April 3, 2017

Anne Margolis

Childbirth, Homebirth, Pregnancy, Birth Plan

How To Manage 'Pain' of Normal Labor at Home

April 3, 2017

Anne Margolis

Childbirth, Homebirth, Pregnancy, Birth Plan

“Undisturbed birth does not imply that birth will be pain-free. The stress hormones released in birth are equivalent to those of an endurance athlete, which reflects the magnitude of this event, and explains some of the sensations of birth. And like a marathon runner, a woman’s task in birth is not so much to avoid the pain – which usually makes it worse – but to realize that birth is a peak bodily performance, for which our bodies are superbly designed. Undisturbed birth gives us the space to follow our instincts and to find our own rhythm in an atmosphere of support and trust, which will also help to optimize our birth hormones, aiding us further in transmuting pain.” – Sarah Buckley, MD., Gentle Birth, Gentle Mothering. (link to Sarah’s blog here: http://sarahbuckley.com/category/blog)

You may have had a similar experience to the one I share: Being given Pitocin to make my labor progress more quickly, and then an epidural– as I could not take the pain of the stronger sensations from the medication, lying on my back, attached to continuous monitors and intravenous fluids, without any labor support or doula. I was in my early twenties back then. I didn’t ask many questions and assumed this was standard procedure when bringing life into this world. And I was an obstetric nurse on the unit where I was laboring! This was what I saw and thought was routine.

Also, statistically, these are very common practices. However, no one shared with me the opportunity to have a natural, undisturbed, well supported childbirth. There was no online information or many books about it available to me back then, and because I didn’t have anyone in my life talking to me about intuitive pregnancy and birth as a normal physiologic process, I thought I was covering all my bases when I was eating healthy, exercising, attending all my check-ups, tests, screenings, and taking Lamaze.

They say that when the student is ready, the teacher appears….

…and perhaps I was not yet ready to dive into myself…. And let go…. I was so young, and scared by what I saw in the hospital and heard from others.

This blog post focuses on the mindset around ‘pain’ during labor and childbirth, as well as my perspective on managing it in an out-of-hospital birth setting.

Photo by @alwaysmatilda_katie

What do you do at home if a mom can’t take the pain of labor and wants an epidural? How do you manage pain at home?

In all my years as a homebirth midwife I have not once had to transfer a mama to the hospital for epidural or pain meds because she could not cope with the sensations of normal labor. Not once.

It is not because women who have home births have different bodies and no intensive sensations. It is largely the mindset, the language we use, the attitude, the preparation in advance, and how the mamas are cared for and supported in labor.

I was always terribly frightened about pain after my experience giving birth to my first two babies on the obstetric unit where I worked as a nurse - one in the operating room while I was waiting alone for over an hour, waiting for the assistant surgeon to come perform an emergency cesarean because my baby’s heart rate dropped dangerously from the medications. My baby was miraculously fine (so much for the accuracy of the monitoring, as there was no emergency after all; so much for feeling safe in a hospital that took over an hour to rescue my baby from the emergency stress they allegedly caused), but I was not fine. That and my similarly handled second birth were the most traumatic experiences ever.

When I woke up and went to midwifery school and began to heal from my own birth traumas, I was still petrified of the pain and wanted to see if the wimp I considered myself to be could do it without an epidural. I wanted midwifery and natural birth to work for me to be authentic about providing that kind of care.

I told my fears to my midwife and she validated me. She also reassured me she was confident I could do it naturally as I was now with a midwife and my care will be very different - I would be eating and drinking, upright, moving and vocalizing freely, and would be more empowered, supported, and encouraged to trust my body’s ability to give birth; She was sure I would surprise myself.

She was so right. I felt so healed and like a superstar after my next two babies were born without epidural or any pain meds, just loving excellent midwifery care and encouragement to tap into my own capacities and strength as a woman.

