Midwifery History and Witches

Just a taste of a much larger discussion. History for most of history was mostly ‘his story’. Through the majorly of it, women were mostly illiterate as they were not allowed to be educated like men. But until relatively recently, men would not provide care for women and their gynecological and childbearing needs even when they became physicians - as their reputations would be tarnished if they associated with women’s genitalia and their business. It was the domain of women. Women supported women.

Midwifery is mentioned as far back as biblical times, and recorded in Egypt as early as 1900 BCE. Birth was a normal part of family life, men were kept out, and certain women in each community took on the role as midwife, by following and learning from the elder midwives. They used natural remedies. Some did secretly train under physicians. In the medieval times, there are some conflicting historical accounts whether or not they were falsely accused of witchcraft and were persecuted- especially when some unsuccessful outcomes became apparent, their lack of formal training, and use of natural remedies - all a catch 22, as they were not allowed to do formal training or to practice medicine, had no access to medicines, so they used natural remedies, and were thought to go against the church, medical hierarchy and legislature which were often intertwined.

Today, thankfully there have been many beneficial changes like standardized formal education for women in the practice of midwifery, which includes sexual and reproductive health as well as equal rights of women in most developed countries. We do have a way to go in the United states and other countries, as barriers and obstacles to midwifery practice still exist. Midwifery is respected by the medical profession and encouraged for low risk population by leading health organizations. It’s now organized into a profession and supported by legislation as well as biblical religions. Hard to do the real history of midwifery justice in a blog, but at least I can reassure you I am a good witch.

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Upright Physiologic Vaginal Breech Birth

So grateful to Dr. David Hayes OBGYN @breechwithoutborders for their amazing continuing education workshop to thoroughly review the data and teach skills of attending vaginal physiologic breech birth globally. Some key take aways are: 📣Modern US clinicians and hospitals, and other countries that follow US, where only cesarean is taught and practiced for breech - please get back your skills and follow ongoing current impressive research and guidelines of other western countries where upright vaginal breech birth is being heavily studied and practiced as the norm, as it has been among community out-of -hospital midwives around the world through history.

More & more mamas don’t want c-section and all the risks associated with major abdominal surgery for them, their babies, and future fertility as the only option, and are seeking safe alternatives. Breech presentation occurs at term ~ 4% of the time ,vast majority are called frank with hips flexed, legs extended upward. Sometimes they can be turned head down to vertex presentation, sometimes they can’t and are breech for a reason. It’s very rare for a term baby to stand in the uterus, presenting one or two feet first - which is usually NOT footling (a common misdiagnosis) but complete or incomplete breech - hips flexed, buttocks in pelvis like a frank breech but one or two legs flexed, with one or two feet dropped down. These presentations in healthy pregnancy are fine candidates for term vaginal breech birth. It’s crucial for providers to know when to keep hands off, support mamas own movement and pushing efforts, upright positioning, how to resolve uncommon stuck arms, shoulders and head behind the pelvic bones, monitor baby’s condition, expedite birth and effectively resuscitate baby if needed.

Significantly less invasive maneuvers are required in physiological breech birth in upright positions with improved outcomes for mamas and babies. For mamas, breech birth is often claimed to be easier than birthing babies in head down position, with less injury to pelvic floor muscles and reduced tearing. Those I’ve attended all went well. The trouble and poor reputation associated with vaginal breech birth are mostly caused by unskilled providers, keeping mama on her back, impatience & pulling - which skewed the data of the older term breech trial they still quote. If you have a persistent breech baby know you have options. Get true informed consent!

If you’ve been told that your baby is breech at your mid pregnancy anatomy scan, know that baby is still swimming and it is likely they will be head down by term. If baby is breech later in the third trimester, don’t freak out. There are many ways to gently and lovingly ease your baby into vertex. Since there is slightly greater risk to breech babies born vaginally and by cesarean, and many people do not have providers near them who are skilled to attend them for a vaginal breech birth, it is ideal to try to encourage baby to turn head down.

Towards the end of pregnancy, the baby settles into its favorite position. Ideally, this position is vertex, meaning that its head is down towards your pelvis and its bottom is high up in your abdomen.

Less commonly, the baby is breech (with its head up and its bottom down towards your pelvis).

It’s not always known why a baby is breech at term. Sometimes it has to do with:

• Relationship between the shape of the baby and the shape of mom’s uterus or pelvic bones

• Location of the placenta

• Issues with the umbilical cord

• Excessive amniotic fluid

• Lax abdominal or uterine muscle tone

Labor and birth does carry more risk of complications when the baby’s head is not down towards the pelvis, even though breech is a variation of normal. So, when a baby is breech by the 30th week of pregnancy they should be encouraged to convert to the ideal vertex position. That said, the majority do turn by themselves at the beginning of the ninth month.

