to transfer from an out of hospital setting for ‘therapeutic rest’ aka an epidural or if planning a hospital birth, request an epidural for pain relief and rest. With an epidural comes a slippery slope though to the cascade of interventions that takes your labor from being normal to abnormal and with higher risks.

Babies that are hanging out posterior in pregnancy are most likely going to remain in that position and perhaps even be born that way. However, there is another position that most likely will result in a posterior position in labor: right-side.

When a baby is presenting persistently on the right side in pregnancy (the back is on the mom’s right side with baby’s kicks felt on the left), those babies are more likely to go posterior rather than anterior (front) in labor.

There is a slight rotation at the base of the uterus that goes in a clockwise direction, and in labor the uterine muscles will naturally contract and rotate the baby in that direction. If a baby is on the left side of the uterus, it only has to make a 90-degree rotation to find the optimal ‘exit’ (the part of pelvis with widest diameter). Whereas the right sided baby will have to rotate to the back, then to the left side and then to the front, which is a much longer arc to travel in order to be born (and on the way will cause back pain to make such a long arc turn).

In order to stack the odds in your favor of having the birth that you intend and not get dealt a difficult hand in labor i.e. mal-positioned baby and slow dilation, here are some things you can do ahead of time.

Be aware of your baby’s movements and where your care provider is getting the loudest heart tones with either ultrasound, Doppler or a Fetoscope. This will be indicative of where the baby’s back is as well. If the baby is persistently on the right side, try to spend more time leaning forward: use an exercise ball at work or at home while at your desk or watching TV. Spend time on your hands and knees doing ‘cat cow’ yoga exercises or squats and start sleeping on the opposite side you have been dominantly sleeping on.

Start getting routine chiropractic adjustments. This is key in pregnancy especially towards the end as you are coming up to your estimated due date.  You have a wonderful hormone coursing through your body called relaxin that does just as it sounds, relaxes your muscular structure. This is especially important in your pelvis in order to accommodate a little person navigating through your body. As your body is getting looser and more malleable in pregnancy, there is also more risk of misalignment. So, giving your body and pelvis an opportunity to re-align itself is going to create balance and thus facilitate an optimal environment for your baby to settle into.

For those of you living in Los Angeles – I would recommend seeing Dr. Elliott Berlin starting at 36-37 weeks. He is a very talented, intuitive and effective chiropractor who specializes in pregnancy and is the only chiropractor I know who works specifically on the round ligaments (two ligaments on either side of the uterus that holds the weight of uterus, baby and amniotic fluid up and grows 10x its pre-pregnant size) as they can be very tight and prevent the baby from engaging in your pelvis.

Spin Your Baby. Spinning Babies is a website and an amazing resource started by Gail Tulley, a Midwestern midwife, who noticed how a baby’s position greatly affects a woman’s labor pattern – for better and for worse. She came up with exercises for mothers to do every day starting at 37 weeks to encourage a balanced pelvis and therefore an optimally positioned baby.

If you do all of these things and your baby is still presenting on the right side or posterior in pregnancy and/or in labor, then there is probably a reason we cannot see or know from the outside. We trust your babies know how to find the way out, and sometimes they hang out in not the most optimal positions for mothers because it is the best or safest way for them to be born.

In this unknown and uncontrollable process of childbirth, we can do what we can to prepare for the safest and most satisfying experience possible and then let go of the rest. If your birth experience ends up different from what you intended on, you are much more likely to integrate the unexpected outcome better knowing you did everything you could to prepare for a physiological birth.

Approaching the birth with this sense of surrender, also helps facilitate a smoother recovery – physically and emotionally – and a better breastfeeding and bonding experience with your new baby. And who doesn’t want that?

Baby Wearing

on by Guest Blogger

By Jennifer Buchanan CNM WHNP-BC, IBCLC

In the United States wearing your baby may seem like a new concept, but this activity goes back thousands of years and spans the entire globe. In a time before babysitters, daycare or maternity leave (and in some areas of the world where culturally this is not the norm), mothers have to carry their babies with them while working, doing household chores and everyday tasks.

