There Are No Rules

With my current pregnancy coming to an end soon (theoretically), I’ve been learning a lot about birth. I thought I already knew a lot, but I’m finding that there’s an infinite amount to be learned in the subject. One thing that I’ve discovered and am trying to embrace recently, is that when it comes to birthing, there really are no rules.

Women are told by many sources about how things go during “labor.” There is an order to things, or a general order, and a lot of rules about what will happen. But the truth is, none of it is actually set in stone.

 

Here are seven common myths about birth:

 

Myth: A woman’s water will break before she goes into labor.

Reality: Many women experience their bag of waters rupturing well into birthing time. Some babies are even born with the sac still intact. Other women may have amniotic fluid leaks earlier in pregnancy, or multiple episodes of their “water breaking” throughout their birthing process. And yes, for some women, their water breaking is the way that their body begins birthing.

Myth: Women must dilate to 10 CM before they can have their babies.

Reality: Every woman’s body is different, and while 10 CM is the “standard” measurement for full dilation, some women’s bodies may dilate slightly less or more. And, since birth professionals don’t exactly use a measuring stick, even the process of measuring dilation is basically a guess, which can vary greatly based on the practitioner’s perspective. The only real rule here is that all women giving birth vaginally will dilate enough to pass their baby through the cervix.

Myth: Birthing women dilate at a steady pace, so dilation is very important to gauge where a women is in her birthing process.

Reality: Some women may be 1 CM dilated for a long time, then become fully dilated within a short amount of time. Other women may reach 6 CM quickly, but take longer to complete. Some women walk around for weeks being a few centimeters dilated, before they really begin their birthing time in earnest. It’s also possible (I know from experience!) to dilate, even to almost complete, and then regress and close back up significantly. So checking dilation during pregnancy or birth is really quite useless, as this information does not tell us when a woman will give birth.

Myth: All women experience a bloody show, and this is a sign that birthing will soon begin.

Reality: Some women pass their mucous plug and/or some blood during birthing time, and some women never notice this phenomenon at all. Other women have a bloody show hours, days, or weeks before birthing. Still others may notice they pass some blood and mucus several times before and during birthing.

Myth: Babies are not ready to be born before exactly 37 weeks, and are “overdue” if they’re not born by their “due date” at 40 weeks.

Reality: Babies can’t tell time or read calendars. They don’t have tiny invisible in-the-womb iPhones to notify them when it’s time for their birth appointment. According to our labels, babies may be born pre-term, early-term, full-term, late-term, or post-term; but none of these labels will tell us if a particular baby is healthy or not. Some babies truly are ready around 36 weeks. Other babies truly aren’t ready until after 42 weeks. Most babies are ready somewhere between 37 and 42, but most is not all. And, it is very important to realize that our pregnancy dating system relies on the assumption that every single woman in the world ovulates on exactly day 14 of her cycle, which is quite false. So when a baby is born before 37 weeks, it warrants taking precautions, but it does not warrant panic or automatic assumptions that the baby needs special care. And when a baby is not born by 42 weeks, it warrants more patience and birth encouragement techniques, but not necessarily medical induction. (Induction before 42 weeks is even less evidence-based.) There are exceptions, but most babies will be born at the right time for them, if allowed to do so.

Myth: Birth begins and progresses in a clear pattern.

