Tips for Ten Month Mamas
-by Leilah McCracken and Gloria Lemay
AVOID SUGAR. This cannot be overstressed- sudden drastic peaks in maternal blood sugar can harm a baby. (I even know of one baby who died in utero after his mom, at 43 weeks with undiagnosed gestational diabetes, ate two ice cream sundaes). Drink no fruit juice either, and avoid the simple sugars found in refined foods, like white flour products.
Eat lots of high quality protein foods, and keep your blood iron levels high.
Eat lots of dark leafy greens for the nutrients, and to fight constipation.
No drugs!!! (Including alcohol and "natural herbals" that are smoked.)
Remember to exercise- swimming is best. Exercise has been shown to reduce the likelihood of developing gestational diabetes by HALF.
If you can't sleep, use that time to write, draw, paint, look at the night sky- connect with your creative and spiritual side.
Remember that the fruit that is taken before it is ripe is hard, bitter, and not able to bear seeds well that will propagate new life. Adding chemicals to ripen fruit leads to an inferior product as well. And when fruit is chemically treated to appear ripe, it tends to rot from the inside (right at the pit) outwards. This bizarre process is like how the effect of induction agents eat right through the posterior fornix of the cervix, causing back wall ruptures of the uterus.
Trust in your body, trust in your birth. Nature is brilliant; human minds are flawed.
Avoid people who give you fear "vibes"- even your mother.
Set your answering machine so your phone only rings once, and give updates in your message, if you like. DON'T PICK UP THE PHONE if you're feeling weak and sad inside- an invitation to callous people to start to hassle you!
Connect with other ten month mamas- we are few and far between with the current induction epidemic, but we do exist- and can offer great support to each other.
Rest if you want, walk if you want, eat if you want- do what feels right (as long as that doesn't involve chocolate bars).
Have lots of orgasms. They are relaxing, and wonderful for preparing your body for birth.
Some women like to drink red raspberry leaf tea (I never bother, personally.)
For most women, long pregnancies are safer and healthier than labor inductions- which carry far greater risks in and of themselves. If confronted by hostile people, tell them that labor inductions are dangerous, unproven, and put you and your baby at risk of a hazardous cascade of interventions- possibly leading to c-section. Also tell them that your baby is smart enough to pick her own birthday.
Remember that your body was smart enough to conceive, and then grow a child beautifully; it is also smart enough to know when it is the right time to give birth.
How can you tell your baby is doing well past 40 weeks of pregnancy?
Two ways.
One: heart rate- and you don't need a fetoscope. Have your partner put his ear to your lower belly with a toilet paper roll- let him move around from place to place to find a good spot. The baby's heart rate, if he is listening carefully and patiently, should be evident. 140-160 beats per minute is good.
Two: do the Cardiff fetal movement test. From 9am to 3pm count each of your baby's movements- there should be 10 movements at least in that time frame.
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Quotes and Wisdom about Long Pregnancies
"Postdates" does not mean "postmature", and ensuring a good outcome
"Maternal weight loss is the key: it can tell us if the placenta is beginning to lose function (which causes the baby's rate of growth to slow, and the amniotic fluid to decrease. But as long as the baby is still gaining wieght, and there is plenty of amniotic fluid. then the kids can go a long time over dates. The little bit of weight a kid gains each week after 40 weeks isn't likely to be a factor on birth (rate of growth slows to about 4 - 6 oz a week after 39/40 weeks). A kid who is big at 41 is still going to be big at 43, and that little bit extra won't be a factor then- unless the fit was so tight it would have been a factor earlier. Only in the most rare case is 'size'- by itself- a factor in birth.
"But we need to watch kids after 43 weeks. The rate of stillbirth does start to rise- very slowly- after 43 weeks (NOT 'after forty' as some have been taught!). The rate rises more steeply with later dates- post 44, 45. We need to be watchful for signs of dysmaturity. The kid who has little amniotic fluid and is sort of 'shrink wrapped' in the womb may be in big big trouble within a few days, if not hours! He needs to get born! But most kids aren't like that. Most kids do great- and the calendar means nothing to them. Our job as midwives is to find the ones who are getting sick. I've had a good number of moms over the years go to 43 weeks- and a few over that- with no problems. I've also had the occasional kid who had GOOD dates and was on-time, yet looked like the baby we call 'post-dates' (clearly lost weight, little water and meconium stained).
"I think we should follow the lead of some texts which advocate using the term 'dysmature' for baby's who show that syndrome- because it can happen at any point, and the great majority of babies who are 'post-dates' are not 'post-mature' or 'dysmature'. The stats point out that less than 10% of babies at 43 completed weeks show any signs of 'post-maturity'."