What to do When Baby is Breech

If your baby is breech at 30 weeks, consider doing a couple of the following exercises 10-15 minutes 2-3 times each day until your baby turns.

1. Belly massage. Massage your abdomen GENTLY in the natural direction the baby will turn. But stop if you meet any resistance, and never attempt to forcefully turn the baby yourself.

2. Visualization. Close your eyes and imagine your baby with his or her head moving down in your pelvis.

3. Coaxing. Play classical or relaxing instrumental music by your pelvis, so that the baby will turn towards the soothing sound. Or shine a flashlight by your pelvis, so that the baby may move towards the light.

4. Go for a swim. Swim laps and do some handstands in the pool.

5. Pelvic rocking. Shift your pelvis up and down and side to side while on your hands and knees.

6. Act like an elephant. Walk around the house on your hands and feet.

7. Bridges and inversions. If you have an established yoga practice, go upside down with any of the inversions, using props for supportive modifications. Headstands and downward-facing dogs work wonders.

Beginners should start with bridges. To do this, simply lie on your back with your feet flat on the floor approximately 1 ½ - 2 feet apart and your knees bent. Elevate your hips 9-12 inches higher than your shoulders. You can support yourself in bridge with a yoga block under your sacrum.

Alternatively, lie on your front in the same “upside down” position, keeping your weight on your forearms and knees wide, with your bottom in the air. Lying on three pillows or a beanbag chair can help further elevate your hips.

Or, lie bent over the edge of a sofa or top of a staircase with your legs on the floor and your body lying down the sofa or stairs. Support your body with your hands or forearms so that your torso is inclined upside down.

Gently roll your hips side to side while in any of these positions.

Taking homeopathic Pulsatilla 30C will help the above exercises be more successful. Allow 4-5 pellets to dissolve under your tongue 3 times daily for 3-5 days. As with any homeopathic remedy, avoid eating or drinking for 15-20 minutes before and after.

Natural Remedies for Breech Babies

In addition to exercises that help your baby move into the best birth position, there are a few techniques that can be administered by care providers. If you’ve tried the above suggestions without success, look for a practitioner that practices one of the following.

MOXIBUSTION

Find an Acupuncturist or Doctor of Traditional Chinese Medicine who has had success turning  breech babies to vertex with moxibustion. The technique involves burning certain herbs close to the skin at specific acupuncture points.

WEBSTER TECHNIQUE

A chiropractor trained in the Webster Technique can use this sacral adjustment to help facilitate the pelvic alignment needed for your baby to get into birth position.

MANUAL TURNING (External Cephalic Version)

If all else fails, you can opt for having your baby turned manually if the right conditions are met (such as no cord around the baby’s neck or short cord, adequate amniotic fluid, and healthy baby as detected on ultrasound with a normal fetal heart beat). Sometimes this is can be easily done in your birth practitioner’s office at 34 -36 weeks, especially in a woman who has delivered vaginally before, while carefully assessing the baby’s heartbeat. It has a high rate of success in skilled hands and supportive conditions.

Experienced midwives can turn breech babies. Most obstetricians prefer to do it in the hospital, often with medication to relax your uterus, ultrasound guidance, and continuous fetal heart monitoring. But it can safely be done out in of hospital settings while monitoring baby.

Ask for a wedge pillow to support you in a tilted pelvic lift position, or a bed that can be placed at an angle, with your legs higher than your head to help baby out of pelvis. Also, having it down while in deep meditation being supported in a pool of water has been effective and a wonderful experience.

Once the baby is turned to the head down position, stop inverting yourself, wear an abdominal binder at all times to prevent the baby from turning back to breech.

If your baby insists on being breech as you approach your due date, discuss your options with your provider. If they are not supportive of your choices for a vaginal breech birth, find a different practitioner, optimally one who has the essential skills and philosophy of birthing breech babies vaginally when appropriate and safe to do so. You can ask for recommendations at Breech Without Borders.

A baby lying in the transverse position, however, can only be delivered safely by cesarean section.

For more information on having the birth of your dreams, check out my Guide to Pregnancy, Birth and Postpartum

If you desire personal guidance, schedule an online or in person coaching call with me.

Tearing at birth

Worried about tearing at birth? If so, you are not alone. Although no guarantees (for example baby can come out with their hand by their head - compound presentation, that can result in lacerations), there are things you can do to help prevent tearing during pregnancy and at birth, even if you tore or had episiotomy previous birth. I have helped many mamas not tear or not tear enough to need stitching repair, despite the most serious of tears last time.