What are the Benefits of Wearing Your Baby?

Wearing your baby is not only a benefit to your baby, but also a benefit to you, your partner and even your breastfeeding relationship with your baby. The close proximity allows you to learn your baby’s delicate clues, understand your baby’s behaviors and breastfeed on demand.

Being able to remain in constant contact with your baby allows you and those who wear your baby the opportunity to create a close bond. Babies who are “worn” are less likely to cry; they sleep better and have reduced stress which helps with healthier weight gain and mental development.

How Wearing Your Baby Helps with Breastfeeding on Demand

The notion of “breastfeeding on demand” is the baby’s preferred schedule to breastfeed; not yours. With baby wearing, your baby is the one regulating when they want to eat. The more you wear your baby, the more effective it is to follow this method of feeding on demand.

Baby Wearing using a Carrier, Sling or Wrap. What’s the Difference?

It doesn’t make a difference. It’s based on your personal preference on what you feel is the most comfortable to wear.

What to Consider When You Wear Your Baby

There are many baby carriers, slings and other devices to carry your baby. I am not attached to a specific product or brand as it’s a personal decision depending on your lifestyle and budget.

Here are some helpful tips when selecting and using a carrier, sling or wrap to wear your baby:

   • Safety always comes first. Second in priority should be comfort for you and your baby.

   • Always be aware of your baby’s body alignment while in a carrier, sling or wrap, especially during the newborn period.

   • Your baby’s face should always be visible, with their head and neck placed in a position that does not risk closing off the airway.

   • If you have a newborn, your baby’s legs and hips should never be spread, rotated or turned out like a frog while on your chest. This can cause damage to the growing and fragile hips of your baby. I suggest you look for particular inserts, products and wrapping techniques made specifically for newborns and to ask the sales representative for more information if needed.

Happy Baby Wearing!

High Blood Pressure In Pregnancy

on by Guest Blogger

By Hayley Oakes LM, CPM

What is blood pressure?

Blood pressure is the force with which your blood moves through the blood vessels in your body when the heart pumps. The blood pressure reading is a reflection of how hard the heart has to work to adequately circulate the blood. The systolic pressure (the top number) measures the heart contracting and the amount of pressure used to push blood through the arteries to the other parts of the body; and the diastolic pressure (the bottom number) is a measurement of the heart relaxing and the pressure it takes to refill with blood before the next contraction.

What determines high blood pressure or hypertension?

High blood pressure is defined as two blood pressure readings of 140/90, taken at least six hours apart but no more than a couple of days. This is due to the fact that blood pressure is variable throughout the day and can be altered depending on your mood, environment, and interactions.

In the U.S., hypertensive disorders (including pre-eclampsia and eclampsia) are the most common cause of medical complications in pregnancy, affecting 2-10% of all pregnancies.

How does one have high blood pressure in pregnancy?

The greatest contributors to high blood pressure are stress, poor nutrition, and lack of exercise. Although one could have chronic hypertension (pre-existing high blood pressure before the pregnancy) that she may or may not have been aware of, or it could be pregnancy induced which develops and increases after 20 weeks of gestation.

What are the risks of high blood pressure?

Firstly, the general risks associated with hypertension are: lack of adequate oxygen flow to the baby, the potential for low-birth weight, and possible stillbirth. Furthermore, because the force of the blood behind the placenta is increased, the risk of placental abruption (in which the placenta prematurely separates from the uterine wall), is a potentially dangerous situation for both mother and baby.

Secondly, while not all high blood pressure results in complications, it is one of the symptoms of pre-eclampsia, a more serious condition that we screen for as well which has other symptoms: not feeling well, slow growth of the baby, visual disturbances, upper abdominal pain, headaches, kidney, heart or thyroid problems, and the presence of protein in the urine.

