#115 | July Q&A: Nausea Remedies; Pregnancy Cravings and Aversions; Partner Struggles; Fear of Childbirth; Baby Engaging in Pelvis; Induction; Transition; Writing Your Birth Story

July 28, 2021

It is time for our monthly Q&A! We are back with a short birth story of a necessary C-section birth followed by your input on food cravings in pregnancy, nausea remedies and your most common pregnancy food aversions.  Next, we discuss the most common relationship challenges in the early postpartum followed by your questions including: Can I have an unmedicated birth if I have a low pain tolerance?  Do I need to workout in pregnancy to have an easier birth? How do I get my baby to engage in the pelvis? Is it safe to go past 42 weeks of pregnancy? How do you manage transition? And what do you recommend for writing your birth story? So many great questions! Thank you to those who have submitted, and keep them coming!

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Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood. You can reach us at Contact@DownToBirthShow.com or call (802) 438-3696 (802-GET-DOWN). We are always happy to hear from our listeners and appreciate questions for our monthly Q&A episodes. To join our monthly newsletter, text "downtobirth" to 22828.

You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

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View Episode Transcript

I've been a doula for years and I've always loved pregnancy, birth and babies. I've wanted a baby for so long. And now my husband and I are finally financially and emotionally ready for a baby. My question is, can I have a natural birth? If I can't even go through my period without taking pain medic, how do I get my baby to engage in the pelvis I am 38 and a half weeks and the cervix is closed and my baby is high and not putting pressure that no one wants this is airing right to be zero.

We want to eliminate unnecessary scissoring sections and we have to allow room for the necessary ones. And it's hard. That's what makes this work hard. We don't get hell bent on one way to birth we can't get to a doubling is a relative risk, their actual risk of stillbirth is still very small. So we need to think about it in terms of those numbers. You're intervening and getting and putting your two cents in on everything, you will drive her crazy. She has to have leeway. That has to be the benefit that comes with all the work she's doing as the primary caregiver, She is the mother. 

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Welcome back everyone to another q&a episode. Trisha You said you had what is it a birth story you wanted to read to start off today.

It's it's a short burst story short anecdote of somebody's birth experience that they wanted to share with us because of the influence that the podcast had on how they processed it. This is a personal email as I had a rather crazy and traumatic birth yesterday morning and I wanted to share my gratitude to you both for your podcast, which I have listened to religiously during this pregnancy as well as my birth story. I had planned for waterbirth at the birth center after having two natural births. So this is her third baby. I spent weeks listening to positive birth stories, your podcasts HypnoBirthing meditations and grounding myself to let go of past fears. I woke up at 4:30am on Wednesday morning to mild cramping at 36 weeks plus six days. After a few minutes, I felt a gosh and I thought that perhaps my water had broken. I went to the bathroom and discovered that I was gushing blood. I knew that this was a sign that it needed immediate medical care. So I woke up my husband and called my midwife who was assessing the level of blood and told me to drive to the nearest hospital. I was terrified. But I went into a very calm state and kept repeating to myself I am brave, I'm strong, I can do this. My husband and I had our family at our house to be with our kids 10 minutes later, and we got into the car and drove to the hospital where I was diagnosed by ultrasound with a placental abruption. The baby's heart rate was good and the doctor was willing to let me deliver vaginally as long as the baby's heart rate stayed that way. However, shortly after the baby's heart rate dropped, and the doctor changed his mind quickly and told me I needed an immediate seseri and section. I believed and trusted him but I was terrified. However, I kept repeating the mantra in my head, I am brave, I am strong, I can do this. I also remembered a recent podcast in which one of you said that the most important thing with the C section is whether the mom believes she truly needs it. And I did believe it, I was rushed into the O r where I had to undergo general anesthesia. And I was terrified that I wouldn't wake up. When I did thankfully wake up, the first thing I noticed was my husband holding our sweet baby boy. And I immediately knew he was okay. My recovery has been so much harder than with my vaginal deliveries. And I cannot imagine anyone choosing this way to give birth. However, I've had nurses, midwives and the doctor all come by to check on me and give me space to process what happened and tell me that it's okay to feel emotional about the trauma of what happened and letting go of what I thought my birth would look like. I feel extremely cared for and nurtured. They did tell me because I was so busy from the medication that I wouldn't be able to hold the baby or breastfeed right away. But I did not take that as gospel and I had my husband helped make it out of the bed and position the baby and had him breastfeeding. As soon as I was aware enough to take control. He didn't need to go to the Nikki at all. He has strong lungs and now he is small. He's extremely healthy and strong. Having said all this, I know I will have some emotional work to do over the next few months to integrate this experience into my life. I'm hoping that I can join your postpartum support group as I know I will need all the support I can get. Thank you again for opening my eyes so much I took in so many messages from your show that stayed with me and helped me through a very difficult birth.