First off, say NO to routine episiotomy, in which the provider cuts your perineum and vagina at birth. It is is not only one of the most harmful, painful and unnecessary routine obstetric procedures, but also can lead to more serious tearing extending to the anus (third degree) and even the rectum (fourth degree). Make sure you maintain excellent nutrition, take in low glycemic foods and drink (especially if previous tear was related to baby’s large size - white four, fruit juices and sugar foods tend to grow bigger babies), avoid toxins like smoking, encourage baby anterior as you get close to term to prevent posterior positioning - I go into all this in more depth in my Natural Birth Secrets book 2nd edition. Research is conflicting about benefit of simple perineal massage to prevent tearing. What is more clear according to the research are devices specifically made to stretch vaginal and perinal muscles. In the last three to four weeks of pregnancy, you can prepare the muscles of your birth canal with one of the researched effective, pelvic floor medical training devices like Epi-no, or Aniball (easier to get in the US) as athletes and dancers stretch before working out or performing to prevent injury. They are like a balloon of sorts, that you insert into your vagina and gradually inflate 15-20 minutes daily, over a period of time to the size of baby’s head. They not only significantly reduce the risk of tearing or episiotomy, they also help you feel more prepared physically and mentally (and get a sense of what it feels like to have your birth canal stretch to the size of baby’s head so you relax into it), they ease childbirth, prevent stress urinary incontinence and been demonstrated to have other important benefits from reduced length of second stage of labor to improved Apgar scores - less fetal distress during the pushing phase. Incorporate the practice into your love making and have fun with it. Many mamas in my practice and midwives around the world swear by them, and urge first timers as well as mamas who have had more severe tearing or episiotomy previously to use them because of their successful results.

At the time of birth, to try to prevent tearing, you can honor the resting phase of labor, between end of transition and before feeling the urge to push. Wait for that powerful instinctual urge to bear down, when the baby descends low enough in your birth canal to elicit your natural fetal ejection reflex, and then use soft blowing breaths, to gently allow the emergence of your baby without forced coached pushing or pushing before you feel the urge, especially just because you are told your’e fully dilated. Gentle grunts to work with your body’s natural urges are not the problem. Avoid birthing positions like lithotomy (lying on your back with legs in stirrups, a flat surface or held wide open) or deep squatting. Use more upward, forward leaning, hand and knees or side lying, standing or dangling high squat positions, and if you are concerned, ask for perineal support by your attendants or have a water birth. I discuss this more comprehensively in my Online Guide to Childbirth.

You make plans for the best outcome, then surrender to the journey. Lean into the wondrous intensity of it all.

Routine Newborn Procedures

Many mamas who want a natural birth may not be as familiar with the the number of choices they need to make regarding interventions to baby postpartum. These are routine in many hospitals, with more freedom of decision making out of hospital at a freestanding birthing center or home with a midwife. Healthy babies are suctioned, all exams and procedures are done in the nursery, not by bedside, they are bathed, given Vitamin K injection and antibiotics in their eyes, and Hepatitis vaccine, and babies with a penis are told they need medical circumcision. Other procedures are pulse oximetry to screen for critical congenital heart disease not picked up on the mid pregnancy anatomy scan if baby had one, audiology screening, and the newborn screening blood test.

Healthy vigorous babies born vaginally can clear their own lungs and don't need suctioning - even with bulb syringe. That's not a gentle welcoming for them, but invasive and traumatic. Suctioning can be harmful to baby’s transition from womb to world, and isn't evidence based care. It's more effective and less harmful to do percussion and postural drainage or use ambu bag if needed. Most of the lung filled fluid is cleared with the big squeeze through the birth canal. The rest is absorbed into the body, and for ~ first 24 hours, baby spits it up, coughs or sneezes it out.

All routine baby exams and decided upon procedures can be done in room with parents. It’s an important part of bonding, nursing and sensitivity to baby’s nervous system. Baby needs to be skin to skin for warmth and comfort after birth, close to mama for nursing. There’s no medical reason for healthy newborn nurseries, with babies separated from parents in bright rooms in isolettes filled with strangers. Nurseries serve hospitals, not babies. If mama needs a rest, it can be done with baby in room cared for by another support person.

Babies born in hospitals are still be given unnecessary baths with chemically laden soaps and kept dry with toxic talc and artificially fragranced baby powder. The birth juice and meconium can be wiped with your own natural products by you or your partner, but there is no rush to wash off the skin disrupting the flora of good bacteria that protects baby’s health, and remove the vernix (the white waxy, cheesy protective material that covers baby’s skin) so most of it can absorb into baby’s skin and allow baby to receive its protective benefits. It is not only a skin moisturizer and softener, it’s also an antioxidant and skin cleanser with anti-infective properties. It regulates baby’s skin pH needed for health, helps control baby’s temperature and insulate the baby, so crucial after birth from womb to world. It might help babies latch, as the scent of vernix may trigger neural connections in babies’ brains needed for breastfeeding, and bonding with that delicious new baby smell. It also smells of mama, which can provide comfort to baby and enhance bonding after birth. The The World Health Organization (WHO) recommends waiting at least six hours — and if you can go a full 24 hours, even better to give the first bath. Since it doesn’t fully absorb until day 5-6, I’m not sure why the first bath can’t wait until then. Leave it on and even rub it in like body butter. Don’t let anyone wash it off.