Reality: For some women, there may be an easily identifiable “early birthing time,” followed by a more active birthing time, and culminating in pushing and the actual birth. For these women, pressure waves (“contractions”) begin fairly mildly and about 15-20 minutes apart, and continue to grow stronger, longer, and closer together until they reach transformation (“transition”), when they are very close together and strong. This process may take 8-12 hours or so. Other women may have a longer early birthing time, lasting 24 hours or more, before active birthing time begins. But for still other women, there may be a very long, unpredictable period of “warm-up,” “pre-birthing,” and/or prodromal birthing waves, which lasts days or weeks, before leading into true early birthing time or even straight into a more active birthing time. (Prodromal birthing tends to feel and like the real deal, but then it stops). This is what I’m currently experiencing. And yes, I feel like a car that keeps stalling out. So for some women, like me, birth doesn’t begin in an obvious way, but rather a very slow and ambiguous way. And even after birthing begins, it doesn’t always continue to progress smoothly. Some women experience starts and stops in their birthing process. Others never have a rhythmic pattern of pressure waves at all, instead experiencing sporadic waves that nonetheless work to bring baby out. This is why timing pressure waves periodically can be somewhat helpful for many women, but confusing and discouraging for others. Seeing a pattern may bring false hope that birthing time has started, while not seeing a pattern may be needlessly discouraging. Ultimately, birth happens in its own way on its own time.

Myth: Birth is always painful.

Reality: While many women do experience pain during birthing, it is not actually necessary and certainly not a rule. Many women have used Supernatural Childbirth, childbirth hypnosis programs such as Hypnobabies, simply a positive mindset, or yes, even drugs, to eliminate pain during birthing. (It should be noted that pain medications for birthing are not without risks and side effects, nor are they always effective). Not only that, but some women simply experience birth much more comfortably than others, perhaps because of unique biological, psychological, or cultural reasons. There are even many women who have experienced orgasmic birth (yes, you read that right!) The belief that birth is excruciating is one of the very reasons why so many women experience it that way. But it doesn’t have to be so! Birth can be an easy, comfortable, and enjoyable experience; much of this is in our mindset, and much of it is in the tools that we choose to use.

 

When it comes to the institution of birth, particularly in our country, there are so many other myths that have been perpetuated as well. But, that’s a topic for another post. For now, I will simply end with this: birth is a mysterious process. We can’t control it, predict it, or put it in a box, no matter how hard we try. Our best bet is to respect the birth process for each individual woman and baby, trust in our natural abilities to birth as women, and do our best to keep moms and babies safe when issues do arise (without looking for or making issues where there really aren’t any).

In birth, there are no rules, only guesses. That just might be why it’s such a fascinating and miraculous–and, yes, sometimes frustrating–thing. Fortunately, no matter what path a birthing takes, the end result of a precious and beautiful newborn baby is worth every moment of uncertainty.

The In Between

For the past few weeks, I’ve been anticipating my baby’s birth eagerly. Even though I’m only 38 ½ weeks pregnant now, I’ve been feeling hopeful that baby will come soon. Since about 36 weeks I’ve been experiencing a lot of warm-up pressure waves (braxton hicks), which have very gradually become more intense, long, and frequent. At this point, I’ve been having pressure waves that feel more like true birthing waves (labor contractions) for about a week, many of which last a minute or longer, and often they come as close as 5-10 minutes together for a decent period of time. But, unlike baby-bringing waves, these waves don’t come in as clear of a pattern and they eventually stop. Each time, I feel excited and begin wondering if today is the day, only to feel discouraged once again when the waves stop, and I have to “start all over” some unknown time in the future. It’s really emotionally draining, as I’ve said before!

In my last post, I wrote about distinguishing between warm-up pressure waves and true birthing waves, which signify early birthing time. But since then, I have discovered yet another phase of birthing that some women experience, called “prodromal labor.” In Hypnobabies, we don’t use the word “labor,” which has a negative connotation, so I will refer to this as prodromal birthing time.

In prodromal birthing time, women experience birthing waves that are nearly as strong, or as strong as, true birthing waves. They may be somewhat sporadic or very rhythmic, but they come more frequently than warm-up waves. They are similar in length to true birthing waves, lasting somewhere around 60 seconds. Because they feel the same as early birthing waves, many moms may believe they are beginning their early birthing time when they experience prodromal birthing waves. But prodromal birthing waves eventually stop, and they tend to not dilate the cervix, or only up to a few centimeters at most. One common distinction between warm-up waves and prodromal waves, that does not apply to Hypno-moms, is that prodromal waves are supposedly painful, whereas warm-up waves are not. For Hypno-moms, who often don’t experience any type of pressure waves as painful, this would not apply; however, there is a certain level of intensity that changes between warm-up and prodromal waves. Prodromal waves are for all intents and purposes true birthing waves… they just don’t bring a baby.

