I'm Cynthia Overgard, birth educator, advocate for informed consent, 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 Show. 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.

Good day, and welcome to the August Q&A.

Well, hello, hello. What's new with you?

Oh, you know what's new with me. We talk every day. We've been spending so much time together.

No formalities here. What's on the agenda?

Well, you know our usual. We have some sort of hilarious opener.

Oh, good.

Maybe sometimes educational, maybe sometimes silly, maybe sometimes hilarious. And I'm hoping today is hilarious. I have no idea. I haven't looked at this, but I posted a question yesterday, and I have no idea what the responses are. But let's find out.

I'm curious to hear what the question was.

Yes, the question is, what's one thing that happened during your birth that no one prepared you for?

How many of them?

I can think of the first thing that comes to mind.

Me too. I'm sure we're thinking of the same thing.

Half of them said that.

Probably. Then again, everyone prepares them for that, so everyone's afraid that's going to happen. Let's see if you're willing to say the word on the podcast.

Poop.

Oh, look at that!

Yeah, I know. I've come a long way.

You said it.

Yes, I have come a long way. I have matured to reverting to three-year-old language.

We could call it stool.

I know, that's just silly. No, but how common is that, Trisha? I hear it's extremely common, but to me, it's also very common for a woman, as an early sign of labor, to have those repeat trips to the bathroom during which her body is clearing out before labor begins.

Yes.

So that's also very common, and in that case, I don't think those women would experience it. Am I onto something here?

I think often women experience both. There is typically a bowel cleansing that happens early labor, pre-labor, and then actually during pushing, there is, you know, whatever's left. If you've had a long labor, there's probably, you know... Anyway, the important thing is that it is actually a really healthy part of labor, and it gives your baby a beautiful blessing of bacteria at birth. The bacteria that is most important is the rectal bacteria.

Okay, so you're bringing us back to an episode we did, if I'm recalling correctly—and who the heck knows if I am? It was like about a year ago. I'm feeling like last September or something. You think I'm onto something there? You talked about the—

Microbiome one?

Yes. Was that around September?

I have no idea.

Okay, well, anyway—

But I know it was a good episode. Whenever we did it, very important.

Now I feel like I should look it up.

All right, look it up for the people who want to. You're encouraging them to listen to it. Let's give them the episode number and the name and the date.

Momentito. Really, I'm just looking it up because I want to see how far off I am. All right, let's see.

I can't remember where I ate last week, so you can't count on me for dates.

Trisha, I am so good. I'm so good. I must have missed some other calling.

You should have been maybe a—

How is this of use in any other—

Data analyst?

Well, that's obviously similar to my background to begin with in finance. No, just the fact that I remember things like this. I remember numbers very easily and times of year. It was September 3rd of last year. I can't believe I remembered that. So it was episode 332, and you love that episode and talk about it all the time.

Yes, because I think it's so interesting, and it's something that people really don't understand. And the light bulb moment for me was when I realized that the reason babies are born with their faces toward your back is so that they get a mouthful of rectal bacteria at birth.

Okay, so back to today's opener. I'm going to predict that I'm probably going to be way off on this, though. I'm going to predict that one-third of women responded—

A third? That would be a lot.

That's a lot. Maybe it's too many. I don't know. All right, well, let's just hear what they say.

Well, let's go.

Okay. Well, we have at least—holy cow—we have at least 100 responses, and so we'll see if 30 of them are poop. Uh-oh. Okay, here we go. First one. Well, we're not going to read—

Wait, wait. Let's just reassure our audience. We're not going to read all 100. I don't know when you posted this, maybe just a couple hours ago, but we're not going to read all 100 anyway. We're going to trust you to scan and just get a sense of, you know—

Try to grab the best ones. Breast ones.

Yeah.

Okay. So we'll find out. We'll have the sample size, the first 20. We'll know. "I was in labor for 53 hours." Ha ha. That would be unexpected.

The laughing about it is unexpected.

Yes. "Needing"—in all capitals—"to eat two whole bananas right before transition hit."

Nice. I like it.

Great. I mean, that's a lot of food to eat in labor. Two whole bananas. That's impressive. "My care being transferred from a midwife to a doctor." Understandable. "Vomiting."

I was going to say that next. Yeah, I hear that's common too.

"Wrists, elbows, shoulders being on fire from only being able to handle contractions on all fours."

Yeah, that would get a little sore. You need to be on a yoga mat or something.

"Obstetric violence." That's the one that isn't necessarily—

Unexpected.

"I didn't feel as obsessed and in love with my baby as I thought I would."