Gail Hart, Midwife, Oregon
www.midwiferyeducation.org
Every Mom is different and has varied gestation cycles
"Most births that I attend end on their own from 40-42 weeks. I have done a few that were 43-44 weeks. In my opinion, let the Mom go unless there is a cause to intervene, besides the normal, 'I want to have my baby now'. : ) Remembering that two weeks either way of the 'estimated' due date is very normal. Then add that every Mom is different and has varied gestation cycles. Who are we to say in a normal healthy pregnancy: 'you need to have your baby now'? In most cases, it takes a lot of encouragement from me for the moms. As we all know, the last weeks and days feel like forever and when there was still no babe, moms would be very anxious (to have babe in arms). So, lots of encouraging words, lots of humor, and lots of patience!" -Jill Peck-Colin, CPM Las Vegas, NV
Prond Mama Apple Tree, letting her babies grow
"Babies really need to 'ripen' in their own way- regardless of whether that fits an arbitrary timetable or not.
"Imagine a tree filled with apples. Now we all know that some apples ripen early, many at the same time, some much later- we all know about how one apple will just stay on the tree for days and days- even weeks- after all the others have fallen off. I have personally waited for apples like that- and gently shaking the tree has no effect on getting them to come off. Whacking the apple with a stick would make it fall off... but the apple would not be at its most delectable. So- I wait, and my reward is a sweet, big, juicy apple.
"Well hitting the apple to get it off before its ripe time is like inducing a baby because of 'postdates'- making it be born just because other babies mature earlier. And I would rather get hit as a baby than be made to be born before my time, before my systems and brain have 'ripened' to what they need to be for my own optimal health and wellbeing. Induction is a grave insult to the baby.
"My own babies are like those apples that take so long to come off. I wait and I wait- and when the time is right, my babies come down to me- as perfect as their internal schedules dictate they should be. And, writing this in my tenth month of my tenth pregnancy, I'm proud to be that strong, healthy mama apple tree- and I will nourish my newest baby as long as he or she needs." -Leilah McCracken, March, 2002
Lots of late babies in her practice
"I have a good number of late for dates babies every year and that I find a healthy, well-fed woman usually grows a baby longer, and that's not necessarily all bad. Women just need and want reassurance that it's OK. I've assisted women as late as 43 and 44 weeks at home with no repercussions, but I think it's a good idea to have a good score with a biophysical profile and/or non stress test. I have also seen women birth in hospitals on my L&D unit (years before my midwifery calling) birth that late both fine and not so fine, yet most did birth without a hitch.
"Historically, I've heard of fine babies birthed at 10+ calendar months. The Christian missionary Nora Lam from China birthed her son after being in a concentration camp years ago (verified by Chinese doctors at that time) at exactly 12 months. Apparently, it wasn't 'safe'for her to let go of her baby boy during her interment. Once she was allowed to leave, she successfully gave birth to him." -Lynda Sizemore CM, RM, Colorado
Meconium in postdates babies
"The philosophy that women should be induced to prevent having a baby with meconium in the amniotic fluid ignores the possibility that the induction causes the passing of meconium. I have seen a lot of late babies in my career. We seem to grow them big and late up here in the Pacific Northwest, just like the trees. I very seldom see meconium in the amniotic fluid of 42 week plus babies.
"I associate meconium in the amniotic fluid with smokers (dope or nicotine) in the few cases I do see. Every time a woman smokes a cigarette it has the effect that putting a pillow over the face of a little baby would have. When the baby is getting mature it can evacuate the bowel as a response to oxygen deprivation. You know the expression 'scared the s___ out of him' - when we're scared, smothered or choked we will poop or have diarrhea as a defense. When they used to hang prisoners by the neck, they knew that they would poop once the oxygen was cut off.
"The thing about meconium is that it's not really a problem. It's a wake-up sign for the practitioner to watch for distress but it's estimated (don't know by who) that only 10% of the time it is distress. The other 90% of the time it means nothing. So, to induce thinking you're going to prevent it is ridiculous." -Gloria Lemay, Vancouver BC. For more about meconium, go here.
Babies mature at their own rate
"Some babies take longer to bake. Just think about babies' development after birth: there is great variation in when they reach certain milestones of growth, activity, achievement, etc. Why do we expect them to all mature at the same rate in utero?
"I have done a birth for a woman an absolutely-known conception date- she went 42 1/2 wks and had a term-looking baby, clear fluid, lots of vernix. I did a birth for a woman with twins this Spring- Baby #1 weighed 7 lbs and looked full-term. Baby #2 weighed 4 lbs12oz and looked about 35-36 wks. They were born at 39.1 wks. NO QUESTION about any of those conception dates/gestational ages." -Patrice Bobier, Midwife in Michigan
Letting births happen in their own time
"There is a sort of chemical ‘combination lock' that starts labor. Everything has to be lined up just right to ‘unlock' a good labor pattern. When we interfere with that, it can be as frustrating as using the wrong combination of numbers to open a locked safe." -Midwife Gail Hart, "The Birthkit", Autumn 2000
Should women be induced when they go "postdates"?
