#120 | August Q&A: Family Boundaries; Good Babies; Measuring Big; VBAC Safety; Tandem Nursing; PTSD in Labor; Lotus Birth; Testing for AMA

August 25, 2021

Hello Again! It is time for our August Q&A. Because we love our IG conversations so much, we open the episode with the very important topic of establishing family boundaries postpartum and share your biggest concerns while offering our best advice.  Next we have a short convo on "good babies" followed by answering your questions including: Is measuring too big a reason for C-section? How to handle questions around the safety of VBAC in a birth center? Is high blood pressure in pregnancy a reason to be induced? In tandem nursing, will the new baby still get colostrum? How do you relax in labor if you have a history of birth trauma? Is there a happy medium between a lotus birth and delayed cord clamping? Do I need to do testing for AMA if my due date is just after my 35th birthday?

As always, thank you for your questions and your contributions to this awesome community!

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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!

Support the show (https://www.paypal.com/paypalme/cynthiaovergard)

View Episode Transcript

What happens after you become very well informed? Through childbirth education is you can ask them better questions more telling questions such as, what are the most common reasons you give certain sections? When you find out the reasons that they give them, then you really get to know that I

was wondering if you have any tips on how to relax during birth for women who have had significant trauma or PTSD, you can tell them that that's what you need to hear from them.

And if that doesn't work, then you have to stop being willing to discuss your birth with them because they're not serving you.

A friend recently was induced eight days before her due date. She was planning on an unmedicated birth in a birthing center, but her blood pressure one day was 140 over 95 and the following day was 130. overnight. One

is unbelievable to me. I couldn't believe my eyes when I just read this. I have a question for you ladies. My baby is due October 10. And my 35th birthday is October 6. At my last prenatal the midwife mentioned if I do have him after my birthday, even if it's the next day that I will have to do I will have to have extra testing done since I would be considered geriatric. This is insanity. This is evidence of how crazy we have all gone. Oh, come on. I

mean, we know that the day you turn 35 everything just goes absolutely downhill.

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.

Hey, everyone, we are back today with our August q&a. We have some excellent questions. Thank you for submitting them. But before we begin, Cynthia, do you want to kick it off with sharing this most excellent recent review on Apple podcasts? It just came in. So it seems destined that we should read it right now. So

thanks. So it says the Down to Earth show is one of the best podcasts and resources I found involving all things pregnancy and birth. They cover a wide variety of topics, including more sensitive slash controversial topics, just the way we like it that needs to be talked about more. That is just the way I mean, you know, somebody's got to talk about them because everybody's thinking about them. So Cynthia and Trisha have wonderful personalities, no pressure, and make learning about birth enjoyable. They seem like the type of people you could easily sit down and have a cup of tea with and talk for hours. Yes, yes, true or false for true. Whether you're on your conception journey, currently pregnant, or in the throes of postpartum, you're simply or you're simply a birth junkie, this podcast is for you. Thank you so much for that review. Much says it all, I would say very nice. So what's on the agenda today, Trisha?

Well, we have excellent questions. So we're gonna get to those. But we also had some interesting conversations happening on Instagram this week through our stories. And the I think the one that was most popular this week was about boundaries with family most most of all parents and in laws.

Yeah, this is a topic that you don't tend to think about in pregnancy, but postpartum boundaries becomes if it's not something you've faced or dressed up to that point in your life, you're probably about to so the first several questions that we received all centered around family boundaries. So let's, I'm going to just read those in a category Trisha cuz so many of them sounded like the other. So here's the first few that were specifically around boundaries. One question was, how often should grandparents get to see the baby? Another is should I allow my in laws to come over unannounced? Do you have any do's and don'ts for whether family should be allowed to post photos of your baby on social media? And the last one in this category says I want two weeks with no visitors after the baby is born. How do I tell my own mother and mother in law? Well, let's start with the last one because that was really easy. We'll take our fourth trimester workshop and we professionals insist you have a weakness for two weeks and then you can blame it on

we will give you strict orders of two weeks of basically no visitors. It's really easy to say no to that because those first two weeks are absolutely 100% about you and your baby healing, resting bonding, breastfeeding and you and your partner and your family establishing your own little circle of new Life. And

