Ask any questions that are relevant
Is she certified?
When did she become certified or why is she not?
How many births has she attended?
How many clients does she usually take in a month (any more than 5 clients in a month is a red flag)?
How much will she charge, does she have a sliding scale, what is the payment schedule?
Does the payment change if she is unable to attend or if you end up needing a c-section? If it doesn't work out can you get a refund or find someone else who might work for you?
Does she have other services available like belly casting, placenta encapsulation, photography, breastfeeding services, babysitting, or postpartum services?
Does she have a back up, can you meet them?
Get to know your doula on a personal level
Is she married, if so how long?
Does she have children, how many, how does she feel about her birth experience?
Why did she become a doula?
What is her overall philosopy on birth?
Did she breastfeed, how long, how does she feel about it?
Build a relationship
You should have at least 2 prenatal appointments with your doula. During these appointments you'll probably go over things she'll do to help you along during labor and if complications arise. Also during these times you should begin to get comfortable with her touching you in case massage, hair stroking, or counter pressure are used to comfort you during labor so you can let her know what you do and do not like beforehand and to build the comfortableness with her. If you would like she may have relaxation techniques to practice too which would be helpful so you know you can completely relax in front of her. Personally, I found an included belly casting session really helped me open up and get comfortable with my doula.
If at any point you are not comfortable with your doula: First determine if the issue can be resolved and try to fix it. If you think it is something that will affect your ability to remain comfortable with your doula for future appointments and/or during labor, birth, or postpartum then you should talk to her respectively and tell her you just can't do it; She may know someone else available that you may be comfortable with.
If you are a doula or want to become a doula: The steps also apply to you but from a different standing point. Try to give your client as much information as possible so that the family can feel comfortable with you; like a friend rather than business. Reassure partners that you aren't there to take their place, but rather to help them help the mother or step in when they need a break. Beware them that you can not speak for them, you are not a medical professional, and can not give medical advice; You are simply there to support the family and help comfort the mother.
In the United States, 44% of women who have been raped are under the age of 18, and 80% of women who have been raped are under the age of 30. Every 2 minutes, someone in U.S. is sexually assaulted (http://www.rainn.org/statistics). There is a good chance that you know more than one person that has been affected by rape, molestation, or sexual assault.
I have been a victim of rape, sexual assault and molestation on more than one occasion. Many people know about my story, but what they don't know is the pain and fear that I have experienced. The following is the story of my abuse and eventual recovery.
I fell victim to rape for the first time at the age of 14. I had experienced my first kiss, but I was a virgin. I knew nothing about what was happening to me- it was a very scary experience. It happened in my home with someone I knew. It took me two months to tell my parents what had happened.
Little did I know, that was just the beginning of my hardships. Soon after the rape, I became sexually active. I had no respect for myself, or my body, and everyone knew it. I can't even say how many times I was taken advantage of at parties, even after I said no and tried to walk away. They knew I was damaged, and they knew they could get away with it. Everywhere I went, people were trying to touch me and have sex with me: at work, at school- I could never get away. It was heartbreaking and frustrating. I had such little self-respect that most the time I didn’t even care. Deep down, I knew everything was wrong, but I didn’t know what to do about it, or how to fix it.
The second time I was raped I was 16. I only remember pieces of that night; something was slipped into my drink. From that point on, I had no caring left. I let people abuse me, and I didn't think twice about it.
It wasn't until I met the man who is now my husband that I was shown a different way to live. He taught me to respect myself, and he treated me how a woman should be treated. He respected me and my body. He was the first person to ever say no to me sexually. He knew I was broken, and he wanted to help. This was something that I was not used to. He helped me overcome something that had become a huge part of me.
I thought I was fixed. I thought I was 100% better, but I wasn't. We got married and soon became pregnant with our first son. The thought of my past and the feelings my past brought never crossed my mind in terms of reappearing during pregnancy and labor.
As a society, we forget that birth can be very sexual, and it can be a very hard thing for the women who have had unpleasant sexual encounters to have to experience.