Unfortunately these risks would no longer make someone a candidate for an out-of-hospital birth.

How can I prevent and/or remedy high blood pressure?

The suggestions below may help you in preventing high blood pressure if you are prone to it, and/or lowering it should it become elevated.

* First and foremost, maintain an adequate diet of 80 grams of protein, sufficient calories (2400-3000) salting to taste and drinking to thirst of at least an 8 oz. glass of clear fluid every 2-3 hours or so.

* Relaxation techniques i.e. hypnotherapy, visualizations of blood vessels expanding, trauma releasing exercise (TRE), stretching, meditating, taking a bath, deep breaths can be used several times daily and lifestyle modified as much as possible to reduce stress and anxiety.

* Moderate exercise can be very beneficial to improve circulatory function i.e. yoga, walking, swimming.

* Avoid stimulants such as strong spices (mustard, black and white pepper, ginger, and nutmeg), black tea, cola drinks, or coffee.

* Add foods and herbs to reduce hypertension:

≈ Watermelon has the richest edible source of L-citrulline, a type of amino acid that helps promote and regulate healthy blood pressure.

≈ Buckwheat helps relax blood vessels and improve blood flow and nutrient delivery. It contains almost 86 milligrams of magnesium in a one-cup serving which helps lower blood pressure.

≈ Raw garlic (causes vasodilation and inhibits platelet build-up and inflammation), parsley  (a diuretic that increases the elimination of sodium, potassium and fluid by the kidneys), and onions (contains same nutrient, allicin, as in raw garlic that aids in vasodilation) in large quantities.

≈ Garlic oil capsules 2-10 or 800 mg daily. Discontinue 3 weeks before due date.

≈ Cucumber (natural diuretic) – ½ cup of fresh juice or a whole fresh one daily

≈ Juice of half a fresh lemon (blood vessels soft and pliable and removes their rigidity which in turn lowers the high blood pressure) or lime plus 2 tsp. cream of tartar (high potassium level which controls bp due to decreasing amounts of sodium in system) in half a cup of water, once daily for three days. This can be repeated once after a rest of two days.

≈ Hops tea (sleep-inducing herb that calms nerves) 1 tsp. to 1 cup of boiling water steeped 20 min. Can safely and effectively be used nightly during the last four months of pregnancy CAUTION: Hops is contraindicated for regular use throughout pregnancy, or for use during the first trimester, due to its hormonal precursors.

≈ Passionflower (a relaxant as it increases the brain’s levels of gamma-amino-butyric acid (GABA), a neurotransmitter that turns down the volume of activity in the emotional center of the brain.) 2-4 capsules daily or 15 drops of tincture three times daily; must be taken for several weeks to obtain the best result.

≈ Skullcap infusion (helps in reducing physical stress) 1 oz. to 1 qt. boiling water; cover and steep for 4-6 hours 1-2 cups daily as it builds and strengthens nervous system.

≈ Hawthorn berries (work cumulatively to strengthen the heart and is said to help improve and prevent congenital heart defects) 1 oz. crushed dried berries in 2 cups cold water steeped overnight brought quickly to a boil, strained and sipped 1 cup daily. Tincture dosage is 15 drops 2-3 times daily.

* Vitamin supplements containing magnesium, calcium, and potassium in a balanced formula

* Homeopathic remedies are chosen based on various specific details of the person seeking treatment, so consult with midwife or specialist.

Please consult with your midwife to come up with a safe plan for you and your baby in lowering your blood pressure to remain healthy throughout your pregnancy.

* Adapted from “Holistic Midwifery: Vol. 1” by Anne Frye and “The Natural Pregnancy Book” by Aviva Jill Romm

Handling the Heat for Pregnant Moms & Newborns

on by Guest Blogger

By Jennifer Buchanan CNM WHNP-BC, IBCLC

The rising temperatures of spring and summer can be a fun but physically uncomfortable time for everyone – especially pregnant mothers and babies. A pregnant woman circulates more blood than the average woman due to the increased demands of getting enough oxygen to her growing baby in her body. Thus staying cool in hot temperatures can be difficult.