Being in the water helped. Movement and moaning helped. But a complete shift in mindset and perspective was key, as was my preparation. I learned to use different language for the sensations of labor, instead of pain which implies illness and something that needs to be remedied, and to see them for what they were. I learned to use other words for contractions, which imply tension and negativity, and the word contraction is not empowering, and does not fully explain what is happening. Yes, the top of the uterus contracts so the birth canal can open and expand, as well as push out my baby. So expansions are also happening in labor – that is really the goal of what I am doing – expanding so my baby can emerge from my womb to the outside world, and we can both be birthed as a new mother and baby.

Suffering is a choice. And I chose to embrace my intense sensations for what they were, as healthy signs, what was needed to birth, what my baby needed to transition earth side - not that anything was wrong.

They came in waves with a delicious rest in between and I kept staying in the now. My yoga and mindfulness helped me calm myself, witness and get curious about the sensations, to release and dive right into them without fighting them, and notice that most of my body actually felt fine. I also noticed that when more relaxed, the labor was easier and the sensations were less intense, easier to deal with.

I could do anything for 60-90 seconds, every few minutes at the maximum. I also felt confident with the support I had - and the peak intensity was only at the peak of the wave in later stages of labor, when the waves are at their most intense, closest interval and longest duration. Prior to that, they are shorter, less frequent and not as strong – so even more manageable. Later labor I knew was a relatively short period of time, and as indication that my baby would be born soon. So, that's the kind of care I provide and encourage others to provide.

Natural hormones for management of labor sensations

“In labor, such high levels [of beta-endorphins] are released and help the laboring woman to transcend pain, as she enters the altered state of consciousness that characterizes an undisturbed birth. In the hours after birth, elevated beta-endorphin levels reward and reinforce mother-baby interactions, including physical contact and breastfeeding, as well as contributing to intensely pleasurable, even ecstatic, feelings for both.” – Sarah Buckley, MD.

These natural pain-killers are programmed perfectly to release and work with a woman’s body and her baby as she progresses through pregnancy, labor and after-birth.

Beta-endorphins work with another hormone produced naturally, oxytocin, the love hormone, to contract the uterus before and after the baby is born. Physiologically, a birth in which a woman feels safe, heard, supported, loved and undisturbed, a woman’s body is a divine machine that was designed with miraculous and purposeful intent.

Although epidurals and other interventions have their place and are beneficial when necessary, routine use of them interferes with the natural tendencies and process of labor, as well as birth and the after-birth period where breastfeeding and bonding between mother and baby are so important.

Can labor and birth actually be pleasurable?

Many women who I have cared for in my practice have used the word “ecstasy” to describe it! I have helped mamas dance, laugh, sing and sensually release their babies out.

Just as I have compared some of the experience of labor and birth to that of a marathon runner, feelings of ecstasy can be compared to something similar to a runner’s high. Although birthing your baby is a much more powerful, peak-like experience as you can imagine, this is an experience a woman may only have once or a few times in her life.

“I never thought I would see the day that anyone other than me would describe childbirth as total ecstasy! I know exactly what orgasmic birth is – I have experienced it myself. There is absolutely nothing else on earth like it. There is no moment in a woman’s life when she feels stronger, more capable, more an embodiment of the Divine than when she pushes her child into this world.” – an excerpt provided by Christine B., included in Elizabeth Davis and Debra Pascali-Bonaro’s book, Orgasmic Birth: Your Guide to a Safe, Satisfying, and Pleasurable Birth Experience (link to Debra’s blog here: http://www.debrapascalibonaro.com/blog/).

Oxytocin is released both during love-making and during labor. There is a deep connection between the love that put baby there and the love that helps baby come out. It’s the same sensual energy that is needed, in an atmosphere and mindset conducive to it flowing organically…as in making love, as in giving birth.

A woman’s relationship with her body, both sexually and sensually, can be an integrate part of experiencing labor. The contractions and expansions that occur during labor and childbirth are comparable to those of orgasm.

Art of an actual woman after birth by Amanda Greavette

Most of us have grown up with a belief about labor and childbirth, one in which it has to be painful. We hold a vision in our mind of a pregnant woman, screaming in pain, wearing a hospital gown, with her legs up in the air, an obstetrician and nurses taking over – doing all sorts of emergency care on the laboring mother. That is what we are told by many others who have given birth in many hospital settings for the last few generations.