Pregnancy was very scary to me, and I couldn't even think about the birth. I saw a male OB-GYN early in my pregnancy, until it came time for weekly visits and vaginal checks at 32 weeks. I can't even describe how uncomfortable and wrong it felt, even though he didn't do anything wrong. This wasn't my first encounter with a male OB-GYN, and while I had felt the same way with the others, I was pregnant now, and it just sent me over the top. I cried in the car on the way home, and left my OB-GYN to found a group of midwives for the remainder of my pregnancy, labor and birth. At this time in my life I had no idea why I felt that way. I couldn't put two and two together, so I blamed it on other things. Inside, I felt dirty and violated.
Giving birth to my oldest son was the most terrifying thing I have ever done. Having a room full of people staring at my vagina for 4 hours, I felt like an object, not a mother. I never told anyone how I really felt about everything- I put on a happy face and said that it was the best thing that I had ever done. Inside, I was dying, but couldn’t ever put into words or feelings as to why I felt this way. So I pushed it back behind my exterior wall, and went on with life.
Sixteen months later, I got pregnant with our daughter. I saw the same midwives for this pregnancy that I had seen with my son. The feelings and emotions that I had been through seemed to surface again this pregnancy. The vaginal checks, my body changing, hormones running though my body, emotions high, flashbacks of my past- everything was so different, but I had those same feelings. I hated being propped up on the bed like just another pregnant woman. I wasn't just another pregnant woman. I am me. I have been abused, and doing something that is supposed to be natural and no big deal, felt sexual in a bad way to me. Her birth came and it was better than my son, but again, I told everyone it was amazing and the best thing. Inside, I was being to be overwhelmed with all of the feeling and emotions that I wasn’t ready to tackle.
I still hadn’t put everything together. I began to tell myself that everything was normal and that everyone felt this way, even though I never talked to anyone about it. I couldn’t even put into words exactly how I felt. I still can’t.
Another 16 months went by, and I got another positive pregnancy test. I don’t know if it was because we had moved across the country, or if I was finally ready to face my dark demons, but I lost it. I pulled away from everyone and everything, even my husband. The thought of him touching me was repulsive, and I would shutter and shut down. I wouldn’t let him see me undressed and or even kiss me. I became deeply depressed, unlike anything I had been through before.
I had some very scary thoughts during my pregnancy, and I knew I was in trouble. I finally got up the courage to mention it to my midwife. I was about 6 ½ months pregnant at this point. I was terrified to bring it up and I started bawling before I could even mutter the words “I need help”.She listened to every word I said.
After this, I started to work on things. I told my husband what was going on. I finally figured it out- the puzzle clicked in my head that my feelings were from my past. Everything was because of what happened when I was younger. It felt good to finally figure out that I was different. That not everyone goes through this, but that I AM NOT ALONE! I began to read things online and find different people that had gone through what I was going through. Life started to make just a little bit more sense.
For me, the relief and recovery didn’t come right away. I still felt like I did, but I was excited to finally know and understand what was going on with me. I didn’t know when it would go away, if ever. I went on with my day-to-day life, and just had to remind myself every now and again: “I can do this; I figured it out, and I am getting help. It will get easier.”
The day came where I went into labor, and I felt the fear starting to creep up on me. (Birth story) I was determined to make it through, though. I ended up having an accidental unassisted home water birth, and it completely healed me. Being by myself, not on display, focusing 100% on ME and MY BABY. Not having that worry in the back of my mind “Do I look okay down there; are they going to think I am gross?” All of the sexual thoughts that I had with my first two births were gone. I got to feel my little man’s head as it crowned and got to pull him up to my chest and comfort him. It freed me from those negative thoughts, and I couldn’t have asked for anything more. It was a very intimate moment that my husband and I cherish every day.
This is something I have dealt with for the past 11 years, and I was excited to finally feel free and light. I wish I would have figured it out sooner, and I hope that no one has to go through this. Despite my hopes, it will still happen. For those of you that have been or are going through this, please know that you are not alone; there are people here to help. It is hard to talk about, and it is painful, but being healed is the most important thing.
So I am 8 weeks and 1 day pregnant! Our little newbie is still hanging in there and I still definitely feel pregnant. Still insanely excited and very much looking forward to the end of the first trimester when we can feel a little bit safer.
I had an "intake appointment" last week, and the more I think about it, the angrier I get. We have done a lot of research and a lot of talking, and had decided we would decline a lot of the "standard" tests and such. The GD test being one of them. The hard part about this is I am a very non-confrontational person, and my normal attitude literally makes me the perfect submissive and docile patient. I knew that I would have to prepare myself in advance every single time so that I would be able to say no.