Okay, that's important. That's an important thing. I just want to say something. That is a horrible, scary experience for women because we set these expectations about how magical it is. And for all the women who say what it was like just taking their baby into their arms, when women don't feel it, it is terrifying. It's overwhelming enough having a baby and thinking, "Am I able to do this? I have no idea what I'm doing." But to then not feel connection, it's so scary for these women. It always ends up coming, but she needs a tremendous amount of support and people around her until she is feeling it. Wow. Okay. I don't take that one lightly at all.

Yeah. That's very concerning. It's a big thing for some women. It lasts days. For some, it can last even a year.

Yeah, we've talked to women where it's lasted that long.

Yeah.

Those are the women who really spiraled into a really scary depression. All right. I feel that one. I feel that because of my training in this field, I met women who experienced it. It's very frightening. Okay, go ahead.

So much for funny.

I know. Go on. I mean, we haven't encountered poop yet.

Okay. "Overlapping contractions from a malpositioned baby." "Projectile vomiting."

Whoa.

"That I would hate the birthing tub." Some people do not like the water. It might have been the wrong temperature, might have been the wrong kind of tub. "The after-shakes. I was not okay." Those are very surprising.

Yes, they are, because they're really intense, really powerful, and if you haven't felt them before or nobody has explained them to you, they're definitely unexpected. Isn't that like the adrenaline all just coming down?

Yeah, it's just massive adrenaline.

Yeah, the whole body starts shaking involuntarily. I met a woman who had a C-section once. It was at a little private party gathering, and she was sharing her whole story with me, and she was like, "And it was so scary because after, my whole body started shaking." And I was like, "Oh, no, no, no, no. That's something vaginally birthing women experience as well." And she was so surprised.

Shivering, shaking, cold.

Yes, just shaking. The whole body, head to toe.

"How swollen your labia are after birth."

Yep.

They bounce back. Don't worry.

Yeah, if you take a mirror to yourself—

Don't. Just don't. No need.

Just know you will fully restore. And if you need help, you'll go to a pelvic floor therapist. But that's a whole other conversation. No, you will fully restore.

"Running out of hot water for the birth tub." So common.

Really?

Be prepared. Yes. Have a backup plan if you're planning a water birth, because unless you have a hot water system that's constantly regenerating in the moment, you'll run through a tank of hot water for sure. "Not wanting to be touched at all."

Happens.

Yes. "Realizing I am not the one in control. It's my baby and God."

Of course, you're not completely out of control either, though.

Yes, but there is—

It's like—I've never thought of this analogy before—it's like riding a wave. You can swim a bit. You can play your role in riding on that wave, but you're on a wave. You're not getting off that wave. So you can participate, but it is a major degree of surrender. I met with a group of clients on Tuesday night, and a few of them were second-, third-time moms, and most of them had really beautiful births. And they're facing that fear of, "Well, what if the next one isn't?" And we were talking about that balance. They were like, "How much should I practice, Cynthia? How much did I do?" And I said, "Learn and set it aside, and relinquish and trust that you're ready," because surrender is such an important part of it.

"Giving birth in a vehicle." Definitely unexpected. Those car births, they're usually quite smooth, though. Quick and smooth. "The OB tried to use Johnson & Johnson baby shampoo as lube."

Literally?

Oh yeah, I've heard this before.

Yeah, that's not—

Actually, that's not terribly uncommon.

But before the baby comes out?

Yeah.

I would raise hell. That stuff is toxic. That stuff is toxic. If you look that up, I think on a scale to 10, it's like a seven or eight. It's completely toxic, especially the no-tears one.

Also, you don't need lube.

Oh no, of course you don't. But if you're putting poison there where your baby is about to encounter it coming through you—

Yeah. Terrible.

I would go nuts. And to do it without consent.

Well, it says "tried," so I don't know if she caught him, he asked, or they—what?

Honestly, what kind of person would do that?

Oh, they do it all the time.

I can't. I can't with the common sense alone. It's such a harsh smell. You're going to put that on a baby's face coming out? Crazy.

It's pretty routine also, anytime they do a cervical exam, they're using a synthetic lube. They're putting it on their fingers before.

Are they as fragrant and toxic as—

No, not fragrant.

But probably toxic?

Probably toxic, but not fragrant.

Ugh. Wow.

"The amount of fluid and blood that is normal." It's a lot more than you might expect. Yes. "My breech baby pooping the entire 36 hours in labor. Endless poop."

Meconium.