Even if it’s just something we’ve seen in the movies, it would lead anyone to sign up for an epidural without question. No wonder there is a prevalent fear and lack of self confidence.

However, it is possible to embrace and lean into the sensations of labor, rather than fear them or try to escape them. It is possible to birth with joy, and even sensual pleasure.

When a woman prepares for this process, she can feel the momentum that labor provides. She can be guided by her own intuition and the trust of a supportive team around her. Mindset can shift to a positive perspective about the sensations of birth and it’s fully possible to have a birth that leaves a woman feeling empowered, strengthened and deeply satisfied. It is possible for her to feel a sense of bliss like no other, despite the intensity and challenges she may face.

To learn more about ecstatic birthing women and other birthing resources, check out some of the books and movies I love!

Also, this outstanding documentary, Orgasmic Birth here is a must watch! And I was honored to be in it!

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor
Tap into your inner calm to deeply relax yourself, letting go of busy, stressful and fearful thoughts on demand for the health of baby
Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy
Trust yourself, connect with your body wisdom and communicate with baby in belly
Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum
Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

Physicians and midwives around the world recommend my teachings to their pregnant clients and many Doulas across the country learn the secrets of blissful birthing from me to supplement their Doula Training & Certification process!

To learn more, visit: LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy.

Get a 10% discount on your Sleepod purchases ataskrembla.com-use the code SWEETHOME to get your discount.

March 26, 2017

Anne Margolis

Doula, Childbirth, Birth Plan, Pregnancy, Postpartum

What's a Doula and Why I Recommend One

March 26, 2017

Anne Margolis

Doula, Childbirth, Birth Plan, Pregnancy, Postpartum

Happy WorldDoulaWeek! This is a week initiated by a doula in Israel to empower and support doulas around the world to improve the emotional and social health of birthing and postpartum women and their families; this is so needed in modern times, with the breakdown of community and resulting lack of sisterhood mothering, along with the prevalent fear and lack of exposure to birth, and the medicalization of childbirth. Says Dr. John H. Kennel MD, "If a #doula were a drug, it would be unethical not to use it." When I think of the many #doulas I have been blessed to work with, I am reminded of strong, beautiful, kind, passionate, dedicated, fun-loving women who have found their calling supporting other women - these women rise by lifting others. Hug your doula this week; and if you don't have one, find one to hug, and research the many proven benefits of having a doula, especially if you are giving birth for the first time.

I do love my vintage office bumper sticker.

What is a doula is and why do I recommend one when you don't have that kind of support around you?

A doula or a labor support person like a doula is must - someone calm and nurturing to mother you, who knows how to help mamas in labor, birth and postpartum and trusts the process. Women were surrounded by homebirth and supported other women in labor through history and around many parts of the world still today. In the US and many parts of the modern world today, many mamas don't have this, and it negatively impacts their birth and postpartum. My transfer rate is ~ 7% and it's mostly first time moms with prolonged labors, exhaustion and with a common theme - they did not set themselves up with doula or doula like labor support, despite what I said, now documented by solid research. I want mamas to optimize their chances of having an empowered, deeply positive and healthy birth experience. See if your midwife knows great doulas with a sliding scale. An awesome one is worth every penny.

I could talk for hours about this, but here are the main reasons I believe pregnant moms, especially first timers, those planning to VBAC, and those who have an obstetrician as their provider, should hire a doula. Doulas and midwives compliment one another even in out of hospital birth settings, and preserve rather than interfere with partner & family support & privacy. Often dads are grateful they do not have to learn to be a labor coach.

In many cultures today, and throughout history, until relatively recently, when birth was moved into the hospitals in the 1920s to 1940s, and people dispersed away from their villages, women supported women through childbirth and postpartum. Doulas fill this void, and are trained to provide emotional support, comfort measures, reassurance, encouragement, empowerment, advocacy, and basically mother the laboring and postpartum mother. Most doulas go through a short training and certification process, although many take continuing education and serve childbearing families in other ways such as facilitating pregnancy and postpartum support circles, doing birth photography, creating mother blessing ceremonies, encapsulating placentas, and becoming childbirth educators to teach childbirth classes. Doulas are not medical providers like midwives and obstetricians, responsible for the actual maternity and newborn care - although midwives are more likely to provide doula like care which is integral to authentic midwifery, that is not their main role.

