Abby Block, CD(DONA), CBC

Doula & Breastfeeding Support ~ Serving Brooklyn & NYC

pregnancy myths

VBACs are more likely successful if you call the midwife

Abby BlockComment

A new study shows that VBACs (Vaginal Birth After Cesarean) are more likely to be successful if a midwife provides the care instead of an obstetrician. 

You can read a portion of the abstract of the study here, and an excerpt is below:

Background

Research is yet to identify effective and safe interventions to increase the vaginal birth after cesarean (VBAC) rate. This research aimed to compare intended and actual VBAC rates before and after implementation of midwife-led antenatal care for women with one previous cesarean birth and no other risk factors in a large, tertiary maternity hospital in England.

 

Conclusions

Implementation of midwife-led antenatal care for women with one previous cesarean offers a safe and effective alternative to traditional obstetrician-led antenatal care, and is associated with increased rates of intended and actual VBAC.

Natural Hospital Birth

Abby BlockComment

As a birth doula serving clients who live primarily in Brooklyn and Manhattan, I work with many women who see both OBs (often low intervention practices) and midwives in the hospital setting. However, many of my clients are looking for a holistic birth experience, or a natural birth experience, within a setting that typically is not set up to accommodate un-medicated births. The odds are generally stacked against women hoping to have intervention-free births in a hospital. BUT, as a doula, I have witnessed many women successfully do this! Here are a few resources on how to work towards, or achieve some version of, a natural hospital birth:

Video

Book

 

Advanced Maternal Age

Abby BlockComment

What does this mean? In the U.S., women who are 35 years and over who are giving birth are considered "Advanced Maternal Age" (AMA). According to the research, only about 15% of women who are giving birth are 35 years are older, however it's hard not to believe that rings true in NYC. I would estimate that about 1/3 of my clients could be categorized as AMA. The important thing to know about this, if you are 35 or over, is that your care provider may apply different policies to you than if you were under 35. Please read this very important article from Evidence Based Birth by Rebekkah Dekker, Mimi Niles, and Alicia Breaky for some well-rearched info on what AMA means in pregnancy:

The Evidence on Advanced Maternal Age

The Truth About Your Due Date

Abby BlockComment

Get some perspectives on your due date, or "EDD" (estimated due date), as well like to call it. Read what a midwife, a doula, an OB, a labor nurse, an acupuncturist, and a pediatrician have to say about. it And in case you didn't know already, only about 5% of women give birth on their due date. The rest of us tend to naturally go somewhere from week 37 (full term) to week 42. There are exceptions to this, of course - as always, with birth. My best advice on the "due date" situation is to consider it your due month, and when people ask you when you are due, you give them the month, not the date :)

Read the article on due dates from Well Rounded NY here.

Eating during labor? YES, it's very important!!

Abby BlockComment

Newsflash, everyone: Eating during labor is safe, and might even be beneficial! (Insert some sarcasm and eye rolling.) Can you imagine running a marathon and not being able to have anything except water and ice chips? For women in labor, who are embarking on one of the most physically (and emotionally) intense experiences, eating and drinking to hunger and thirst is essential. Read more here.

Things you can stop worrying about in pregnancy!

Abby BlockComment

Great article here! You have enough to worry about it as is, so check out this article to help you let go of some of those things that may have been weighing on your pregnant mind . . .

PREGNANT? 11 THINGS YOU CAN STOP WORRYING ABOUR RIGHT NOW, by Dr. Aviva Romm
October 23, 2015, published on Mind Body Green

As a family doctor specializing in obstetrics, a midwife for 25 years, and the mama of four grown kids, I know firsthand what women go through during the precious nine months of pregnancy. And if there’s one universal emotion I’ve seen, it’s worry. 

Worry is a normal response to the uncertainties of pregnancy, as well as to caring deeply about our babies. And there are a lot of legit things to be concerned about, like the health effects of the chemicals in our cosmetics and the antibiotics in our foods. 

The truth is, most babies are born healthy and perfect. And when there is a problem, it’s just not your fault.

But here's the thing: While we should definitely pay attention to the risks we can avoid — and make the most educated choices we can — worry itself doesn't usually help. In fact, it tends to make us lose sleep and feel overwhelmed, and can even affect stress hormones in ways that affect pregnancy and labor. 

So, to encourage you to step away from the stress, here's a list of 11 things you definitely don't have to worry about during your pregnancy: 

1. Harming your baby.

I find that the most common fear is that we’re going to do something that harms our baby. The truth is that most congenital problems are a result of genetics or an environmental exposure that we didn’t even know about or had no control over. 

If you’re reading this, my guess is you’re already a health-conscious adult and aren’t regularly engaged in activities that can harm baby, like drinking excessively or using cocaine. 

The truth is, most babies are born healthy and perfect. And when there is a problem, it’s just not your fault. Period. 

2. Eating for two.

The idea that we have to "eat for two" in pregnancy is a flat-out myth — and one that has encouraged women to both suspend good dietary habits and worry about whether they're getting enough. 

The truth is that during the first and second trimesters, you don’t need any more calories than usual. And by the third trimester you only need 300more calories a day (double that if you’re pregnant with twins). That's the equivalent of just a glass of milk and half a sandwich. 

So if you're eating an overall healthy diet, let go of the worry that you’re not eating enough for baby. 

3. Having sex during pregnancy. 

Having sex while you're pregnant doesn't usually cause miscarriage or preterm labor. The only precaution? Making sure your sexual partner doesn't have any diseases that could be passed on to the baby. 

But if you're having symptoms of miscarriage, preterm labor, or have what's called placenta previa, that’s a different story — follow the “nothing goes in the vagina” rule until your midwife or doctor clears you. 