Both warm-up pressure waves and prodromal birthing waves have been labeled “false labor” by the birth community. However, this term is not only discouraging for moms, but a misnomer. While both of these types of pressure waves don’t directly bring a baby, they are still very real, and many birth professionals believe that they work to accomplish things in the mom’s body, particularly softening the cervix and toning the uterus for birth.

Based on what I’ve learned about this phenomenon, I now believe that this is what I’ve been experiencing for the past week or so. I can share that prodromal birthing waves are exhausting, both physically and emotionally. It’s as if I start my early birthing time over and over again, day after day (or night after night), only to find that I’m not in my birthing time after all. It can feel very defeating, frustrating, and monotonous. And unfortunately, prodromal birthing can last for days or even weeks before those waves continue to progress and finally bring a baby. Looking back, I now think that my week-long early birthing time with my son was actually a week of prodromal birthing. There were two or three nights I can remember before he was born that were very intense, at the level of active birthing time, but then were followed by a step back the next morning. I don’t know if this birth will take the same path or not, but so far, my progress towards my true early birthing time has been similarly slow.

These “false starts” are frustrating and challenging, but knowing that what I’m experiencing has a name, and that others experience it too, is helpful. While prodromal birthing is not something all moms or even most experience, it is part of the process for some. And I don’t like it, not at all. Both last time and this time, it has brought me to what has felt like the end of my emotional and mental rope. Some days, I feel that this baby will never come, and I feel depressed and hopeless. (Yes, I realize that may seem dramatic, but I’m pregnant, okay?) Other days, I find myself more at peace with the situation, and I have patience knowing that one of these days, it will be the day.

*A note to non-pregnant people: It is not helpful to tell a full-term pregnant mom who is feeling frustrated that her baby hasn’t come yet, that she shouldn’t feel discouraged or that she should be more patient. Her feelings are valid. If anything, just remind her that her baby will come, at the perfect time, and tell her you’re hoping right along with her that it’s soon. 😉

For those other moms out there who experience prodromal birthing waves as a part of their birth process, I want to offer encouragement. It will not last forever. Baby will come, and you soon will be able to look back on this experience as something in the past, just one of the stages in your unique birthing. This, too, shall pass. And when it does, you will have a baby. 🙂

The Pressure Wave Puzzle

Near the end of pregnancy, it can be hard to tell the difference between Braxton Hicks contractions (which I will refer to from now on as warm-up pressure waves), and true labor contractions (birthing waves). Pregnancy books, and pretty much anywhere you can look it up on the internet, often make it seem like the onset of early birthing time is a clear-cut stage of the process. But the reality is that for many women, the beginning of birthing time can be hard to pinpoint, because the transition between warm-up waves and true birthing waves is a slow progression. For me, personally, it’s a very frustrating, discouraging, and emotionally draining time of pregnancy.

That being said, there are certain ways to distinguish between warm-up waves and true birthing waves, which hold true for most women.