An example of a necessary c section, a necessary c section. Right now we did an event last night Trisha as you know and And this is an important distinction that we need to make. Because while we plan our births, and we get excited to get educated for our births, and envision the births that we want and intend, and all of those things are driving up the likelihood of having that kind of birth, it's important to remember that in the big picture, what we really want is a birth that we feel at peace with. And we often don't feel at peace right after it happens. It's actually a known phenomenon that it takes birth experiences about a year to process you can have a phase like out of the blue and three or four months where you suddenly feel very angry, or a lot of grief. Maybe suddenly, in six months, you're crying about it and feeling more grief than you're feeling today. And it's like peeling off the layers of an onion. And it's almost like the psyche isn't ready to process birth all at once. I mean, I have seen this happen with all births, not just the births that are somewhat traumatic or deviate from the plan. But in that event, you and I did last night, we talked about the fact that no one wants this is airing right to be zero. We want to eliminate unnecessary Syrian sections, and we have to allow room for the necessary ones. And it's hard. That's what makes this work hard. We don't get hell bent on one way to birth, we can't get too attached or hell bent on it. That's what makes the educational process complex, because you need to know when you really need it.

Yeah, and fortunately, it sounds like she had a good team of people around her who really helped her to understand that this was an absolutely needed, C section. And sometimes that is just how birth goes. We just have to relinquish and accept that and thank goodness we have the resources we have when we need them. Sounds like she had a good provider because this provider did not make her go to an immediate seseri and when she walked in the door with a placental abruption, she still gave her the choice to labor for as long as the baby would tolerate it. So I think a testament to good care providers and that's called the trial of labor VBAC. Women need a trial of labor, women who are in the pushing stage for a long time need to exhaust that possibility. They need to feel like they've really attempted everything, because if not, they're going to be hard on themselves later in some cases. So that's an important thing providers have to allow us. Alright, so what's up next?

Yeah. So before we get into our questions for this week, we had some really fun conversations on Instagram.

I love that crowd. It's a spicy crowd, and they share really cool things with us. And there's humor and there's boldness and we just can't get enough of hearing from people on Instagram. When we post stories. I'm I get those responses, and I just I love it. Some of them make us laugh out loud. Some of them bring tears to our eyes.

Yeah, I love We love you guys responding to us speaking with us and not being turned off by our strong opinions. Are you kidding?

What good are we if we don't have opinions? We're not here to impose opinions on anyone. Yeah, it's like it when you hear people's opinions, like our opinions. Your job is to see what sticks. That's right. Your job is to say, oh, that resonates or that doesn't resonate. And then you discover who you are in this process. Your job is never to necessarily agree with us or anyone or your own family or parents, or spouse or provider. That's why we say here, Everyone, listen to yourself. Yeah.

So first, we were speaking to you guys about morning sickness.

I think 85% of women experience morning sickness, did you? I never did. Oh, yeah. My gosh, No, I didn't.