Hepatitis B vaccine is given to prevent baby from blood born infection spread by contact with blood and body fluids like unsafe sex, IV drug use, accidental professional needle stick, and high risk communal settings. If baby has not had these sources of exposure, it can be delayed until prior to entering school, if you choose infant and childhood vaccinations. Refer to my blog on immunization for more info.

Vitamin K injection and Antibiotic eye ointment are given routinely to all babies born in US hospitals without considering individual situations. In some states you can refuse, in others it’s the law and they can report you to Child Protective Services - but these organizations have bigger problems to deal with and often the case is dropped after some unnecessary stress and aggravation. We don’t have these laws in most homebirth settings.

The antibiotic eye ointment is to prevent sexually transmitted infections gonorrhea and chlamydia that could cause blindness in newborns after exposure in birth. It is given within the first hour of life during the most alert time of baby after birth, interfering with vision at such a sacred crucial time when initial bonding and breastfeeding take place. It is irritating to baby and disrupts the delicate balance of flora in their eyes which can lead to other infections. Needing to give antibiotics is not relevant to babies born to mutually monogamous parents who do not have these infections. Taking into consideration that one may not know for sure there is another secret partner, these infections can be tested for in a pregnant mama at term, and if negative, the antibiotics can be refused in good faith. If you do test positive for one of these sexually transmitted infections, you and partner can be treated and retested to see if cured, but it may be wise to consider the antibiotics for baby’s eyes, since exposure can happen again. Then you can delay the medication until after you and baby look into each other’s eyes, have some time for bonding and breastfeeding.

To give vitamin K to the newborn within the first hour of birth is to prevent a rare but serious blood clotting disorder called vitamin K deficiency bleeding (VKDB). There is an early onset VKDB that happens within the first 24 hours, classical expression in 2-7 days, and late onset that usually occurs in 3-8 weeks of life. Our bodies need vitamin K to help the blood to clot when needed. Giving it to babies at the recommended dose via injection is currently evidenced based care, but still not a simple matter.

The American Academy of Pediatrics opines strongly in favor of it. The current evidence does support the injection, saying there is little risk other than rare potential allergic reaction, and that the benefits far outweigh the potential risks. The injection is mega dosed, with 20,000 times the amount new baby has at birth, 5000 times the recommended daily allowance. It is injected into the muscle, which is a more rapid route than oral. In its synthetic form, it is considered a class C drug which means its safety is unknown in pregnancy, risk cannot be ruled out, there are no satisfactory studies in pregnant women, but animal studies demonstrated a risk to the fetus or potential benefits of the drug may outweigh the risks. The package insert itself warns that it can cause sometimes fatal allergic reactions when injected into a muscle or vein, and is ideally take by mouth or injected under the skin. The synthetic medication contains concerning chemical preservatives. It is available, but not accessible in most hospitals without the preservatives, but the preservative free vitamin K still does have some chemicals to increase absorption. It is also concerning to ponder the impact of overdosing on a fat soluble vitamin that stays in the system, as opposed to water soluble vitamins in which excess is excreted out in the urine.

In formula fed babies, the risk of VKDB is negligible as the formula contains synthetic vitamin K. For babies who breastfeed, an alternative is the oral form of vitamin K, in which some protocols have not been as effective as the injection in preventing VKDB - although some of the increased risk was related to parents not administrating of all the doses. Vitamin K using the Danish protocol is just as effective at preventing VKDB, though not accepted by modern medicine and hospital practice in the USA. Several European countries have a licensed oral vitamin K available with varied protocols, for those who wish to decline the injection, which is most effective according to the research to prevent vitamin K deficiency bleeding in babies. Except the Danish protocol. The Danish protocol is preferred as it seems to be just as effective as the injection according to the studies. It is vitamin K1 - phytonadione: 2 mg orally at birth, the 1 mg once weekly for 6 months as long as breastfeeding is greater than 50% of the baby’s diet. As it is a supplement in the USA, it is not regulated, FDA approved or certified like the injection made from pharmaceutical companies, for preventing VKDB in new babies. That does not mean it is not effective or unsafe. Still many who decline the injection prefer it as a viable alternative. Finding it in the states can be a challenge, but some homebirth supply companies and midwives carry it. If doing this protocol, best to do with a feeding as vitamin K is fat soluble, to increase absorption.

Little research is available on the alternatives, such as breastfeeding mamas eating more vitamin K or supplementing (like with 5 mg daily) to boost levels in breastmilk and prevent the rare vitamin K deficiency in newborns.

