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What to Do When you are Overdue

  • Posted on August 22, 2011 at 9:37 am

What to Do When You’re Overdue

I am sharing this short and simple blog entry from Giving Birth with Confidence. I couldn’t say it better myself. BE PATIENT.
 
August 22, 2011 By Cara Terreri 1 Comment

40 weeks have come… and gone

As I write this, I am five days past my due date with my third baby. I’m no stranger to being “overdue.” With my last pregnancy, I gave birth five days after my estimated due date. I was lucky enough with my first to go into labor three days before being due. Despite the fact that a perfectly healthy pregnancy can last between 38 – 42 weeks,  we are so ingrained to hinge on the almighty 40 weeks “deadline.”

Here’s the reality: 40 weeks is an average time for pregnancy that is based on a date (last menstrual period or conception) that can be uncertain or inaccurate. The result is an estimate – not a deadline, expiration or delivery date. Your baby is not a FedEx package. And yet, women who go beyond the magical 40 weeks due date are made to feel like a pressure cooker. Well-meaning family and friends call, text and email to check in, asking questions like, “Are you still pregnant?!”; some care providers put women who are postdates on a time clock, often stripping membranes to jumpstart labor, performing a barrage of tests to check on baby and scheduling an induction date; and then there is the general discomfort and exhaustion that comes along with the end of a pregnancy that makes a woman feel like she is “so done” with pregnancy. With all of this pressure, even the most patient and informed woman becomes irritated, on edge and prone to doing whatever it takes to birth her baby.

Have you ever heard anyone say that children develop and hit milestones at different rates? The same is true for developing babies. Some may be ready for birth at 39 and-a-half weeks while others need an extra two weeks or more. Allowing baby to initiate birth helps ensure that he or she receives enough time to develop and mature. Contrary to what many believe, the last few weeks of pregnancy are not just for fattening baby up. Important organs, like the brain, lungs and liver, are still developing, as well as functions like sucking and swallowing. Interrupting these processes by scheduling an induction — unless there is true medical reason — can deprive baby of the time he or she needs to grow, and poses risks associated with induction.

So, what do you do when you’re overdue? Having been in this situation twice now, my best advice is to stop waiting around. Sitting around, jumping at every little twinge, ache or contraction, waiting for labor to begin will do nothing but drive you absolutely crazy! If you’re physically able, schedule something to do every day for three days straight. Make dinner plans, get a pedicure, see a movie, visit a friend, make freezer meals — you get the idea. If you come to the end of those three days and baby is still cooking, schedule the next three days. Having something to look forward to besides the birth of your baby will help pass the time and keep your mind occupied. And when you encounter the questions, comments and suggestions from others about your overdue-ness, smile and say something like, “Just like a cake, baking times may vary.”

WHY CAN’T WE WAIT FOR BABY?

  • Posted on July 12, 2011 at 4:33 pm

WHAT IS FULL TERM FOR A BABY? It is an uncomfortable reality that most women are unaware of what is a health full term pregnancy.  When asked this question, many think 37 or 38 weeks is good. The BEST ANSWER IS WHEN THE BABY GIVE’S ITS HORMONAL SIGNALS TO THE MOTHER’S BODY TO BEGIN LABOR. Far too many babies are being born earlier than is healthy and precious mother-baby time is being interrupted with time spent in a NICU.

The ‘average’ human gestation period is about 40 weeks, but as we all know, we are all slightly different, so for every baby that is ready prior to that time, there is an equal number not ready until beyond the average. In an attempt to quantify pregnancy(which the medical community does far too much now-a-days), an estimate of 40 weeks from the date of conception is set as a predicted date. However, once that date is determined, it takes on a new life and too much emphasis is centered on it. There are many variables to consider, the first of which is “Do you really know exactly when your partner’s sperm united with your egg?” OK, in most cases that is an estimate too. Even if you know when you had sexual intercourse, the uniting can vary a couple of days. So why are we stuck on selecting an exact date and gearing baby’s growth and labor expectations so precisely around it? Every pregnant mother should convert any calculation into an expected date RANGE and change her story to “I am due mid-March,” rather than getting caught up in a one day deadline.

By selecting an exact date in our culture and medical community, we artificially sabotage a woman’s ability to celebrate the wonders of the late stages of pregnancy and obtain a birthing experience optimal for her and baby:

  • We cause worry when a pregnancy extends even moments beyond this date with threats of baby too big to birth vaginally, a placenta that cannot sustain a few more days and more. Women should be reassured that their baby will be the ‘right’ size and her body will be able to birth that baby with her active support. The must trust that their bodies can sustain that baby until it is ready. Women can be educated to monitor their baby’s activity level and continued health (even use a home Doppler) as her pregnancy extends beyond the predicted 40 or 41 weeks.
  • We feed into the medical community’s ability to initiate labor artificially which second guesses whether the baby is truly ready for birth. This initiates a cascade of interventions which often end with the baby admitted to a NICU as premature. We need to stop using science over nature.
  • We allow a buy-in by physicians and mothers that it is safe to ‘schedule’ a birth (either by induction or cesarean) because we have predicted the maturity of the baby. Often the planned cesarean is scheduled at a predicted 39 weeks as if the woman going into labor is somehow a great risk. I often wonder what the fear is of allowing this natural onset, then doing a cesarean. Women, especially first-time moms, have plenty of time to get to a hospital for a planned cesarean.  Let’s let these babies tell us when they are ready!!!
  • We allow fallible scientific measurements to trump nature and a woman’s intition in predicting gestational age.  Although ultrasound is continually used to predict baby’s age in late pregnancy, it has been well documented that only interpretations of ultrasounds early in pregnancy act as somewhat accurate predictors.
  • A planned induction second guesses the woman’s readiness for labor. If the Bishop score is used as a predictor, there is definitely room for subjective evaluation by caregivers. Unless a woman or baby’s health is in danger, artificially inducing also contributes to our high levels of failed labor progress resulting in cesareans.