But but not it's not just vomiting. It's also just feeling not just vomiting and feeling nauseous. It's also to me morning sickness is also the food aversion. Yes, that's triggered, you see a food and it triggers an aversion and a feeling of being nauseous. And I had a lot of that with, with my first and my third. Remember with my second I had no clue I was pregnant for a very long time. Right? I did not experience it that time around. And this is what's so interesting about it is that you can have it terribly with one pregnancy and not at all with another. You can have it for a couple of weeks. You can have it unfortunately, sometimes lasting through the whole pregnancy. But the responses were just really funny because some of the things that made people feel better I just cannot even possibly imagine what were they I don't think I saw the responses to this. So the number one thing was ginger, ginger tea, ginger root, chewing on Raw ginger, Ginger gummies. Anyway, go for ginger first. We know a standard is vitamin B six that's routinely offered for morning sickness and nausea. So that wasn't very unusual. But here we get into some funny ones. We had Sour Patch Kids.

I'll come on Really? That's a specific how to how do people discover that they try all the candy in the candy aisle? Well, I think that you know when you're in early pregnancy, you become so specific about what you crave and you crave it. virgins too. So they probably were craving Sour Patch Kids because it actually made them feel better.

What did the cave women have instead of Sour Patch Kids minds? Okay.

Pickles. That's like the standard right? Everybody talks about craving pickles and pregnancy. Potato chips salty potato chips Really? Alright, so surprised to hear all this now I can see that one pink and only pink electrolyte freezer. Wait, wait pink and only pink what electrolyte relay freezer pops? What's a freezer pop? What's a freezer lab popsicle? Oh it's called a freezer pop in the freezer implied don't move from the Midwest. Oh, okay. It's gonna be like sneakers versus what's the other word? tennis shoes. tennis shoes, right?

Oh, athletic shoes or tennis shoes in the Midwest. I you know how uncomfortable I was when I moved out here and had to start eventually saying sneakers.

Look at you cringing at the word. I still cringe when I say it. I didn't know you look down on the word we thought well we think here in the northeast that the word tennis shoes is just funny. We don't only specific to tennis it's not like that's the only activity we ever nation in our lives.

Anyway, I think freezer props might be Canadian or something. But the pink part is only paying only the pink lilac pink ones worked for her.

Like it had to do with the color more than the flavor. Okay, crackers.

That's very typical and very common crackers are a great way to prevent morning sickness. If you my midwife, you always tell me keep crackers by the bedside eat them before you get out of bed in the morning because getting up in the morning on an empty stomach can really trigger the nausea. So put the crackers in your mouth. Get a little something in your tummy before you get out of bed. Cinnamon that doesn't surprising. I don't know why it doesn't. It doesn't mashed potatoes. Really? Well. Maybe that's kind of like the cracker Thaler.

Maybe they're a little salty buffalo bites. I don't even know what those are. So what's up buffalo? I think it must be some sort of Buffalo spicy flavored meat bite. Me bite.

Meat bites are great. Said the vegetarian. I think she said buffalo bites from Costco. So. Yeah, well wait a minute is Do people eat buffalo meat? Is that what we're talking about? Or is that true?

No. People do eat buffalo bison. Yeah, I just assumed it was buffalo flavored like like you would get a buffalo of spicy chicken wing.

I'm sorry. Like a flavor. I never met a chicken wing until I went to undergrad and Pennsylvania. You remember that? Right? So when you order hot wings, they asked if you want buffalo or some other weird flavor. Oh, okay. I always want the you know, the buffalo flavor? Of course, you do. And the last one was peppermint tea, which makes sense if that works. Peppermint oil, peppermint tea. It's helpful.