Yeah, baby meconium. Very common in breech birth. "Dry mouth."

That sounds uncomfortable.

Yeah, a little dehydration.

I've had dreams where, if I'm dehydrated in real life, I'm drinking water and nothing's happening. I'm chugging water in my dreams. It's horrible. It's like it's not satiating me at all in my dreams. You wake up and you're just like, "Oh my God, why can't I just wake up and drink?" That sounds terrible.

I don't think I've ever had that dream.

Oh my gosh, I have. Yeah, terrible.

All right. "My husband hitting me in the head with a clipboard while trying to fan me."

Oh God!

Oops. Poor guy.

Yeah, I feel so bad.

"Gagging while in transition."

Gagging?

Gagging.

Okay, that's frightening.

That would be, yeah. Maybe like almost vomiting.

Okay, yeah. Gagging. "Not being able to talk during transition. I just wanted a cold towel and ice for my water." Yes, that's always a really good sign. When you can't talk during a contraction, that's a really good sign. "My husband would say watching poop fall out of me like a horse at the state fair."

God, just what you want to hear from the person you care about being sexiest in front of.

Oh, you know what? Look, this is a couple with a great sex life for sure because they're so close and intimate, and it's adorable. There's not shyness between them. That's actually very, very unique. That's it. I guess we're ready for questions.

We're ready for questions.

All right, let's jump in.

Hi, Cynthia and Trisha. Thanks for all your hard work on the show. I love listening to your podcast after having two kids, and I think I'm done having kids. I still can't get enough. I look forward to it every Wednesday.

My question is about prodromal labor. That is something that I actually had never heard of in my prenatal classes, and I experienced it twice in both my labors. So it's funny they say that every labor, every birth is different, but my two births were actually identical down to the day. My daughter was due February 9th, 2023, and she was born February 14th. My son was due March 9th, 2025, and was born March 14th.

With both kids, I started having very mild contractions at 40 weeks and one day, and then that led to days of prodromal labor, mostly at night, but quiet during the day. And then with both kids, I did end up going to the hospital. I was under midwife care, but I would go to the hospital and meet them there. And I was always about two to five centimeters when I got there. Never dilated past five centimeters. And then, I guess due to quote-unquote "failure to progress," I ended up going for a C-section because I was just exhausted.

I was just wondering if you could unpack a little bit why prodromal labor happens, why it takes so long, and could there be anything anatomically—I don't want to use the word misshapen—but different that could lead to both kids not being able to dilate me past five centimeters after days of labor? Any input would be great.

I do want to say that my second C-section was a gentle cesarean, and it was wonderful due to all the informed consent I had thanks to your show, and I felt very empowered by it. So thank you for all you do, and I look forward to hearing about prodromal labor on the show. Take care.

That's so funny. I was just talking to a mother yesterday who was telling me that her babies all come exactly five days before their due date, and her babies always come exactly five days after her due date.

Yeah, and it's great because we're always saying, like, you're not going to have the exact same birth, so don't replay your first birth. But she did, and I love when the exception comes along. I remember the first time as an instructor, I was always teaching about episiotomy and how they should virtually never be done. And after a couple of years, one woman was like, "You know what? I had one. I loved it. I needed it."

Okay, there you go.

She actually—

"I loved it."

Yes, she did. She said yes, and I knew the midwife who did it. So the midwife was not episiotomy-happy. She was not someone who was gung-ho about doing them. And she was like, "No, no, it felt like such the right thing." And the woman later had three more births and didn't need to be cut. So I never quite made sense of it, but it was good to be humbled. I learned very early on not to make absolute declarations because there is always, like, "Don't birth on your back. Don't birth on your back." You have said, and other women have said, "No, no, it was right for me." So whenever we make a declaration, we end up humbled. And I have long made declarations: "You're not going to have the same exact birth." And here comes a woman to say, "Well, I did." So there you go.

There are a few laws of the universe that are fixed, and everything else always has an exception. There is always an exception to everything. So yeah, let's just make sure everybody knows that when we say things that are more like declarations—

I mean, they know that. It teaches all of us to just know there's always the exception. It's fine.

That's right. Yeah. All right. So for her question, prodromal labor. It's interesting because she technically was never actually in labor if she had a C-section. She was never technically in active labor if she had a C-section at five centimeters. Six centimeters is the standard definition of active labor, and you can have days and days of prodromal labor before actually getting into active labor.

