#219 | June Q&A: Assault in Labor, Home Birth Risk, a Swollen Cervix, Parental Conflicts, Laboring in Water, Nuchal Hands, Being Dropped as a Patient

June 28, 2023

We are back answering your questions in the June Q&A episode.  We kick it off with a woman's story of multiple non-consented vaginal exams in labor, her complaint to the hospital, and the hospital leadership's response. Next, we jump into our questions including:

  • I really want a home birth, but I am afraid that hospital birth is safer and that home birth is dangerous. How do I determine this risk?
  •  My mom had a c-section for a cervix that swelled shut. Is that possible?
  • I am struggling with boundaries and decision-making with my husband around staying home and home-schooling the children versus returning back to work. 
  • Could getting in the water too early slow down my labor?  Barbara Harper from Waterbirth International calls in her response. 
  • I am ten weeks postpartum and have a positive pregnancy test.  Could this be for real?

In the extended version, available on Apple subscriptions and Patreon, one woman asks if she should have listened to her nurse who ordered her not to push.  Could a nuchal hand in labor be a justified cause for a c-section? Should the cord only be cut after the placenta has been delivered? Who should I notify about being dropped as a patient and black-listed in surrounding practices?

In our quickies segment, we discuss weight gain in pregnancy, periods returning too soon, precipitous labor and increased bleeding,  birth pools, early pregnancy, red raspberry tea and dates, strengthening the amniotic sac, a fear of sex in pregnancy, and our best marriage advice for after baby. We were also asked to share something we can do that most people don't know about us.

Finally, don't miss the outtake!
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Please remember we don’t provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

View Episode Transcript

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, welcome.

Hello, it's June.

It is June.

And it's hot and I love it.

So what have you got on the agenda today?

Well, we have a lot of questions. And we have a story that came in through our Instagram DMS about a woman's experience in labor that I thought was worth sharing. Okay, because this is why we have a podcast. This is why we talk about what we talk about because women are experiencing literal abuse and labor. Of course not in all cases, but this happens and we have to discuss it. So shall I share? Sure. Okay. She writes, I figured I'd share as I follow you as I followed you guys for a long time and didn't think I'd end up as one of the statistics. I was assaulted during my delivery and the hospital doesn't seem to care. So I'll try to condense a longish story. I went in with a birth plan. I wanted to do things as natural as possible. So when my water breaks immediately contractions are three minutes apart, then quickly become back to back. When we get to the hospital, I was rushed upstairs. When I got upstairs, it was like I lost my rights. They wouldn't let me use the bathroom and literally took over total control. My partner gave everyone a birth plan and had them read it. I wanted limited cervical checks. I was handling each contraction as expected. I was checked by a nurse and was five centimeters. The doctor came in and checked and then another nurse and then some random girl, we still don't know who she was, or what her job title was nothing. She never introduced herself. She never asked to do a cervical check. She just barged in the room, stuck her fingers and hand inside me and the pain I felt was out of this world. I don't know what she did while she was in there. But I was begging for her to get her hand out of me and she wouldn't. I said please, I need a break begging and in tears. Finally, my husband screamed at her. And she stormed out of the room. I never saw her again. After that at every contraction, something changed. It felt like my ovary was going to burst it was a million times worse than the contractions. I was in so much pain I stopped progressing. So I got an epidural and the epidural stopped my contractions completely. So then they had to start Pitocin when my baby came out, he had a really bad bruise on his head exactly where that girl's hand was. My wishes after that weren't respected and my birth plan was mocked. This woman literally assaulted me. And then the staff made a joke of my birth plan. And it was awful. I filed a complaint. And this is a response I got back. Pretty much my voice doesn't matter. My note didn't matter. And the letter said, This is what had to happen. So I have the letter from the hospital as well, which says this letter is in follow up to the concerns you shared with the Office of Patient Experience. I'm going to skip some parts the Office of Patient Experience. I love it. It's so neutral, right, where they're collecting all their trauma stories from the women who take the energy to even give their feedback which is exhausting to begin with and emotional to begin with. Right what they went through and and send it in with expectations that they're going to get a satisfying response. That's part of the that's part of what stops women from contacting hospitals. They're the thought of going through the effort of telling their story. worry and it landing on deaf ears is too painful. So many women don't even bother. So what what what does it say?