And like an adult, a baby feels rising temperatures and can become increasingly uncomfortable during these hot times. Did you know a baby can sweat too? While it’s the body’s way of regulating core temperature, this is can be dangerous for a newborn as he or she can become dehydrated at a faster rate than an adult. See below for some helpful “stay cool” tips for handling the heat!

SUN SAFETY FOR MOM

Just like you would want to protect your future child, it’s important for pregnant mamas to protect themselves from the harmful rays of the sun too. If you’re going outside, don’t forget sunscreen and a hat! Apply a sunscreen that contains both a UVA and UVB protection. I recommend wearing a wide-brimmed hat to protect your face, neck and shoulders. Find shade or a place out of the sun as much as you can when outdoors.

DRINKING ENOUGH WATER

High temperatures can cause uterine cramping, which may feel like contractions. Drinking 2-3 liters/day can help prevent your uterine muscle becoming dehydrated and thus tight. The last thing a pregnant needs on a hot summer day is to sit in an ER thinking she is in labor. Also, swelling is more common with dehydration. If you have access to a pool, submersion in water will help push the fluid back into your tissues (and cool you off!).

CLOTHING

Wear appropriate clothing for hot weather, such as light, loose fitting, cotton clothing. The heat also make feet swell. Wear comfortable and supportive shoes. If your feet do swell, elevate them above the level of your heart to help with circulation or have your partner give you a nice foot rub!

HYDRATION FOR BABY

Breastfeed regularly to prevent dehydration. For newborns, I recommend eight times in a 24-hour period. It has been shown that breastfed infants do not require additional water when the temperatures increase; there is enough water to maintain adequate hydration in breast milk. For older infants who maintain a healthy diet of complimentary foods and have weaned from breastfeeding, the pediatrician may recommend 4-8 oz of sterile water per day to maintain hydration. Check with your pediatrician for the proper dosage for your baby.

Dehydration is a serious health risk to babies and needs to be addressed immediately by a physician whether it is in a clinic, a pediatric office, urgent care or emergency room.

SUN SAFETY FOR BABY

Sunscreen, sunscreen, sunscreen. I cannot say it enough. Even if the stroller is covered by a blanket, keep your baby’s gentle skin safe from harmful UV rays. Apply a sunscreen that contains both a UVA and UVB protection and one that is meant for infant skin and don’t forget a hat. Stay in the shade as much as possible.

WATER SAFETY

Water can be a great way to keep babies older than 6 months of age (only those able to sit unassisted without falling over), cool and comfortable. Filling a small kiddy pool with water in the back yard (under a tree for shade) is always fun for the little ones. If you use a kiddy pool, NEVER leave your child unattended, even for a moment. Do not fill the tub more than a couple of inches with water; an infant can drown in even the shallowest of depths. Read more about water safety.

CLOTHING

Don’t bundle your babies when outdoors. A diaper and onesie are perfect for hot temperatures. It’s better to drape a light blanket over the stroller to keep the sun off rather than wrap the baby in long sleeves and pants.

IN THE HOME

Don’t place your baby too close to the air conditioner. Babies have a hard time keeping their body temperature up when in a cold environment. When infants become cold they use more oxygen and metabolism, which can be stressful for a newborn infant or an infant with health issues.

Most importantly – stay safe and have fun!

Optimal Preparation for the Out-of-Hospital Birth You Planned

on by Guest Blogger

Photograph by Leilani Rogers

By Hayley Oakes LM, CPM

While birth can be an unpredictable process and approximately 23% of first-time mothers planning an out-of-hospital birth will transfer to the hospital (with the majority being due to non-emergent issues, i.e.‘failure to progress’ or a desire for pain relief), (2) there are a few things you can do during the pregnancy to stack the odds in your favor of having the birth you want.