Now, why it happens? Nobody's really done any kind of research on that because nobody really cares except the woman going through it, because it's really annoying. It's very frustrating. It's like, "Is this happening? Is this happening? Is this happening?" No, it's not happening. It comes and it goes, and it's really common for it to be more active at night and go away during the day. And that's because our oxytocin levels are higher at night. But if it's happening overnight and going away during the day, you're actually not really in labor yet.

Position is a factor, though. She did mention that. Baby's position is definitely a factor in how the cervix responds to the pressure of the baby's head. So if a baby's head is a little bit kinked to the side or asynclitic, or sometimes even posterior, that can make labor be more stop-and-start or sort of erratic contractions until that baby's head position gets a little bit more centered over the cervix, which eventually happens.

What stands out to me is that she said, "I got to the hospital and never went into labor," and I'm so curious to know how long she was at the hospital. Now, I did hear and feel that she said exhausted. That I understand, going to C-section because she's exhausted. I get it. But saying, "I never went into labor," I can't help but ask myself and wonder, well, eventually you would have had those babies. Would it have been days later? An impossibility, basically. What did "never" mean? How long was she in the hospital? Because a woman can go for a C-section because she's exhausted. That makes sense. She's completely fatigued. But to say she never would go into labor, like never would birth the babies, is the big question, and I wish we could know.

So a couple alternative scenarios could have been getting an epidural so she could have gotten rest. I don't know if that happened anywhere in there, but that could have been an option. Or the possibility of something called therapeutic rest. Exhaustion is a totally legitimate reason for moving to a C-section, and when you have prodromal labor, you do become more exhausted. It's hard to eat. It's hard to sleep. It's hard to recover. So something called therapeutic rest, where they actually give you medication to kind of put you to sleep, can sometimes be a resolution to prodromal labor. Or an epidural. Or opting for a C-section.

And probably because she had gone that way the first time, it made her a little bit more inclined to just take that route the second time also. Probably encouraged by her providers, who probably hinted at something related to your pelvis not being equipped to birth a baby, because in both cases she kind of stopped at five centimeters.

That doesn't mean that your pelvis is not equipped to birth a baby or that there's something structurally wrong with your pelvis. It means that just the position of the baby relative to your pelvis needed more time. The babies maybe needed to move position or needed more molding. So time was the issue here, and she was too exhausted for the extended period of time that it would take.

I don't think there is any way to prevent prodromal labor. It just happens for some people, and it's just basically a little bit of a discoordination in the hormones getting in sync with each other, so the labor isn't actually getting into an active pattern. And again, fetal positioning can be one of the reasons.

Okay, onward.

Hey, ladies. My name is Michelle. I'm calling from Indiana. I have a question on navigating a change in your motherhood values or decisions, I guess would be the best way to say that.

So, background is: I breastfed my first baby for 16 months. We do things very naturally, holistically, home births, etc. However, my second-born, our breastfeeding journey is not going well. He's six months old. He has multiple food intolerances, and we're having a really hard time finding what the trigger foods actually are. I'm very restricted on my diet currently. I feel like my supply is dropping because I'm not eating enough, and it's been really hard.

I'm considering switching to formula, which for someone like me and the values and the beliefs that I have is just really crazy. So I'm just having a hard time with that. I know that formula might really, really benefit him and me. My mental health is really in the toilet because I'm always so stressed about what I'm eating and if I'm going to hurt his stomach. And if he has a bad day or a bad night, I blame myself because I must have eaten something, and it's just getting really, really exhausting.

But I don't know how to deal with the guilt of feeling like I'm giving him less than my daughter got—10 months less. It's just so wildly different from me and what I value to switch to formula. There's no shame in it, but it's, for me, just not how I envisioned things going. And I'm having a hard time with that. I'm wondering if you guys have any thoughts on this. Would love to hear. Thanks.

Okay, so this message is from a woman in my postpartum support group, and her suffering is off the charts. She has tried giving up food after food after food. She consistently sees her son struggling, suffering. It's all she thinks about. She's under unbelievable stress. She has other major things going on in life, like temporarily not living in their own home and moving. It is very, very difficult what she's facing right now.

I'm glad she called in. I didn't know she was going to. She knows all about our Free to Feed episode. That was an amazing episode for women going through the same thing.

I just want to respond to what I hear, Michelle. I'm just talking to Michelle now. Michelle, I want to just respond to what I hear you saying when you left this message. You said things like you're giving him "less." The thing that I'm grabbing from this is the story that each of us as mothers tells ourselves. And what I'm hearing her say is she's giving him, quote, less than her daughter got.