Okay, we understand that you have concerns about the following aspects of your care. You're alleging that a staff member abused you specifically during your service exam, you are concerned with your birth plan not being followed. And you are concerned with the communication you received from staff. We want to thank you for bringing these concerns to our attention. Your concerns have been reviewed, have been referred and reviewed by the hospital leadership team, which is the attorney and

Okay, keep going. From our review, we understand that your cervix which was posterior, which made it more difficult and more painful for your cervix to be checked, because, wait more is there. There's knowing anyone it likely was but that still doesn't excuse her feeling abused by the cervical exam or three people examining her cervix. And one of them not asking and not introducing yourself and just entering her without any informed consent whatsoever.

And when she said stop, they didn't stop. Of course, well, that's everything right there. There's there's the lawsuit, because her cervix was posterior more cervical checks were necessary in order to determine your dilation, which in the end was not consistent with your birth plan or dilation?

No, no, I don't think they I don't think they mean the dilation wasn't consistent. I mean, the fact that she quote, needed repeated cervical exams was not consistent. That's not I think that's stated? No, I think they're just dilation. I think they're saying this was necessary despite that it wasn't consistent with your birth plan.

The dilation is a critical piece of ensuring the safety of you and your baby. No, it's not. The leaders would like to offer their most sincere apology, the leaders, the leaders. Sounds like North Korea just came today.

Exactly. That's what I was thinking like the personal, the leaders extend their deepest condolences for your suffering. My god, that's pretty much what they said. The leaders would like to offer their most sincere apology that the importance of this was not clearly communicated to you the importance of your cervical dilation for your safety, they're doubling down, we do strive to follow each of our patients birth plans as closely as we can, but ultimately must do what is safest for our patients and their babies. I think we could have an argument there. And sadly, we do wish that communication between you and our staff had been better, but your feedback will help us to improve the services we provide to all of our patients, please accept our most sincere apology for your experience and how we truly regret any additional discomfort or inconvenience that you may have encountered. We appreciate the opportunity to review your concern even even though your experience was less than optimal. It gave us the opportunity to review the process from the perspective of a patient. Now, do you think they're going to do anything different?

No, they're going to cross their fingers. They don't hear from her again and get a letter from her attorney. That's right. So part of the mistake they're making if they really want to avoid litigation, if I were on that leadership team, if I were there failing to acknowledge what she said they're just changing the language less than optimal. She said she was assaulted. That's her experience. And at a minimum, the very first step is they need to pick up the phone and talk to her. I mean, the President of the hospital should call her. If they want to avoid litigation, if they really want this woman to feel heard. They have to listen to her. Well, if they if they can we make it better. They have to say how can we make it better? That's what you do not thank you for your feedback in the patient experience.

Chamber, they should acknowledge is what they should acknowledge is that they failed to provide informed consent. She said no. And they can they'll never acknowledge that. This is the thing. This is what they would say if they were in court, they would say we did what we had to do in the interest of the safety of the baby and the mother, which and how can they prove that? No, they proved that the baby was any danger to the baby. That is the classic rhetoric. We're always talking about. Everyone folds right there. Right, we had to make sure there was a safe outcome. You had a woman who was invaded physically who's saying, Stop. End of story.

Right? That's pretty much always that's just like, why her mean, Hayes Klein says you'll never get sued for the C section you performed because you can always fall back on. We did it for the safety of the baby. You will only get sued for the one you didn't do. Never for the one you did do. Because when you do it, you're you can say it was for the sake of the baby.

It's very disturbing.

So that starts us off on a happy mood. Yeah, thanks a lot for that, Trisha.