it's really, really reasonable to ask people to wait to meet the baby. Now to even have the question, how often should you allow grandparents to see the baby? That's an interesting question. I mean, is it because you want privacy in the early weeks? Is it because they don't respect your way of child rearing? Or they're not respecting your approaches, and you feel like you have to defend yourself? Or is it something that you can make better for yourself? In our postpartum support group, we find a lot of this stress comes simply because women aren't willing to speak their truth. They're not willing to say how they really feel. If it's not a good day for them, they're not willing to cancel or say, could you come a couple hours later, I need a nap. They're not honest in saying, I think I might have postpartum anxiety. And if you don't mind, I'm not ready to let anyone hold the baby yet. Or to say, Can you just please help me when you come? Can you do something when you come? Can you throw in some laundry? Can you bring food? Are you willing to be honest, because if so, and if they can hear that, then the more that they come, the better you'll feel. So I think that's a lot of

Yeah, I think your point about what's the purpose and then coming is the first place to start. Because if you can have visitors come and your visitors can understand that their role in visiting you is about doing all the things that are going to help you take care of your baby and not about them. And their need to meet, Bond, love, whatever with the baby, those first couple of weeks, everything has to be about taking care of all of the things outside of you, so that you can be 100% with your baby. So if your grandparents can do that, if your mother in law can do that, if your friends can do that, then visitors are helpful.

Sometimes we especially in the early postpartum, we can be really obviously exhausted, and very sensitive. And sometimes there's a little bit of a defensiveness like Well, I'm the parent now I'm doing things my way kind of voice. Communication is everything here. It's just everything is it, don't take things personally, if you can help it and just ask yourself, if you were giving honest communication before you jump to that conclusion, because I do find more and more Trisha people close to each other. Even in families, they're really not honest about their Well, you know, right of hurting each other. They're afraid of offending

because people aren't always honest, within their own self, you know, you have to really know what you want. First, you have to be able to be really honest with what you feel so that you can communicate that with others. And sometimes we get confused about what we feel because we let external pressures and external influence actually mask what we really feel. Everybody feels so differently. Some people love having the baby health. They feel like that's the loving gesture. Thank you for helping me and supporting me. Other people, as you said, feel like that's taking something away from me and assuming I need help that I don't need.

And you can't think other people know how you feel you have to be clear about your emotions. tricky. Certainly as let's continue with the other comments that came in. Oh, I can totally relate to the next one. totally relate to thank God, this didn't come up. This one seems worse would have been hard at this one. This would have been so hard for me. How do I let people know not to wear strong three houses around me

I had to do that and shut with a child care a lot. This one also seems very justified because we know that synthetic fragrances have health detriments. So it's very reasonable to say, Please don't wear fragrance or on my baby. It's not good for their health. It's not good for the person health who's wearing it. But that's not our job to worry about. But we can protect our baby. Alright,

when do other kids and cousins get to meet the baby? Aren't you? Are you amused by the how people are phrasing this? When do they get to meet the baby? Right? Isn't it kind of just up to everyone? Now, you know, for some people, my nieces and nephews were holding my newborn. But for others, they are really anxious again, is this about germs? So I don't think there's a right or wrong answer to this what feels right to you? What are your thoughts? I

mean, I completely agree. I think it's, I think your cousin's and other kids can meet the baby within a few hours of birth. If you're having a home birth, they might be there welcoming the baby. I mean, we were just saying that, you know, we totally support no visitors in the first two weeks. But we totally support that if that's what you want. And I think it's very reasonable to request that. But if you want people to visit on day one or day two, or whenever that is okay, too.