It's not terribly common for women who breastfeed to breastfeed their children for the same amount of time in the first place. But this is clearly a different person and a different situation, and I think that it's important to reframe it. If, Michelle, you're going to transition to formula, I would stop first and make a list as to why you must do this now. Because if you spend the rest of your life saying, "Maybe I should have gone longer. Maybe I didn't try hard enough. Maybe I didn't suffer enough," you need to go back and remember exactly what this actually feels like, to be living in this torment that you are living in right now.

There's another way to look at this: your daughter didn't ever give you the signal to stop breastfeeding. Your son has been giving you that signal. That's one way you can look at this. He keeps giving you the message: "This isn't working. That's not working, Mom. I appreciate that you changed your entire diet and you gave up 15 foods that you love. Still not working. Not working. Not working."

What more can your baby do to indicate that this isn't working? You know breast milk is optimal, but what more can he do to say this isn't working?

If you do go the route of formula, I'm just going to say what I always say: do your research and pick a formula you're at peace with, because they range from terrible to very decent quality. You know that, so you can feel peace in researching the best one that you're completely at peace with, that doesn't have additives and corn syrups and all that.

Until they get recalled.

Well, the ones in other countries, they're in Europe, they're producing better-quality ones than here. I don't have much to say about that other than put some of your energy into researching that, because they're all over the board, especially in the United States.

And finally, her overarching message was that she seems to be saying she's betraying her motherhood values. That's her overall message. Like, how do I handle going off course from my values? And what I'm hearing is she feels she's betraying her values.

What if, Michelle, you are actually in perfect sync with your values? What if your values are to feel sane and at peace and rested while you're loving and taking care of your children every day? What if your values are to make sure your son is getting enough nutrition rather than endlessly stressed that he isn't getting enough nutrition? What if this plan that you never intended is actually right on course with your values?

It's not your first choice, like a C-section isn't anyone's first choice, not in this audience. But we all have our moment where we say, "Thank you for this C-section, because I didn't know I would be facing these circumstances in my birth, and now I can be grateful for Plan B."

I think that last point is so important. Everything you said makes perfect sense and is very important. But that last point is like, welcome to motherhood. You are going to experience this again and again in your life, where you have to make a decision for your child that may not be aligned with what you expected, even with who you are as a person, as a mother, how you envisioned yourself. And you do get to change course when things in your life necessitate that. This is just one of those scenarios.

It's actually growth.

It's absolutely growth.

It's not growth we're seeking, but it's growth.

And it's life, and it's something you're going to face again and again and again along the way. So the only other thing I would say, just as an IBCLC, just throwing in my two cents about this scenario: first of all, if her milk supply is going down because she's not eating enough, breastfeeding is not going to work much longer anyway. So we need to get back to eating enough. Okay? That's very important for her. She needs to be nutritionally repleted. How that impacts her milk supply or not, we'll see, but she needs that for her own self. So if it's depleting you physically, we must change course.

Whether or not the dietary restrictions that she is currently doing are necessary, I don't know because I don't know their clinical scenario. But I would want to make sure that she has tried to reintroduce certain foods, and I would want to make sure that she has investigated other causes for the baby, like looking at tongue tie. I'm sure she has done all of these things.

She has.

Okay, good. That's important. And then I would like to just finally say, she's breastfed her baby for six months. That's a ton of time. At some point, they all get food other than breast milk.

It's absolutely breastfeeding success.

Completely.

We wish all American babies were breastfed for six months.

Exactly. I mean, that's the milestone we're trying to get to. You're already there. So yeah, comparing one child to another child—I breastfed one for 14 months and one for two and a half years. One got many extra months of breastfeeding, but that doesn't matter. It worked better with the one child to stop earlier and the other child to keep going. That was based on the child.

Yeah. I also want to make a point exactly on what you're saying. Let's just make it an easy example. If you breastfeed your first baby for one year exactly, and your second baby for six months, that mother is going to walk around saying, "Oh, I only gave the second baby half as much. Half as much." The truth is, the benefit is accelerated to the beginning. Colostrum alone is just a massive benefit, and the later six months of breastfeeding that first baby are not as beneficial as the first six months.

Totally. Completely different.

Yeah, completely different scale.

It's not a linear scale at all.

No. And that's not to downplay the benefit of breast milk for longer term, but it's not the same thing. She's already achieved the most important critical window. And she doesn't have to completely stop. There is also another scenario here where she does primarily formula, half formula, three-quarters formula, and she can still put her baby to the breast twice a day. That is an option too.