Well, you know, we need well done things. It'll only go up from here. You brought everybody down. All right, no, I mean, these stories have to be told it's why we do the work we do. That's right. You know, there's the beautiful inspiring part of our work. But the reason we have the energy to keep doing this is because we want to minimize the trauma and the injustice that's happening on a regular basis. Women have to be taken seriously. And it's scary when one, you know, authority figure or one adult claims, they have the right to be more concerned about your baby than they have. You know, it's just, it's just scary. Even if a mother were being irresponsible, even if it's still her baby society can't do anything about that, right? I mean, you know, they're chained smoking in the home, let's say, what do you do? Go in and put out all the cigarettes? Oh, no, that's fine. A baby can live in a home with chain smokers, and no one really cares about it. But now she's in the hospital, and they're gonna put her through hell, just to know how dilated she is. I can't think of a scenario where checking her dilation that urgently by three people would have made a damn difference in the safety of the baby unless the baby was unless there was a cord prolapse or something like that, and there wasn't. So this was not an this was not about safety of the baby. This was about us, doing what we feel we need to do to manage your labor, and not listening to her.

Ego power, you never know what draws people into the work that they do. The desire to help the desire to love and support, the desire to dominate and bully you never know. You're just dealing with another human being and all of their issues. So if you're begging and pleading stop, what kind of person has what kind of person does one have to be not to stop? You know, even a dentist says raise your hand up if you're getting uncomfortable. Right? Like, let me know if I need to stop or pause. So what happens in childbirth suddenly, where all bets are off? We better get to our questions and we'll work out how we could go we could go down a rabbit hole there. Okay, let's begin.

My name is Maddy. I'm a listener from Minnesota and I absolutely love love. Love your show. I've had two beautiful babies both born at the hospital after Pitocin inductions due to high blood pressure. I've been applauded by nurses and doctors for birthing both of my babies without epidurals. And I find it a little frustrating that I get this like gold star for doing something that I believe all women are capable of. But not all women get the support they need to do so I really hope to have a home birth in the future. But I have this barrier that I just can't get past I have this little voice in my head telling me that hospital births, overall big picture are saving women's lives. Women who may have died if they had tried to birth their babies at home 200 years ago or so. Overall, what has happened to the maternal and infant deaths over time and what influence has has burning and hospitals had over this. To be blunt. I wonder if women like me would have died if we were pregnant 100 years ago, and we're birthing at home. Anyways, I'm hoping our next baby can be born at home. And your guys's show has just been so crucial throughout my journey. I'm truly so grateful for you. Thank you. Thank you. Thank you. I love you guys.

That's always nice when they finish the question women I love you. Yeah, this is always the question that comes up. Right? What basically what safer hospital or home birth? Is this? What's going on here?

I think so there were a lot of components to this question. I feel like the answer could be a book. I think that in general, I think that was the question. Yes.

I think that we need to get away from this obsession with him. You know, I'm one to talk because I love. I love numbers. But I think we do need to get away from the temptation to turn everything into statistics. The truth is, and the fact of the matter is that hospital birth has made birth safer. And the hospital birth has made birth more dangerous.

That hospital birth has made birth safer. Well, strictly statistically speaking for babies, not necessarily for women. Well, I mean, statistically speaking, there are there's a category of women who are much better off because they're in hospitals. And there's a category of women who are a lot better off because they avoided the hospital. And it's your job once you figure out where you prefer to give birth to figure out which category you're in. Because the you know, look, maternal mortality statistics have been rising in our country for decades, and, quote, unnecessary medical intervention has been identified as the major contributor to that trend. So when you take a woman who doesn't really need intervention, and now she's getting unnecessary intervention that is a risk to her life and to her baby's life. Of course at home, if a woman really needs intervention, she'd be better off potentially in the hospital or her baby would be when the baby needs intervention there. We're not going to boil it down to a little neat answer here. It's always complex work is always difficult.

Well, we know that babies who are born by cesarean and have a three fold increase in mortality except for the baby that genuinely needed. This is Arian section, right? So it did like, it's what you're saying it's really it's not apples to apples, it's really difficult to just say, hospital birth is safer than home birth. And this is what hospital says this is what providers say all the time. I mean, they're they're very black and white about it. And it is just not a black and white decision you have to birth where you feel safest, you have to know your individual risk, you have to trust your provider. And you have to have a deep sense of trust in the birth process, and birth where you in your body literally feel the safest.