But as with all other routine interventions in the entire healthy normal physiological process of having a baby, the more we study, the more we find their lack of benefit and increased risk, and that mother nature or the Divine intelligence that created it all did not get it wrong. Maybe there is a reason we do not know yet why newborns are born with low vitamin K that does not reach optimal levels until the eighth day of life, from the gut flora. Is it a deficiency if they are all born that way? I defer to Dr. Sara Wickham who has analyzed the research for over 20 years and even wrote a book on this subject alone. “Several thousand babies need to be given vitamin K in order to prevent each case of vitamin K deficiency bleeding (VKDB), a disorder formally known as hemorrhagic disease of the newborn. Unfortunately there is little research interest (as is so often the case) in questions such as 1- how we might be able to pick out the babies who are truly at risk rather than giving the universal prophylaxis and 2- whether and why it might benefit babies to have a relatively low level of vitamin K compared to adults.”

Newborn screening checks a baby for serious but rare and mostly treatable health conditions at birth. It includes blood, hearing and heart screening. The newborn screening blood test may screen for up to 50 diseases, including phenylketonuria (PKU), sickle cell disease, and hypothyroidism but know it is only a screen that leads to more testing to confirm or more likely rule out the rare diagnosis. It has a high false positive rate, as there are more than 50 false-positive results for every true-positive result identified through newborn screening in the United States. This means baby tests positive on the screen but do not actually have the disease. Screening is mandatory in and funded by nearly all states - despite the varied diseases for which each state screens; although most will reluctantly allow parental refusals on religious and other grounds, and such refusal does not usually engender civil or criminal penalty. The American Academy of Pediatrics opines strongly about the importance of the screening, but it does not control the different conditions screened for by each state. You or your partner can certainly hold and comfort baby during the blood test which hurts for a few moments.

The American Academy of Audiology supports early identification, assessment, and intervention for all types of hearing loss in infants and young children to minimize deleterious effects on speech, language, education, and social/psychological development. The screening should take place by an audiologist at 1 month of age and does not need to be done after birth. It is not an invasive screening and can be done in your room by your side, so if you gave birth at the hospital it can be more convenient doing it there. Or you can take baby to an audiologist by one months of age if you choose the hearing screen.

Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for critical congenital heart disease (CCHD) in newborns, if done within 24 hours after birth. Current evidence supports consistent accuracy for detection of CCHDs in newborns by pulse oximetry screening in addition to prenatal ultrasound and clinical examination. Overall, early diagnosis of CCHD with pulse oximetry is judged to be beneficial, identifying disease that may be treated and lifesaving, and potential harms associated with false-positive tests are not serious, but stressful, while missing CCHDs and other serious diseases detected by hypoxemia without pulse oximetry screening can lead to serious consequences. It is interesting that this is not the position of other institutions such as the United Kingdom National Screening Committee and the Royal College of Pediatrics and Child Health. Further research is required to understand and improve the effectiveness and efficiency of the screening and its algorithm. Some mamas do not want this philosophical standard medical approach of looking for diseases, prefer to address the issue if baby shows signs, and have Divine faith that whatever happens is meant to be.

Medical (non-religious) circumcision is the most controversial routine surgical procedure done mostly in the US on babies with a penis, prior to discharge. The vast majority of boys in world aren't circumcised. There's no evidence to justify this routine procedure on medical grounds & its risks are downplayed. The American Medical Association classifies it as a non-therapeutic procedure, as it has no proven benefits and risks outweigh them. The American Academy of Pediatrics has never, in its over 75 years of operation, recommended routine newborn circumcision. The foreskin is a normal, sensitive, functional part of the body, protecting the head of the penis from urine, feces, and irritation; it also has an important role in sexual pleasure, as it has specialized, erogenous nerve endings, gliding and lubricating functions. For a thorough analysis of the literature, science & research, potential risks & alleged benefits, cultural/religious roots & human rights bioethical issues see here.
THIS ISN’T ABOUT PAST, HOW WE WERE ADVISED MEDICALLY OR CULTURED TO DO. IT’S ABOUT DECISIONS MOVING FORWARD.

I like to promote informed choice, question routine status quo, and help those interested in studying the data and what factors create opinion and dogmatic policies, as well as encourage those who wish to ponder this topic with a more critical eye and make their own decisions about their baby’s health care.

Educate yourself & make an informed decision about what you want or don't want for YOUR baby, with my online Guide to Pregnancy, Birth and Postpartum. And in adjunct, my Natural Birth Secrets book 2nd edition, as in many cases, it is totally safe and appropriate to investigate natural alternatives.

High Blood Pressure in Pregnancy: How to Prevent and Treat Naturally

High Blood Pressure in Pregnancy: How to Prevent and Treat Naturally

About 6-10% of pregnant women develop consistently high blood pressure. Typically if mild, by itself it’s usually harmless. But, if not monitored or controlled, it can be dangerous, and it may lead to a more serious condition known as pre-eclampsia, which poses a threat to the health of you and your baby.