All right. Next thing was I'm 20 weeks and dreaming of a home birth mom, my family would freak. How do I not tell them? Don't tell them? This is don't tell them? It's so common. I know. It feels like it'd be trial not to be honest about something like that. But if they're crossing boundaries about having opinions about where you decide is the right place for you to birth, then you've got to take boundaries into your own hands and not tell them. That's what a lot of people do. I think it's best when you can tell them and just tell them look this we don't need to come to consensus here. We don't all have to agree. You just need to hear and respect our opinion. If they can't hear that, then you have to manage it by not Yeah,

because what you really don't need when you're getting ready to have a baby is a lot of negative input about your choices. Just keep it to yourself. It's okay. Lots of people do that,

that one leads really well into and your comment leads really well into the next one, which says how to get my mom to stop telling me how painful and hard birth is. Tell her to shut up. Right? There are two things you don't have to listen, you don't have to be see what there's so much pressure on us to be polite. But you can politely remove yourself from the conversation. You can also say this isn't serving me, that's a really useful way to get through a lot of these things. Use the term serving I Mom, I have to ask myself, is it serving me when you're telling me this? And the answer is no. So please don't tell me but I'm so polite about it. Well, I think that is how I would say it. But I I don't think I've ever told anyone to shut up in my life. I email what I can. But I

only said that because she says my mom keeps telling me I mean, at some point, you're like Enough,

stop 100%. I mean, there's a point where anyone can get pushed and say, That's it enough. But I will also say I find it helpful. Personally, I did have this experience a little bit not at all with my own mother. But I did have this experience a little bit with someone close to me when I was pregnant. And it helps to recognize, you know, it comes from the Four Agreements, nothing anyone says or does is because of you. And there's something called a need for significance. And a lot of times when women really have a need to talk about all Boy, you have no idea with you off, it was so hard this that it's kind of their own need for significance.

Your mother is still processing her birth experience. 30 years later. Yeah, I mean, really, that's kind of if that's what's happening, that it could be very true that that's still there's still some on resolved feeling there that she's feeling the need to pass on to you.

And it's also that people just have such a need to feel seen and heard. That's what I mean. And she probably didn't feel that way then she probably never had the acknowledgement. That's right. That's exactly

what I mean. Or, you know, her birth was a maybe a painful, difficult experience that never really got resolved within her nobody. She never felt that it was recognized how hard it was.

It's also cultural. It's definitely become a badge of honor in this culture. I mean, I grew up recognizing it as some kind of badge of honor. Painful Oh, you have no idea. What sure like the women telling stories? Of course you just hear throughout society. Oh my God, my birth Oh my God, I thought I was gonna die. Bla bla bla bla bla. You know, it's, it's odd to me like a little bit

of like a hero thing. Like, it was so hard. Like I did or got through it. Or I mean,

no one does a triathlon and talks that way. And they should they can they have a right to they can be like, Oh my gosh, it was okay. They take it in stride, because they want to look super cool, like a super cool people that they are showing us what they can do. I have a lot of friends who've done triathlons.

Not a lot, I have a few. Now, the last one says how do I get family and people to respect my non toxic lifestyle when gifting things to maybe I can remember going through that? Well, there's two ways. One, you just say thank you and put it in the giveaway pile, or you explain your position and just say, you know, right now we're sticking with organic, whatever would not plastic, whatever your preferences are, just let them know. I think people respect that.

I think so too. Also, the house gets cluttered so quickly, it's overwhelming. And I remember by age like three, we started asking for experiences rather than stuck. Just take them like little they're beautiful little like kids play, we always did the theater a lot. So like little local kids theater, take them to plays, take them to shows. It's a great way to avoid it altogether. This stuff. Yeah. But it's it's not easy when you're informed. And this is true in every area of life, when you're really informed in anything. It's not easy that you're in a society that isn't and when you're informed in the matters of the harms of toxicity or however you choose to live naturally. If you do choose to. It's difficult that you're in a society that doesn't understand or agree. So you just have to sit with that discomfort and careful of who you engage with because you don't have to explain yourself to anybody. But when it comes to things coming into your home, you have a right?

Well, as we always say, you know, when you have a baby, this is the time when you move out of one role and into another role. And that new role requires setting a lot more boundaries and getting to be really confident in your decisions in a way that you've never had to be before. Nothing like parenting to throw you into that.

