Screening for Gestational Diabetes

Gestational diabetes is rare in the healthy population. Occurring in about 6% of pregnancies, it’s incidence is increasing largely due to the growing obesity, insulin resistance and adult onset diabetes, poor diet and lifestyle habits in the United States. There is much controversy around gestational diabetes, how it is screened for and diagnosed, and whether universal screening improves outcomes as opposed to testing when there are risk factors. If you do have it, however, treatment that includes appropriate actions like maintaining ideal weight, enhancing nutrition and exercise habits does make a significant difference in reducing the serious health consequences for both you and your baby.

In the US, it is standard of care that all women are screened for gestational diabetes at 24-28 weeks of pregnancy, although in some other European countries, only women with risk factors are screened. Screening that is most common involves giving pregnant women a “Glucola” drink that has 50 grams of sugar in the form of dextrose, and then testing blood sugar an hour later. Many holistic providers and the families they serve are concerned about this potentially toxic drink laden with chemicals that may make them feel sick, harm them and their babies, and can be associated with false positives that label them unnecessarily as high risk. This increases stress and angst, leads to more testing, monitoring and potentially other risky interventions. They want alternatives.

While it is within your right to refuse the test, you may want to consider screening for gestational diabetes in another way and discuss your concerns and options with your provider. If your provider is unwilling to work with you on this, consider switching providers to one who will. Although we do not have enough evidence that alternative screens are as accurate as using the more extensively studied Glucola drink to screen for diabetes of pregnancy, alternatives are not to be easily discounted, and may be a viable option in the low-risk healthy population. 

There is an option for screening for gestational diabetes by home testing. This involves checking your fasting blood sugar at home when you wake up in the morning, and then again 1 hour after eating your usual breakfast, lunch and dinner. While approved for monitoring blood sugar once diagnosed with diabetes, this method of screening is less studied and without clear standards. It is also more cumbersome and costly, as you need to get the supplies to do it, then take the time to get it right and keep records to discuss with your provider at your next prenatal visit. 

Alternative Gestational Diabetes Screening Options

Do note that not all sugars are the same and they each have various effects on blood sugar. The Glucola drink is the most studied to screen for diabetes of pregnancy, and the blood test results are based on its ingestion. We are aiming to get as close to it as possible. Follow the instructions below to properly prepare for the test and increase the accuracy, avoid false positives and negatives, as well as improve your tolerance of it.

Starting three days before your appointment, increase complex carbohydrates such as whole grains, sweet potatoes and winter squash.

The meal before the test should only contain protein, vegetables, and unsweetened dairy. A veggie cheese omelet is a great choice! Avoid sweetened foods, fruit, and carbs. If this last meal before the test is lunch or dinner, you can eat a normal breakfast, but avoid carbs or sweets for the rest of the day.

Fresh Start is a new organic alternative that is also said to taste good, with only three ingredients. It has exactly 50-grams of glucose yet is void of unnecessary artificial additives, and is laboratory tested to be virtually equivalent to the Glucola without the unhealthy ingredients. To make your own drink that is most equivalent to Glucola without the chemical additives, dissolve 50 grams of organic dextrose in 8 ounces of water. You will need to do some math. If there are 20 grams of dextrose in 2 Tbsp for example, then you need 5 Tbsp of the powder. You ideally want dextrose, as it is the sugar made from corn that makes up the Glucola drink, and it is most bioidentical to the sugar in your blood called glucose. Therefore, it is the best alternative to screen for gestational diabetes as the standard Glucola drink does, according to the laboratory parameters designed and tested for this purpose.

Another alternative is to drink an equivalent amount of pure corn syrup dissolved in your tea, since the sugar in corn syrup is dextrose. You can find organic non GMO varieties in the health food store, but you still need to do some math, to get 50 grams of sugar total. 

Reputable research indicates that you can instead, eat 28 all natural organic jelly beans or enough that equals 50 grams of sugar, which is studied to be a reliable alternative to the 50 gram glucose beverage. It is not standardized as is the Glucola drink, amounts and types of sugars vary with each product, so you need to do the math and make sure you are eating 50 grams of sugar. The study was relatively small but results can certainly be considered.

Other less ideal options are iced tea, organic Gatorade or a cola drink that has 50 grams of sugar added in the form of added table sugar or dehydrated cane juice (sucrose) - similar to the kind of sugar in jelly beans. They are not a first choice because they are not as extensively researched, the form of sugar is different than dextrose, and thus may have a different effect on your blood sugar levels and test results, designed to screen for diabetes based on your response to dextrose. 

The blood test to screen for gestational diabetes was studied and formulated to test your reaction to ingesting 50 grams of dextrose. Sucrose is made up of 50 % glucose and 50 % fructose. You will need to read ingredients and nutrition labels to use an alternative, an important skill to develop anyway. And you still need to do some math, as the nutrition label might say something like 23 grams of sugar per 8 ounce serving. 

When going for sugars that are not dextrose extracted from corn, you can choose any sugar sweetened drink without added fruit juice. Fruit contains a different type of sugar called fructose that makes the test less accurate as it has a different effect on your blood glucose levels than does dextrose and sucrose. If you can not find or have no time to figure it out and have low risk of gestational diabetes, Snapple 16 oz raspberry peach drink is second choice. Although it is mainly sweetened with sugar (sucrose), it does have a little fruit juice, which again is mostly fructose.