There is an impressive body of research on the many benefits without risks, of the continuous support of an experienced doula during labor, such as improved coping, self confidence, esteem and empowerment, enhanced satisfaction and positive feelings about their childbirth, shorter and easier labors, an easier time adapting to motherhood with enhanced skills, longer breastfeeding, more positive feelings towards their baby and even improved relationship with their partner! Scientific evidence from gold standard medical studies also reveals less pain and fear, less childbirth interventions including cesarean, vacuum and forceps deliveries, less episiotomies, medication for pain and stimulating labor, less babies in poor condition needing intensive care and longer hospital stays, and all the associated risks to of above interventions, and less postpartum depression. This is HUGE! It's having a personal coach so that you have the most healthiest, wonderful experience possible. All successful professional athletes, performers and most leading businesses and entrepreneurs have a coach of some sort.

This is doula love, given by my amazing birth assistant, doula and childbirth educator, to a superhero mama having her second homebirth. "The wisdom and compassion a woman intuitively experiences in childbirth can make her a source of healing and understanding for other women." - said the beloved Steve Gaskin. I want to honor all doulas this happy world doula week, and all superhero mamas who have given birth anyhow, anywhere. Photo by Julia Sywers.

For personal questions and need for individual guidance you can schedule an online consultation with me- this is one of passions and areas of expertise. Many mamas ask to consult with me about their personal fears and concerns and what to do about them. I love helping mamas in person, and now with this global IG community, via Skype or phone conversation. You can also take my unique online ROCK and LOVE YOUR BIRTH course, which basically guides you through your pregnancy to birth and postpartum journey, as I guide the families in my midwifery practice - without the hands on care, to prepare and plan for an experience of their dreams.

Do you need supplements for preconception and pregnancy? Here are some of my favorite I recommend to mamas in my practice, along with my favorite herbal tea recipe for your journey.

Make your Red Raspberry Leaf and Nettle herbal infusion.....rich in needed nutrients and specifically nourishing for pregnancy, birth and postpartum. Place 1 oz of dried red raspberry leaf, 1 oz of dried nettle leaf in a quart-sized glass canning jar with strainer, fill it with boiling water, cover and steep for at least 2 -4 hours at room temperature. Strain and place in a covered pitcher. You can make it in larger quantities and store in the fridge. For taste, dilute with water or steep for less time (but no less than half an hour), add lemon or lime juice, mint leaves or a teaspoon of honey. Drink 1-4 cups daily hot or cold.

I am passionate about changing lives. This 44-day course is changing lives. Vital Mind Reset is a program that will hold your hand and help you heal your life without a prescription. It will also introduce you to a community of people just like you – all working to transform their lives and revive their power and joy. Be a part of this community. Be a part of something greater and get yourself back! This course is a must, by renowned holistic psychiatrist Dr. Kelly Brogan, author of NY Times best seller 'A Mind Of Your Own', a dear friend and trusted colleague I can vouch for personally and support whole heartedly.

Below are some supplies to help you Rock your birthing experience! For more details check a recent blog I specifically devoted to my recommended top 10 must haves for your birth - to make it easier and so much more wonderful.

March 15, 2017

Anne Margolis

Womanhood, Childbirth, Postpartum

The Strength of A Woman

March 15, 2017

Anne Margolis

Womanhood, Childbirth, Postpartum

"Today, along with every day since this day, I am so proud to be a woman and a mom." wrote inspired mama @mikalacatherine. "I had the incredible opportunity and privilege to carry my little boy for almost 41 weeks. But what I am most proud of is the fact that I was able to give birth to him. It's something I think about literally every day. I did it. Women every day do it. It blows my mind because the frequency of births makes it seem common. But let me tell you, it is not common. It is quite literally the worst and best thing I have ever done. Having given birth has made me so proud of all moms because now I know what each and every mom has had to go through with pregnancy, delivery, and postpartum. None are easy. All are important and meaningful. I know I risk seeming conceded with this post, but I am so dang proud of myself for doing it. Some days I am in awe of that fact. So today, I am so proud to be a woman and to stand with other women. With all mommies and caretakers. With all moms whether they have carried their babies physically or in their hearts instead. I am honored."