And it's funny because if you really think about it, they're asking us, you know how we always say here, Everyone, listen to yourself. That's our motto. They're asking us Should I let family post photos on social media what to do about how often family should visit or get to? Or should they come over unannounced? No, no one should come unannounced. We didn't really acknowledge that when no one should come come over unannounced. That's not respectful. We all have cell phones. It's easy enough to check in. I wrote, I wrote to one of those posts when they said my mother in law or keeps coming over unannounced. And I wrote, I was obviously joking. And hopefully, hopefully people understand my dry humor. But I wrote that she had a key or break him. Because I don't know how people can come unannounced if they're coming to the door. And it's not a good time, don't answer the door. Right? I mean, are they just walking in? So you have to manage that. But what I was going to say is sometimes people ask us questions, because they want us to tell them what to do. And we love to have the discussion. And we love to share stories of what other people are going through. But we're not here to tell you what to do either. When nieces and nephews and cousins should see the baby how often people should come visit, how to manage what they bring into your home. Your process of figuring this out is what's going to turn you into you're the full on Adult that you're evolving into. That's right. Because the more we talk about things, you sit with it and you go, Oh, I could never do that. I would never say that to my Oh, like, Oh, I would never not tell my family where I'm giving birth. All right. Well, now you've learned something about yourself. Yeah, we threw that out there. Now, you know, that's not the approach for you. So now you have to think, alright, guess I'm going to tell them then let me think about how to have the conversation, say so the more we throw things out, you see what resonates what sticks, what you have an aversion to you discover who you are. That's why we're here not to tell you that you need to be how we are. Because that would make no sense. And rob you of your own evolution here. So I loved that you put out there. This was another thing we did on Instagram. Do you feel pressure to have a good baby, the term good baby has bothered me. Since before I've had children. I find I it pains me when a client of mine says Well, she's a good baby. And I'm like, they're all good babies. Is there any such thing as not good? I always say does that mean compliant? does good mean compliant?

Good means good means they eat every three hours. And they sleep for four hours at a time. And they sleep for eight overnight and they don't cry when they're in public. I mean, really, what does it mean?

Part of the reason women struggle so much with finding their voices, and there's so much pressure on wanting to be liked by their doctor or wanting to be polite in that birthing room. And we're all for politeness, we're all for civility. But part of the problem is we're raised to be good. And what does good really mean? It This has nothing to do with being good, good hearted, is being compliant, or were you raised to be compliant. So when you have an following the forever set following the rules. And if when you have a six and seven year old who sounds like a little clever attorney, trying to talk you into something and debating the pros and cons of something they want from you, I hope part of you really respects that little kid, even if they're making that moment difficult because you think well, you know, you're going to be a really good adult you're really good at at saying you're a piece you don't want just want kids to say yes, please. And no thank you all the time and do everything you say without exerting their own will once in a while.

Yeah, I totally. I mean, I always say that when you have a feisty kid. Yeah, it's hard. But I mean, you're gonna really, really appreciate that quality in them as they grow up, and especially when they become adults. So when we put this question out there to all of you 74% of you said you felt pressure to have a good baby.

That's a sad to me, I'm so sorry that people have that pressure on themselves. So if you're in the store, and the baby's crying, you're afraid of what people are thinking. If you're afraid to admit to friends or family, the baby got you up seven times during the night, cuz you're afraid they're gonna conclude your baby isn't good. I see

this so much. In the lactation work that I do. I see this so much influencing how many times a mom is willing to feed their baby, because when they feel like their baby wants to feed every two hours, that feels like not a good thing compared to their friend's baby who's eating every three to four hours. And you know, they're feeling like they have to offer the breast constantly. And that feels like a not good baby. And it actually influences their breastfeeding relationship. I mean, it's a it's a major reason that moms can experience low milk supply because there's so much pressure to not feed the baby in the wrong place in front of certain people too often too long.

Sometimes it takes having a baby to learn how to build. This is just probably the first time in most people's lives where they do develop that muscle so that you can have it from day one.

I agree. I mean, I agree. I remember feeling that way with my first I had, you know, a baby that wasn't as good as the next door. You just said could I keep the dream rotation? Okay, that air quotes changes everyday. Okay, I mean, I actually felt that way. I was like, what your baby sleeps all the time your baby doesn't cry. Your baby feeds so much faster than mine. I mean, I can remember feeling that way with my first I was only 26. I had no idea but it of time, it took time to realize that we like, well, first of all, a baby cannot be bad. It's just, it's an oxymoron there. It's impossible for a baby to be bad. They don't have. They don't have the will to be bad.