Always remember that blood pressure varies widely in healthy individuals and is normally sensitive to moment-to-moment changes in activity, posture, nutritional status and emotional factors. It can even be a response to a fear of high blood pressure or being diagnosed with a complication! It is the steady and consistent increase that is concerning.

To Prevent High Blood Pressure In Pregnancy

Regular aerobic exercise involving moderate exertion throughout pregnancy is one of the best ways to maintain health and prevent high blood pressure. Some good options are brisk walking, dancing and swimming. If you are a beginner, build up gradually to the ideal goal of at least 30 minutes 5 times per week. Gentle forms of meditative movement like Tai Chi, Qi Gong, and yoga (especially Yin, gentle, prenatal and restorative) also help maintain normal blood pressure. Below are more tips for preventing high blood pressure during pregnancy.

CONSIDER YOUR DIET

Avoid stimulants such as spicy or peppery foods (including foods with large amounts of nutmeg, mustard or ginger), caffeinated products, nicotine products, cocaine, diet pills, and other stimulant herbs and medications. 

Avoid excessive weight gain. Eat a highly nutritious, high fiber and protein diet to prevent hypertensive disease and to avoid excess weight gain. Avoid foods that are highly processed and refined or laden with sugars, white flour and unhealthy refined vegetable oils and partially hydrogenated fat. Replace with lots of fresh organic fruits and vegetables, whole grains, and at least 80 grams of protein. Healthy protein options include:

• Fish tested free of pollutants or from non-polluted waters, like wild Alaskan salmon

• Tempeh, tofu, beans and seed products

• Lots of nuts, nut milk and nut butters 

• Limited animal protein in turkey, chicken, beef, lamb, and wild game, fresh organic raw dairy, ideally goat or sheep, and whole organic eggs 

• Protein powders

Take your prenatal supplements so you get the nourishment you need for your pregnancy, that is not supplied by diet alone. Especially important are an excellent whole food prenatal vitamin and omega three essential fatty acids.. Be sure to include foods high in Calcium, like raw or cooked greens except spinach, sesame seeds/tahini, salmon and sardines, and dairy. You may need additional Calcium so you get 1200 -1500 mg of Calcium daily. 

Substitute vegetable oils with healthy fats like organic cold expeller pressed extra virgin olive in your cooking. You can salt your food according to taste (a dash of Himalayian sea salt or tamari is best), but avoid excess and processed foods high in sodium. 

Drink at least 64 ounces of fluids each day between meals, at least 20-30 minutes before or 2 hours after eating. Opt for filtered, spring or well water, herbal tea, soup broth, or whole juiced veggies.

Add 1-2 Tbsp of powdered Spirulina to your daily smoothie or take as directed in capsule form. 

Drink strong Nettle, Red Raspberry and Dandelion teas regularly, as well as decaffeinated green tea. When feeling stressed, drink some strong calming Chamomile, Lemon Balm, Lavender , Passionflower, or Skullcap tea. Add honey, fresh mint, juice of fresh lemon or lime to taste.

REDUCE STRESS

Cut down on the stress in your life. This is easier said than done, but this is an important time to be clear about your priorities. If you feel very stressed and pressured and your blood pressure is on the rise, your body is sending you early warning signals to rearrange your schedule and increase your rest periods in order to protect the health of you and your growing baby. Don’t be afraid to ask family and friends to help with chores or child care. Even better, treat yourself to hired help. And be sure to rest on your side three times a day for 30-60 minutes.

Especially learn to master your reaction to outside stress and relax yourself from the inside, which relaxes your blood vessels and lowers blood pressure. Reduce inner tension and increase feelings of centeredness and calm by focusing all your attention on your breath, simply watching all sensations as you inhale and exhale. Also try regular conscious slow deep breathing and a regular breathwork practice, meditation, and/or progressive muscle relaxation techniques (yoga nidra) for a few minutes several times per day, and certainly before coming to your prenatal appointment to have your blood pressure checked. There are many phone apps like Calm and Breathe to help you establish a regular practice.

Before rising in the morning and going to bed at night, while waiting, in transit, and whenever you feel triggered or stressed, practice the any of the following calming breathing exercises: 

3-Part Breathing 

1. Exhale slowly through your mouth with an audible sigh while consciously releasing any and all muscle tension.

2. Imaging a pump expanding your abdomen and lower back as you breathe down deep into your belly.

3. Allow ribs to expand with air, then inhale air into your upper chest towards your collarbone and shoulders 

4. Inhale in this way for a count of 4.

5. Hold for a count of 4 while staying relaxed.

6. Exhale slowly through your mouth for a count of 4, releasing in the same order as the inhale, collapsing/returning to baseline, your abdomen, ribs, then upper chest. This is the ideal form of breathing, as opposed to rapid shallow breathing. With each exhale, let go and relax more. 

