Pam England’s Birthing from Within has been hailed as “… a landmark in the history of childbirth” (Dr. Michel Odent). Published in 1988, this book is still relevant and influencing couples preparing for childbirth today. Pam England is both a Certified Nurse Midwife and a psychologist, and she calls on each of these backgrounds and experiences in her childbirth preparation education and recommendations.
When my brother-in-law saw this book sitting out at my house, he jokingly said, “Birthing from within? What other way is there to birth?” But, as Pam explains, its often the internal preparation that is overlooked when preparing to give birth, and that can make a huge difference in the way parents experience birth. Throughout the book, Ms. England offers a wide range of activities to help expectant parents prepare for birth—from the inside out.
The book is divided into seven sections:
1. Beginning Your Journey
2. The Art of Birthing
3. Preparing Your Birth Place
4. Being Powerful in Birth
5. Fathers and Birth Companions
6. Birthing Through Pain
7. Gestating Parenthood
In each section, Pam offers activities that expectant parents can do together or individually as they prepare for birth. Here is a sampling of some of the activities:
Surrounding all of the activities is tons of important information about birth: what to know and expect physiologically and psychologically, historical and ethnographic perspectives, and research and experience say about various birth choices (e.g. helpful comfort measures, home birth considerations, birthing positions, epidural use pros and cons, how to have an empowered cesarean, etc.).
In all, Birthing from Within is a vastly useful book with information that can appeal to and offer relevant information for families in a variety of circumstances, with varied goals and backgrounds. It certainly appeals most apparently to those preparing for an unmedicated birth, but it calls on all birthers to do the internal work necessary to have the best birth experience possible. I’d definitely recommend it as a resource to call on in preparation for birth. Check it out from my Lending Library!
This book review blog post was originally posted on 11/21/2018 on the blog of my previous website, www.sarasbirthservices.com (no longer active).
As you can tell from the sticky notes, this book is packed full of good information!
I appreciate the Searses' well-rounded and positive approach to pregnancy they take in this book. They begin with detailed information about how to have a healthy pregnancy through wise nutritional choices, movement, sleep, and self-care skills. This starts the book off on a great foot for helping women be the responsible agent in their pregnancy and birth, which I believe is critical! They list helpful nutrients for pregnant women and their developing babies, the foods that offer them, and even recipes to incorporate them in your diet. In the section on exercise, they emphasize the importance of moving healthily and the wide range of activities that pregnant women can do to stay in shape and help their bodies and their babies be as healthy as possible.
The next section of the book details the month-by-month changes that occur in the developing baby and the pregnant mother's body. They address concerns and discomforts that may arise by offering helpful tips and solutions. In the section on birth, they offer a detailed explanation of the "hormonal symphony of birth" and beautifully describe how mom and baby's bodies work together to bring baby into the world. They address common interventions and when they can be helpful and when they'd be better avoided.
In the final section, uncommon pregnancy complications are addressed. The section begins with the directive to read only those sections that pertain to a complication you have, as there's no need to worry about things that could but likely won't--wise advice for an expectant parent! I especially appreciate their re-framing of the term "high-risk pregnancy." They explain that this term is necessary for doctors to be aware of women whose pregnancies and births should be monitored more closely, but invite women in this category to instead consider their pregnancy as "high responsibility":
"Instead of resigning yourself to the high-risk label, becoming a passive patient, and leaving all birth decisions up to your doctors, become a high-responsibility mother. Take an even more active role in your birth partnership; cooperation between you and your care providers is essential. You need to be more informed and more involved in decision-making than the average mother, and you need to take better care of yourself. The first question you should ask your doctor after you are classified as high-risk is what specific things you can do to lower that risk."
I especially appreciated this advice because both of my pregnancies have been "high-responsibility," the first because I was carrying twins, and the second because I have a blood-clotting disorder and was planning on a VBAC. In my first pregnancy, I resigned myself to the "high-risk" label and stopped asking many questions and taking personal responsibility for my pregnancy, and I ended up with some complications that I believe I could have avoided if I'd been a more active participant in my health care. In my second pregnancy, I made sure I was well-informed and the responsible agent for caring for my extra needs, and I had a very positive experience as an active birth-giver!
In all, I definitely recommend this book as a comprehensive guide to having a healthy and positive pregnancy. It's the best book of its kind in that category!
This is the second post in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.
Today's interview is with Richelle Jolley. Richelle has been a Certified Professional Midwife for 20 years and is one of the few midwives experienced in breech and twin birth deliveries. She lives in Springville, Utah and attends home births in Utah County as well as Salt Lake and San Pete counties. Richelle is passionate about the work she does to strengthen women and families. She is uniquely positioned to do a very specific and powerful work with her clients. Let me introduce you to her!
For Richelle, it’s impossible to separate her work as a midwife from her spirituality. She became a midwife after a very clear spiritual call from a dream, and has never looked back! “I do this work with the intention to glorify God,” Richelle confidently states. From the moment of her call to midwifery, she felt “an unstoppable drive and desire to get myself educated so that I could do what I knew I was meant to do.” Richelle did just that and has now been serving growing families for over 20 years.