1.   Optimal nutrition is important in order to grow a healthy baby and maintain a low-risk pregnancy. Part of prenatal care with your midwife is assessing your and the baby’s health in making sure you are a suitable candidate for an out-of-hospital birth. Having a healthy diet (and lifestyle) reduces your chances of risking out of her care and transferring to a physician for conditions such as gestational diabetes, hypertension, preeclampsia (3) [complication of pregnancy characterized by high blood pressure which can lead to liver or renal failure], and polyhydramnios [excessive amounts of amniotic fluid that can lead to premature birth, excess fetal growth, cord prolapse].

Check with your care provider first about modifying or changing your diet, but in general, the above-mentioned conditions can be prevented by decreasing sugar and carbs and increasing protein and calcium rich sources.4 In fact, most sugar and carb cravings come from a lack of protein, so try a protein filled snack first, then have some water and see if you still feel that pang for a sweet treat.

2.   Dates. Studies have shown that eating six dates a day shortens the total length of labor by ripening and softening the cervix in pregnancy and thus encouraging faster dilation during labor.5 However, six dates is a lot of sugar, about 75 grams (!), and since it is advised to reduce sugar in the pregnancy as mentioned above, this should really be the only source to prevent excessive weight gain, amniotic fluid, and the presence of group beta strep (GBS) [a common type of bacteria in the body but if a high concentration is present in the vaginal canal at the time of birth, it can be potentially very serious for the baby. It is treated with intravenous antibiotics in labor].

3.   Incorporating 30-60 minutes of cardio activity daily helps maintain a healthy weight gain (25-35 lbs. for women with a normal BMI), prevents high-risk pregnancy conditions as mentioned above and physically prepares you to have a smoother birth (and a quicker recovery postpartum). The 2015 Guidelines from the American Congress of Obstetricians and Gynecologists report that women who engage in vigorous, heart-pumping exercise every day may have shorter labors and may require less interventions in labor, including a significantly decreased rate of cesarean birth. (6) Along with this, there are psychological benefits including reduced fatigue, stress, anxiety and depression. With all the hormonal and physical changes in pregnancy, who wouldn’t want to maintain a balanced (or improved) well-being?

If you were not physically active prior to the pregnancy, then it’s best to slowly work up to getting that much activity every day. Also, start with low impact activities like walking, swimming, and yoga. If you are already an active person and would like to maintain your exercise routine, just make sure to check with your care provider and trainer to modify as needed. (6)

Think of the birth as preparing for a marathon – it’s important to train and build your strength and endurance for what could be an 18-24 hour event for first-time mothers. (7)

4.    Take a childbirth education series that specifically prepares you for a natural, out-of-hospital birth. Knowledge is power, and can help reduce fear around the unknown of childbirth. Active labor is the stage of labor when it’s time to be in the setting of your birth and with your care provider present to monitor the health of you and your baby. This stage is characterized by a dilation of at least 6 cm (10 cm is considered ‘full dilation’), which means a lot of the early labor will just be you and your partner (and your doula if you have hired one) at home prior to your midwife joining you. So it’s important to feel confident with the labor process and familiar with all the normal labor signs and symptoms so that your labor can progress normally without you (or your partner’s) fear or anxiety slowing things down. (8)

5.    Read positive birth stories and write your birth story. We are not a culture that sees natural birth or know it to be a normal occurrence. We more often know birth to be a ‘condition’, one that is life threatening, scary, painful, and traumatic – or dramatic as depicted in the Hollywood films. It’s important to take the time during pregnancy to mentally undo the negative things you have been told about birth and become a blank slate, since your experience will always be inherently different from what you have observed in others.

When you read positive stories and watch normal birth videos, you familiarize yourself with the foreign and unknown process of giving birth – receiving the message again and again that birth happens in many different ways but most importantly that natural birth does happen!