I wasn't expecting them to want me to take a GD test before I even saw the doctor.
Because I'm overweight, they insisted upon the chugging of the glucose solution and the drawing of 7 vials of blood before I had ever even seen a doctor. I was not prepared to say no, and submitted. And I am angry. I am angry and humiliated. I am not defective just because I am overweight. I am not sick. I am not necessarily any less healthy than someone who weighs 50 pounds less than I do.
I did not deserve to be treated like I was broken right off the bat; before anyone even bothered to look and see if I was healthy or not. I did not deserve to be talked down to when I expressed some concern about "standard" procedures. Just because I don't think they're necessary doesn't mean that I'm an uneducated idiot who has no understanding of what they're used for or how they're supposed to "help".
I know I already said it, but I am just . . . angry. I'm supposed to actually see the doctor on monday . . . and honestly I don't even want to go. I will . . . but I'm just not ready to put up this kind of crap from the nurses even if the doctor is more respectful.
I am not broken.
So today is 7 weeks and I'm still pregnant! I keep telling myself over and over that we're fine, we're going to be fine this time. I have to, because there's that tiny little voice of worry in the back of my head that's afraid something's going to go wrong. It was just a couple days past six weeks last time that we knew there wouldn't be a baby to hold. So I've been smiling all day knowing that it's 7 weeks and we've made it further along.
We still haven't seen the doctor yet; we are having prenatal care done at a clinic nearby even though we are planning on a UC. We want to have official documentation of the pregnancy so that we don't have any trouble getting a birth certificate after the baby is born. I am seeing the same doctor that I saw during my son's pregnancy. I see her for the first time on September 10th, and I still don't know if I should tell her or not that I plan on giving birth at home, let alone that I plan on doing it unassisted. So the thing I've been struggling most with at this time is deciding exactly what I'm going to say. Plus, to kind of compound the issue, we are not planning on letting them do this first trimester ultrasound or do a pap smear or any internal exams. I don't know how they'll respond to that, or to the fact that I am going to be turning down practically ever test they do as "routine" care because of how unnecessary I feel most of them are. If I felt that I truly needed them, I would ask for them; I have done a lot of work since giving birth to my son learning how to listen to my body and accept that when something just doesn't feel right that there's usually a reason for it. Luckily, my husband trusts me to know what's best for myself and for the newbie; he told me he knows I wouldn't do anything that I thought was bad for either of us, so he's not worried about what I choose to do and he'll support my decisions.
We've been measuring the living room (the largest open floor space we have) and perusing all the options out there for birth pools and such. I'm hoping to have a pool set up and be able to give birth in the water. We've been talking about how I want to turn the living room into a birth cave essentially, and how we're going to block out most of the light to keep it dark and calm. The only heating we have in this house is a wood stove, but thankfully it's right there in the living room, too. So it shouldn't be too hard to keep it nice and warm for baby's arrival; it will probably still be rather cold here in the middle of April.
So there's a lot of thinking we've been doing, but not a whole lot pinned down for sure, yet. I'm slowly re-reading my own collection of birth books, and looking for even more information to devour. I still feel that what we're planning is the best and safest thing for us. No doubt and no fear. I'm working hard on staying healthy so that there will be no reason to change that thought.
Go to Week 8
So, today my little family got the most fantastic news. I am finally pregnant again! After a year and a half of trying, much disappointment, struggle, and one hope that was over as soon as we knew about it, I am 6 weeks pregnant and our darling child is due sometime around the middle of April. With any luck at all, we’ll be able to welcome a healthy babe earthside next spring.
I had been feeling rather tired and a bit sick for several days. I kept having nausea that would come and go, my breasts were a bit tender, and I was using the bathroom rather frequently. It was during this time that my husband and I started thinking I might be pregnant. It felt very familiar to me; it felt very much like the early days of pregnancy with my son. At the same time, we were afraid to really hope for it because we’d already had so much struggle and disappointment. I decided that I would test at the beginning of September.