I honor of the billions of strong women who have found their strength and birthed (majority at home, naturally) since the beginning of time. Billions. Something to remember in labor, to encourage and empower.

I saw the exam table and thought what a great place for warrior - because women are warriors, period - no matter where and how they birthed, whether they had babies or not. In all these years I have met so many amazing women, women who have faced and dealt with a range of serious life challenges, many many women who grow, birth, feed and raise little humans, and those who were unable to even get pregnant or carry their pregnancies. The warrior pose is in honor of all women who find their strength at times when it seems impossible - and those are the women I have been blessed to know and learn from.

Warriors are not born and they are not made…Warriors create themselves through trial and error, mistakes and limitations, pain and suffering, being upside down, wide open and vulnerable – and that is strength. Warriors get up and try again in spite of all of it. “Strength doesn’t come from what you can do. It comes from overcoming the things you thought you couldn’t.” Ashley Greene. We women are stronger than we know, and we find that out when we have too. And once we tap into that power, we birth our babies, we handle the challenges, we birth ourselves...each and every day, with the little hardships and the mountains that seem impossible to climb...until we do.

"Behind every man stands no woman. There is no greater man than the man that can acknowledge the woman standing right next to him." ~ Rachel Wolchin. Women rock! Mothers rock! We are strong because we had to be, wiser because we learned through our powerful experiences, always doing our best with what we know, have and are faced with at the time; we are admirable warriors of honor because we stayed the course, did not give up despite the challenges and struggles, and had the courage to plow forward irregardless of fears. Our blessings are that we have a fan club - the little ones we grow within us, birth, nurture and take care of, who adore us without caring about the mess, the laundry, our to-do lists. They are the little ones we adopt or foster. They are the people we deeply care for who are not our babies. We are beautiful to them no matter how we look or dress; we are perfect to them even when we make mistakes. They want our time and loving attention more than any material gift. I would love women to be treated and to treat themselves like the goddesses they are.

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor
Tap into your inner calm to deeply relax yourself,letting go of busy, stressful and fearful thoughts on demand for the health of baby
Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy
Trust yourself, connect with your body wisdom andcommunicate with baby in belly
Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum
Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

To learn more, visit: LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy.

Educate and inspire yourself, ready your body, ready your mind, ready your heart with my list of TOP BOOKS of every category you can imagine listed - with links on where to get them as books, listen on audio, or read them on kindle. The better prepared we are for a situation, the better the outcome will be. I feel passionate about empowering and educating women to get the most out of their womanhood, pregnancy, birth, postpartum, breastfeeding, mama, yoga and life journeys!

I am excited about this course is by a best selling author whose personal story, insights and life changes after recovery from terminal cancer and a near death experience are beyond inspiring and riveting. Not only is it such a testimony to her strength, I feel it can help moms with many of the physical, emotional and psychological challenges associated with pregnancy, postpartum and beyond, also help all women and the professionals who serve them, and really every human being....to find their strength that is already within them.