 

Signs that Pressure Waves are True Birthing Waves:

  1. How hard is the belly? Most of the time, pregnant bellies feel similar to a puffed-up cheek. They’re full, but soft and squishy when you press on them. During warm-up pressure waves, the belly may feel more like a chin. There’s a certain level of hardness to it, as the muscles tense involuntarily. It may seem rock-hard at this point, but when true birthing waves begin, it often becomes even firmer, more like a forehead.
  2. How intense are the waves? Some women may not feel warm-up pressure waves, or not feel all of them. Other women feel them, but they can easily walk and talk through them, and continue any activities they may be doing. Sometimes, warm-up pressure waves start to become more intense, and a woman may want to close her eyes and breathe more deeply through them. But when true birthing waves begin, they require much more concentration (and Hypno-moms will want to use their hypnosis techniques to remain completely comfortable).
  3. How long are the waves? Warm-up pressure waves can vary in length, but often they are under 60 seconds long. Mine tend to be anywhere from just 15 seconds to 45 seconds. Very occasionally, I’ll experience a wave lasting a minute or longer. When true birthing waves begin, they are usually at least one minute long, consistently.
  4. Is there a pattern to the waves? My warm-up waves are very sporadic. Sometimes, I will experience several back to back, or feel them every 5 minutes for up to an hour, but the pattern doesn’t hold. I may have a wave, and then another in 20 minutes, and then in 15 minutes, and then in 30, and then in 5, etc. There is no real pattern to them, even though they sometimes come frequently. The length and strength of the waves tends to vary as well. On the other hand, true birthing waves tend to come in a pattern; some women have a very clear pattern like clockwork, and others have more of a loose pattern. Neither is better than the other, but either way, they are usually less sporadic.
  5. How far apart are the waves? As I said, warm-up waves can vary in terms of frequency (as well as length and strength). But typically, they are not very close together, or only close together for a short amount of time. True birthing waves in early birthing time usually come every 10 minutes or so, for at least an hour and then continuing from there. As birthing progresses, they will come closer and closer together. 

 

The overall idea is that true birthing waves are longer, stronger, and closer together than warm-up waves, and they will continue to grow more so. They follow a pattern, rather than being sporadic, and they are more intense. Although that still doesn’t always make it easy to tell when birthing time begins, they are helpful signs for most women. Aside from those factors, there are also a few “clues” regarding the difference between warm-up and true birthing waves.

 

Clues that Pressure Waves Might Be True Birthing Waves:

  1. Has there been a bloody show? This is a common term to describe the loss of the mucus plug from the cervix. (Some sources claim that the bloody show and loss of the mucus plug are actually separate events that often occur at the same time, but it seems to be a matter of opinion. For the sake of simplicity, I will assume they are one and the same.) A clump of blood and mucus is expelled from the vagina as the cervix begins to soften and open in preparation for birthing. The bloody show can happen weeks or hours before birthing, or it can even happen well into the birthing process. So while it definitely is not a clear sign of birthing time beginning, it can offer a hint for some moms. If there has been a bloody show, and other signs of true birthing waves are present, it is more likely that mom is in her early birthing time.
  2. Has the bag of waters broken? A pregnant mother’s water breaking is a popularized sign of birthing time beginning, at least on TV. In reality, most women will not experience their water breaking before birthing begins, but rather at some later point during the birth process. That being said, if the water has broken, and other signs of true birthing waves are present, then again it is more likely that mom is in her early birthing time.
  3. How far along is mom? This is a clue that may seem obvious, but it is worth being said. When mom is less than 37 weeks pregnant, her pressure waves are much less likely to be true birthing waves. (If a woman is concerned that her waves are more serious than they should be before 37 weeks, and has concerns about pre-term birthing, then listening to Hypnobabies’ “Baby Stay In” hypnosis track could be a wise choice.) After 37 weeks, and as the baby’s “guess date” approaches, pressure waves are more and more likely to be true birthing waves.

 

Overall, I believe it is important to realize that all women’s bodies and all births are different. Some women are “textbook” when it comes to these signs and clues, whereas others have a very different path and process of birthing. Ultimately, the only 100% sure way to tell that birthing waves are true is to wait and see if a baby comes out! While that may seem discouraging, it ultimately means that the best approach is to develop a sense of surrender and respect for the process of birth.