Coconut water is another, but less than ideal option, as it contains sugar in the form of mostly sucrose and glucose, and it does have some fructose as in fruit. ZICO coconut water 16.9 ounces has 20 grams of sugar, so you would need to drink 2 ½ bottles. Honey is another alternative, but it is also not made up of an equivalent sugar - it is sucrose and fructose. Again, you need to read the label. Different honeys have different amounts of sugar per serving size. 

Hopefully there will be more studies on these alternatives, but for now, are listed here to consider with your provider, if for some reason you can not take the dextrose or corn syrup equivalent and you are healthy, with healthy weight and lifestyle, with low risk for diabetes. 

45 minutes before your appointment, eat the jelly beans or drink an amount that equals 50 grams total of sugar, then nothing until the blood test, which will be drawn 1 hour after you consumed the drink or candy.

If you have time, do some form of exercise like taking a brisk walk for 20-30 minutes after drinking, but before the test.

Bring a high protein, whole carbohydrate and healthy fat snack to eat after the test if needed, to keep blood sugar stable. This will help you avoid unpleasant symptoms once your blood sugar drops, like shakiness, lightheadedness, fatigue, anxiety and irritability.

Rest assured, most healthy pregnant women (about 94%) do not have gestational diabetes. A positive screen simply means you need more testing to confirm it or rule it out. And if you do have it, you can learn how to keep your blood sugar normal throughout the rest of your pregnancy and life. 

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

Check out my number one international best selling book Natural Birth Secrets now out in second edition, and in adjunct, my Love Your Birth course, an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!

Suffering with low back or pelvic discomfort? Having common pregnancy aches and pains and need some additional support? Try Bellefit’s prenatal support wear. I am thrilled to announce that you get a $20 Off with code: ANNE20 at checkout - if you purchase here. They also sell excellent postpartum support garments.

I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. 

I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it here. Have a Great Postpartum Recovery (with a little help from Bellefit)!

For those with blood sugar issues, and diabetes, there are things you can do from making changes in your diet and exercise habits, as well as natural remedies to help!!



Postpartum Bleeding: Holistic Prevention Strategies

It is normal to have light bleeding in labor as your cervix dilates and breaks its tiny blood vessels. And as baby emerges from the birth canal there can some local tearing that can cause bleeding. Expect to experience the most bleeding at delivery and postpartum. Most of this bleeding is from where the placenta was located in your uterus. 

At normal vaginal birth and immediate postpartum, it is common to lose up to a half liter of blood. After cesarean birth, one liter of blood loss is the average. After birth, your uterus needs to contract around the major blood vessels that supplied the placenta to close them off and prevent excessive bleeding. 

The first few days, bleeding can be like a heavy period. Then, it tapers to a moderate period, after which it becomes lighter and changes color over several weeks from shades of red, then pink to brown. The body is healing the former placental site, shedding the internal scab there, and extra tissue and blood that was lining your uterus during pregnancy. 

Postpartum hemorrhage usually occurs immediately, or up to the first 24 hours post birth, and remains a major cause of maternal death in the US and around the world. It must be taken seriously. Currently, there is substantial evidence in support of what is termed ‘active management of the third stage of labor,’ to reduce the risk of severe excess postpartum bleeding. It includes the use of:

•  The synthetic hormone oxytocin (referred to as Pitocin in the US) via intravenous or intramuscular injection

• Early cord clamping with waiting 1-3 minutes until baby gets at least most of the cord blood

• Controlled traction on the cord along with counter pressure on the uterus to effect placenta delivery within the first 5-30 minutes after birth

• Uterine massage to make sure it is firmly contracted

• Assessments every 15 minutes for the first two hours. 

The above process, or a similar version, is done routinely in most hospitals, and can certainly be done in out of hospital birth settings. However, the studies that determined these procedures, were based on hospital births in mostly resource poor but also well developed countries. Like all studies, they have their limitations and flaws, some were even considered to be of poor quality according to the esteemed Cochrane Review. Also these interventions are not without side effects and concerns. The American College of Nurse-Midwives support the use of active management of third stage of labor in low resource settings, according to their position statement, although they do admit its benefits are not as clear in the low risk healthy population, and encourage the provider to have a risk benefit discussion with each pregnant family so they can make an informed decision about it. 

Most homebirth and birth center moms and providers are passionate about physiologic birthing, minimal interventions and holistic modalities, do not routinely want an injection of medication, and are more interested in natural alternatives. They trust the incredible wisdom of the normal birthing process, which has worked for thousands of years or we would not have survived as a species. They share a common belief that if it is not broken, don’t fix it, wary of medication and interventions unless absolutely necessary and benefits outweigh risks. They tend to like the alternative, ‘expectant management’ approach, which also entails close observation by the provider, but tends to take longer, allowing for the normal physiologic process to take its course, and for interventions only if needed in select cases. 

After birth, mom and baby are of course carefully assessed, but encouraged to bond skin to skin. There is no rush. Cord clamping is delayed until pulsation has ceased, or after placenta is birthed. Mom and baby are assisted to breastfeed which helps release mama’s own natural oxytocin.

The provider waits and watches for signs that the placenta is naturally separating and then assists mom into an optimal position usually using gravity, and encourages her to use her own bearing down efforts to birth her placenta. The provider may sometimes guide the birthing placenta with gentle traction on the cord, while supporting the uterus, then massages the uterus to make sure it is firm, assesses the bleeding until stable, and assesses and repairs tearing as needed. 