So that was kind of fun. Do you have the answers to what food aversions people had? Because I found that really interesting. And I was stunned at how many people said chicken. It was so common. It was like 35% of everybody said chicken. Yeah, I actually can remember feeling having a version to chicken in my first two. Let me pull up that one really quickly and read some of these. Okay, aversions, red meat, and I love this. This was someone who felt better eating Cheez Its, and she wrote, so what made her feel better? She would choose it and then what were your versions? Her response was red meat. Pretty much anything besides cheese? Cheese. You know? Bacon. That was another comment on bacon, yellow and white onions. red onions are okay. It's so weird, right? I mean, why am garlic I think that is so funny. That makes sense. Um, chicken, bacon again, fruit and cereal. brewed coffee. to one person. One woman wrote anything healthy was her food aversions? That had to be how I started my first pregnancy. I wanted to get hotdogs and mac and cheese and chocolate milk. The other one wrote me with an exclamation point. Chicken and ground beef. This woman wrote pork except bacon, peanut butter and sprite, an aversion to spray but to spray I bad like I guess seven apples. Okay, you know, eggs? Definitely. tomatoes and coffee. pesto tortellini. She must eat a lot of pesto tortellini before so I just love it. I love the specificity, you know. And then cravings were really fun. Women's cravings were popsicles and ice cream. Diet Coke. I normally don't drink soda, avocado and other fruits, sushi and root beer. plain Greek yogurt with blueberries, olives, sourdough bread and sweet potatoes, but not altogether please. And then look at this one pesto. The one thing that the other one had to avoid this one road presto was her craving. I wish she had passed I tortellini bacon for baby number one. Chocolate malts for baby number two, frozen fruit, ice and sushi. A lot of sushi Yep, got to sushis shirota hot dogs were my craving they normally grossed me out completely same same carbs all thin carbs, Indian food, lemonade or eat chorus You know, it makes sense Skittles gummy candies, pineapple all the time. pepperoni pizza and ranch dressing. Salt and carbs box to macaroni and cheese not homemade exclamation point right their craft all the way. She wrote not homemade powdered cheese product only. Yes, exactly. With a laughing face of vinegar and salty food, peanut butter and jelly only at 1am and receipes. blizzards. no rhyme or reason to any of this.

Yep, just kind of fun. kind of fun to talk about. Alright, what do we have up next? Okay, so the next thing we talked about, and a little bit more of a serious note was what people are struggling with most with their partners in the early postpartum. getting enough alone time, at night after the kids go to bed is our only time and of course at that time, we are both totally exhausted. The pillow is the sexiest thing in the house. For a while there, wow. Yeah, for a while. He doesn't pay attention to the baby or really anything the way I do.

I think a lot of women feel that way. But at the same time, who could possibly match your level of care and attentiveness to the baby right now? That's right. It's no consultation to meet. And when your partner is married to someone who's so attentive and does all the research and all the decisions and finds the right pediatrician and looks into the best solution for this and the best approach for that they consciously or subconsciously can relax because you're running things. So well. I mean, I know that dynamic happens in relationships,

it's a bit meant to be that way a mother's brain is hardwired to be extra alert, and attentive to her baby, it's meant to be that way, at least in the beginning. So we are maybe putting a little too much too much expectation on our partners to have them meet that level of attention and and care, at least in the beginning and right. And we can, we can read too much into seeing the partner being a little bit less attached, and it can hurt. It can hurt. But you don't know how they'll they'll be with a seven year old with a teenager weight and adult child. And you might really see them thrive in the other stages if you don't see them thriving now. So right something to keep in mind, your partner is going to keep changing because your child is going to keep changing. And you will too.

And we each are going to excel at certain stages of the parenting. And when one is down a little bit you hope the other ones up, right. That's how it's meant to go. Right like a balance beam seesaw not a balance beam. This is a good one. She says we can agree on bedsharing. I want to but he does not and I am exclusively breastfeeding.

I mean, I'd like to know why he doesn't. And this is one of those things. I'm very biased. If she's breastfeeding, and she's the primary caregiver. That's it. She gets to say she makes the decision. I'm with you on that. Yeah. Now if he's concerned about safety, then you guys need to look at the research and and find that it is very safe. When done responsibly. It's easy to do it responsibly. But what's the reason?