And when they talk about those statistics, they're including all the unplanned home births. So that's why this doesn't boil down to, you know, our whole podcast and all the work we do, it doesn't boil down to, here's where you should birth, and here's where you should not birth, it's Listen to your intuition. Get educated, find out how to advocate for yourself, work through your birth plan and hire the provider you trust, because we don't know, we just don't know, you have to get to the point where you trust yourself to navigate your labor and delivery while you're in it.

And we also have to acknowledge and respect that birth is not perfect, it will never be perfect. Even in the hospital. Birth things can go severely wrong. Like it's a hard thing to accept. But in the home and a hospital in a birth center, wherever you are. There are very rare circumstances. And it is not a guarantee that birth is going to be safe in any one of those locations. So birth, the safety of birth is always relative.

Hi, Cynthia and Trisha. First, I just want to say thank you for all the to do, I think you're amazing and just so inspiring. I have recently just been going down a rabbit hole and educating myself in preparation for future pregnancy. And one of those things that I've done is talk to my mom in depth about her birth. She mentioned how she had to have a C section with my older brother because she was in labor for so long and wasn't progressing. And her cervix apparently swelled shut. And I asked her some questions about if she was given any medications or anything prior to that, like Pitocin or anything like that. And the doctors who said no, and the doctors just said that there was no way that he was coming out naturally. And they had a C section. I just found this really interesting and couldn't quite put it together with what I have gathered in knowledge and was wondering if you would be able to speak on this and let us know. Thank you.

Well, I have an inkling of a feeling that this was passed on like the one of those like operator games, you know where like the story changes as it goes through different people. I highly doubt her cervix was completely swollen shut. It was probably swollen. Yes, that happens. Service services can become swollen in labor, especially if a baby is malpositioned. And there's premature urge to push back can happen. I think I mentioned this recently. Did we talk about this like sometime I will maybe it was an Instagram stories or something. I have used ice on the cervix before. sounds horrible.

Can women feel that? It's not comfortable? Do they feel it?

You can feel it there. Yeah, you can feel it. They can feel the ice cold or they just feel the pressure. Both. You can feel bad.

Yeah, it does work. It can work.

I thought getting an epidural can help to just Yes, sometimes if labor goes on for days it can get swollen because of that and getting an epidural can just make the body basically less efficient and working less hard.

Right so the cervix then has time to move the swelling out and relax in common. Yes, yeah. Her serve at the beach, her mother's cervix could have been swollen, I highly doubt that it was swollen completely shot. But most likely, this is just another one of those scenarios of you know, failure to be patient. Failure to offer alternatives that could have ultimately ended up in vaginal birth.

Yeah, I've heard of services that were like you know, 10 centimeters swollen down to a seven or something but I've never heard of completely shut either. Haven't seen it. How is a woman to know either way. She's not the one with the hands up inside. Right? It's frustrating that we can tell her almost anything and there's no way to know.

I think it's just comes down to patience and time and not having been offered alternatives and kind of that rush to like, Oh, you've been lonely. Never long enough, let's let's time to move to C section. And the swollen cervix was an easy excuse.

Maybe don't tell your mom that part. Let her be at peace with her birth.

Well, not that it wasn't swollen. I'm just saying the right the extreme. Yeah, no, no, but still, it's that the daughter is questioning and she doesn't have to take this back to her mom now, and she does also doesn't have to take this with her into her birth experience and think that it's going to have any influence over her birth experience. Right? Next, I said the answer shot. This may be a little bit of a different question. But this is surrounding boundaries and decision making with my husband for things and our beliefs. And once the needs have changed since becoming parents. So as for just a quick context, my husband and I have been together for 14 years and married for seven. And my wants and needs for our children and our family have changed drastically since becoming a mother specifically in that I want to be able to stay home more, and to homeschool their children. And he wants me to continue working, and then send our kids to traditional public school. And it's primarily due to financial concerns, and living income, my income. So how do I navigate these boundaries and decisions? How much do I push back? Or when do I just accept that he is not going to get on board? How do you navigate those differences in parenting decisions? In what we both feel we're doing as best for our children, even though that may look different. Thank you. Ah, tough.