Right? They haven't learned yet from you how to be bad. That's right. hasn't been installed yet. I mean, truly is old school things stick

like there used to be thank god This has gone away, but spoiling the baby. I mean, that was just crazy. I don't know. Thank God, like around the time we had kids that was phasing out. I don't think this new generation I think specific people still hear that. Don't spoil the baby. That just doesn't even make sense. Show me a spoiled. I mean, what does that mean? You hold them to me anyway, we won't get you. Well, that you can teach your child bad habits don't do that. But if you pick them up and meet their needs, you're not spoiling them. It's it's so much pressure, so much pressure on that primary caregiver. Let's move into our questions. All right. Hi, ladies, my friend is at 40 weeks, but measuring at 42. And her doctor is adamantly telling her that she needs to do a C section. She desires a natural birth. Do you have any suggestions on how she can avoid a C section? So wait, let's, let's break this down a little. I want to make sure I'm understanding this.

She's measuring 42 based on fundal height. She's 40 Weeks Pregnant based on early dating ultrasound.

You think she's 42? based on fundal? height? I think she's 42 based on ultrasound? No. They don't measure fundal height in most places. I think they mean based on ultrasound, which is

having this. How do you how do you date? How do you date? 42 weeks? Based on ultrasound?

They say based on the size? I mean, it happens to people they try to change it?

I don't think so I think it's fundal height? The answer to the question is the same. But the understood. Just clarifying the question, I think it doesn't matter if she's measuring 42 weeks on fundal height or ultrasound. They're both not predictive of anything. Right?

I mean, a scheduled c section that's outrageous, because it's crazy. I mean, it would be bad enough to be saying induction but a scheduled c section.

You just cuz she's worried the baby's gonna get too big because she's measuring bigger than that it's five greater

right and size of baby has nothing to do with. So this birth. So there's misinformation at the premiere. And

this is an this is classic for certain hospitals and certain doctors to want to schedule a Syrian based on predicting a big baby. And the problem in this woman's case is that she's 40 weeks and trying to change providers at 40 weeks is challenging.

I love to point out to people sometimes that the majority of the reason that my clients have had home births, for those who have had home births is that they simply ran out of options. There's a minority of those couples said I want to have a home birth, we're so excited to have a home birth, but probably 70% of my home birthing clients just ran out of options. Yeah, vbacs most of the vbacs and several of the VBAC after two c section moms had home births because no one would accept them. And one of my first home birthing clients from 15 years ago, was in exactly the situation. They went to a late 40 week ultrasound and the doctor said, You know what, you're measuring big, you should have a C section. And they were like, they were shocked. They were like, Oh my gosh, this is exactly what we were warned about. They scrambled and had a home birth, because they just felt like we can't birth here. So it's not to say your friend has to have a home birth, it's to say she absolutely can refuse to have a C section. I'm stunned that the doctor didn't recommend induction instead, which is already controversial enough and not just

about the reason she's not she's not recommending induction because she thinks this baby's too big for her body. She's worried about shoulder dystocia. And induction isn't going to prevent a shoulder dystocia.

And this is why we have the worst birth outcomes in the entire developed world because of doctors like this and practices like right,

so this is a this isn't an obstetrician who's practicing surgical obstetrics, and not real obstetrics? Because in right, as Dr. Su would say, in real obstetrics, you understand the pelvic anatomy enough to deliver a breech baby to manipulate a baby's position to prevent shoulder dystocia to mean to maneuver a mother's position to prevent shoulder dystocia. First of all, we know that the size prediction whether this is fundal height or ultrasound is very inaccurate at this point. So this woman is going to have a hard time finding another hospital based provider to take her at 40 weeks. That's just hard to do. If home birth is not an option for her, it would be even difficult to find a home burbot hungry midwife, but her next best option, I think is to just stay home labor at home for as long as she can. And hopefully she can get to the hospital at a point where birth is happening. Yeah, it's going to be a challenge.