March 13, 2017

Anne Margolis

Birth Story, Birth Plan, Midwife, Homebirth

Birth Story: When Things Did Not Go As Planned

March 13, 2017

Anne Margolis

Birth Story, Birth Plan, Midwife, Homebirth

Usually births do not go as planned, and the unexpected happens. I encourage pregnant mamas to actually expect the unexpected, make birth references known and fully prepare for the birth they want, choose their provider and birth team wisely, then be very present, flexible and surrender to and actually embrace whatever happens each moment as meant to be because it did happen (a higher level would be to know it happened for your benefit - but that is a spiritual perspective); I do what I can to help them know that they did their absolute best - there is no judgement, no place for shame and blame, while acknowledging their feelings and telling them it will take time and support to process. Most of the time the unexpected is innocuous and could simply mean you birthed in your bed when you wanted a waterbirth, you told your mom to take your kids out when you previously wanted them there, or you wanted your partner to help catch your baby when he ended up holding you in a standing squat and you told him not to move as baby was crowning. Sometimes it could mean medical intervention was needed in any setting; sometimes, less commonly, it means transfer to the hospital from a freestanding birth center or home, when being there is no longer safe or appropriate because of complications, and sometimes that could even mean surgical birth. This mama @holisticnutritionandme loved her birth and was extremely grateful for her care and the outcome, because she had excellent, personalized, compassionate, sensitive and respectful care and because of her attitude and mindset. She know she did her absolute best and interventions were needed. She writes her beautiful birth story in spite of the challenges. #BirthWithoutFear

"My baby girl, Liliana Dylan, was born on July 5th at 41+2 weeks pregnant, weighing 7lbs 13oz and 21" long. I was in active labour at home for 12+ hours with my midwives, doula, husband (Daniel) and mom. I got through contractions by alternating between using a birth pool, my exercise ball, walking and moving around. Staying still intensified the pain for me. My#midwife broke my water and I reached 6cm dilation. For hours my contractions continued to get longer and stronger but I wasn't dilating further than 6cm. My baby was posterior which made it harder for her to drop and gave me excruciating back pain. My #midwives recommended we transfer to the hospital for an epidural and pitocin due to lack of progression. So Daniel and mom drove me to the hospital while I was on all 4s in the back seat trying to make it through my contractions. Another 19 hours of labour at the hospital and 2 hours of pushing and my baby finally arrived! Although I didn't get the natural home birth I had planned for, I'm so grateful for the way everything turned out. Birth plans are great to have, but ultimately you have to roll with whatever you're served with when the time comes. Getting my baby out safely was always my one and only priority. My midwives and #doula were warriors and cared for me from start to finish. Daniel and mom were my rocks and did everything to make me as comfortable as they could. I couldn't have done it without every member of my birth team. Liliana has been doing great, she nurses like a champion and is the light of my life." What an inspiring #BirthStory and outlook to learn from @holisticnutritionandme. It is also an ideal model of supportive home to hospital transfer for the compassionate use of epidural and needed interventions that enabled mama to have a deeply positive birth experience despite the challenges, despite her #homebirth not proceeding as planned, despite hospital care that became necessary. All#BirthIsBeautiful and #WomenAreAmazing.

I compiled a list of my favorite reads on the journey from birth to birth and postpartum, that also include inspirational books about being in the now and embracing what is - all with links on where to get them. Below is one for LIFE, as most of it does not go as planned and we all inevitably face unexpected challenges. I hope this helps!!

The benefits of cultivating a regular yoga and simple meditation or spiritual practice are huge, when it comes to staying present, calming yourself, and embracing all of life - even when things happen that we do not want. To create your own home sanctuary, a place where you can practice, here are the supplies I use and recommend. Yogaglo.com has wonderful online classes and here are some great prenatal and postnatal yoga classes on my favorite list of movies - when you can not get to a local class.

Enjoy radio shows from some of the world’s greatest teachers in spirituality, health, and wellness. Begin your journey of personal growth and healing now by listening to HayHouseRadio.com – radio for your soul.

March 8, 2017

Anne Margolis

Pregnancy, Womanhood

The Estimated Due Date and Preventing "Being Late"

March 8, 2017

Anne Margolis

Pregnancy, Womanhood

VIDEO CAN BE SEEN HERE.