Hi, Cynthia and Trisha. My name is Mackenzie, and I am 25 weeks pregnant with my second baby. And at my anatomy scan, they found that I have a single umbilical artery cord instead of a one-vein and two-artery cord. And they suggested I do another ultrasound, possibly two, as a growth scan.

They're really low-intervention. They're pro-baby, pro-skin-to-skin. They're really wonderful. I had a great experience with them my first birth, so they're not very pushy. But I did have a growth scan my first pregnancy because they thought my baby's head was in the one percentile. Turns out he was just very low and engaged at 38 weeks, so I have had that experience where it was very wrong. He came out with a perfectly fine head.

So my question is: Is this a similar scenario where I do have to be concerned with the nutrition that I'm eating, or is this scan just another growth scan that will probably be wrong? Currently, I'm scheduled to have it at my 30-week appointment, which my husband and I kind of want to cancel. So I would just love your opinion and your input on the situation and what you would do.

So she's describing a scenario where the umbilical cord has two vessels instead of three. Three is the typical number of vessels in a cord: two arteries and one vein. She has an umbilical cord with two: one artery, one vein.

So that is not extremely uncommon. It does actually occur in almost 1% of pregnancies. It can be an absolutely normal variation of normal. It can also be associated with certain anomalies. So if it is a two-vessel cord with no other identified anomalies, like genetic anomalies or anatomical issues—which I think she said she already had the anatomy scan and everything was fine—then it is much more likely to be just a variation of normal and not associated with anything.

If it is a two-vessel cord and there are other anomalies, then it's more substantial and significant and something that you would want to pay closer attention to.

With a two-vessel cord, the reason she is being recommended to have follow-up ultrasounds in late pregnancy is because it can, in a small number of cases, be associated with growth restriction in the baby. So that's basically what they're wanting to make sure of, that it isn't causing any type of growth restriction in the baby.

Now, that doesn't mean she needs to have serial ultrasounds in late pregnancy. She could have one more, and if she feels satisfied, she feels satisfied. She doesn't need any more. She could have no more if she feels confident that her baby is growing based on fundal height and how she feels and what she perceives. But that's why they're recommending it.

Even if there's no reason for it, if it looks like it's one of those normal variations of normal, as you said, would there still be the concern that the baby could not grow as much just because the vessel—is it not delivering as much nutrients or oxygen? Is there a risk there? Just in and of itself, is there a risk just by virtue of the fact that there are two vessels instead of three?

Slightly, yes. So there is a 10, maybe 10 to 15% increased risk of a small-for-gestational-age baby or fetal growth restriction. We are not worried about an SGA baby, right? That doesn't mean anything. So how many of those 10 to 15% are just SGA versus IUGR? I don't know.

There's a small increased risk of preterm birth, maybe one and a half to two times the baseline. I guess my question is, I don't see how ultrasound protects or prevents any of these. It tells you if there's IUGR, and then what? But not very accurately. And then what? All they want to do is what? Induce early and get a small baby out sooner, as if that's definitely the right course of action.

I mean, I think this is one of those scenarios where you have to be really, really careful. This is probably meaningless, and we know the danger of routine ultrasounds. But of course they are going to recommend it. And of course, if they find anything, like they measure the baby's head small, they're going to want to induce sooner. This is just the classic scenario of late third-trimester ultrasounds being invasive and potentially putting you at risk of an unnecessary intervention.

And you know that wouldn't be the last one. They're not going to look at 30 weeks and go, "All right, everything looks great. We'll see you whenever you go into labor." They're just going to say it again.

They won't, but she might.

She might.

She might say, "Hey, everything—"

But she'll be in this position again and again, is the thing.

They will keep asking, yes.

So skipping the 30-week might buy her some time to get to a 35-week. And by the way, you and I did a very deep dive on ultrasound. The risks in early pregnancy versus the risks later, they're starkly different, and that's on Patreon. And I will be sure that we get the link to that download in the show notes for this episode.

And at 30 weeks, it's not like if they find SGA or IUGR, she's going to do anything.

That's what I was saying. What's the point anyway? Just to look at that time.

No, but maybe later on in pregnancy.

So maybe buy time and check later on, especially if fundal height is growing.

Exactly.

Okay. Yes. Well, guess what? Quickie time.

Quickie time! Yay!

Did you ask for them in the past day? Did we get new ones, or do we—

Yes, of course.

Our stash of 10.

I prefer not to organize them in any type. I like to just spontaneously see them now, so I always ask shortly before the episode.

Yeah, that's what I thought.

I don't look at them. All right, here we go. Quickies. "Do intrusive thoughts lessen to a degree once you wean?"