Many women are unaware (and many physicians seem to discount) that critical fetal brain growth and development occurs during the last weeks of pregnancy. Evidence of late preterm brain immaturity is seen in problems with breathing, apnea, heart rate, sleeping and feeding. The fears of the medical community are causing avoidable medical issues in exchange for trying to prevent others.

I applaud the March of Dimes for managing a campaign to counter today’s medical practices that results in so many preterm babies. It is just sad that they must do so at all! Their resources could be spent on unavoidable infant issues. 

It is hard to plan for anything when it comes to children….Why do we allow women to think birthing their child is something controllable and schedulable? Patience, calm, confidence  in oneself, one’s body and coping abilities makes for better birthing and long term parenting. Let’s celebrate late pregnancy and let birth begin on its own!

Lamaze Health Birth Practice #1: Let labor begin on its own

BIRTH SHOULD BE TAUGHT AS POSITIVE

  • Posted on March 3, 2011 at 11:07 am

Television Abomination Turns Me Radical-One Born Every Minute should be taken off the air.

I cannot believe this television show is being allowed on the air by physicians, nurses, birthing moms, etc. And shame on Jamie Lee Curtis for being involved as the narrator. It takes a lot to get me riled up, but after the first birth, I was sad. After the second I was mad. After the rest (that I could bear to watch), I am extremely fired up, irritated, disappointed and just plain mad. IF YOU ARE PREGNANT, DON’T WATCH IT. Watch positive films such as Organic Birth, Born in the USA or Natural Born Babies. Or meditate on a calm birth and attend real birthing classes designed to give you tools and train your support peope.

The only women who would watch this horrible show repeatedly are pregnant women or those looking to get pregnant, and THESE ARE EXACTLY THE WOMEN WHO SHOULD NOT WATCH. These are sensationalized, poorly explained, poorly and highly medically managed births. THIS IS THE WORST DISSERVICE we can do to the young women birthing today. BIRTH IS NOT/SHOULD NOT BE TELEVISION DRAMA.  There is no representation of the many peaceful hours of most labors, only the last 5-10 minutes of drama and medical interventions.  Women who make loud sounds and scrunch up their faces in the last stage of labor are usually reacting to the profound urges of their bodies. THESE REACTIONS  ARE OFTEN SOUNDS OF POWER, ENERGY AND RELIEF and are not necessarily exhibitng pain, as the viewer interprets and the narrator fails to correct. This kind of drama should be driving women to home birth every minute of the day. It sure would me!

NEGATIVE, MEDICAL MANAGEMENT OF LABOR

The first thing that could make the births I was able to get through is to STOP PUTTING WOMEN TO BED, in labor. This may be easier to film, but is not where women should be laboring 90 percent of the time. If women are encouraged to be up and about during labor, they will need less, if any medication, less labor augmentation, less vacuum extraction and shorter labors.  This would also be the result if the NURSES SPENT TIME IN THE BIRTHING ROOM , ENCOURAGING, SUPPORTING AND OBSERVING birthing women instead of sitting, chatting at the nursing station and relying on the often misleading monitors to tell them of a woman’s labor progress and condition.  If women are encouraged to BIRTH IN UPRIGHT, HANDS AND KNEES OR SIDELYING POSITIONS, they can avoid the vacuum delivery so often shown on this show and Cesarean Surgery that is presented as some kind of ultimate relief to the mom and baby.  NORMAL BIRTH HAS ITS OWN NATURAL RELIEF.

LACK OF SUPPORTIVE EDUCATION

It is sad that this is what young women see as birth. We have unnecessarily frightened an entire generation of women into thinking that birth is painful, scarry, traumatic and something horrible to have to endure. Women approach birth now with fear, more than ever before. They do so to the extent that they are willing to take medication they think will numb them from the entire experience.   BIRTH IS NORMAL AND NATURALLY MANAGEABLE AND IF WOMEN ARE CONDITIONED TO UNDERSTAND THIS AND HOW BIRTH CAN BE POWERFUL AND WONDERFUL, they will approach the experience with calm and confidence. Women are failing to receive quality education and failing to get quality support in labor. They are clearly not being given THE REALITY OF BIRTH AND HOW THEY CAN CONFIDENTLY AND POSITIVELY PARTICIPATE.  Those around them who are supposedly there for support are not being given the tools and assertiveness training to handle birth themselves, rather than acquesing to every medical intervention available. MANY INTERVENTIONS SIMPLY LEAD TO A CASCADE OF ADDITIONAL INTERVENTIONS, resulting in complications and trauma to mom and baby: hence the “drama” for the films. 

RESPONSIBILITY OF THE HOSPITAL          

I could go on, but I question the hospitals reasoning for allowing this program to use their facility and their patients. It reeks of just another revenue center, just as births with multiple medical interventions have become. MAKING MONEY AT THE EXPENSE OF THE BIRTHING FAMILY is unconscionable, but becoming an accepted practice. 

BIRTHING WOMEN; Don’t  get caught up in the negative mental and emotional cycle being promoted by shows like this. AVOID THEM!! EDUCATE YOURSELVES ABOUT NORMAL BIRTH. NORMAL BIRTH IS GOOD. NORMAL BIRTH IS EMPOWERING. Sure normal birth is hard work, but NORMAL BIRTH IS NOT TO BE FEARED.