We often recommend asking your provider early in pregnancy what their c section rate is. But then usually there's the caveat that you have no idea if they're going to give you an honest answer. What happens after you become very well informed? Through childbirth education is you can ask them better questions more telling questions such as, what are the most common reasons you give certain sections? When you find out the reasons that they give them, then you really get to know them. But before you're educated, you don't know which reasons are legitimate and which aren't. And if you're hearing things like, Oh, well when the baby is too big, that is a red flag not supported by any evidence at all.

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How do you handle family questioning you about the safety of a VBAC in a birth center. I will not be going into a hospital again. But my family members in medical in the medical field think it's dangerous, it still doesn't change my mind.

Well, the safety of a VBAC in a birth center versus a hospital. I mean, first of all, most birth centers are well affiliated with hospitals. So if there were any things that came up in the birth, that required a hospital transfer, that's very reasonable. There aren't really specific data. I don't believe that discuss VBAC in centers or homebirth homebirth v backs compared to hospital birth backs, but we do know, overall, that V back is very safe for low risk candidates. So if it's very safe for low risk candidates, to me, that means that it's safe. Also, universe center, your risk doesn't go up because you're having a birth in a birth center. Right. And in fact, there's gonna be fewer interventions in the birth center. So the risk of uterine rupture, which is of course, is always the biggest thing on everybody's mind is not going to be greater because you're in a birth center is probably going to be safer.

I think the key thing here is, how do you handle family? Again, it's another boundary thing, stop engaging, I think one line that I think is very helpful, that I once had to use, not with my immediate family members, but I had to use once is we don't have to come to consensus. If they start to give you their opinions, you can say we don't have to come to consensus you whether you're comfortable or not with it, you have to respect our choices. Yeah. And this is this is just the beginning of they're having to step back, they've had their opportunity to have their births to raise their children. Look, one of the affirmations in my program that I give out to clients is I make good decisions. And the most loving thing that you can say to your child is you make the decisions. And that's what you need to hear from your family. You can tell them that that's what you need to hear from them. And if that doesn't work, then you have to stop being willing to discuss your birth with them because they're not serving you. It's not serving you.

Yeah, and if you feel the need to show them the safety on VBAC show and the safety on VBAC, and it doesn't necessarily change between the two birth locations. And we also always say this, that you need to give birth in the place where you feel the most comfortable and you feel the safest, that is the safest way to give birth, you have to feel safe. If you feel safer. In a birth center, then that is where you should give birth. If you feel safer in a hospital, then that is where you should give birth. And because that's linked to safer outcomes linked to safer outcomes. Yeah. All right, here's the next question. A friend recently was induced eight days before her due date. She was planning on an unmedicated birth in a birthing center but her blood pressure one day was 140 over 95. In the following day, it was 130 over 90, she pushed for five hours before an epidural, and then pushed another four hours after getting an epidural. Whoa, nine hours of pushing. They eventually had to use forceps to get the baby out. Was this necessary or Could she have waited a few more days to see if her blood pressure would have gone down more well Of course, when you don't know the whole clinical picture, it's hard to answer these questions. But I would say that she didn't necessarily have to be induced eight days before her due date, she did have high blood pressure and high blood pressure. And late pregnancy is definitely something that needs to be watched carefully. Obviously, we're concerned about the development of preeclampsia with blood pressures in that range. Her liberal pressure was probably not going to go down more, but it does vary from day to day, and you just have to kind of make the decision looking at the whole clinical picture of this woman's overall health. You know, obviously, you'd be looking at preeclampsia labs and making sure that she wasn't trending in that direction. And it would be a decision between her and her provider, at what point in induction actually was truly necessary. I think the thing here is, the real question here is because she was induced, was that why she had nine hours of pushing, you know, if she would have allowed her if her body would have been able to allow her baby to move down further into the pelvis? Maybe the baby wasn't planning on coming for 10 more days? Would that made a difference with her pushing stage? I guess we'll never know. But I mean, if she was developing preeclampsia, then yes, she needed to be induced, if she just had elevated blood pressure and these blood pressures are in the hypertensive range, then that's a decision between her and her provider as to how much longer you let it go. As for the forceps, I, you know, I don't know if, if she would have pushed for another hour, maybe she wouldn't have needed for September, we don't have enough clinical information to know if that was necessary. I think the thing with this whole picture is the cascade of interventions. So she was induced, had an epidural, because she was induced, had elevated blood pressures, nine hours of pushing force at birth, if we would have left this situation alone, and never started the induction, would she have had a normal length of labour and a normal second stage and a non force at birth? I think that's the question that this, you know, woman is trying to get to? Nobody knows. There's no way to know, we don't know. But this is sort of the classic case of cascade of interventions and how it can alter the course of a birth. Just, you know, just to wrap it up. It's like if blood pressure is an issue and preeclampsia is an issue, then yes, there wouldn't have been any choice but to be induced, you can't let preeclampsia go.