7. Repeat this cycle a total of 8 times or for at least a few minutes. 

Once you get the hang of it, play with various types of breathing. Try several minutes of inhaling and exhaling, each to a count of 3, 4, 5 or 6 without the hold, keeping it smooth and even. Then double the length of exhalation. For example, so if you inhale to a count of 3, then exhale to a count of 6.

Box Breathing

To try box breathing, inhale to a count of 3, hold for a count of 6, exhale for a count of 6, hold for a count of 3. Repeat for several minutes. You can also play with ratios, for example:

1. Exhale slowly through your mouth with an audible sigh, while relaxing all muscle tension.

2. Inhale slowly through your nose for a count of 4.

3. Hold for a count of 7 .

4. Exhale slowly through your mouth for a count of 8, releasing and letting go more each time.

5. Repeat this for a total of 8 cycles.

Forced Exhalation

Another great breathwork technique that disengages your conscious attention from thought and relaxes the nervous system is forced exhalation. To do this, after a normal breath try squeezing as much air out as possible using your intercostal muscles in your chest. Then, allow your breath to come in naturally and deeply, but automatically. Repeat the cycle for at least several minutes or as long as you would like. 

These breathwork techniques are simple to do, health enhancing, totally safe, and without side effects. They are all natural tranquilizers, especially if you do it often. If you need more personal guidance, schedule a session with me. 

Life is stressful and always has been, and eliminating all outside stress is not an option. But, you can learn to activate your own relaxation response and quiet your nervous system. Not only with breath awareness, breathwork and relaxation techniques, but also by making a conscious effort to be aware of anxiety-provoking, tension-causing thought patterns that are not serving you. Try to stop them or shift your attention to something more positive and ultimately change your mental state. You have the capability to change your attitude and reaction to your life experiences to more health enhancing responses. For example, you can surrender to and totally accept unpleasant events over which you have no power. You can view them as a wake-up call, an opportunity for personal growth and redirection. Try to focus as much of your attention as possible on the present moment, literally without letting your thoughts wander into the past or imagined future. 

For more information about this and other great ways to improve your physical and mental health and well being, read Natural Health, Natural Medicine by Dr. Andrew Weil,  Practicing the Power of Now by Eckhart Tolle, and Prescriptions for Living by Bernie Siegel.

Avoid things and people that agitate your mind and raise your internal tension. Surround yourself as much as possible with calm centered people, things, sounds and places that inspire, relax and restore you to inner peace and safety. For many, this means being around nature or beautiful art and soothing music.

Make a conscious effort to work on increasing your own feelings of forgiveness, appreciation, love, joy, optimism, and healing, while letting go of anger, resentment, envy, fear, sadness, and negativity. Do not be afraid to seek counseling if you need help with this. 

Do more of what you love, and figure out how to make chores more fun (like doing them while dancing to music or with a friend).

Natural Remedies for High Blood Pressure in Pregnancy

Once you have been diagnosed as having pregnancy induced hypertension (PIH), you will get lots of extra attention in the interest of monitoring how mild or serious your condition is and to protect the health of you and your baby. You will be asked to go to your provider’s office more frequently to check your blood pressure and the baby’s heartbeat, as well as to check for excess swelling, protein in the urine and labs that signal developing complications like preeclampsia.

Periodically take your blood pressure in your own home when you feel relaxed and secure. You can buy an easy to use digital blood pressure monitor. Sometimes, there is an artificial elevation in blood pressure in the office due to anxiety about being examined and having your blood pressure reading be too high.

Continue to use the preventative suggestions, but increase the amount of time you are resting on your side to as much as possible. Depending on your individual situation, you may need to maintain strict bed rest on your side all day – this means no housework or errands – but often this is not necessary. 

Increase the frequency and duration of your breathing and relaxation exercises. Visualize your blood vessels dilating for 5 minutes several times daily, while thinking that your blood pressure is now normal.

Watch comedy. Laughter is extremely healing, reducing internal stress reflected in lower blood pressure.

Be in tune with your baby’s movements. Make sure you count at least 10 moves in 1 hour during the times your baby is most active, which is usually after you eat and when resting.

Take biofeedback training to lower your blood pressure.

Take several warm baths daily with Epsom salts and a few sprinkled drops of the essential oil of Lavender.

TIME TO CONSIDER SUPPLEMENTATION

Reputable brands of the supplements and herbs I recommend include Innate Response, Wish Garden, Gaia, Herb Pharm, Wise Woman Herbals, Pure Encapsulations and Eclectic Institute, or any of those in my online holistic apothecary.