Certainly, if there are certain concerns or risk factors, you may truly benefit from medical prevention and active management.

If there is an actual hemorrhage, make sure your provider is skilled, experienced, and fully equipped to deal with it with at least the commonly used effective medications, IV fluids, suturing material for lacerations needing repair, and hands on care that are usually sufficient to control it successfully. 

However, you can build up a strong blood supply and reduce excess bleeding and its risks with the following suggestions for natural support both in your pregnancy and postpartum.

Prenatal Support

Make sure you get checked and treated for anemia common in pregnancy, that your iron stores (ferritin) are sufficient. 

Eat 3 large servings of wild greens or dark green leafy vegetables every day. They can be made into a salad, lightly sautéed or steamed. Good options are parsley, dandelion, alfalfa, kale, collard greens, comfrey and turnip greens.  For additional support, you can try the following:

NETTLE AND RASPBERRY TEA

Starting in the third trimester, drink 1 cup of this nourishing herbal infusion several times per day. 

1. Combine a handful each of the dried herbs Nettles and Red raspberry leaf with 1 quart boiling water.

2. Steep for at least 4 hours.

3. Strain to a glass mason canning jar.

4. You can add fresh mint leaves, lemon juice, or honey to taste.

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GREEN DRINKS

Drink 1 ounce fresh, frozen, or powdered  wheatgrass juice 1-2 times daily to enrich and build your blood.

Or, try 1 scoop daily of powdered greens in your smoothie, 1-3 Tbsp bottled chlorophyll, or tablets or powders of spirulina and chlorella.

Postpartum

You need to rest in bed, on the couch or an outdoor lounge chair as much as possible for the first 2 weeks to recover.  Make sure you arrange for help in the home during this special time. Limiting activity and increasing rest help the area of open uterine blood vessels where the placenta detached to heal. 

Check the top of your uterus regularly for firmness, and massage it if it feels soft, until it hardens. Postpartum bleeding can be minimized when mothers are taught regular postpartum self massage of the uterus so that it stays firm and contracted around the blood vessels that supplied the placenta. 

Start breastfeeding right away, and every 1 ½ - 3 hours thereafter, especially taking advantage of the times when your baby is awake and alert and eager to suck.  Nursing frequently causes the body to secrete its own natural hormone oxytocin to keep the uterus firm and decrease bleeding.

Urinate frequently to keep the bladder empty so the uterus can contract easier.

You can also take homeopathic caulophyllum 30 or 200 C immediately after delivery, then 3-4 pellets arnica 30C under your tongue every 2-3 hours. Or, try herbal shepherd's purse, 1 dropperful of the tincture three times daily for the first 3-5 days after birth. If you need additional herbal support for heavier or persistent bleeding, you can try a dropperful of Angelica tincture a few times daily. 

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for postpartum bleeding prevention or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

As always, if you need more personal guidance, schedule a consultation with me. 

If bleeding becomes heavier than a heavy period, and you are soaking through two maxi pads an hour for 2 hours, empty your bladder, make sure the top of your uterus is firm and massage it if soft until it becomes hard. If no relief, take 1 tsp shepherd’s purse herbal tincture under your tongue. You can repeat the dose a few times, but if the bleeding becomes heavier, contact your practitioner. 

Do read my Natural Birth Secrets book, to prepare yourself for a healthy, joyful and calm pregnancy and childbirth - NOW OUT IN SECOND EDITION!

For further inspiration, empowerment, and optimal health in pregnancy, birthing and postpartum, please make sure to take my online Love Your Birth course, so you can ROCK your journey wherever and however you plan to give birth.

Photo by Megan Hancock Photography

'Overdue' Baby: What to Do If You’re Past Your Due Date

Although it’s totally normal to have an ‘overdue’ baby, it can be very frustrating. The ideal is to prevent it early on by knowing when you conceived and getting accurate pregnancy dates.

Try to keep busy past your due date by continuing to exercise as tolerated and planning some daily pleasurable activities to keep your morale upbeat and positive.

There is a five week time frame around the estimated due date, when babies are considered term, in which it is normal and most common for moms to go into labor.

In a well-nourished, healthy woman whose pregnancy has been accurately dated, the actual time of delivery often extends 1-2 weeks past the estimated 40-week due date. This is especially true with first-time moms.

Only a small percentage of women give birth on their due date, and most babies are indeed born at the perfect time for them.

A pregnancy is actually “postdates” when it exceeds the 42nd week of gestation. In this case, it’s still best to wait for labor to occur naturally, assuming:

• Your baby is still as active as usual

• The amount of amniotic fluid is adequate

• Your baby has a normal heart rate

• The size of your baby is estimated to be compatible with the characteristics of your pelvis

• You are healthy and there are no other pregnancy complications

Monitoring a Postdate Baby

There is an increased risk of complications associated with postdate pregnancies, mostly related to an aging placenta that ceases to function as well as it did earlier, or to a baby that continues to grow to an exceptionally large size. Therefore, there will be a need to monitor you and your baby more closely after 41 weeks. Rest assured, though, that the majority of postdate babies do just fine.

FETAL MOVEMENT COUNTS

Fetal movement demonstrates adequate nourishment and oxygen from a healthy placenta. A baby will significantly decrease its movement as the condition of the placenta deteriorates. With that in mind, a wonderful way you can monitor the continued well-being of your baby throughout the third trimester is to do daily fetal movement counts. 