Alright, the next one is a breastfeeding question. When a mother doesn't stop breastfeeding before her new baby is born, the new baby doesn't have a waiting period for the milk to come in. So did they not receive colostrum? I've wondered about this. Trisha, do you understand the question? Isn't normally when you're a first time Mom, you give birth, you've got colostrum for a few days and milk comes in. But for mothers who breastfeed in tandem, they have a one one and a half to two and a half year old that they're still breastfeeding when they're pregnant. Yeah, what does happen Trisha does collateral

note because Mexico law strong. That's amazing, right? The human body is so awesome that they

I know that newborn is the priority. I know the body does that. But I had no idea it could revert all the way to classroom It absolutely does.

So this is why a lot of toddlers wean in pregnancy because when the milk goes from full mature milk back to colostrum, they're like, what's this? It actually helps toddlers wean. Okay, next question. I've recently started listening to your podcast and I'm learning so much even though I'm secretly 10 weeks pregnant with our seventh Wow. Amazing. I was wondering if you have any tips on how to relax during birth for women who have had significant trauma or PTSD. Our fifth baby died from a severe and non hereditary congenital heart defect. It didn't happen at birth, she was six months old. But being in any sort of medical situation immediately puts me in mama bear defensive mode. We had a surprise rainbow baby immediately after we lost her daughter and my pregnancy was full of anxiety in my labor, which I elected to be induced at 40 weeks because I was afraid of stillbirth took 48 hours ending up with my now healthy baby boy spending a week in the nick you because my water was broken for a long time and they were worried about infection. I'm convinced my labor was so long and he ended up in the Nikki because of my fear.

And now she's pregnant with another baby. I would recommend 100% EMDR eye movement desensitization and reprocessing. It is phenomenal at eliminating trauma. So basically whenever you have a trauma that's like a seven to a 10 on a scale no matter what it is, it could be a childhood thing. fear of flying, of traumatic birth experience a traumatic relationship, anything at all. You have to find a therapist who's qualified and EMDR and it's kind of like a rapid therapy. You go you talk about the issue, you find the negative belief. And then there's this method and they're married various different types where it gets better As I move in happening as it does during a dream, he might hold little gentle buzzers in your own hands. And it might go left, right, left, right buzzing while you're recalling the memory. And it really it rapidly processes the experience on an emotional level. I've recommended it to a couple dozen clients now and have consistently seen them come back and just feel transformed. That's one thing I would recommend.

Yeah, I think that clearly, this is, it's very normal for her to be experiencing what she's experiencing. And this is a serious trauma that she experienced. And it would be hard to overcome it without doing some sort of intervention like that.

I would also recommend Emotional Freedom Technique, which is a five minute practice, you can learn on YouTube, they're really good ways to learn how to do Emotional Freedom Technique. you name your fear, you name your negative belief, and it's a rapid way of releasing and by tapping on acupressure points yourself. Very, very cool, very effective.

Okay, next one, is there a happy medium between Lotus birth and delayed cord clamping? And are those things you could touch on in more depth? Well, why

don't we start by defining a lotus birth,

okay. So with a lotus birth, you're keeping the umbilical cord and the placenta attached to the baby until it naturally falls off, which can take several days, up to two weeks, I would say you know, four or five days is probably the average. So normally, when baby is born, we clamp and cut the cord and the placenta gets separated from the baby and the main clamp off the umbilical cord and make it a little stub and it falls off whenever it falls off. And you don't worry too much about it. If you have are having a lotus birth, you're keeping that placenta connected to the baby letting it fall off whenever it's ready. And I think it's more of a spiritual practice than it is anything else. So it is about providing this very, very gentle transition for the baby not doing any unnatural severing of anything, keeping everything connected. And I don't know that there's a lot of benefit, I do think there's some risk to it. And it's not a lot of risk. But it is possible that you can get you have this placenta which is a large organ full of blood that is attached to your that's attached to your baby. And there's of course risk of infection. So that would be something you have to be on the lookout for. But happy balance between the two. I would say that you know you let the court you let the cord stop pulsing and then you can feel fine to cut the cord if you're not choosing a lotus birth. Yeah,