Also, if he's uncomfortable with it, maybe until he gets comfortable with it? He sleeps somewhere else?

Yeah, it might be about the room in the bed, we'd have to see the reason for it. Yeah, I'm biased. But like once your bed sharing and their nursing while you're getting your sleep, and you don't have to keep getting up and down. Oh my gosh, it's safer. It makes you Drive Safer later that day, because you're more rested. And it's wonderful for the baby safely sleeping near our babies when you're exclusively breastfeeding is protective against SIDS. It's known fact. Right?

So take that. Right. All right. So that's it for Instagram shares for today. Fun.

So I wanted to say one more thing on that topic. Because sure we you know, we talk with postpartum women so much. And there are times where you and your your spouse or your partner are going to disagree about how to do something. And let's put aside safety questions, right. Like, for example, if one of you is more conservative about a safety thing, I think the more conservative parents should always rule. If one thinks something isn't safe, and one thinks something is safe. You should err on the side of the more nervous parent who wants to keep things safer like that. That's that's fine. But for all other things, I think it can't be a 5050 decision. I think there has to be more weight on that primary caregiver. Because she's gonna go crazy. If she's taking care of this baby 90% of the time. And then her partner comes along goes, I don't want to do it that way. I don't think we should. I mean, we had a mom just talked to us about her husband giving her guilt about weaning. I mean, that's just not it's not his decision to Make when it's her body and she knows what she's willing to do and what's working for her, and how far she can go with it. What? Yeah, you just both have to agree she's going to make most of the decisions because you will drive her crazy. If you're intervening and get and putting your two cents in on everything, you will drive her crazy. She has to have leeway. That has to be the benefit that comes with all the work she's doing as the primary caregiver. She is the mother. Yeah, I mean, I mean, I think I think if the if the other parent or the father is the primary caregiver, I say the exact same thing. I've known a few dads who are in my classes who she kept her job he stayed home, I would absolutely say the same for him. Don't drive him crazy. Let him own this role. There are certain decisions you need to make together. Obviously, if one of you is uncomfortable with the pediatrician, that's a showstopper. That's not okay. But with the little daily decisions. I mean, come on, if she wants to bed chair because she's bleary eyed, and she has to make that decision. I think it's like any job you do if somebody else is micromanaging your job. That's right, never gonna feel good, and that's never going to help you have a good relationship. Exactly.

Alright, so let's jump into our questions.

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Here's the first question. I've been a doula for years. And I've always loved pregnancy, birth and babies. I've wanted a baby for so long. And now my husband and I are finally financially and emotionally ready for a baby. I've always wanted to have a natural birth at home. But I'm starting to doubt my ability to tolerate the pain. I have a low pain tolerance, I get chronic headaches and have extreme period pain. So I take medication for that often. However, I know that I'm strong and can overcome anything. I even trained and ran for my first marathon to prove to myself that I'm physically and mentally that I physically and mentally have the endurance and strength to give birth naturally. My question is Can I have a natural birth? If I can't even go through my period without taking pain medication? I plan on having one maybe even two doulas and taking HypnoBirthing during pregnancy with my husband, even though I already know most of this information. Thank you so much. Any advice you have will be greatly appreciated. So yes, yes, you can have a natural birth. Yes. And here's here's the main thing I want to say of course, this is a very common type of question I get as a as a HypnoBirthing instructor. Women sometimes sign up for the class and First they want to know like, Is it okay, if I don't plan on having a natural birth? Of course it is. The goal is to be calm and in control, no matter what kind of birth you want. However, this doula in her training has become convinced this is a matter of overcoming it and adoring and I can do this. And that's not ever what we're looking for. We want you to relax into this. Just trust that at any moment. If you feel you want an epidural, just have the epidural, your goal is to feel good and calm and at peace. Not you can do this. You've got this. I don't give that message. Because what if she chooses an epidural? Did it mean she didn't have this? Does it mean she couldn't do this? The idea here tell yourself, I'm birthing on my terms. As long as I'm comfortable, I'm going to keep planning this birth every moment by moment, planning this to be a natural birth, if at any point I changed my mind, I'm going to change my mind. What if you go into labor at 130 in the morning and you've had two hours of sleep, that's not the same as having a full night's rest. What we want to put our focus on is how you will respond to it and allow yourself the freedom to change course or to have intervention if you want to during the birth just take the pressure off yourself is what I'm thinking or because she's very used to having very uncomfortable periods labor might not actually feel that different to her. I mean, I have definitely attended births where women who have had very painful periods throughout their life, say labor day it was just like a little step up the pain of your period is something you don't want to experience. It's something you want to make go away. You probably have to go to work that day, you probably have to get up and do things. You don't need to tolerate that pain because you have options. Good point. She wants a natural birth. She wants to have an unmedicated natural birth. And so it's a very different mindset. Yeah, it's a good Trisha. Yep. It's not something you need to mask. It's something you need to embrace. And I bet we'd love to hear her experience after her birth, but I bet she does. really well.