Pick a time when your baby is usually most active, often this is after meals, when resting or at night when lying in bed. Make sure you count at least 10 distinct moves in 2 hours. If you notice less, the baby may be sleeping. Try again a little later after drinking 2 large glasses of fruit juice, a cup of coffee and eating a complex carbohydrate and natural sugar meal, such as peanut butter and jelly sandwich on whole grain bread. Lay down after 30-40 minutes and count the number of moves. If baby is not moving after this, or you still feel that the baby is moving less than usual in a 12 hour period, contact your practitioner right away. The baby needs to be evaluated, and if in trouble, will need to be delivered as soon as possible.

IN-OFFICE TESTING

Two tests commonly done in the office to monitor the condition of the placenta and baby’s well-being are the twice weekly NST (non-stress test) and the weekly BPP (biophysical profile sonogram).

The NST uses an external electronic fetal monitor to note the character of the baby’s heart rate and its response to fetal movement. A desired response is a fetal heart rate that varies from beat to beat within the normal range, and increases at least twice when the baby moves, 15 beats per minute for at least 15 seconds within 20 minutes. Out of hospital midwives are asked and can use a fetoscope or doppler to check fetal heart rate and record accelerations manually, but it is less accurate, without a recorded tracing, not the standard of care nor evidence based; it is also not supported by modern medicine, or most of the collaborative obstetricians midwives work with.

The BPP uses ultrasound to examine the fetus and its environment in utero by assessing a variety of parameters including the baby’s movements, muscle tone, the placenta and the amount of amniotic fluid. The ultrasound can also provide estimates on the baby’s growth and weight, but they are only estimates and not always accurate at this late stage of pregnancy. Try to schedule this test during a time the baby is usually active and moving the most. On the day of the test, make sure you are drinking your usual daily 8-10 glasses of water so the baby has plenty of amniotic fluid. 30-40 minutes before the test, make sure to have 2 large glasses of fruit juice and a natural sugar/carbohydrate meal or other foods that usually wake baby up and causes lots of movement. You can even have a cup of coffee or tea just in case the baby is still sleeping after the meal. The test is somewhat dependent on the baby moving, and we would not want a false report of no fetal movement indicative of fetal stress, when the baby was just sleeping healthfully.

Natural Measures to Help Prevent Problems Related to Postdates

These recommendations are especially helpful if you had complications from postdates in prior pregnancies, you are attempting a vaginal birth after a previous cesarean, or you have other complications such as diabetes or high blood pressure and it is not advisable to let the pregnancy extend past term. Research on natural induction methods is sparse, but growing. Sometimes one remedy or a combination of them does the trick, and all is well. Sometimes, no matter what we do, we can not get labor started. Nothing works consistently, including the medications used in hospitals. Ultimately, unless there is a scheduled cesarean birth, when a baby comes into the world is ultimately not in our human control.

KNOW YOUR STATUS

If you are planning a pregnancy, keep an accurate record of your cycle and know the first day of your last menstrual period. Or better yet, the day of conception around the time of ovulation. If there is a question about your dates (if you are breastfeeding, recently miscarried, went off the birth control pill, or have long  or irregular cycles), an early first trimester ultrasound can accurately date your pregnancy. This will prevent a lot of aggravation later on, like unnecessary testing, pressure to deliver and induction based on miscalculated dates.

EAT RIGHT FOR BABY

Maintain a healthy well balanced diet including lots of:

• Organic fresh fruits and vegetables

• Whole grains

• Seeds and seed products like tahina 

• Nuts and nut butters

• Beans

• Organic tofu and tempeh  

• Organic whole eggs

• Turkey or chicken

• Beef, lamb, or wild game

• Wild Alaskan salmon 

• Organic fresh raw whole dairy-ideally goat or sheep

Use healthy fats for cooking, such as organic cold pressed extra virgin olive oil, coconut oil or goat butter. Drink at least 64 ounces of filtered, spring or well water or herbal tea per day, at least 20-30 minutes before meals. Limit intake of fruit juice and refined white flour, sugary products, and refined vegetable oils or partially hydrogenated fat. Aside from being unhealthy and fattening, the refined sugars and starches grow big babies that are harder to push out.

Make sure to eat plenty of dates and pineapples - some swear by them to encourage labor. I am not convinced, but no harm trying.

Prepare Your Mind

Prepare for a deeply positive childbirth experience. It is very important to enter labor and birth with positive feelings, trusting your body and the whole birth process.

It is helpful to write a positive birth vision, what you wish your labor and birth to be like from start to finish, and include the role and involvement of all persons who will be there.

This is something you and your partner can think about and write together. You may write as little or as much as you like, but enjoy thinking about this special time in your life. 

There are a number of methods to help you get ready for the amazing experience to come:

• Childbirth classes

• Hypnosis for birth in adjunct 

• Gentle, Prenatal and Restorative Yoga 

• Breathwork, meditation, and progressive muscle relaxation techniques (yoga nidra)

• Watching positive birth movies

• Listening to inspiring podcasts and birth summits

• Books. Some of my favorites are:

  • Mindful Birthing by Nancy Bardacke

  • Orgasmic Birth by Elizabeth Davis and Debbie Pascale Bonaro

  • Ina May’s Guide to Childbirth by Ina May Gaskin 

  • Baby Catcher by Peggy Vincent 

  • Natural Birth Secrets by me, Anne Margolis! 