But then, one morning after my husband had already left for work, I was sitting in the kitchen eating breakfast with my son. Immediately after eating, I ended up making a mad dash for the bathroom and spending about ten minutes being quite sick. So right then I decided if I was pregnant, and pregnant enough to be sick like that, then I was pregnant enough to get a positive on an HPT. Lo and behold, two pink lines! I sat there, just staring at it, simultaneously super happy, and disbelieving that I was finally pregnant again.
This morning, August 23, I went to take an “official” pregnancy test at the doctor’s office, and I have my proof of pregnancy. 6 weeks pregnant with a baby whose supposed to meet us come spring time. We are hoping and planning for a natural birth. A private and intimate unassisted home birth; myself, my husband, our son, and a couple female friends to help me and help us watch our son. We are hoping and planning for this birth to be a healing event for both my husband and for myself. And most of all, we are hoping for a sweet healthy child to add to our family, so there’s that much more love to go around.
Go to: Week 7
Preeclampsia is a serious disease that can occur in pregnancy and the post-partum period. It can range from being very mild to life threatening. The Preeclampsia Foundation reports that 76,000 women die annually as a result of preeclampsia or preeclampsia related conditions. The development of preeclampsia can be very sudden, women have been known not to have any symptoms early in the morning but be extremely sick by evening. Preeclampsia is often one of the true obstetric emergencies warranting either induction or cesarean section. However, milder cases of preeclampsia, especially before 37 weeks can often be monitored rather than having baby delivered early.
The cause of preeclampsia is widely believed to be a reaction between mom and the placenta/baby. It is almost an allergic type reaction which affects placental development. There are some newer studies claiming they may be able to diagnose preeclampsia earlier, before symptoms develop by looking at the placenta and the umbilical cord with ultrasound. Though there have been many proposed theories which have not been ruled out including insufficient blood flow to the uterus (uterine ischemia), excessive maternal inflammatory response to pregnancy, disruption of the balance of hormones that maintain the diameter of the blood vessels, damage to the lining of the blood vessels that keep fluid and protein inside the blood vessels, a calcium deficiency, injury to the blood vessels due to excessive blood flow or pressure, undiagnosed high blood pressure or other preexisting conditions (diabetes, lupus, sickle cell disorder, hyperthyroidism, kidney disorder), the mother’s immune system mistakenly responds as if damage has occurred to the blood vessel, deficiencies of protein, fish oil, vitamin D and other dietary factors, High body mass index (BMI) is linked to the genetic tendency for high blood pressure, diabetes and insulin resistance, and also to the effect of obesity on the inflammatory system, and the hereditary transmission of inherited characteristics among family members (Preeclampsia Foundation
Recently, Ananth Karumanchi, a kidney specialist has identified proteins developed by the placenta of preeclamptic women which harm blood vessels. These proteins are not seen at the same level in non-preeclamptic women. His studies are still in the early stages, but show great hope for early diagnosis and treatment.
The signs and symptoms of preeclampsia are very varied. Many women show no outwards symptoms. Hypertension is the one symptom that is diagnostic for preeclampsia. While some providers set the diagnosis of preeclampsia at 140/90, others have a slightly higher threshold, especially if mother’s pre-pregnancy baselines are higher. A 15 point rise in your bottom measurement (diastolic) or a 30 point rise in your top(systolic) measurement can also signal the development of preeclampsia. Blood tests are often done when preeclampsia is suspected and time allows for it. Protein in your urine (proteinuria) is also needed for a diagnosis of preeclampsia. During your prenatal visits your provider will frequently check your urine for the presence of protein. However, some women will not show any protein in their urine during these checks. A 24 hour urine collection is frequently done as a more definitive test. Some providers have started to use the protein/creatinine ratio for the diagnosis of proteinuria. Other possible signs and symptoms include edema, sudden weight gain, nausea, abdominal pain, shoulder pain, lower back pain, headache, changes in vision, hyperreflexia, and an impending sense of doom. A woman may have all or none of these symptoms.
There seems to be disagreement on whether having a second child within a couple years time or spacing the children out has any effect on the development of preeclampsia. There have been a lot of studies that have shown small decreases in preeclampsia rates such as low dose aspirin therapy prior to pregnancy and in the first trimester, or l-arginine & antioxidant supplementation. These either haven't been replicated, have such small gains, or have other possible side effects that they currently aren’t recommended. Calcium has been identified as providing pregnant women with the ability to lower their blood pressure during pregnancy, though this hasn’t translated into a decrease in preeclampsia rates overall.