Yeah, birth and she's planning to take HypnoBirthing which of course, I'm happy to hear. I think that's terrific. She might even take my HypnoBirthing class. Trisha, wouldn't that be fun?

Yeah. I know. That'd be really good. We would, then we'd get to know the birth story, too.

Yeah. Yeah. So yeah, I mean, I just think this notion of, I'm strong enough to do this, I can overcome anything. It's setting the stage for experiencing birth as something we're meant to conquer. And just know that the more relaxed you are through your labor, the more comfortable you're going to be. What you're going to feel in labor isn't predestined. Labor sensations change based on your position, they change based on your thoughts, they change based on your emotions, the support in the room, water makes you more comfortable, even listening to water reduces pain receptors in the body, we just learned that in Episode 100. with Barbara Harper, founder of waterbirth, international, there are so many things that move the needle into a more comfortable birth.

I you know, one of the most common reasons that women do choose an epidural is when labor goes on for a really long time. And having trained for a marathon and having been able to run and complete a marathon, she clearly has endurance and endurance is very helpful. If you have a long labor. We hope to hear the burst story. Absolutely. All right. Oh, so here a little bit of a similar question. The next one says, I am worried that I won't have an easy birth unless I workout in my pregnancy. Is this true? What do I need to do?

I mean, that I find that to be an interesting belief as well. Did your ancestors train? Did your great grandmother, let's say around 1900? Did she train? Or did she just cook all day and do her chores. so careful of your belief system? I had a mom in class years ago who shared the first day of class, she always believed she wouldn't be able to give birth. And I said, you know, why is that? What Where's it coming from? And she said, because I'm not flexible. And I was like, that that's okay. That's okay, the splits, you don't need to be flexible. You don't need to train there, there are things you can do that will really benefit you. But just come from a more I think a more positive belief system, like everything I'm doing is going to make this easier for me rather than if I don't do this, I'm not going to be able to give birth.

I think being healthy and active in your lifestyle is only going to help you in birth. I mean, that's just kind of a given. But do you need to specifically train and do squats and stair walks and other birth related exercises, as some people would tell you? Yes. And there are a lot of really good people out there in the birth world like doula krisha, she has a whole program around training for birth. So it's only going to help you Yes, but if you do not train for birth, it absolutely does not mean that you're not going to have an easy birth. If you aren't an exercise person, but you do want to do something, yoga is probably the best thing you could do. Oh, yes, I completely agree with that. That's the best thing you can do. So one funny thing, this probably is very anti HypnoBirthing. But one thing I can remember my midwife telling me when I was first pregnant was to hold an ice cube in your hand for a full minute. Have you ever tried that? Have you ever heard this? We got a question about that. Remember, we got to do it. No, no, that was about a comb. I know, like squeeze a comb. I think it's the same way. Yeah, I've heard of techniques, also in yoga classes where you do a repetitive action until it kind of burns. And I think that's cool. I mean, can you stay calm and in control hold an ice cube? Yeah, it's very challenging until your whole hand goes numb, and it's fine, then it's like having an epidural in your hand. It's like, but I mean, in practice, not reacting.