Accept and express feelings that might be holding you back, such as anxiety or fear about childbirth or becoming a mother, uncertainty about your changing role as a person or relationship with loved ones, and hesitation about giving up the special attention you’ve enjoyed while being pregnant. Do not hesitate to talk with a close friend, family member, childbirth educator, or therapist, as labor and birth is heavily influenced by your emotions. Often, simply sharing and releasing ambivalent or troubling feelings does wonders to help you open up, let go and give birth. When that does not help, try releasing it from your body with breathwork.

Practice the following thoughts daily while doing slow deep breathing in a quiet meditative space: 

Spend some time saying goodbye to your pregnancy and inviting your baby to come out. Tell yourself that you and your baby are ready for labor and birth to occur. Imagine your uterus contracting. Visualize your cervix softening and opening, and picture your baby descending through the birth canal so you can cradle your beautiful newborn child in your arms. Affirm that you will surrender, let yourself be relaxed and open so that your body will do what it was perfectly designed to do - give birth to a new human being.  

HERBAL SUPPORT

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for labor stimulation support or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

Drink fresh infused Red Raspberry leaf tea regularly. Among its many benefits, it encourages more effective uterine activity and thus an easier birth. It is optimal to make your own by adding a generous handful of the dried herb to 1 quart of water. Let it soak in a glass canning jar for approximately one hour, then strain. You can add honey, fresh mint leaves and/or lemon juice to taste and drink several times per day.

Dr. Christopher’s Birth Prep herbal formulation is designed to cause an increase in toning contractions in late pregnancy and prepare your body for labor and birth. It can be taken during the last 6 weeks of pregnancy under supervision by your provider. The recommended cycle is 1 capsule per day at week 34-36, 2 capsules per day at week 37, 2 capsules twice per day at week 38 onward, until you have your baby.

Make your own wonderful late pregnancy herbal tonic, to be used 37 weeks onward. Combine 1 dropperful each of red raspberry leaf, partridge berry, blue vervain and cramp bark with ¼ dropperful each of wild yam and motherwort in a separate tincture bottle and shake to mix well. Take 1/2 dropperful of the mixture a few times daily. You can double the dose in the last week before your due date. Other reputable herbal brands include Gaia, Wish Garden, Herb Pharm and Eclectic Institute.

You can take Evening Primrose oil capsules, 500 mg daily, as early as 36 weeks to help ripen the cervix. 

At 38 weeks gestation, start inserting 6-8 caps of Evening Primrose oil deep inside your vagina behind the cervix every 8-12 hours if:

• This is your first baby OR

• You have a history of post-term pregnancies

At 41 weeks gestation, start inserting Evening Primrose at the dose above if:

• Your cervix is still not ready for labor as measured by internal exam AND 

• Your bag of waters is intact

You should have a ripe cervix within a few days. At 41 weeks, you can also increase the oral 500 mg dose to three times daily. 

GET IN THE MOOD

As long as your bag of waters is still intact and you do not have a history of premature labor, engage in frequent sexual intercourse, especially after 36 weeks. Semen contains prostaglandins which can help ripen the cervix for labor, and reaching climax can bring on uterine contractions that may stimulate labor if the cervix is ripe and the baby is ready. The same energy that gets baby in, gets baby out, so turn up the sensual and make lots of love.

She is dancing to the music on her phone.

GET MOVING

Likewise, if you do not have a history of preterm labor, engage in regular moderate exercise like brisk walking, cycling, dancing, swimming or low impact aerobics for at least 30 minutes 5 days per week. As you get closer to term, moving around while upright uses gravity to help get the baby in an optimal position for birth, as well as press on the cervix and cause it to ripen and stimulate contractions.

As women get closer to the term, it is common to feel an increased frequency, length and intensity of Braxton Hicks contractions as the uterine muscle warms up for labor. These contractions are felt as occasional lower abdominal menstrual-like cramping in early pregnancy. But, as you get closer to term, you can actually feel your uterus ball up and harden, often from the top on downward before it softens again. They are usually brief, painless and irregular without pattern, increase with activity and resolve with rest. 

If you do not feel such uterine activity beginning at 39 weeks, you can do nipple stimulation every 10 minutes for an hour 3 times per day to stimulate contractions. To do this, roll the end of your nipple between your fingers and compress and pull slightly as a suckling baby would do. Alternately, you can, or use a breast pump, which will come in handy postpartum. 

Natural Ways to Bring on Labor

Only use the below methodologies if you have reached or passed your due date and you have discussed options with your practitioner.

Increase nipple stimulation to every five minutes for 2 hours, 4-5 times per day. It may take several hours, but with a little persistence, this can get labor going. Nipple stimulation causes release of your body’s own oxytocin, the hormone that ripens the cervix and stimulates uterine contractions. Don’t stop until labor is progressing on its own.

Take homeopathic Cimicifuga 30c, 4-5 pellets, alternating with Caulophyllum 30c, 4-5 pellets every hour for 12 hours. Repeat for two days. This gently stimulates your cervix to ripen and labor contractions to begin.

Massage your uterus with Castor oil until you get a contraction, and then repeat every 5 minutes until a labor pattern is established on its own.