It's so hard. I mean, wouldn't it be so great if we really had the answer to this, I've had friends in this. So we did ask on Instagram about an hour ago, what our followers think this woman should do. So I'll share some of those. But I guess my feelings are, I know it seems you and your partner have different values, but take heart that you probably don't have different values, you probably have different knowledge, and your partner lacks the understanding of the emotional connection you have to your baby, no matter how bonded your partner is, they probably truly don't understand that for many women, it's inconceivable to be parted from their babies. And for those women, I do think it's, I mean, I think it's so important to figure out how to stay with your baby, when every cell in your body is telling you that you must. And you might have to be creative about how you're going to start earning income, if that's a real, you know, very real situation for you and your partner. And if they're gonna boil it down to money, and you're talking about an emotional thing, well, then that has to be a separate conversation. But homeschooling you just you just have to share with them the resources and knowledge you have and see if you guys can come together and you also might be five years away from the decision anyway. So take a little pressure off. What do you want to say before we check these responses?

I think the important thing here is her feelings as a mother have to be really, really listened to and respected or she is going to likely develop a lot of resentment. But that's probably going to be the outcome. If he doesn't listen to those feelings, because those feelings are those are like, you know, the the mama bear feelings those are like, they're not just wants their needs. And if you know if it comes down to like, well, we truly cannot afford to have you not working. What choice do you have, you know, you maybe can work part time, maybe you can figure out something like you said Get creative working from home in some way. But that's super stressful too. So she has to make sure that she really expresses that to him and tries to get him to hear that.

Well, I think what happens in a lot of relationships, especially in these years when babies enter the picture is the moms, especially the moms in our community, like very conscientious. They're doing a lot of reading and researching. And they can forget, like we forget, the more we research and the more we educate ourselves that we are changing. And the partner might be static, you really have to bring the knowledge to them, even if it means like reading a book out loud in bed at night together in your reading it and they're just listening and you're going through the book together. But you've got to bring them in on the education you're getting. Because when you get informed, it seems like common sense. And they're still back where you were a few years ago, thinking you would be working after you had a baby and going to public school. So you just got to bring them in on it and see if you guys maybe do share the same values.

It's also not a it's not so not a forever thing. This doesn't have to mean that she never works. Again, this might just be a period of time when the kids are of a certain age. I mean, she may not want to homeschool them all all the way through high school. Let's hear what our community says.

Alright, here's some of the answers that came in right away. They're all over the place. Of course. Sure. There are always financial sacrifices that can be made for mom to stay home with baby. Right that's one woman Another one says go back to work as long as it's not a wash financially. No, no one would do that. Take time to lay out the pros and cons budget and come up with solution, a solution for the finances. Yeah, the pros and cons works with the financial part of the discussion, but not with the emotional. Does her working really fix the situation? If you're paying for childcare, work slash talk it out. I respect my husband and his opinion greatly. And it's why I chose him as a partner. Well, that's nice for you. It's always someone's opportunity to look about how great her husband is, happens every time I'm in the same situation, I want nothing more than to stay home with my newborn. Is there a hybrid solution work part time or homeschool program that has put in person classes. This is the only thing holding us back from living the same way. Show him an updated household budget so he can see how you can afford it. Definitely trust your gut homeschool, if you want depends on income, ah, gosh, if we only had more support in this country, so many others about money. Everyone's talking about money.

I mean that well, that's the part of it that is a little bit black and white. Like if it's truly, if there truly is no way to make it work. And some people are in that situation, you have no way to make it work. And one woman said I found a work from home position so I could stay at home with my boys, tons of options.

Okay, this is what you know, there's probably always a solution to finding a way to make it work with work from home.

The last one says hell no mother is the ultimate decision maker in this arena. Like that. You'd like that one.

