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.

Self-Kindness in the First Trimester

Pregnancy is a special time for women and families. It’s a normal and natural process, but it also can feel mysterious, magical, and challenging. The changes in a woman’s body, and the development of a fully formed baby from two tiny cells is an incredible process. It is many things, but “easy” is not a word I would use to describe it. Although it may be perfectly normal and easy for a woman’s body to produce a baby, it isn’t usually easy to the mother herself. The physical discomforts and emotional changes during pregnancy, and the physical and emotional feat of giving birth are both challenging and rewarding. The ultimate reward, of course, is the new life brought into the world– a treasure beyond description.

Each trimester brings its own unique challenges. During the first trimester, many women experience nausea, food aversions, and fatigue, often quite severe. These discomforts can make it difficult for women to continue with their usual daily tasks, such as work, childcare, and chores. At the same time, during this first trimester there is usually very little to “show” for all of that. It can feel like a weeks-long case of the flu, rather than the beautiful beginning of a new life.

This is where a positive and focused mindset can make all the difference. I am currently 8 weeks pregnant myself, and I have found that having a positive mantra has been helpful. Rather than groaning and complaining and obsessing over the discomfort, I acknowledge it and reframe it. It is good to remember that nausea and fatigue are signs of a healthy and strong pregnancy. (That being said, women who don’t experience nausea can have healthy and strong pregnancies as well!) It is also good to remember that in most cases, this stage is temporary and will pass when the second trimester arrives. My mantra has been, “This is a strong and healthy pregnancy, and this part will pass.”

While keeping a positive and peaceful state of mind, I also acknowledge my discomfort and practice self-kindness. This means respecting my limits, asking for and accepting help, and taking care of myself. Right now, my limits are high. I am not able to contribute much to household chores, which I usually consider one of my main jobs as a homemaker. I also find myself very limited in my ability to play with and entertain my toddler, which of course is my full-time job as a stay-at-home-mom. I find that I require a lot of rest, and I’ve been taking it easy by doing only the bare minimum and allowing others to help. Most of the help comes from my husband, who is an understanding and helpful partner. I’ve also hired a babysitter to play with Cody a couple of times per week. We are limited in our budget, of course, so on the days when it’s just me and Cody, I remind him often that I need to rest and I do my best to play with him from the couch or floor.

Maintaining a healthy diet during this stage is also not just challenging for me, but impossible. I find that I am unable to eat most foods, let alone highly nutritious foods. During this time, I eat anything I can, and remember that my nutrition before and after these short months is perfectly able to overcome this period of a lower-quality diet. I accept my needs as they come, and treat myself with compassion rather than guilt.

With all of these challenges, I accept that I am doing my best and that there is no shame in that. I reject mommy-guilt (and wife-guilt, and health-guilt, and any other kind of guilt!) in favor of self-kindness. I remember that this is a relatively short phase in our lives.

Pregnancy is a time of many changes, and accepting those changes with positivity and compassion allows this time to be more peaceful, joyful, and even transformative. It’s not always easy, but it is one of our incredible abilities as women, and in many ways it is an amazing gift to be able to bear life. Let’s treat ourselves kindly during the journey of pregnancy!

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.

My Experience with Different Types of Midwives

Although there are certainly many articles on the internet explaining the practice of midwifery and different types of midwives, I wanted to contribute my own experience on the subject.

The two types of midwives available in my area, in California, are direct entry midwives and certified nurse midwives, or CNMs. When I was pregnant, I started out with a CNM at a birth center, but later switched to a direct entry midwife. Here’s what I learned through the process.

CNMs are certified as nurses, as their title may suggest. They are commonly found in hospitals and birthing centers. Direct entry midwives have birth training adequate to be certified by a governing board such as the North American Registry of Midwives or the American Midwifery Certification Board, and may have the title of CPM (certified professional midwife) or CM (certified midwife)—these types of midwives most commonly attend home-births or births in a birthing center.