4. Eating foods that could give your baby allergies.

A lot of food-conscious mamas avoid dairy, gluten, nuts, and soy during pregnancy, worrying about how it will affect their baby. But while nutrition is super-important, restricting foods during pregnancy has not been found to prevent allergies. In fact, it may even increase risk

So unless you have to restrict certain foods for your own health, liberating your diet can actually be beneficial to your baby. Keep it healthy, but don’t restrict. 

5. Sleeping on your back.

You’ve probably heard that you shouldn’t sleep on your back during pregnancy because it can cut off oxygen to your baby — and that might be leading to a lot of uncomfortable nights on your side. 

But until you’re six months pregnant, this isn't something to be concerned about. After six months, the weight of the baby and your uterus can cause pressure on a large vein called the inferior vena cava, restricting blood flow to you and baby. 

However, if you find that you’ve rolled over onto your back during the night, don’t worry! It’s very unlikely that this would cause harm to baby. 

6. Stress during pregnancy.

You might have heard that a mom being stressed during pregnancy can affect the baby’s long-term mental health. The irony is that this very information is what gets pregnant mamas all stressed out! 

The truth is that you’d have to be under a lot of stress (we’re talking war zones or violent homes) for stress to have a serious impact on your baby’s health. 

The normal stresses most of us experience daily — money worries, relationship tensions, and job anxieties — are not going to cause your baby to have three heads or lifelong depression. As a species, we’ve given birth to healthy offspring under much worse threats. 

You can’t force a homebirth, vaginal birth, unmedicated birth, or a perfect story. And worrying about it is not going to get you there.

7. Being a vegan or vegetarian. 

No, you don’t have to eat meat and dairy — you can be vegan or vegetarian and have a perfectly healthy pregnancy. In fact, I was vegetarian for three of my four pregnancies. 

Just make sure your diet includes plenty of vegetarian protein sources(legumes, beans, nuts, and seeds), calcium (organic tofu, almonds, tahini, and green leafy veggies), and iron (legumes, green veggies, red beans, dried apricots, and raisins). And if you're vegan, make sure to take a B-12 supplement. 

Work with your midwife or an integrative nutritionist who is pregnancy-savvy to make sure you’re meeting your prenatal nutritional needs. 

8. Normal pregnancy symptoms.

Pregnancy brings with it some quirky symptoms, including nausea, increased urination, round ligament pain, breast tenderness, changes in your sense of smell and taste, sleep disturbances, mood changes, and many more. Knowing what’s normal — and what’s not — can make a huge difference in letting go of unnecessary worries. 

There aren’t too many symptoms to worry about, so make sure to talk with your midwife or doctor about those. You can also learn about natural solutions for common symptoms in my book, The Natural Pregnancy Book

9. What labor will be like.

Labor can't be controlled. All you can do is set a destination on your GPS, prepare well for the journey, and then move gracefully through any obstacles on the way. 

You can’t force a homebirth, vaginal birth, unmedicated birth, or a perfect story. And worrying about it is not going to get you there. 

The best thing you can do is prepare for labor. Take childbirth classes and read books that are supporting of the kind of birth you hope to have. (I recommend Spiritual Midwifery and Birthing From Within to start.) You can also take a hypnobirthing class to give you mind-body skills that can help.

If something comes up that requires you to reroute your plans — for example, a medical reason to have a cesarean — it’s totally appropriate to grieve. But be gentle with yourself and just make sure you’re in good hands. It’s all good. 

10. Dying.

OK, truth be told, the most common fear that women experience is probably fear of death — our own, our baby’s, or our partner's. 

Fear of our own death stems from the intense uncertainty of the process of birth, compounded by the historical risks, magnified by movies in which birth is depicted as dangerous and even life-threatening. That can make birth feel really terrifying. 

The reality is that there is an infinitesimally low for healthy women in the U.S. There's also a very low infant mortality rate

Remind yourself that it’s normal to have such thoughts. And then have an affirmation or meditation you can use to transform the fear. Talk your worries out loud with your midwife or other women, or write them down in a journal. If you're severely plagued by worry or anxiety, it's important to talk to a prenatal mental health professional. 

11. What other people think.

The hard fact is that women can be really judgmental with one another around pregnancy and parenthood choices. 

I’ve had many wonderful women tell me they were kicked out of natural mom online groups because they had an epidural or needed a C-section. My response? What other people think is not your worry. 

How you do your pregnancy, birth, and parenting is your business alone. If you’re worrying about what other people think, please, stop right now — because it will keep you from making the choices that are best for you and your baby. 

And when you make the choices that are right for you, your family and friends will get on board, and you’ll find the right mommy groups for yourself too!

 

http://www.mindbodygreen.com/0-22112/pregnant-11-things-you-can-stop-worrying-about-right-now.html

Stop Telling Women that Birth Plans are Pointless

Abby BlockComment

Excerpt from this great article by Milli Hill:

Yes, birth is unpredictable, but don't let that fool you into thinking the whole thing is just pot luck. There are elements that you can include in your birth plan that will maximise your chances of having a positive experience. They won't be a cast iron guarantee (remember that bit about how life sucks?). But they will maximise your chances.

Birth plans are not just idyllic wish lists lit by pretty tea-lights and trimmed with home-made bunting. A birth plan is a chance to take a detailed look at the huge amount of choices and options available to you, to consider the many ways birth might unfold, and to really make sure your voice is heard in the labour room. "Don't offer me pain relief unless I ask for it." "Keep voices and lights low" "Delay cord clamping" "I don't want V.E's" "Immediate skin to skin" "Husband with me in theatre" "Yes / No to Vitamin K", the list of options is endless and worthy of a great deal of time and consideration. 
Read the article in its entirety here.