I just think it's I think it's like an instinct for moms. And if it's not that strong, and all mothers, some mothers are dying to go back to work, that's great. But if you are the woman who is, like you said every cell in your body is saying that you must be home and be with your children. And it's torture every day to go to work. That is just not gonna work out well for you, or your husband or your children.

I just want this woman to know that this don't get down about your relationship, you're going to work it out all couples go through this stuff. If it's not this, it's vaccines. You know, if it's not vaccines, it's like, the way you're going to manage your relationship with family. People have really really difficult situations you're gonna you're gonna work it out. You just have to talk. Don't get down about values. Just share with him. What's going on? Hopefully, you have an understanding an open minded partner in the process. I wish we could be more than just understanding I just want her to not get too down about her relationship. They'll work it out. Right? Not easy.

Hi, ladies, I had a quick question for you about water birth. I had a water birth last October and I labored at the first imam for about 12 hours total. The time that my water broke and things intensified till baby was on my arm. And I wanted to know, for my labor and delivery, I getting in and out of the water throughout the day. And I'm wondering if I should have waited to get in the water if that maybe has like slowed things down for me. Because I do feel like I was a lot more relaxed in the tubs. I'm wondering if I should have waited until the very end to get in the water. Just wondering if you guys have any insight on what to do for the next birth because I do plan on doing another water birth. If maybe I need to try to wait before I get in the water until I'm really close like transition. Yeah, thank you so much.

The classic midwife response to that is typically in early labor, shower and lint in active labor tub. Just because too early in labor some times in the tub, it does seem to slow things down. So always water just in that order. I wonder what Barber Harper says ...

Hi, this is Barbara Harper. I was asked by the lovely ladies at Down to Earth to chime in on a question about when to get into the water. And what I'd like to say right up front is birthing your baby in the water is never the goal. The goal is to increase your comfort, your sense of well being and provide deep relaxation. Being in the water changes the consciousness of your being. Dr. Wallace J. Nichols wrote a book and published it called Blue mind how being near on in our underwater changes your brain brings you more peace. And there is a physiologic response in your body when She's stepping into a tub that's at least 43 centimeters or 18 inches deep, and it provides hydrostatic pressure all around your body. And that can sometimes lower your blood pressure, it will definitely make you more relaxed, it will release more oxytocin. It's a pleasure Cigna, it interrupts any pain signals that are coming from the contractions or from your pelvic floor. If you get into the water, and early vapor, when you haven't even started to dilate, it could bring on the labor itself, it could increase the intensity, the contractions. And what I tell women is get in whenever you feel like you need relief. If you feel like you need some assistance, you can try the shower and the shower will give you oxytocin, but it's not going to give you the same physiologic effects as deep immersion. If your home bathtub is not 18 inches of depth for the water, it's not going to be the same. Most common Bathtubs are 13 inches. So use the water effectively. When you feel like you need relief I've watched women get in at two centimeters, and three hours later, they're ready to push. So labor happens between your ears First, give your body the chance to relax when ever it means that if the labor does slow down, which could be a possibility, and your membranes are still intact, there's no harm done. Take a rest, walk, squat tag, get back into the water. And when you are in the water. Most women like to change positions about every two to three contractions. approach is best for second stage, you want to be on your knees, you want to have your feet on the floor. You don't want to be just lying back passively, and trying to push the baby out. So those who might queues and I think I've reached the end of a few minutes here. So I wish you luck. And if you'd like more information, send me a message from waterbirth.org. That's my website, you can send me an email at barbara@wordpress.org. And you can find me on Instagram at the Barbara Harper. Take care. God bless. Bye now.

All right. Thank you to Barbara as always for being there for us. She's always available. She In fact, I think she was in what little island off of Spain? Was she a couple months scenario. And that's where she was when she sent me the response.

I leave. Thanks for your wonderful show. I am currently 10 weeks postpartum. And I just got a positive pregnancy test. Definitely not an accident. But I'm wondering how long after birth, you can still test positive from the HCG leftover from your baby that you just had. Or if I am really pregnant, I will continue testing. But curious if maybe it's just a false positive. Thanks for your show.