Yeah, I'm not sure it really prepares you for labor. But it's a it's an exercise of the mind.

It does prepare you because what you want to practice is not responding to what you're feeling physically. Right, just separating it. It's very powerful. And then you can go so much beyond it, which is what we do in HypnoBirthing. Now it's like, well, where do I put my mind? We don't want to hold the ice cube and be like, Oh my god, oh my god, it's so cold. Okay, I'm not gonna react. I'm not gonna do anything. I'm gonna keep my relaxing. You know, you want to like, visualize truly relax into it. Could you smile and relax into it? human beings can do that, if they're determined to that's, those are the kind of techniques you can learn in HypnoBirthing very easily. They're just everyday techniques for everybody. Right? That's so give that a go. give that a go.

How do I get my baby to engage in the pelvis. I am 38 and a half weeks and the cervix is closed. And my baby is high and not putting pressure on my cervix. Any tips on what I should do? Be patient Wait, wait and be patient. I mean, honestly, if this is the first time Mom, it's very normal for the baby not to engage until labor begins. So they babies do tend to stay high, the cervix tends to stay closed, until really closer to the time of birth and 38 weeks, you know, you might still have three weeks of pregnancy. So I would not worry about this, I would not lose sleep over this and try not to recline too much forward leaning is the best suggestion. So if you are reclining a lot in a on a couch, you know, leaning back on a couch or sitting in a car or a ladder sitting at your desk, you want to try to get away from those positions and sit on a birth ball and sit in any position that gets you a little bit more forward leaning. That's not necessarily going to make your baby engage in the pelvis, but it is going to help your baby to rotate more into the anterior position, which will be more helpful.

What are your thoughts on going past 42 weeks?

Yeah, so my thoughts on this are that the first things I would ask is your baby doing okay. And are you doing okay? And if you both are doing okay, and there are no signs of distress for baby or signs, warning signs for mom of in late pregnancy, then I think it's fine. The concern, of course, is that the risk of stillbirth goes up after 42 weeks. And it does in fact double after 42 weeks. But you have to think about that. Doubling is a relative risk, the actual risk of stillbirth is still very small, so we need to think about it in terms of those numbers. So at 41 weeks, out of 10,000 pregnant women 17 of them will experience a stillbirth at 42 weeks out of 10,000 women, that number doubles to 32. But that's still an extremely small amount of people.

And you know, for years, the World Health Organization up until recently now, I think there's a lot of pressure from the medical community to back off of this recommendation. But for years, they recommended not inducing a day before 42 weeks, and you still would have the choice at 42 weeks. What was interesting is with that recommendation, most providers in the United States just ignored that and said well I induce at 41 weeks well I induce at 39 weeks, and it didn't matter that the World Health Organization said no sooner than 42 weeks, around the same time about 15 years ago or so. In the Netherlands, they also heard the World Health Organization recommendation of inducing no sooner than 42 weeks. And they too ignored the recommendation. And they as a national policy induced at 43 weeks. And at the same time period as we were becoming number one in maternal mortality in the world in the industrialized world. They were number one in maternal safety. So it just puts a lot of different angles on this discussion. There's no right or wrong answer. It doesn't mean don't induce it. 42 weeks, it's complex. We don't know the right thing to do. But don't go into your fear based state and react if it doesn't feel like the right thing for you.

If everything is fine, let it go.