For myself, I feel encouraged during the waiting time by reminding myself that baby will come, that it becomes more and more likely with each passing day, and that my body is warming up, which is clearly what it needs to do. Personally, my faith plays the biggest role in keeping my peace during this time. I remind myself to trust God, because He knows the best time for my baby to be born, and I remind myself that it will be soon, even if “soon” means another 4 weeks.

Waiting is hard, and obsessing over birthing waves can be easy to do. These feelings are valid. But in the end, I’ve found it best to choose to let go of my attempts to control the birth process, and simply trust.

Healthy Pregnancy 101

Did you know that having a healthy pregnancy can affect not only your baby’s health, but the ease or difficulty of your birthing time?

This is why one of the main components of the Hypnobabies program is teaching women and their partners about how to stay healthy during pregnancy. Healthy pregnancy encourages the best possible outcomes for birth and beyond.

So what are the keys to a healthy pregnancy? I would say the most important factors are balanced nutrition, gentle exercise, and mental/emotional peace. I believe these puzzle pieces of health are far more important than any medical tests and procedures that care providers might recommend. That’s not to say that prenatal care from a competent provider is not important, because it is. But your health, especially during pregnancy, is in your hands more than anybody else’s.

Balanced nutrition is not as complicated as it sounds either. A diet focusing on protein and including plenty of whole grains, veggies, and fruits is optimal during pregnancy. Some foods that are extremely good for pregnant women include fish such as salmon and tilapia, avocados, beans, eggs, sweet potatoes, leafy greens, and berries. Salt should not be limited during pregnancy, and water should be the main beverage. Hydration is important! Vitamin D from sunshine is needed, as well.

Gentle exercise during pregnancy can help keep the body fit and strong for birth. Some excellent prenatal exercises include walking, prenatal yoga, and swimming. There are also specific targeted exercises that help strengthen and prepare mothers for birth, such as kegel exercises, squatting, and pelvic tilts (also known as cat and cow poses).

Mental and emotional peace are an often ignored, but vital component of having a healthy pregnancy and birth. The mind is powerful! When we believe we should feel miserable during pregnancy, we are more likely to; then, we are less likely to take optimal care of ourselves during this special time. When we believe birth is going to be dangerous and painful, it is more likely to be so, even when it doesn’t have to be. That fear can add stress to a pregnancy, and stress is not a helpful ingredient to health! Hypnobabies is an excellent way to learn tools to maintain a peaceful and calm attitude about pregnancy and birth.

Having a healthy pregnancy is not as difficult as it may seem, but it does require making mindful and intentional decisions about self-care. If you put the effort in, the rewards will be great! You and your baby deserve the best.

Newborn Care Choices 

Although parenting begins as soon as you discover you are pregnant, your parenting choices begin most dramatically at birth. In those first few hours and days, and the days and weeks leading up to them, you must make many decisions about your baby’s care. In hospital births, there are procedures that are often done routinely, which you may want to consider refusing. Even in home births, you must make decisions about how you want your baby treated immediately after birth.

Here are some newborn care choices to think about:

Cord Clamping

In many hospitals (and with some birthing center and homebirth midwives) the umbilical cord is clamped and cut almost immediately upon birth. Unfortunately, this practice deprives babies of a large percentage of the blood volume they could receive through the cord. That blood is rich in oxygen, as well as iron, which is important for babies in their first year of life since breastmilk is naturally low in iron. Allowing the baby to stay attached to the cord until it stops pulsing gives them their best chance at optimal health. As long as the baby doesn’t need to be resuscitated, or have some other life-saving procedure done immediately, there is no reason to clamp the cord prematurely.

Eye Ointment

After birth, it is common procedure to treat newborns’ eyes with erythromycin ointment. This is done to prevent blindness as a result of an infection caused by gonnorhea transmission from the mother to the baby. If the mother has gonnorhea, or doesn’t know if she has it, then this might be a good idea—although it is still not the only option. Transmission of the virus is not guaranteed, and even if it does happen, babies can be treated for infection with antibiotics. The reasons for refusing this treatment may be as simple as wanting to avoid unnecessary medications for your baby. There are also concerns about the blurriness caused by the ointment interfering with the immediate bonding time between mother and baby. A bigger concern may be the use of other types of eye ointments, for the same purposes, which have not been proven as safe.