HCG levels typically returned to normal nonpregnant levels, two to four weeks postpartum. Yeah. Yeah, I'm surprised we have any honestly, I didn't realize that that was just a pregnancy hormone.

But no, it is.

You don't have anyone you're not probably returned to non pregnant levels two to four weeks after delivery. So I think this woman and she knows this by the time this episode is out. I think she's pregnant.

She's pregnant at 10 weeks to have hCG. She's pregnant. It wasn't bloodwork. It was a piece that yeah, they have to be high enough to register on that. So yeah, she's most likely price pregnant.

Sorry. Well, if another irate started bouncing little babies on the way, it'd be a good thing.

Yeah. Congratulations. Congratulations.

Congratulations, you're pregnant again. Well, you know, when they're breastfeeding, especially they really trust that they're not going to conceive again. But there's always that anomaly. Everything is possible.

Yeah. Yeah. Well, there's so many variables that go into lactational amenorrhea. People don't understand it only works. You can't use pacifiers can't use bottles, you can't be pumping. So if you're not exclusively at The Breast Around the clock, it doesn't count. It doesn't work. You can't count on it. It might still work but you can't count on it.

I did not know that about the pacifiers and the pumping.

Yeah, well you know what she's going to be really happy when she's 50. Her kids are going to be like off to college and she's going to be that means she

has to pay for two colleges at the same time. You better stop there. Just quit while you're ahead. All right, that's a wrap for our regular episode. If you're with us in Patreon or Apple subscriptions, let's move on to extended otherwise, it is quickie time. Ready?

I am ready. Let's do it. Quickly. Number one. I'm 29 weeks and have not gained any weight whatsoever. Is this normal? No.

That is not normal. What if she's already pretty significantly overweight? Yes.

I mean, the weight gain guidelines are definitely less but I still think by 30 weeks there should be that should be addressed. I only have headspace to read one book to prepare for natural hospital birth, what would you recommend

Henci Goer's The Thinking Woman's Guide to a Better Birth.

That's a great one. That's a great one. I have one to one. So you can get two recommendations, gentle birth, gentle mothering by Sarah Buckley, that's my favorite. I am exclusively breastfeeding and my period returned to four months. Why? Probably, well, first of all, periods. With exclusively breastfeeding moms can come back like five to six months is the norm. So four months is not that early, it is early. That's the norm. No, I'm sorry, that's when you can't count on the lactational a memory anymore. That does not mean your period can come your does. That doesn't mean that your period will come back, but by four to six months, lactational amenorrhea isn't really legit anymore. And that's because you could ovulate at any point, okay. And if you ovulate, you're gonna get your period, probably because there's too long of it in there maybe too long of an interval between some of the feedings maybe her baby's sleeping seven or eight hours at night, that can make your period come back. Maybe the baby's getting bottles, maybe she's pumping all those things can make your period come back or it's just your body Sorry, can precipitous labor cause postpartum hemorrhage? I had a peaceful home birth but I still hemorrhaged. Unfortunately, yes, it is. It is one of the variables that does increase postpartum hemorrhage because your uterus is working so hard so fast. Do you both have oh, do you have a birth pool recommendation? I loved the birth pool I got and I'm trying to.

I had one called lava seen. I don't even know if there's I don't remember the brand of mine. But the thing that I loved about it was it was blow up. It was inflatable. And I think the inflatable are awesome because they're a little softer. That'd be my advice. I am pregnant with my fourth and I and I feel huge already and it's hard to breathe at only 14 weeks. Is this normal? Yes, it is totally normal. And the hard to breathe isn't just about having you know that doesn't just happen because we get a big belly in the belly pushes up our lungs and takes up all this space. There's all this respiratory and cardiovascular changes that take place in early pregnancy that can make difficulty breathing early on. Plus, by the time you have a fourth baby the belly just pops like oh yeah just pops fast and looks more pregnant at like eight nine weeks and my second than I did at 1213 weeks with my first amp really normal. Is there anything over the counter that is safe to raise libido during pregnancy and breastfeeding? Maca? You can probably take maca. I don't know about during pregnancy. I wouldn't take market during pregnancy but during breastfeeding. Yes.