I don't I don't understand the question to be quite frank because it says a happy medium between a lotus birth and delayed cord clamping they go perfectly together delayed cord clamping is you're not clamping the cord. You're letting the baby get all of its blood and then you continue not to cut the cord and you have a lotus birth but I

think she's wondering if there's some where in between like is it best to leave the it doesn't make a difference if you leave the placenta attached for 24 hours or six hours or two days. And I don't think it makes any difference once the cord stops pulsing.

Your your baby has had that infusion of all the blood from the placenta if you're going to cut it, it doesn't really matter at what point you cut it then after that, or you're going for the full lotus, which would mean that it naturally falls off. All right.

This one is unbelievable to me. I couldn't believe my eyes when I just read this. I have a question for you ladies. My baby is due October 10. And my 35th birthday is October sixth. At my last prenatal the midwife mentioned if I do have him after my birthday, even if it's the next day that I will have to do I will have to have extra testing done since I would be considered geriatric. Now mind you, I've had a very healthy pregnancy so far. And I'm low risk. I mentioned this to another doula and I follow that I follow and she said I can decline testing and it's not required. Is this true? The midwife made it seem like it was not something I could decline. I do not plan to have another baby after he is born. This is insanity.

Well come on. I mean, we know that the day you turn 35 everything just goes absolutely downhill. I mean, you're

This is unbelievable. I mean, yes, the answer is yes, you can decline without all my commentary, the answer is yes, you can decline. But if she says you have no choice, of course you have a choice, you're allowed to decline testing. And I don't like that tone she's taking with you because no provider should tell you that you don't have a choice you always have a choice.

Well their policy is going to dictate that you know you have these the your now fall under the geriatric protocol and you need to do these tests. That of course does not mean you need to it just means that they're going to pressure you to buy now what's so ridiculous about this what is so incredibly ridiculous is that they're talking about the day she turns 35 that suddenly things are dramatically different.

I mean, that's the part that's just it's all ridiculous. You know, I had my On birth when I was 38, and no one ever, ever mentioned my age to me in any pregnancy, my first birth I was 34 fine. My second I was 13. No one ever brought it up. Why is that? Maybe I had evidence based providers.

Yeah. Because your providers? Yeah. That's crazy. I mean, had you been with your ob that you had? Oh, so forget about it. And it would have been day one, but I would have had sure to given you a white wig to where the Yeah, the

word geriatric is so offensive and create and wrong. The first time I ever heard it was like, 15 years ago, and everyone in the room burst out laughing because it was so crazy. Like, this isn't gonna take now No one's it took and it took it freakin took.

I can't believe it.

It's terrible. And then you have these like healthy women insisting like I'm done. I take care of myself. I'm I'm otherwise you're healthy. You're perfect. Don't let anyone tell you otherwise. And medical indication is something we don't want to ignore. We just talked about high blood pressure. And we're saying, Yeah, go for that induction. Yes, your friend needed to be induced if your blood pressure is high. That could be preeclampsia. That's serious stuff. You have a birthday. You turn 35. Now you're high risk. Everything just changed. Have we lost our minds?

That's just the irrationality of it all is so

shocking. It's unbelievable. But this is what protocol does to people. Well, we hope that was helpful. And you're going to make your own choice. And you do have to work this out with your provider. But you've heard our thoughts on it and what we would do if we were in your shoes, but you have to see what's right for you. Whatever you do, ask her to show you the evidence. Ask her to show you the evidence. Get away from the conversation. Look at the data. Well, on that blood pressure inducing note. I think we call it a wrap here, don't you think?

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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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