If all else fails, you can try drinking Castor oil. This induces labor by stimulating your bowels, so be prepared for the possibility of diarrhea. Take 2 ounces of Castor oil in orange juice every hour for a total of 3 times. Two ounces of vodka, brandy or bourbon can be added to this mixture to loosen you up psychologically if needed. After each drink, go for a walk around your house (staying close to a bathroom!) and then take a hot shower, letting the water flow onto your nipples and persistently massage your belly with some of the Castor oil.

If still no labor, there are other things we can recommend like an enema, gently stretching your cervix open and stripping your membranes (separating the membranes from their attachment to the lower uterine wall), or as a last resort, breaking your water and/or medication if your baby needs to be born without delay.

If you need more personal guidance, schedule a consultation with me. I am happy to help!

Dizziness During Pregnancy

Dizziness during pregnancy can be alarming, but is actually fairly commonplace.

Occasional feelings of lightheadedness or being about to faint without actually fainting is most often related to the pooling of blood in the lower body from circulatory changes, but can also be caused by:

• Pressure of the enlarging uterus on maternal blood vessels

• Warm or overcrowded environments, especially if one is overdressed

• Exposure to toxic agents, including some medications

• Low blood sugar

• Not enough fluids

• Anemia

• Hyperventilation

• Sunstroke

• Eye strain

• Anxiety

How to Avoid Dizziness During Pregnancy

Some amount of dizziness during pregnancy may be unavoidable, but following the suggestions below will likely reduce the frequency and intensity. Try to note any patterns that provoke your dizziness so that you can implement preventative measures.

POSITIONAL DIZZINESS

Avoid sudden positional changes by making gradual adjustments. Avoid prolonged periods of standing by taking periodic rest breaks. Prolonged periods of sitting (for example at work or during travel) should be interrupted by getting up every few hours to stretch and do some moderate form of exercise like marching in place or taking a brisk walk wherever possible.

In later pregnancy, if you feel lightheaded while flat on your back, stick to side-lying positions.

NUTRITIONAL DIZZINESS

Going too long without quality food or drink can cause a person to feel light-headed, but best not to overstuff yourself either. Eat smaller, more frequent meals and light snacks that include:

• Organic fresh fruits and vegetables

• Nuts and nut butters

• Beans

• Seeds

• Organic tofu and tempeh

• Whole eggs

• Whole grains

• Whole raw organic dairy (goat or sheep is best)

• Beef, poultry, wild game, and lamb

• Fish from non-polluted waters (like wild Alaskan salmon)

Remember to drink lots of fluids. Aim for at least 64 ounces per day, between meals, ideally at least 20-30 minutes before or 2 hours after you eat. Opt for filtered spring or well water, or herbal tea. For more details, check out a previous blog on my suggestions on what to eat in pregnancy. 

Make sure you are taking whole food prenatal vitamin and mineral supplements, and herbal iron as advised if your iron levels are low. Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for lightheadedness or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days.

Avoid caffeine, sweetened drinks and heavily processed foods, especially those with lots of sugar and/or refined white flour. Although they can give you a quick “fix,” a quick drop in blood sugar usually follows, resulting in more dizziness. Processed foods that contain certain additives and chemicals, like MSG, also cause dizziness in sensitive individuals.

MEDICATIONS

Avoid medicating yourself without first consulting your healthcare provider. Many medications – even those sold over-the-counter – have a side effect of dizziness.

When Dizziness Occurs

Dizziness during pregnancy most commonly occurs:

• After eating a large meal

• After a long interval without food, drink, or rest

• When eating white flour, refined sugar foods, or fruit without a protein and or fat

• When feeling overheated

• Upon quickly rising from a sitting or lying position

Warm, stuffy or crowded places can cause the sensation of dizziness in pregnancy. If you find yourself in such situations, loosen or remove a layer of clothing and/or get some fresh air and sun by going outside or sitting near an open window. Wearing support stockings may also help.

Try to increase circulation to your head by lying down with your feet elevated. Do this by assuming the yoga position viparita karani or - ‘legs up the wall’, a wide child’s pose, or do any yoga inversion with your head lower than your heart. Modify your exercise or yoga practice as needed, and get out of poses slowly and with care.

If you are at work, try sitting or kneeling down with your head between your knees until the dizziness passes. Splash some cold water on your face and, if available, rub some oil of peppermint, orange, citrus blend or lavender under your nose so you can breathe in the strong refreshing smell. Cup your hands over your nose and mouth for a few minutes as you take some slow deep breaths.

Practice breathwork. Sit in a comfortable position sitting with your back straight or lying down and begin with with simple awareness of your natural breath for a few minutes. Get curious about it as you inhale, as you exhale, and even note the pauses in between.

When ready, take a deep diaphragmatic breath, by inhaling deep into your belly, expanding your ribs and chest. Really stretch the inhale to your fullest capacity. Then take a huge automatic sigh of relief on the exhale, while consciously relaxing all tension. Keep up the deep breathing, and release more with each exhalation.

Send breath and its healing energy up to your head when you exhale. Stay very calm, present, and mindfully focus on all the details of your sensations without a mental story about them, without resisting and fighting with what is, which makes it worse. Practice consciously embracing and even intensifying the sensations, which actually helps alleviate it. See this as an opportunity to train yourself to surrender and relax with discomfort. It is great practice for labor and life.

To help you learn deeper diaphragmatic three tiered breathing, place your hands on your belly, and concentrate on breathing into them.