"Women in good health (non-smokers, with normal blood pressure, and no history of diabetes) are best left to have the baby by Nature's clock. There is no SAFE induction method." -Gloria Lemay, private birth attendant
Advice for women with long pregnancies
"With my last (my 7th) I was in prodomal labour for a good 6 weeks, and she came 4 weeks later than all the rest. She decided to come once I had given up watching and waiting for her. Let yourself relax and do stuff just for you, it may be the last time for quite a while. Enjoy those last little kicks and movements. I missed them almost right after the birth, and feel some regret for not enjoying the last days of pregnancy. It was probably my last." -Jamie
Lovely blossoms open when they're ready
"Attending births is like growing roses. You have to marvel at the ones that just open up and bloom at the first kiss of the sun, but you wouldn't dream of pulling open the petals of the tightly closed buds, and forcing them to blossom to your time line. " -Gloria Lemay
From a doctor regarding postmature babies
"In the eight years when I practiced homebirths as a registered doctor, out of the 1,190 bookings I had 106 postmature babies (more than 42 weeks) of which three went to 48 weeks, a few more went to 46 weeks, and lots went to 44 weeks- and all these babies fared very well. Of those 106 babies, only one fitted the textbook description of postmaturity, looking like a little wrinkled old man with stained skin, but that baby was extremely alert, and insisted on looking around the room instead of suckling.
"What decided me to do no inductions for postmaturity was a very early mother in my homebirth series who refused induction despite my anxiety, went to 44 and a half weeks and gave birth to a chubby pink, strong healthy baby, with absolutely no sign of postmaturity. Babies mature at different rates, not exactly at 40 weeks, just as we adults do not become senile at seventy years." -John Stevenson, MD, "The Birthkit", Autumn 2000
Note that Dr. Stevenson also advises prospective parents to not tell family and friends exact "due dates", but to be vague, with "due seasons" to avoid being pestered by nervous well-wishers.
God Knows Babies
"I've come to realize that a God who is big enough to so perfectly form little eyes and ears and a little round nose and a heart and lungs and every single part of a little person is certainly big enough to work out the details of their coming into the world." -Vicki in Mars, PA
About castor oil inductions and impatient midwives
"Inducing with castor oil isn't safe. Once swallowed the castor oil is hydrolized by intestinal lipases to recinoleic acid which stimulates intestinal secretion, decreases glucose absorption and increases intestinal motility. Castor oil is used in lipsticks, too. Many women who can tolerate the oil quite well on their lips get a reaction on their mouths if the oil converts to recinoleic acid. My question to a midwife who says castor oil is not absorbed is 'Would you please provide me with references for that statement'.
"It's not so long ago that birthing women were given soap suds enemas (high, hot and a helluva lot) because someone started a rumour that soap was not absorbed through the colon. We know this is not true and that this black page in Obstetric history is best forgotten. Too many women have turned from saying 'My doctor says' to saying 'My midwife says'. Take responsibility for your and your family's health. It's fine to respect professionals but ask for references on everything you're not l00 % sure of and use your internet to scope things out. There is so much crap that passes for science without anyone questioning it.
"On the subject of all the women in a hurry to get their babies born: I was 3 weeks 'overdue' with my oldest daughter. What really helped me was that I had lunch with a friend at about 8 mos pregnancy. Her son had been born 6 months before. When she saw me walk in the restaurant all hugely pregnant she said 'Oh, Gloria, when I see you I miss my pregnancy so much'. I knew that one day I'd be saying that, too, so I made up my mind to enjoy it as long as poss. and I'm so glad I did. Six months from now you'll be wondering what the rush was. I worry about women taking castor oil because you also give your baby castor oil when you take it through the gut. This means the baby will get diarhea and pass mec, too. then you're into all the transports for mec.
"The other thing about self-inducing is that you end up with erratic labours that stop and start and are difficult to complete. I just attended a Coroner's inquest here into the death of a full term baby girl. The midwife stripped membranes and got the woman into labour but she had no urge to push. She was in second stage a long time and then her perineum wouldn't stretch. They cut an episiotomy to get the baby out. Baby had bleeding in the brain and only breathed on life support. Later, Mom's placenta had to be manually removed because it wouldn't come out. It seemed to me that this woman's body wasn't ready to give birth and that the membrane stripping caused an emergency response in her body that produced dilation but eventually wore off.