I think and ask your intuition because when we have heard I mean I hate to even say the word stillbirth. It's the most horrifying word. But when we have like our stillbirth episode, Episode Number 14, I mean, how many women said they just said I knew something was wrong. I knew something was wrong. So I think no one can tap into that as well. As you you know, when things are safe, you know when you need to take action, you know when you don't need to. So be careful of getting jerked around by all the advice. You know, don't listen to us too heavily. Don't listen to your provider too heavily take it all in, there's no right or wrong. There are different approaches. Globally, it's a very difficult decision, you really have to ultimately check in with yourself. These are hard decisions, but there's no absence of risk. I mean, we could pregnancy, whether we intervene or choose not to intervene. There's no absence of all risk. So that's why there's no right or wrong answer. And these decisions are hard.

And really importantly, make sure your dates are correct. I mean, there's so many inaccurate due dates based on you know, not knowing when we can save not having regular menstrual periods. So it is really important to know if you're actually 42 weeks, go back and double check those dates, make sure the right yes. And you're going to take it day by day at this stage, you're not going to say you know, I declined induction at 42 weeks, and I'm not, you know, waiting till 44 absolutely want to make an assessment daily on this. So that's where tuning into your body is really important. As you said, I think we probably can squeeze one more in.

Well, I mean, I can answer this one quickly. What's the best way to manage transition, it totally freaks me out. Don't even worry about it. But just if you're freaked out if you're scared about giving birth, take a HypnoBirthing class or find something that works for you. You know, if you're deep enough in yoga, meditation practices, I, you know, I'm so pro HypnoBirthing because it comes with so much other evidence based information, but just trust in the tools that you're going to practice to keep your calm, there's nothing to fear about transition, I had no idea when I was in transition, just let's let go of those notions completely.

I also would say that when you if you do notice transition, because some people do feel a really strong sense of labor progressing quickly, just ride that feeling. That's your labor progressing, the next step is pushing. And that's a whole different feeling. So when you hit that maximum peak intensity, and a lot of women will know they're in transition, because they start vomiting, or shaking, or they do have some physical signs of it. Not everybody, not everybody, some people just go right through and labor kind of feels the same all the way. But when you get to that point, no, you're close. No, the next step is working with your body to push your baby out and let that bring you comfort, as opposed to feeling fearful of it. Okay, last one, here we go. I am overwhelmed by the idea of writing my birth story, do you have any pointers on the best way to do it or how to get started, just put down some words on paper, I think we can really, really get ourselves worked up into a writer's block. Because, you know, sharing our birth story is one of the most important stories that we may ever write. And so we want to get it down on paper perfectly. But it's a work in progress. And if you just get some feelings out, you just get some of the key details down on paper, you know, maybe what time you went into labor what time that baby was born, who was there. The sooner you do it, the more inspired you'll be to sort of elaborate on that birth story. Because I I think it's really easy for us to not do it. And time, the farther we get away from the birth experience. Sometimes the harder it can be to write it eventually. Sometimes we get to a point where we don't write it. I know that happened to me. And I wish now that I could just go back and have at least those details, few of those details. So just put something on paper.

Again, I think the easiest thing to do, the most important thing is to capture the details as soon as possible. Because I wrote mine in detail after my daughter was born. I think after each of them was born, of course my son's was written and published. So I know I wrote that one. But I remember specifically writing my daughter's. And I went back and read it a couple of years later, and my jaw dropped because I completely had forgotten a host of details. It was like reading someone else's story. So I would say if you feel overwhelmed, voice recorded, because you'll just chat and you'll go on and on and on and on and on. And then worry about fine tuning it and writing a beautiful version of it later. But capture the details such as voice recorded,
it'll be fine. Isn't this what they say? When if you're a writer, you just put the pen to paper and you just put out whatever comes to your mind. That's how we get past the writer's block. Just start somewhere and then come back to it later does not have to be the final story The first time you write it down. Yeah. Great. All right, that's a wrap on today's q&a. Thank you for being here with us. 

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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