Bathing

Cleaning newborns shortly after birth is another common practice. The benefit, I suppose, is that the baby is “clean.” The drawbacks are that it isn’t necessary, takes the baby away from the mother at an optimal time for bonding, and it removes a protective substance called vernix from the baby’s skin. Although it may look gross, that white cheesy substance may benefit the baby by protecting against harmful bacteria, helping regulate body temperature, and keeping the skin moisturized. (For me, it wasn’t something I even noticed because I was so enthralled with my new baby.)

Hep-B Immunization

A vaccination for Hepatitis B is usually given to babies at birth, or shortly after. This prevents babies from becoming sick from Hep-B, which can be contracted from mothers who have the virus. If a mother has Hep-B, or if she doesn’t know if she does, then this vaccination is beneficial to protect the baby. However, if a mother does not have Hep-B, and knows that for sure, then this vaccine is completely unnecessary. Like any vaccine, there are certain risks to receiving it; however, most vaccines are statistically safe and supported by scientific evidence.

Circumcision

As far as I know, circumcision is not a standard procedure anymore, meaning hospitals don’t just do it automatically. However, if you have a baby boy, you will need to decide whether you wish to have him circumcised. Currently, there is no medical or health reason supporting the practice. It is more of a personal choice, or for some a matter of religion. While it is a minor surgical procedure, it is a surgery, and it shouldn’t be taken lightly.

Vitamin K 

Babies are given vitamin K injections at birth to prevent a condition called Vitamin K Deficiency Bleeding. This condition is rare, but can happen without warning and have severe outcomes, such as brain damage or even death. Essentially, young babies can become deficient in vitamin K, for various reasons including the fact that breastmilk is low in it, and the body doesn’t store it easily or manufacture it. Since vitamin K is responsible for blood clotting, being deficient in it can result in uncontrolled bleeding, particularly internally. The vitamin K shot given at birth offers almost complete protection from this disorder, and there has been no evidence of harmful side effects from the injection. The only drawback is that the injection may be painful for the baby.

Feeding

One parenting decision that must be made early on is how to feed the baby. Breastfeeding is an amazingly beneficial option. If the mother is able and willing, she should allow her new baby to start nursing as soon as either she or the baby desires after birth. Often, mom and baby might need a little guidance from an experienced care provider, such as a nurse, midwife, or lactation consultant. If choosing to breastfeed, make sure you avoid artificial nipples such as bottles or pacifiers, and have any care providers do the same. These things can disrupt the nursing learning process. Even if you wish to formula feed long term, you might consider breastfeeding in the early days, weeks, or months. If this is not an option for you, you and your partner can still feed your new baby with love and care, through a bottle. Use this time to bond with your precious little one!

Skin-to-Skin Contact

Whether bottle-feeding or nursing, skin-to-skin contact immediately following birth is a very special experience. I would encourage all parents to postpone any newborn procedures, including weighing, cleaning, examination, and so on, until after an hour or so of skin-to-skin time with the baby. Mom can be cared for and cleaned up with her baby on her chest, as long as both are in good condition.

Rooming In

Rooming in is another option parents can choose, to support optimal bonding with their newborn. Although many hospitals have nurseries and can take the baby away for some time to allow parents to rest, it is also becoming more common for hospitals to offer or even insist on babies rooming-in with their parents. Not only does staying together encourage breastfeeding, it protects the special time of bonding. To combat exhaustion, parents should take advantage of the fact that newborns spend most of their time sleeping, and use that time to catch up on sleep themselves! Sharing responsibility for the baby’s care between the parents, and perhaps other visiting family and friends, can also help make this time easier.