"Bottom line: be patient with your little babes and yourself." -Gloria Lemay
A cervix isn't made "ripe" by induction drugs or Foley catheters
"I recommend using caution with language and question the use of the word 'ripening' to describe the process of irritating the mother's body by inserting a foreign object. This should properly and descriptively be called 'Foley catheter invasion and irritation'. Prostaglandin gels applied to the cervix should be more honestly described as 'chemically altering the consistency of the cervix'. THERE IS NO RIPENING HAPPENING WITH EITHER OF THESE METHODS.
"Midwives have used the term ripening to describe a NATURAL process of the cervical changes of late pregnancy. We take a word from the plant kingdom because it is similar to the slow, harmonious process that happens to a plum as it turns from green and hard to darker and darker purple, soft, mushy and sweet. If one puts a whole bunch of plums in a box when they are green and hard and sprays them with chemicals, it is possible that in a few days they will look like dark purple ripe fruit. However, one taste will tell you that Nature had nothing to do with the end product.
"Let's not fool ourselves in birth either. This whole hospital induction thing has got to stop. Whatever area we work in we can call these invasions by their proper names- irritation and chemical altering. Lying about what's going on perpetuates the practice." -Gloria Lemay
***Note- for studies about induction dangers, go here. The studies show that labor induction leads to c-sections, shoulder dystocia, and instrumental deliveries.
The baby will say when it's time to be born
"Birth is more than a cervix opening and a uterus squeezing a baby out. It's more than the nuts and bolts mechanics of a baby exiting a vagina- there is such a complex dance of physiological, emotional, mental, and spiritual elements involved in birth. And when this balance is thrown off, distressing things begin to happen with the baby.
"When a baby chemically announces to her mother that it's time for the birth- and many people believe that the signal to begin the birth process comes from the baby- she does it when her body systems are strong, and ready to meet the extra-uterine world. She will not instigate the birth process when her lungs and digestive systems are still immature... and even a few days of maturity will make the difference for a baby's maturity and ableness to survive.
"It is the height of human arrogance to dictate birth- time, mode, speed- to a baby. They have their own needs and innate demands (as in length of birth process); there is no "one size fits all" in birth. It is crucial that this is respected- especially by mothers! We must learn to respect our babies at birth- the most important, crucial event of their lives. The events surrounding birth last a lifetime... as does the respect and dignity a mother learns to give her child." -Leilah McCracken
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Postdates References
Post-term pregnancy: what is the clinical evidence? Rachel Westfall discusses forty-nine references that illustrate amply that there is no definitive reason to universally induce for "postdates" (especially since on-time babies often have more signs of "postmaturity" than ten month babies do).
Meconium Isn't the Problem; Induction Is Midwife Gail Hart shows that even thick meconium isn't problematic for babies, provided that the meconium isn't a symptom of distress- and then problem is the distress, not the mec. Included: a large study that shows that postdates babies are no more likely to suffer meconium aspiration syndrome than on-time babies.
Detailed Paper about PostDates -excellent research from gentlbirth.org.
Postdates not associated in increased stilbirth, meconium, or fetal distress: study
"Here's a large study that deals with almost 2000 postdates women with confirmed dates, and compares them to over 2500 controls who are under 41 weeks. Note that incidence of stillbirth and meconium were no different in the groups, and that fetal distress was actually LOWER in the postdates group!" -Gail Hart, Midwife, Oregon
Expectant management of post-term patients: observations and outcome.
Weinstein D, Ezra Y, Picard R, Furman M, Elchalal U. Department of Obstetrics and Gynecology, Hadassah University Hospital, Ein-Karem, Jerusalem, Israel.
Post-term pregnancy is associated with increased perinatal mortality. In a retrospective study based on our post-term protocol from 1990 until May 1995 1,798 post-term pregnant women with reliable dating were evaluated for expectant management. A group of 2,633 pregnant women who delivered between 37 and 41 weeks during 1994 served as a control group. The perinatal mortality (0.56 per 1,000 vs. 0.75 per 1,000 in the control group) was similar in both groups. The incidence of induction of labor (7.45% vs. 7% in the control group), meconium of more than +1 (5.2% vs. 4% in the control group), shoulder dystocia (0.33% vs. 0.19%), high birthweight (> 4,500 g) (1% vs. 1%), and cesarean section rates (7.5% vs. 7% in the control group) were similar. However the fetal distress rates (11.6% vs 16%; P = .004), instrumental deliveries (10.1% vs. 13%, P = .002), and the rate of 5-minute Apgar score of less then 7 (1.1% vs. 5%, P = .000001) were found to be significantly lower in the post-date group than in the control group. We conclude that the expectant management and our intensive observation and follow-up in post-term is indicated for both mother and fetus.
J Matern Fetal Med 1996 Sep-Oct;5(5):293-7
Gail Hart, Midwife
www.midwiferyeducation.org
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28-11-2004, 01:52 PM
Babies come on their birth days
Re: Babies come on their birth days
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