1. Exhale slowly through your mouth with an audible sigh.

2. Inhale deep into your belly for a count of 4 or 5. Imagine a pump expanding your abdomen and lower back, causing you to inhale, then allows your ribs to expand with air, then your upper chest to rise towards your collarbone and shoulders.

3. For a count of 4 to 5, slowly release your breath through your mouth in the same order as the inhale - from abdomen to ribs then upper chest. Let go and relax more each time you exhale.

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

Play with ratios and see what feels better to you in different situations. First try keeping the length of inhale and exhale the same as explained above. Then try extending the exhale. Inhale deeply into your belly as above, for a count of 3 or 4, then double the exhale to a count of 6 or 8. While breathing in this way, again focus on internal sensations, surrendering and relaxing deeper with each exhalation. Repeat for several cycles for at least a few minutes.  

Practice regularly the form of breathwork that helps you the most. If you need guidance mastering your breathwork or want to learn conscious connected breathing that is sure to increase energy, vitality and well-being, schedule a session with me.

Please call your healthcare provider if you actually pass out, if your dizziness is severe, frequent, or not responsive to these suggestions, or if you feel like the room is spinning or moving. After other more serious conditions are ruled out, consider consulting a professional homeopath for a safe natural remedy specific to your symptoms. For more personalized holistic and comprehensive guidance schedule a consultation with me.

Check out my number one international best selling book Natural Birth Secrets and my Love Your Birth course - an online version of how I have helped thousands in my local practice.

Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!

It is now recommended by midwives, physicians, health care professionals around the globe, and doulas take it for their certification training.

Battling with low back or pelvic discomfort? Having common pregnancy aches and pains and need some additional support? Try Bellefit’s prenatal support wear.

You can check them out and purchase here.

Braxton Hicks and “False Labor”

There is no such thing as “false” labor. The uterus contracts sporadically throughout the entire pregnancy as the uterine muscle cells stretch and prepare for the “real” labor contractions that will open and thin your cervix and push your baby out during childbirth. A better term for these sensations would be “warm-up” labor.

These sporadic contractions or tightening sensations are referred to as Braxton Hicks contractions. They are experienced as occasional lower abdominal menstrual-like cramping in early pregnancy. But, as your pregnancy progresses, you can actually feel your uterus ball up and harden, often from the top on downward before it softens again. 

While not painful, Braxton Hicks can feel like uncomfortable sensations in your abdomen and groin area. They are usually brief and irregular, occurring without any rhythm or pattern. However, they do happen with increasing frequency, length and intensity as your pregnancy advances. This can sometimes make it hard to distinguish them from actual early labor.

To Relieve Discomfort From Braxton Hicks Contractions

Make sure to keep well-hydrated with at least 64 ounces of  filtered, spring or well water daily, ideally between meals, at least 20-30 minutes before or 2 hours after. Lack of fluids can cause the uterus to become irritable and tighten more often.

Frequent Braxton Hicks contractions may also be your body’s message that you are doing too much and need to slow down, so take heed. Braxton Hicks contractions usually subside when you stop what you are doing and change your position, get up and walk around, sit or lie down.

During a contraction, stay mindful and fully aware of whatever is happening in the present moment. Get curious about, and lean into and even embrace your internal sensations without the story. Practice slow deep breathing, while consciously relaxing any tense muscles. Breathe into the most intense sensations you are feeling. This enables you to hone coping techniques for labor, and for life’s challenges!  When you shift your mindset in relation to discomfort and pain, especially when everything is normal (but also when not), miraculous transformation occurs. Start by welcoming it all, and look for the deeper message in your symptoms. Your body is brilliantly wise and has reasons for its behavior. This not only helps lead to relief, but also minimizes suffering, as well as point you in the direction of root causes that you need to address.

Master your breath and concentration by simply being aware of your breathing, doing three-tiered breathing and extended exhale breathing exercises on a regular daily basis. 

Deep abdominal or diaphragmatic breathing is the optimal form of breathing and an effective natural tranquilizer, especially if you do it often. To train yourself in this way of breathing, start getting comfortable in a reclined position or sit up straight. Place your hands on your belly and concentrate on breathing into them. Bring your attention slowly into your body from head to toe, observing and releasing any muscle tension. Be mindful of what you are currently seeing, hearing, smelling, feeling, tasting, and all the sensations of breathing.

Just watch without judgment or attachment. This takes you into the present moment, and is wonderfully relaxing.

Three-tiered, deep diaphragmatic breathing:

1. Exhale slowly through your mouth with an audible sigh.

2. Inhale deep into your belly for a count of 4 or 5.  Imagine a pump expanding your abdomen and lower back which causes you to inhale, then allows your ribs to expand with air, then your upper chest to rise towards your collarbone and shoulders.

3. For a count of 4 to 5, slowly release your breath through your mouth in the same order as the inhale - from abdomen to ribs then upper chest. Let go and relax more each time you exhale.

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

For more guidance and deeper transformation, schedule an online or in-person breathwork session with me.

Visualize what the tightening sensations are doing to “ripen” your cervix as it helps it to soften, come forward, shorten, become thinner, and possibly dilate or open a little in preparation for labor at term. Be reassured that a ripe cervix often responds more readily to actual labor contractions, meaning a shorter and thus easier time getting to the point when you can push your baby out.

If you are bothered by these contractions and nothing seems to help, consider homeopathy specific to your individual symptoms. Homeopathic remedies are safe and amazingly effective in alleviating this sort of cramping during pregnancy. I have had great success with Cimicifuga or Caulophyllum 30 c particular to each person’s unique presentation. You can consult with a classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro. 