Again, if you aren’t already taking a natural prenatal vitamin and mineral supplement, now is the time to start. Also consider additional calcium and magnesium. Take 500 mg of each in the morning, afternoon and at bedtime. If you experience loose stools, you can experiment with skipping the magnesium dose in the morning. 

Eat more potassium-rich foods found in most fresh fruits and vegetables, for example starchy roots, potatoes, dark leafy greens, bananas, oranges and cream of tartar. And daily take 1000-2000 mg vitamin C up until 36 weeks gestation, then reduce to 500 mg. Also take 400 IU vitamin E and 2-3 mg methyl folate to boost your antioxidants.

Make sure to take at least 300-400 mg DHA/EPA Omega 3 essential fatty acids found in fish oil twice daily. You can take a vegetarian source, but they aren’t as ideal. However, some benefit can be derived from eating 2 Tbsp ground flax seed every day. You can add it to your cereal, salad, baked goods or yogurt. Alternatives are 1000 mg of flaxseed oil taken in capsule form or using 1 Tbsp of uncooked flax oil in your salad or other cold foods twice daily, 500 mg black currant or evening primrose oil each day. 

Eat a bulb of fresh garlic daily. You can make it delicious by roasting or sautéing the whole cloves in olive oil, salt, pepper and a dash of parsley. If you prefer raw garlic, eat 2-4 cloves twice daily crushed into your salad or cut and swallow as a pill with a spoon of honey and a glass of water or citrus juice, which minimizes garlic breath and stomach upset. Another option is to take New Chapter’s Garlicforce 2-8 capsules daily. Infuse your olive oil with garlic, by soaking all cloves from a bulb in 1 cup of olive oil for a few days for delicious and health enhancing meals, used on salads, veggies, beans, sprouted whole grain breads and pastas.

Eat more onions, parsley, fresh beet juice, cucumber and its juice, watermelon and turmeric. Renowned herbalist Susan Weed advises drinking a mixture of the juice of ½ lemon or lime with 2 tsps cream of tartar and ½ cup water once daily for three days. 

Prepare your own herbal infusion:

• Steep up to 1 large handful of dried nettle leaf and/or red raspberry leaf, and dandelion root  in a quart of boiling water for at least 4 hours. 

• Strain in a glass mason jar, and drink several times throughout the day. 

• You can add a splash of lemon or lime juice, fresh mint, or a dash of honey to taste. 

• Drink 2 cups daily.

Take 1-2 dropperfuls of tinctures of passionflower, skullcap, and lavender 1-3 times per day, especially if your increased blood pressure is due to stress and anxiety. Alternately, passionflower capsules can be taken as directed, 2 twice daily. 

Drink Hops tea before bed during the last few months of pregnancy.

If you are interested in more healing herbs specific to your situation, you can take Dandelion (a natural diuretic) and Hawthorn berry (a natural vasodilator). The herbs should ideally be supercritical or encapsulated freeze dried extracts. Take 1-2 capsules of each 2-4 times per day or 1 dropperful of each liquid tincture of Dandelion and Hawthorn Berry 2-3 times per day.  

Herbalist, midwife and physician Dr. Aviva Romm in The Natural Pregnancy Book recommends adding equal parts Cramp Bark, Black Cohosh, and Motherwort after the first trimester, as they relax the nerves and muscles, and dilate the peripheral blood vessels, thereby reducing high blood pressure. Take a dropperful of each tincture up to a few times daily as needed, depending on your blood pressure. But stop if you feel a pattern of preterm contractions (4 per hour or every ten minutes before 37 weeks). She also advises mixing together the following herbal tonic tinctures to support the liver and kidneys, especially to prevent worsening preeclampsia, and taking 1 tsp of the mixture 1-2 times daily: 

• 3 tsp each nettle leaf, schisandra, American ginseng, dandelion root, burdock root

• 1 ½ tsp each passionflower and linden 

For those with any sort of chronic high blood pressure in which serious causes have been ruled out and none of the natural and allopathic remedies help, consider reading the book The Mindbody Prescription By Dr John Sarno, MD. He is an amazing pioneering physician whose brilliant approach has helped hundreds of thousands of people without drugs, physical measure or surgery, and using breathwork, to release stress and past trauma energy while transforming health in a deeper way. Also check out Brandon Bays’ book The Journey, and her website for intensive workshops that are extremely effective mindbody cutting edge methods that have also lead to transformational healing for thousands of people around the world.

If you need more personal guidance, schedule a consultation with me.

Call your provider immediately if you have any of the following symptoms: sudden severe swelling of your feet, legs, hands or face, a severe headache or pain in your upper abdomen or uterus, spots in front of your eyes or blurry vision, dizziness or light-headedness, vaginal bleeding, a sense that your baby is moving less than usual, regular contractions, or your water breaks. 

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