Recently there was a novel therapy in which they gave the mom a dialysis type treatment. They were able to delay delivery in almost all of the severely preeclamptic women who participated. This was an extremely, extremely small trial of 7 or 8 women. It has shown the most hope out of any therapy to date. Currently the only 'cure' is delivering the baby, though just as many women develop preeclampsia after delivery as before. Many providers mistakenly believe that once baby is out mom is out of danger, however nearly 80% of the women who die from preeclampsia die after the baby has been born. Preeclampsia has been known to develop as late as 6 weeks post partum, which is why post partum care remains as important as prenatal care.
Author’s Note: Brewer’s Diet
is often purported to decrease the occurrence of preeclampsia. However, none of the well designed studies which have looked at Brewer’s diet have proven to statistically reduce the rate of preeclampsia. I personally believe that it may alleviate some symptoms which mimic preeclampsia, however it will not prevent or cure true preeclampsia, and may actually be harmful in these cases as extra protein will tax a woman’s already damaged kidneys.
References & Further Reading
Maternal and fetal circulation in preeclampsia. Pediatric Research , 66(4):411-5.
Conde-Agudelo A, R. R. (2011). Supplementation with vitamins C and E during pregnancy for the prevention of preeclampsia and other adverse maternal and perinatal outcomes: a systematic review and metaanalysis. American Journal of Obstetrics and Gynecology , 204(6):503.e1-12.
Conde-Agudelo A, R.-B. A.-G. (2007). Effects of birth spacing on maternal health: a systematic review. American Journal of Obstetrics and Gynecology , 297-309.
Hofmeyr GJ, R. A. (2003). Calcium supplementation to prevent pre-eclampsia--a systematic review. South African Medical Journal , 244-8.
Hofmeyr GJ, R. A. (2003). Calcium supplementation to prevent pre-eclampsia--a systematic review. South African Medical Journal , 244-8.
Isabella Neri, F. M. (2010). l-Arginine supplementation in women with chronic hypertension: impact on blood pressure and maternal and neonatal complications. Journal of Maternal-Fetal and Neonatal Medicine , 23(12): 1456-1460.
Kuklina, E. e. (2009). Hypertensive Disoders and Severe Obstetric Morbidity in the United States. Obstetrics and Gynecology , 113:1299-306.
Levine RJ, H. J. (1997). Trial of calcium to prevent preeclampsia. New England Journal of Medicine , 337(2):69-76.
Mikolajczyk RT, Z. J. (2008). Effects of interpregnancy interval on blood pressure in consecutive pregnancies. American Journal of Epidemeology , 422-6.
Pilot study suggests new approach to treat preeclampsia. (2011, August 2). Retrieved March 19, 2012, from Science Codex: http://www.sciencecodex.com/pilot_study_suggests_new_approach_to_treat_preeclampsia
Preeclampsia Foundation. (2011, July 3). Evaluating L-arginine Supplementation: could it benefit your pregnancy. Retrieved March 19, 2012, from Preeclampsia Foundation: http://preeclampsia.org/component/lyftenbloggie/2011/07/03/92-l-arginine-supplementation-the-new-research
Preeclampsia Foundation. (2010). Preeclampsia: A Decade of Perspective. Melbourne, FL: Preeclampsia Foundation.
Preeclampsia Foundation. (2012). Signs and Symtomes . Retrieved March 19, 2012, from Preeclamspsia Foundation: http://preeclampsia.org/health-information/signs-and-symptoms
Preeclamspsia Foundation. (2012). Faqs. Retrieved March 19, 2012, from Preeclamspia Foundation: http://preeclampsia.org/health-information/faq
If there's one thing you take away from this post, I want it to be this: Inform yourself before you make ANY choices about pregnancy, labor, birth, newborn care, and parenting. I consider myself an educated, open-minded and somewhat enlightened person. I'm 29, in grad school, I don't think people who occasionally smoke pot are criminals, and I believe from experience and research in the powers of eastern medicine such as acupuncture and herbals. This belief about my sense of well-informed self was challenged last year during my pregnancy with DS#2 when I discovered a Facebook page called BirthWithout Fear. The woman who ran it spoke of this process of procreation and all things related in a way I had never been exposed to. Her philosophy is simple, you have the duty to yourself and your baby to educate yourself about the process and make the right choice for you. When we learn about the natural processes of birth and view it accordingly, it no longer is something to be feared. The mainstream media and medical community have painted an alarming picture: that pregnancy and birth are a condition to be monitored, managed, and controlled.