For some.

I would say yes, most of the time. And then they come back when you're perimenopausal.

I was going to say that. I hate to say the anxiety never goes down to zero.

Okay.

When you're 80 and they're 50, it's just not going to be zero.

"Do IVF placentas really stick more?" I would say, I don't know what the research is on this, but I would say from a clinical anecdotal perspective, yes.

What does "stick" mean?

They are slower to come out, more likely to be retained. "Should my four- and two-year-old be present for the home birth of baby number three? It's my second home birth."

She has a foreign two-year-old?

A four- and a two-year-old.

I'm just kidding. It sounded like you said "foreign." A four- and two-year-old. She's got a little non-English speaker.

Never met before.

"Should be present—"

Doesn't matter what country they're from.

That's what I thought you said when you were speaking. Should my four- and two-year-old be present at the birth? Is that the question?

Yes, for the birth of the third. Second home birth.

Yeah. We have performance of it. They have no fear of birth, and the only thing is that the child should not be distracting to you. Make sure there's someone who can take care of the babies when they need food and everything, so you don't have to feel you're managing it.

We have a whole episode on that.

Yes, we do.

"What's the best freezer meal to make for postpartum?" The first thing that came to my mind is lasagna. I don't know why. I don't even like lasagna.

You don't like lasagna?

Not really.

Who doesn't like lasagna?

Me.

You don't like vegetables. You don't like lasagna. Is she asking for, like, right after giving birth?

No, the best freezer meal to make for postpartum.

Oh, I mean, gosh, it's so hard to say what she'll be craving and what she'll need. But probably—let me just think. Freezer meal. I'm not a huge freezer-meal cook, but I know soups freeze really well.

Probably my way of thinking—and I do do this, and it does save time—if you have certain meals that require sauces, have the sauces made. Have a big pint of your favorite dressing made. If you make homemade—I don't know, I have a sesame noodle dish that we love. If I made the sauce beforehand, making the rest of the dinner is nothing. So if you have meals that do require sauces of some kind, have those made beforehand, and then do the minimal work just to have a fresh meal each time. You can get a lot of meals out of it.

I feel like anything that goes in a pan and gets baked in the oven is an easy postpartum meal. Just freeze those things. "Is there ever a time or place for an epidural?" Easy. Yes.

Yes.

Yes. I love when we can just say yes. Well, if the mother is exhausted and needs to sleep or rest, if she's been in labor a long time and her cervix has swollen and it needs to come down a bit, it gives her body a rest. Those two come to mind for me very quickly.

I mean, she's stuck at five centimeters in prodromal labor—

So that she can rest.

Yes. Or—

Yeah, well, that's back to rest.

Yes, rest. I was just commenting on that because that's what we talked about in the earlier part of the episode. "Lunch meat while pregnant." Lunch meat never.

Oh, finally we agree on meat, you and I.

That's one meat I don't eat. Except I did have an Italian sub yesterday.

There you go. I knew it was in there.

You're okay, but I try not to. Is Chomps different from lunch meat?

Yeah, I think they are because they're more like—lunch meat's really processed. Chomps are actually—and a meat stick differently. I actually don't eat Chomps anymore. I've changed brands.

Oh my God! I thought you still ate them all the time.

I do. I just eat a different brand, not Chomps.

You still eat meat sticks.

I still eat meat sticks a lot. Stay away from lunch meat. "Can breastfeeding be established at six weeks postpartum?" Yes. Breastfeeding can be established in a woman who wasn't even pregnant. So yes, you can induce lactation.

With domperidone or drugs.

Well, you do have to take medications. Yes, hormones. You've got to take medications, but yes, you can induce lactation.

"Are there free resources for a breastfeeding mom struggling with latch with her newborn?" Oh my gosh, yes. YouTube. Tons of breastfeeding videos. Absolutely. Go look up Jack Newman.

"What are your tips on white coat syndrome and blood pressure?" Stop taking your blood pressure from somebody in a white coat. Take your own.

"What's your favorite kind of cookie?"

I love desserts, but I'm not a big cookie person.

I love a molasses cookie, like a ginger molasses cookie.

I would probably love a cookie that has chocolate chips, of course, 100%, with maybe coconut in it, something like that. But just your basic homemade chocolate chip cookie, that's good to me. I have many desserts I prefer before cookies.

Ice cream.

My new homemade ice cream. Tiramisu, affogato, rice pudding. Ironically, my four favorite desserts are not chocolate.

Whoa!