Most mamas like to count baby's toes and fingers. The amount of creases in the baby's feet are simply one of several signs this healthy baby is "post term", born in the weeks past estimated due date, when this baby was ready to be born. It is one of the assessments we use to calculate the new baby's gestational age (how many weeks baby was in utero). I marvel how this calculation often differs from pregnancy dating. I had a mama in my practice who came to me with her last 4 pregnancies. She told me her first 4 babies were born 4 weeks past her estimated due date, but they were all evaluated as term at birth, without any indications of being "late." Her last 4 babies were also born 4 weeks after her estimated due date, had I calculated it based on the first day of her last period alone; but they actually arrived at just the right time, all evaluated to be term - as I used a variety of other assessments, including past history, cycle characteristics, and when she had intercourse, to get a more accurate dating for her pregnancy.

What is this due date and how can you more accurately help calculate it to prevent false diagnosis of postdates and its associated risks of induction? The estimated due date is just that - an estimate of when mom and baby of a healthy pregnancy will go into labor; it is an estimate of how many weeks old your fetus is at any stage of your pregnancy - which is important to know, as this impacts your maternity care and the well-being of you and your baby. If you go into labor, it would be important to know that your baby is term and there are no issues with the baby's gestational age. For example, if you go into labor at a certain point before your estimated due date, it's important to know if it is too early for your baby to be born, your preterm baby would be at increased risk and need intensive care, so efforts would be made to try to stop it. Likewise, if you are past your given due date, in many modern obstetrical practices, in an attempt to avoid small risk of postdates for babies that increase after 42 weeks, there is a cascade of interventions from frequent testing of fetal well-being to induction when you are not really due or ready to labor yet; this can lead to increased stress, more painful harder labor, anesthesia and other unnecessary interventions that may culminate in an unplanned cesarean birth. Actually, only 5% of women give birth on their due date, even with the most accurately assessed pregnancy dating. I like to use the language due month, as most babies come a few weeks before or after that date - more commonly a week or more after it for first time mamas.

So, when speaking about due dates and postdates, I like to start with education and prevention during preconception, before a women gets pregnant. And even if pregnant, we can still do some detective work and might come up with helpful information that may impact your pregnancy dating. I advise women to know their fascinating bodies and menstrual cycles, to track how often their periods come, when they have signs of ovulation and when they had or did not have intercourse.

With this knowledge, mamas can TAKE CHARGE OF THEIR FERTILITY to either prevent pregnancy, or try to become pregnant, learn when they conceived and even when they are pregnant before a positive pregnancy test. This is one of my favorite books on the subject.

Mamas who know their date of conception, more details about their cycles, and their past pregnancy histories (when they went into labor previously and what the gestational age assessment was of each of their babies), have a much more accurate due date than basing it on first date of last period alone. This is one of many ways mamas can become empowered and proactive.

It also helps to connect with nature, and your connection with it - your body is nature, has its own biological clock, and you might want to look into how it relates to the moon cycles (a very interesting study). It helps to connect with the rest of who you are - your heart, your gut, your spirit, and get out of the busy overthinking, worrying, calculating mind that has become way too dependent on manmade, digital precision of industrialized time, stay present in each precious moment, the only place where life exists, surrender to what you can not control of the natural world anyway, and learn ways to self relax and tap into a state of inner calm (why I love yoga and mindfulness so much). As a midwife, I certainly have other date assessment skills I use, and other suggestions to help each mama on a more personal level, but these are great places mamas can start. But no obstetrical provider or any human, can predict when a mama will go into labor. So one of the great lessons of pregnancy is being ok with not knowing. Might as well enjoy the journey, as this is as real as life gets.

But in today's times, I do feel compelled to debunk some myths. As I indicated above, the due date is not written in stone. It is an estimate around an average time of when mamas go into labor, plus or minus a few weeks on either side. Although I like referring to the 'due month', that has not taken hold in the modern obstetric community, obsessed with measurements. At least we can use it between us and with your extended families, who tend to call you every day after your estimated due date, to find out if you had your baby yet. Yes, now we have ultrasound that, if done in the first trimester by a practitioner with expertise in pregnancy dating, the accuracy of the estimated due date increases a bit. But not all mamas want a sonogram. Again, only about 5% of babies are born on their estimated due dates anyway. And it is often miscalculated, if based alone on the first date of the last menstrual period. That date calculation only applies if a mama’s cycle comes every 28 days, assuming she ovulated day 14, and that still could mean baby could be born on average between 37 and 42 weeks. Healthy term babies can also be born before or after this time frame.