I was stunned. As I began reading, I discovered all sorts of stories, blogs, and scientific research, all of which stressed the importance of a need for us to return to a more hands off way of handling things. Delayed cord clamping, prenatal testing, circumcision, pain relief during labor, home birth: all of these things I either hadn't given a second thought to, or I didn't know existed. Thankfully the circumcision thing was never an issue because DH isn't so he didn't see why the kids should be. I was grateful because later I discovered two great articles. One article illustrates how if a newborn loses 2.3 ounces of blood, they have dropped below the percentage necessary to sustain life. This amount of blood loss would not be noticed until it was too late if the baby is wearing a diaper. Another article clearly illustrated how babies do feel pain and that the pain of circumcision is in fact excruciating and can be seen as a traumatic experience during a critical period in a neonate.
I soaked up all this information, determined to have a more positive experience of this second labor and delivery. With Otto, I had an epidural, an OB who didn't respect any of my wishes, ripped him out of me with the vacuum resulting in me tearing hole to hole (the nerve damage is so severe that I have a prescription for Lidocaine jelly for when I have sex,) shooting me full of Nubain and a slew of "calm that woman down" IV meds, --all without consent from or even consulting me. Luckily all ended "well" and I didn't have any troubles breastfeeding, or any attachment issues that are common in a medically managed disaster like this. That being said, I didn't get to hold DS#1 for over an hour after he was born because it took them that long to stitch me up. I found support from this page and women who supported each other, who empowered me to make decisions that would lead to a much more positive experience.
Ultimately, I broke down and asked for the epidural (but knew enough to ask for the lowest dose of Fentanyl so I could still actually feel my legs), but had I been allowed more time to educate my DH and get a "birth team" together, I wouldn't have needed it. I woke up at 6am, and he was born at 11:54 after only 20 minutes of pushing. I was alert, not in horrible pain, and was able to hold my baby within 3 minutes of him being born.
Does labor hurt? Yeah it freaking does, it hurts like a *#!*#(@!! But if you are informed about your options, and stand up for your choices, you can and will get through it, and likely have a wonderful experience. Is it terrifying not knowing what to expect? Sure. But if you take a great birthing class like Bradley classes or Hypnobirthing, you will go into the experience gunsblazing and ready to rock it.
I served as a doula for a friend of mine who had a home birth in January. No drugs, no doctors. Two midwives, her husband, me and her chiropractor. We all worked in harmony to help support her and she said that even though she would have asked for the epidural had she been in the hospital, she was thankful that she was at home so it wasn't an option. She said this only an hour after screaming at us to just get him out and being absolutely convinced she was going to die because it was such an intense experience. She was glowing, happy, peaceful, and both her and her baby are doing great. This article is my reflection on my experience as an unofficial doula for my friend, in which I share my own thoughts and feelings about having a third birth.
The next 9 months or so will be an emotional roller coaster. You'll be exhausted, your partner will annoy the hell out of you more than you ever thought he could. You'll be uncomfortable, then you'll get to 37 weeks and then you'll get REALLY uncomfortable. You will experience a wide range of emotions and changes. Once the baby is born, you may not be super happy with puppy dogs and lollipops dancing in your head. You may be an emotional wreck after the baby is born, and things may get REALLY tough with the partner. You may feel lost and alone. Conversely, you may be happy and not have a tough time. It's ALL normal. The emotional issues are the result of the surge of hormones during the first and third trimesters, and then the result of the dramatic change in hormone levels after birth. It takes time for your body and brain to recover. Surround yourself with supportive people. Reach out and ask for help, whether it's with chores, clipping your toenails, or talking and venting to someone. This process should bring women together to support one another, you'd be surprised at how many mamas are out there that don't even know you but want to share what they can so you can get through this easier then they may have.