I just listed them. Yeah, they're not even chocolate. My homemade pudding—that's one of my favorites. But that would still be like my fifth favorite dessert. And I don't even know where cookies are on the list. They're pretty low.

"How long can hemorrhoids from birth hang around?" I mean, a long time. Hemorrhoids can stick around for a very long time, years. They do heal, though. They can heal and they can go away. And sometimes people have them surgically removed.

But it is really important to do comfort measures for them and make sure that you aren't doing anything that's going to exacerbate them, which is straining. So you have to have a high-fiber diet. You could do chlorella. You could do lots of dried fruits, just more fiber in your diet, lots of berries. And eventually I think that they go away. But a lot of women do experience them after birth.

Well, vitamin E is also really helpful.

"What's your favorite way to bring play into your life with just 15 minutes to yourself?"

Fifteen minutes. I can't say pickleball, even though I play—

Nope.

I played for three and a half hours yesterday.

You certainly can't say paper quilling.

I can't say paper quilling. Why? Because 15 minutes? That takes hours.

Okay, to be totally honest, I hate the way this sounds because you tease me all the time. This is totally honest. This is something I do virtually every day, including probably every day for the past five days, or almost every day for the past two weeks. I do logic problems. I love that. It is very relaxing. It's not uncommon for anyone in my home to see me curled up on the couch with a pencil in my hand doing logic problems. I love them, and that's how I kill time, and that's very satisfying to me. Sometimes it's what I'm doing right before I go to bed. I love it. So what about you?

Of late, I would say—I don't know if this counts as play, but it feels like it to me—I trim my basil.

You trim your basil. That's so nice. I don't trim my basil. So what do I need to teach—

I have to teach you how to trim your basil. I've just learned.

Okay, I know how to pull off the right—like where to pull off the—okay, we'll talk about this when I come to your house.

Or feed my sourdough starter.

Yeah, I mean, she said play, and essentially she asked play. She didn't say relax. And I want to think about play. So let's just give it another minute of thought because that might not be what she was thinking.

Maybe I don't play enough.

Honestly, I do think it's paper quilling, and I do do it sometimes for just 15 minutes. I can just do a petal or two for a flower, and that is something I might do. And I do consider it play for sure because it's highly creative. It's my true answer these days in my life.

Well, I need to come up with something.

Okay, you do. You're so darn serious, Trisha. You're so serious. What is that from? I feel like I'm reminding myself of something.

This means I'm a Virgo.

You're so serious. You're always in your sauna or at the gym or doing your walk around your block.

Those are all my forms of play.

You're always immersed in self-care or mad with work. You're one extreme or the other every hour of the day. You balance—

I don't know if that's balance.

My work and play are much more merged, and yours are one extreme or the other.

Work hard, play hard. But I'm going to come up with something interesting that I can do for play in 15 minutes that's not necessarily like a chore, like trimming basil.

"Is it okay for baby to stay latched the whole time during a nap?" Of course. Only if you want them to.

Yeah, that's no problem.

Yeah, if you like it, sure. No problem, as long as it's not making your nipples sore.

"What's the number one morning sickness remedy?"

Eating.

Yes. Eating frequently, eating small amounts, eating before you get out of bed in the morning, keeping something next to your bed that you can eat in the morning, and making sure that you have protein at every meal.

"Vaginal tear, stitches, yes or no?"

Usually no, and it depends.

Yeah, if it's a pretty significant second degree or more, then yes. That's the nutshell. We covered this on a Patreon event too. We'll stick that in the show notes too, right? We had a whole thing on vaginal integrity and how to prevent tearing and how to—

So we'll put that one in there as well.

Yes, we'll get that one in there.

Okay. All right. Last one. "Do you follow or resonate with any faith or spiritual practice?"

Yes.

Yes. I would say I do not attend church, but yes, I follow a spiritual and faith practice. You have to have faith in life. Everyone must. Okay, that's that.

It's such a conversation between faith and religion, right? I mean, there's such a conversation there that, again, not a quickie.

No, but yes.

I would say a very, very important part of life.

Yes, yes, yes, yes. Beneficial, I would argue. Very beneficial.

All right. Well, that was rich with varying topics, questions—

And recurring themes.

Some recurring themes. And thank you, everyone, for your calls and your comments and your quickies. It's awesome how creative this audience is and the things that are on their minds. So that's it. We are wrapping for—I don't want to say the summer, just August. September may be blissfully hot and warm.

Thank you, thank you. Don't forget to check out the show notes and the Patreon links that are in each episode now, so you can get more and deeper content from us.

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.