Herbs can also help you relax, sleep, lessen the pain, and either discourage your contractions, or encourage them if you are term.  If you are interested in herbs, there are several options to try alone or in combination. Go for high-quality sources like Gaia, Wish Garden or Eclectic Institute, or other professional grade brands I use and recommend like those in my online holistic apothecary.  Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process there. Look in the category for uterine irritability/false labor or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days. See some samples from the apothecary at bottom of this blog.

For persistent irregular uterine cramping that is not associated with labor, make sure you are getting plenty of calcium and magnesium in your diet. Start by eating lots of green leafy and seaweed veggies, ground sesame seeds (tahini), wild caught fish like salmon, almonds, whole grains, and organic yogurt and cheese. Avoid excessive cow dairy intake, coffee and soda, and even spinach, which decreases calcium absorption. You may need additional supplementation. Take at least 400 mg magnesium and 1200 mg calcium daily in 2-3 divided doses, or make your own infusion of nettles and red raspberry leaf tea, using the recipe here.

Also, helpful herbs to reduce cramping are cramp bark, black haw, and wild yam. You can experiment with one of them at a time, or use all together in combination. Take 1 - 5 cc of each tincture every 30 minutes to few hours, depending on how often and intense the cramping is (particularly if it is interfering with your sleep each night in the last several weeks of pregnancy).

Prior to 37 weeks, you need to drink 2 large glasses of water, lie down and contact your midwife or doctor immediately if you experience any of these potential warning signs of premature labor:

• A feeling of your uterus tightening or cramping in a pattern of every 15 minutes 

• Cramping becomes closer, longer and stronger

• Dull lower backache that feels different than usual (not related to position or strain)

• Pressure or fullness in your pelvic area like something is going to fall out

• An increased amount of discharge, fluid or bleeding from your vagina

• Persistent diarrhea or intestinal cramping 

• A sense that something isn’t right

As Things Progress 

Toward the last several days to weeks of pregnancy, Braxton Hicks contractions can be frequent enough to feel like early labor, and can thus lead to frustration and exhaustion, especially if they are keeping you from sleeping. In this case, it is important that you encourage them to go away at night so you can sleep well. Unplug from the computer or smartphone after dark, dim the lights and go to bed early. For more support winding down, take a warm bath with your favorite essential oils, ask your partner to give you a soothing massage with a few drops of lavender in almond oil, read a boring book or watch light drama or a comedy, and drink a glass of warm milk. But if you need something stronger and do not have a history of alcohol addiction, drink a glass of wine or beer, or take 2 shots of whiskey in juice or before going to bed. Or try alcohol free Hops. Sufficient rest is essential to give you the needed strength for the hard work of labor to come.

Common herbs taken alone or in combination, to ease discomfort once you are in early labor are: 

• Motherwort tincture ¼ to ½ dropperful up to every few hours

• Skullcap tincture ¼ to ½ dropperful up to every hour

• St. John’s Wort tincture a dropperful up to every hour 

For sleep, you can try a great mineral combination of  magnesium and calcium in approximately equal amounts like 400 mg each, or doubling the magnesium available in tasty powder form to make a warm drink.

If you are interested in herbs, take 2 capsules of herbal Valerian standardized extract (400-900 mg) or Hops (300-600 mg). Using these herbs together in lower dose combination can be more effective. 

Also, try CBD from hemp oil, several drops under the tongue and repeat every few hours as needed. This is the new rage, as it helps promote sleep without the potential risks of the THC component of cannabis on the developing fetus. Results from anecdotal evidence and preliminary research, although sparse (as is common with most natural remedies in pregnancy), are promising. Make sure it is absolutely pure, and from a reputable source who can recommend proper dosing or from pharmacies licensed to dispense it, as it is largely unregulated. 

During the day, you have the choice of carrying on as usual and letting nature take its course, or encouraging the contractions to develop into a progressive early labor pattern by:

• Taking a long brisk walk alternating with climbing stairs

• Engaging in another sort of upright but gentle exercise activity like dancing - do both slow sensual with your partner, and more upbeat, funky hip hop, belly or African styles. Turn on the music that speaks to you, get lost in it and move like no one is watching.

• Getting romantic and sensual, and having sexual intercourse

• Rolling and pulling on your nipples as a baby would do during breastfeeding 

• Using a breast pump 

Continue these activities until you get regular contractions every 5 minutes lasting at least 45 seconds. In any case, make sure to drink lots of fluids and eat small frequent meals of nourishing food (especially whole grains, nuts, seeds, beans, fresh fruit and vegetables, and healthy protein) as an athlete does who is running a marathon. Do something that you enjoy and/or organize a pleasant change of scenery, express your fears and emotions with your partner, a close friend or family member, and try to surrender to the process.

If you need more personal support and guidance, schedule a consultation with me. Check out my number one international best selling book Natural Birth Secrets and my online course, an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned holistic nurse midwife of over two decades, who helped thousands and has seen everything! 

Photo by Megan Hancock Photography

For extra support in pregnancy and relief of common aches and pains, wear an abdominal binder. Bellefit makes a fine one as pictured above. They also make postpartum support girdles . I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. 

I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected. Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

Have a Great Pregnancy and Postpartum Recovery (with a little help from Bellefit)! You can check them out and purchase here.