Get joining FB pages: Birth Without Fear, Mamas and Babies, Made to Birth, Mama Birth, Breastfeeding Arts, (many of them have personal blogs too,) and read, read, read! Also, check out my articles on The Birthing Site aimed at helping women who are choosing to birth in the hospital make the best choices for their babies and themselves.
(Stepping down from the soapbox)
I will always be honest about my experiences; did you know you could get varicose veins in your vagina and they have this crazy support thing that is supposed to help with the pain associated with them?? Imagine my surprise when I thought I had a hernia because my vagina was all cottage cheesy feeling when I was 34 weeks pregnant with DS#2 and swollen in a way I hadn't seen since DS#1 was born. I'll never try to coerce you into choosing a natural birth at home (though I do think it is the safest way to go if you do it responsibly.) Your choices are your own, just inform yourself as much as you can and stand up for your choices.
This week, I attended a consultant appointment at my hospital, in preparation for my impending elective c-section. Despite the lengthy journey and even lengthier waiting time, I'm really glad that we had this appointment. It was an important opportunity for me to speak to my consultant before the surgery and to ease my worries a little.
My consultant checked my blood pressure (all fine) and listened to the baby's heart-beat- this was lovely as my son was absolutely delighted to hear the baby inside mummy's tummy! My consultant also confirmed that the baby is now head down, rather than in the breech position as has been the case for the last few appointments. This would explain the pressure I've been feeling low down!
Before the appointment, I wrote a few questions down so that I wouldn't forget to ask them at the hospital:
1. Will the surgeon cut along one of the two existing c-section scars or make a new one?
I've been told that the surgeon will try his best to keep as close to one of the scars as possible but they are not able to guarantee a third scar will not be made. On the other hand, there is a chance that they will 'tidy up' the scar area and leave me with just one scar. It will all depend on the surgeon who performs the operation and other factors that cannot be foreseen.
2. Are there increased risks for me, with this being my third section?
I have added risks with existing scar tissue which could result in excessive blood loss and the need for a transfusion. There could also be damage to my bowel, bladder and womb. The risks are small but they are there and I was required to sign a consent form to agree that I have been told and that I understand the risks.
3. Will I be awake during the surgery?
Yes, yes, yes! General Anaesthetic is, thankfully, only used in extreme cases. I do not want to miss the birth of this baby, as was the case with my son.
4. Will I be given pain relief on discharge if I am breastfeeding?
I explained that the hospital where my son was delivered refused to send me home with pain relief because I was breastfeeding. The agony I experienced contributed to the distress I was already suffering due to the nature of his delivery and I was not willing to go through the same again. My consultant confirmed that I would be given pain relief and to ask for him personally if it is refused!
5. Can I request a 'natural c-section' if circumstances allow it?
I have recently been told about the possibility of a natural c-section and it seems to be the closest to a vaginal delivery that I will ever experience. The idea is to allow the surgeon to make the necessary incisions and remove the baby's head before the screen is lowered. My husband and I can then watch the rest of the baby being born, discover the gender and have immediate skin to skin contact. I have never had skin to skin straight away and am hoping that the elective section will allow for this. I would also like delayed cord clamping for this reason.
Unfortunately, as my consultant will not be performing the surgery he was unable to answer this question. I am to return to the hospital in just over a week for the final pre-op clinic and perhaps I will find out who will be delivering my baby then.
During the appointment, I was require to give swabs for MRSA testing and will receive the results at the pre-op clinic. I found this a little uncomfortable as one of the swabs was taken from the perineum but I knew that it was important. The baby once more measured slightly small for dates, but as both my son and daughter also measured small and we have already had a growth scan which confirmed all is well, we were not concerned. All in all, we are fit and healthy!
All that is left now is to finish the decorating, find a double buggy and set up the new bed. There are now only 12 days left until we meet the baby- how exciting!
At 37 weeks, your pregnancy is officially classed as full term- well done! There could, however, still be up to five more weeks to go, so it's important to continue sticking to a healthy diet and to get plenty of rest. Your baby is still busy in there!
Your Baby's Growth:
This week, your baby weighs around 2.8kg and measures up to 48.6cm in length. It's most likely that your baby's head is now firmly positioned in the pelvis, ready for delivery. This position is also optimum for the essential leg and buttock growth that is now taking place.
Your baby is likely to have a full head of hair by now and general growth is beginning to slow down. Now, your baby is beginning to practise for 'life on the outside' with new techniques such as breathing, sucking and sleeping being perfected.