I think the best thing for libido is how her partner treats her. Well, that's for sure. Okay, moving on. When should you actually start drinking red raspberry leaf tea and eating dates.

I drank red raspberry leaf tea my whole pregnancy with lemon and I loved it and they don't they say like 38 weeks 37 There's no harm in eating them sooner.

No, but you know if you're gonna do the like the four to six a day, you probably don't want to do that. All the way through. You're gonna get sick of them. So start at 37 red raspberry leaf tea definitely from second trimester on is it safe to drink kombucha during pregnancy? Yeah, I can't see why I wouldn't be is there any way to prevent premature rupture of membranes or strengthen your amniotic sac?

Well, many women myself included crave citrus tremendously in the third trimester I thought it was the most delicious food in the world all of a sudden in Egypt all through pregnancy. I critical Oh my gosh. Oh yeah. first pregnancy. I was like Where have oranges been all my life. And then in my second it was lemons and limes. I was just we were buying them by the dozens. And I learned two years after my son was born two years before my daughter was born. I was reading some research that showed that natural sources of citrus make the membranes much stronger. He so hard on me. Next I wish you had a gong and you could just Did you ever see The Gong Show?

I'm terrified to have sex and pregnancy. How can I overcome this? How are we gonna answer this quickly? Is she afraid the baby's gonna get, like thrusted out of the sack? It's not gonna happen. Don't worry, having sex and pregnancy is totally safe. It's really safe. I don't know what else to say everyone does. Literally. Yeah, maybe, you know, practice it, learn to trust it.

Maybe if she's on top, you know, she's feels more in control of the definitely, yeah. Yeah. I mean, the place to be anyway.

She said factually. Okay, next.

What are my options with Group B strep, that is not a quickie. Okay, go to our extended episode on Group B strep, or to Patreon and listen there because everything you need to know is there. Episode 183. What is your number one piece of marriage advice for new parents?

That's a quicky. quicky. Okay, let me think. Take our fourth trimester workshop. Number one piece of parenting advice. Yeah, I think one of them is like whatever you did before the baby was born, you have to wipe the slate clean as though you just moved in together again. I think the partner just has to understand no matter what they're going through, she's going through more. I just think it's fair to say that if the partner is exhausted, she is like 30 times more exhausted? Probably if she's breastfeeding. I mean, she will remember forever how she was treated in the stage of her life.

Do you have a hidden last quickie? Do you have a hidden talent that people don't know about? Really think here.

I am a Foreign Language aficionado. And your master wardrobe for a Wordle is no big deal. But you know, like I just I just took four semesters of German a few years ago and I tutored Spanish in college and studied some Italian I love languages because I love foreigners. For whatever reason. What about you? There's lots of love about foreigners. Oh, yeah.

hidden talent. Okay.

And you're blushing. When you can't tell?

I can tell but I can fit my whole fist in my mouth. was discovered when I was a teenager.

You make me feel like a fool for talking about foreign language.

Now do you want to share now do you want to share another hidden talent?

No, I can't do it on the air. I'm not implying it's sexual. By the way. It's just embarrassing.

I can do 10 Pull Ups.

That's incredible. 10 Pull Ups

Yeah I might not be able to do him right now.  I'm gonna see you tomorrow. Tomorrow. I'm super excited.

Make a reservation. I don't know what to wear to the city. What am I going to wear? It's pouring rain. Oh, it's I don't have slicker here.

A slicker.

I don't even have an umbrella. raincoats. I do know a slicker is different than a raincoat.

So cute.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.

From last month's q&a, the question about the coffee the midwife who brought the coffee for the perineum? Yeah, the woman the woman wrote to us and told us why why. And it was exactly what I was gonna say. But I still not sure I believe it. But basically, the midwife wanted the coffee to be held on the perineum because caffeine does elicit an effect on the blood vessels. And the theory is that it actually brings more blood flow to the area and can help the tissue relax and prevent tearing. I'm still not sure because I'm not sure that caffeine in ground coffee form is absorbed into your body that way.

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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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