It’s also helpful to have a back up reserve of healthy, normal birth experiences that you can draw on during that moment in labor if and when you think you can’t go on or it’s too much (which is very normal, by the way). Ina May’s Guide to Childbirth, Spiritual Midwifery is a great resources for familiarizing yourself with the wide range of what normal, empowering and beautiful birth looks like.

Lastly, a good exercise during the pregnancy is to write out your ideal birth story as a way to visualize and help manifest the birth you want. Some may think that it will ‘jinx’ the birth or cause you to become attached to one particular idea, but writing your dream birth story will instead help you face any fears and focus on what you want from your birth.

6.    Pregnancy discomforts like symphysis pubis dysfunction, low back pain, sciatica, headaches, and heartburn are common side effects of pregnancy. As your body adjusts to accommodate a new human being growing inside of you, these conditions can arise. While they are normal occurrences they are not to be expected or accepted. These discomforts are signs of imbalance and should be addressed. Seek out routine chiropractic care and acupuncture to help bring harmony to the body, especially before birth to facilitate a comfortable pregnancy and smooth delivery.

7.    Take at least 2 weeks of maternity leave before your estimated due date to rest up and flood your body with oxytocin (the labor hormone). If this is something that is financially feasible, there are many benefits.

Anecdotally, I have seen (and heard from other birth workers) that women who are working right up until their birth either go far past their due dates and/or enter the labor depleted and are at risk for transferring to a hospital for failure to progress and exhaustion.

When you are in work mode, you enlist a part of your brain that is the opposite of getting your body into labor. You are using hormones – adrenalin and cortisol – that literally stall the labor hormone, oxytocin. (8) Most likely you are hustling to get a lot of work done before the baby, but sure enough it will be that night that you go to bed really late, fatigued both mentally and physically that your baby will decide it’s go time. Even if you manage to labor and give birth naturally when exhausted, it’s a more risky place to start your labor (for both you and your baby).

Also, when you’re not working you have the time to exercise, take naps, eat well, and start to hone in on connecting with your baby and envisioning your birth.

The purpose in preparing so much for your birth is to control what you can in the pregnancy in order to ‘lose all control’ in the moment of birth. Once labor starts, the most important tool one has is to surrender to the contractions and labor pattern. Therefore, it’s important to take the time in the pregnancy to prepare physically and mentally so that you can allow for things to unfold as they will in the moment of birth (and trust that that was how it was meant to go).

Good luck and enjoy!

Resources

1. Janssen, P. A., Saxell, L., Page, L. A., Klein, M. C., Liston, R. M., & Lee, S. K. (2009). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ : Canadian Medical Association Journal, 181(6-7), 377-383. http://doi.org/10.1503/cmaj.081869

2. Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D. and Vedam, S. (2014), Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery & Women’s Health, 59: 17–27. doi:10.1111/jmwh.12172

3. Nutrition During Pregnancy. (2015, April). Retrieved November 23, 2016, from http://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy

4. Frye, Anne. Holistic Midwifery. Comprehensive Textbook For Midwives in Homebirth Practice: Caring During Pregnancy. Portland: Labrys, 2010. Print.

5. Kordi, Masoumeh, Fatemeh Aghaei Meybodi, Fatemeh Tara, Mohsen Nemati, and Mohammed Taghi Shakeri. “The Effect of Late Pregnancy Consumption of Date Fruit on Cervical Ripening in Nulliparous Women.” Journal of Midwifery & Reproductive Health2.3 (n.d.): 150-56. Web. 27 Apr. 2017.

6. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e135–42.

7. Varney, Helen, Jan M. Kriebs, and Carolyn L. Gegor. Varney’s Midwifery. 4th ed. N.p.: Jones & Bartlett Learning., n.d. Print.

8. Gaskin, Ina May. Spiritual Midwifery. 4th ed. Summertown: Book, 2002. Print.

 
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