When you see your care provider this week, they may do an internal exam to see how you are progressing as labour can begin anytime now. This exam is not comfortable but your practitioner will check three things: dilation (how open your cervix is), ripeness (how soft your cervix is) and effacement (how thin your cervix is). For baby to come on out, the cervix must be open to 10 centimeters, as soft as the skin on the inside of your mouth and 100 percent effaced.
After the exam, you may have a brownish spotting which is normal but if you notice any bright red discharge or consistent spotting, call your care provider immediately. Also, as you get closer to giving birth, you may find an increase in gooey discharge in the last few weeks.
You may find that you are feeling more tired this week- and it's no surprise considering the extra weight and low position of the baby! Make the most of your free time- get plenty of gentle exercise (walking or swimming) but make sure you get lots of rest too. You may also experience Braxton Hicks contractions. These are the body's natural way of preparing for the real thing and should not be too painful. Try taking a warm bath to ease any discomfort. If you're concerned about whether or not they are the real thing, Braxton Hicks tend to ease away in warm water.
Now is also the time when you may be going through a cleaning mode as you are preparing for the baby by nesting. You may find the urge to clean the house, organize closets and prepare last minute details before your baby comes. These are all natural but be weary of tiring yourself out too much.
From the Eyes of a TBS Mama...
This week, I am feeling very tired, which doesn't help when the toddler decides to get up extra early! I'm feeling the strain of lifting and carrying him in my back now so am I trying to limit the number of times I give in! My bump definitely feels a lot lower this week and a visit with my consultant has confirmed that the baby is finally head down- so this explains a lot!
Emotionally, I am beginning to worry about small things, such as will I find a suitable double buggy and will my co-sleeping cot be delivered in time? I'm also trying to prepare the toddler for the new baby as much as I can but I think it will still be a bit of a shock for him. My husband and I are taking about the baby a lot and he got to hear the heartbeat at the hospital this week, which is good.
In the meantime, I will leave you with a line from one of my favourite songs by Bob Dylan. This is something that I have been thinking about a lot lately, for both my children and the precious baby I am soon to meet!
May you grow up to be righteous
May you grow up to be true
May you always know the truth
And see the lights surrounding you
Got back to Week 36
Go ahead to Week 38
Your Baby's Growth:
At 36 weeks, your baby is continuing to gain weight at a rate of around 28g a day. Your baby can weigh almost 2.7kg (6 lbs) and measure 47cm long. No wonder you feel tired!
Another sensation at this time may be that it feels as though your belly is dropping. This is because the baby is settling down for delivery and this is often called engaging. You may feel that you have more room to breath and eat now as your organs become less squashed! One draw back to the baby engaging is that it may feel uncomfortable to walk at this stage. But rest assured that by the end of the week your pregnancy is classed as full term and the end is in sight!
By this point, your baby has fully hardened bones and developed organs and strengthening muscles. Wait til you feel that clenching power! Now your baby is also shedding most of the thin layer of hair similar to down, that covered her body as well as the vernix caseosa, the waxy substance that covered and protected her skin while in the womb.
From the Eyes of a TBS Mama...
This week I am feeling more and more tired. It doesn't help that my youngest son is not sleeping well due to a cold and I am feeling more uncomfortable in bed. I have also seen a return to the morning sickness, strangely enough, which is obviously a drag too.
On the up side, there is now only 18 days until my planned c-section date and I am looking forward to meeting my baby! My nesting instincts have well and truly kicked in this week and I have to stop myself from doing too much whilst my husband is at work.
I have an appointment with my consultant next week to find out whether or not the baby is still breech (I believe that to be the case as I am still feeling painful kicks very low) and to discuss the surgery. I have a few questions I want to ask with regards to the actual surgery, pain relief and other things. I'm going to write them down because my memory seems to be quite poor these days!
I will leave you this week with a quote from one of my favourite songs by an artist called Ben Folds. It's taken from a song called Gracie, where he sings about the birth of his beautiful daughter:
"You can't fool me, I saw you when you came out,
You got your momma's taste but you got my mouth."
This is particularly relevant to my husband and I this week as we have been discussing who the baby might look like!
Got back to Week 35
Go ahead to Week 37