This is my pregnancy dating wheel that has been with me as long as I can remember. Now its online. I like the ones that take cycle length and date of conception into consideration. Most women having regular cycles have variation, with sometimes as much as 21-45 days between them. And that is normal. There are many factors such as stress, illness & travel, that can prolong the time between last period and next ovulation, but once a women ovulates, the next period comes close to 14 days later - unless she conceived shortly before or at ovulation.

As a nurse since 1985 and a midwife for over 20 years, I meet many women who are well informed and know their bodies and histories, and many who are not familiar but are very eager to get empowered and learn more. I have had plenty of women know their exact date of conception from fertility treatments and go into labor weeks before or after their due dates. I have had women who knew exactly when they conceived as they were keeping track, only had intercourse at or before ovulation once as for example they were or partner were busy or not together. And they give birth close to estimated due date. Each mama and story is different. And I have had women not have a clue about their cycles or when they got pregnant. But more often than realized, modern medicine does not know nearly as much as people might expect. Women can empower themselves with some knowledge and they have more wisdom than they think; too much trust is often placed in technology and 'experts' over themselves. I question the value of of having to be so accurate with exact calculations when it comes to healthy women experiencing healthy pregnancies. These are illusions, manmade constructs, industrialized time applied to horticultural biological time that no human can control or predict. This is a fascinating study and discussion if one has an open mind to consider other perspectives, and the more I practice the humbler I become, the more awe I have in a process that has far more wisdom and power than any human being, no matter what their training and background.

Oh the journey of waiting and not knowing when, has been a journey traveled by billions of women since the beginning of time - it's part of the sacred wonder and surprises along the way. Welcome to the Tribe De Mama where we get more and more familiar with nature's own clock, realize there is so much we can not control, and get comfortable with not knowing.

This gorgeous shot of @heidijohnson13 was captured by darling mama's sister @sarahandthewave.

For personal questions and need for individual guidance you can schedule an online consultation with me- this is one of passions and areas of expertise. Many mamas ask to consult with me about their fears of going past their due date, & want to know what they can do, as they don't want to be medically induced & have the barrage of testing which can cause much angst, and the subsequent interventions which increase risk of cesarean. I love helping mamas in person, and now with this global IG community, via Skype or phone conversation. You can also take my unique online ROCK and LOVE YOUR BIRTH course, which basically guides you through your pregnancy to birth and postpartum journey, as I guide the families in my midwifery practice - without the hands on care, to prepare and plan for an experience of their dreams.

Let Me Help You Create The Happiest Birth Experience Of Your Life...

Whether you're a first time or experienced momma,

Or a midwife, doula, or birth professional guiding mommas..

Regardless if you are planning a birth at home, a hospital, a birth center or need a cesarean section, or if you are taking another childbirth education class…

You Really Can Create The Delivery Of Your Dreams.

And have a blissful birth wherever you are.

More Precious Than A Wedding...A Birth Should Be A Celebration!

Let me show you how to…

Understand the sensations of your body and connect your intuition with how your body is communicating and leading you towards what to do during labor
Tap into your inner calm to deeply relax yourself,letting go of busy, stressful and fearful thoughts on demand for the health of baby
Speak your truth from your heart in a way that deepens your relationships, sets clear boundaries, and has people listen to you and support you before, during and after pregnancy
Trust yourself, connect with your body wisdom andcommunicate with baby in belly
Connect with natural time and sync your body and mind up with your unique biological clock for ease from pregnancy to postpartum
Reprogram negative patterns, stories, and beliefs that undermine your confidence, strength and self trust so you can rock your birth

To learn more, visit: LOVE YOUR BIRTH Online Childbirth Course!

It is based on my years of experience, as a midwife and yoga teacher, helping thousands of women tap into their calm and live and birth from a place of grounded relaxation and joy.

Do you need supplements for preconception and pregnancy? Here are some of my favorite I recommend to mamas in my practice.

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