Certified Nurse Midwives

Originally, I chose to use a birthing center which employed several certified nurse midwives. I found the birthing center to be a very appealing environment, and I felt more secure using a midwife who was also a certified nurse. Birthing at the birth center seemed like a safer way to have a natural birth.

I quickly found that I was not assigned to one particular midwife, but would get whoever happened to be there during my appointment. This may be unique to the particular birthing center I chose, but I did feel that my care was less personalized as a result—undermining one of the main benefits of midwifery as opposed to seeing an OBGYN. Ironically, most people seeing an OBGYN would at least have the benefit of receiving care from a single doctor, rather than a rotating set of doctors, thus giving them more personalized care than I was receiving at that birth center.

I also discovered that my care was very managed at the birth center. There were protocols, procedures, and rules that I was simply told to follow, without a great deal of input of my own preferences or thoughts. This is apparently the usual operating procedure for CNMs. I was told to submit to a pelvic exam during one appointment—not asked, but told. Another time, I was told to submit to a blood draw for blood tests. Neither of those procedures was offered to me for consideration, they were just an expected part of the process, and I was not given an option to decline. I found that this undermined another of the main benefits of midwifery, which is the right to be involved and in control of one’s own prenatal care.

The final straw for me with the CNMs at the birth center was when I was told to make my appointment for the gestational diabetes test. After carefully researching the subject, I found that I have an extremely low risk of gestational diabetes. I had not a single risk factor, other than being pregnant. As such, I spoke to one of the midwives about declining this test, and she agreed that it would be fine. Later, I received a call from the birth center again requesting for me to make my appointment, and when I explained that I would be declining, they put me on hold. A few minutes later, they came back and told me that it wasn’t allowed. I was flabbergasted to hear that I apparently wasn’t allowed to make my own health care choices, but I remained calm as I explained that I already received approval from one of the midwives. I was told that they would get back to me on the matter. A few days later, I received another call from the birth center. They told me that they had discussed my case in their staff meeting, and decided that I would not be allowed to decline the test. I told them I would be finding a new midwife.

At this point, I started to really look into all of the available midwives in my area, rather than only looking for CNMs, which there were only a couple of. That was when I finally came around to the idea of seeing a direct entry midwife, and discovered many benefits to this choice.

Direct Entry Midwives

First of all, with a direct entry midwife I was able to have a home birth without paying any extra fee as I would have had to for the birth center I was at before. I discovered that midwives bring all of the same equipment to a home birth as would be available at a birth center, making it just as safe of a choice. Not only that, but a home birth allows the family to be in a familiar and comfortable environment, and eliminates the need to do anything after the birth other than settle in with the new baby. That being said, direct entry midwives often work at birthing centers as well (my midwife has her own birthing center), and offer that as an option.

Second of all, I was able to choose the one person who would take care of my prenatal needs, and build a relationship of trust and comfortability with that person. There was no shuffling around with a different midwife every month.

Third, I was able to make my own health choices and wasn’t pressured to submit to any procedure. Everything was my choice, and everything was presented as an option, as it should be. I chose to decline certain procedures, such as the gestational diabetes screening, while accepting other procedures such as screening for GBS (Group B Strep). None of my choices felt judged by my midwife. I also was never even offered a pelvic exam until the birthing time, which is good because pelvic exams during pregnancy are not evidence-based or beneficial, and may in fact be harmful (not to mention uncomfortable).

Ultimately, I was very happy with my choice and I highly recommend direct entry midwives as an option for pregnancy and birth care. Not only did I have a much better experience, but I paid less for it, and it was much more convenient to have a midwife who was located closer to me and able to attend my home birth. My midwife happens to see clients at her birth center, but also offers a home-visit option, and many direct entry midwives offer home-visits only. Either way, using a CM or CPM is a wonderful way to receive excellent, personalized, and empowering care during pregnancy and birth. As for CNM care, I can only say that my experience was very negative, but others may find that this type of midwife suits them. Ultimately, the decision should be made with an open, yet discerning, mind.