And throughout those 20 years, Richelle has found an ever-strengthening connection with Deity. She reflects, “I have been graced with the priceless gift of experiencing opportunity after opportunity to choose faith, trust, hope, inspiration and courage, resulting in amazing triumph and growth for me and my clients.”
Richelle sees herself as far more than a medical care provider for her clients, though she is certainly that. As I heard her speak about her clients, I sensed the great love and respect that she has for each of them and the honor she finds in being their guide through pregnancy and early parenthood. As she is guided by her faith in her work, she also invites and supports her clients to do the same throughout their pregnancy and birth experience. She calls on her clients to cultivate and follow their inner voice. “Whenever there may be fears or concerns that come up I get to call a mother back to her heart, reminding her of the witnesses of Truth she has felt regarding her baby, her pregnancy, her health or her birth.”
Richelle points out that pregnancy is an ideal time for personal growth and development. As there is literal life growing and developing within the woman’s body, there is an inherent energy of growth that is encouraging personal development within the woman herself. So, Richelle says, preparing for a baby is the perfect time to clear issues and overcome obstacles that may be holding the mother-to-be back: fears, traumas, false beliefs, etc. “This inherent energy of growth within is all a part of the natural preparation for parenthood” Richelle says, “it is a kind-of house cleaning and strengthening preparation for entering into parenthood with greater clarity, connection and confidence.”
Acknowledging that there is a process in preparing to give birth, Richelle notes, “It’s not like, ‘Oh here we are at birth, and suddenly, we’re going to have a great experience’. There’s a lot of preparation that goes into that.” Recognizing that birth offers challenge, Richelle invites her clients to take the time they need to prepare for the experience, to ask themselves, “Who do I want on my team?”, “What experience do I want to have?”, “What kind of personal growth do I want to gain from this experience?” Finding and creating the answers to these questions through pregnancy and birth becomes a journey for the woman. Throughout the process, Richelle holds space for each client and honors her unique, individual journey. Sometimes there are plateaus or lulls during the birthing time, and rather than trying to force anything or intervene, Richelle holds space and waits and watches until her client comes to a place herself where she finds the motivation to ask the questions and do the work to create progress in her birth journey. If needed, she’ll ask clients questions along the way that offer opportunities for self-reflection. Often these questions invite the mother to work through whatever may be holding her back.
Richelle firmly believes that this pregnancy and birth journey is perfectly designed to prepare for parenthood. “I love seeing the potential for bringing the couple together and strengthening their bond,” she says. She speaks of observing husbands developing admiration for their wives as they witness them in their powerful maternal expression. And she watches as a birthing woman’s trust in her husband is deepened as he is emotionally present for her. They face the challenge and go through the process together, and “come out on the other side feeling this sense of strength and capability that they take into parenthood.”
Speaking of the woman in particular, Richelle is inspired by the way that pregnancy and birth prepare a woman for motherhood. She says, “hopefully a woman can look back on her birth experience and know that she can do anything for her baby as she raises that child, because she just did it! She knows she can take on any possible challenge encountered in raising her child for whom she just explored the depths of her soul to give birth to.”
Richelle’s greatest fulfillment in her work is to see the growth and strength of character acquired by her clients. She relishes in the conversations she gets to have at their final appointments, as a client may share with her about everything she’s learned and how she’s grown through their time together. As one of her clients once expressed, “You believed in me and fought for me and helped me find the strength inside myself. I am a better mother because of some of the things you taught me, but mostly because of observing you and the way you interact with care for people. I have thought of your courage and fortitude to do things differently and it has helped me be brave when I am afraid.”
Two months ago my husband and I celebrated our ninth wedding anniversary. We love to hike for our dates, but typically have to find shorter hikes because of schedule restraints. For our anniversary, though, we went all out and hiked to the summit of my favorite mountain, Mount Timpanogos! (That's its silhouette you see in my logo.)
While we hiked, I of course thought about super romantic things, like how grateful I am to be married to such a wonderful man, and how crazy it feels that we've already been married for nine whole years! But I definitely also thought about birth as we hiked. Because... well, I think about birth A LOT. Being a doula will do that to you!
As I hiked, I thought about how giving birth is like summiting a mountain.
I chose the name of my business, Summit Birth Utah, after a conversation with a doula friend, Kjell. Previously, the name of my doula business had been Sara's Birth Services, and it just felt rather ho-hum. I was chatting with Kjell about she came up with her business name, Ride the Waves Doula Services, and she said that as she considered what she wanted to name her business, a friend had asked her, "What do you find peaceful about birth?"
I adapted this question to my thoughts about birth. What do I love about birth?
I love birth because, while giving birth, you can discover your strength in a way that's unequaled by anything else. I love birth because it teaches us about the beauty and wonder of our bodies. I love birth because it builds strong mothers and families.
I also know, that sometimes, birth isn't this way. For giving birth to be a truly empowering and transformative experience, you need preparation and support. And that is what my work as a doula is all about. As I say in the About section of my website:
Welcome to the journey. Whether this is your first baby or your fifth, your pregnancy marks the start of a new path on your journey of motherhood. As your birth doula, I've walked this path before. I have the knowledge and experience to help you prepare for and enjoy a positive and empowering birth.
I love birth. Like hiking to a mountain's summit, giving birth pushes us past our perceived limits. It urges us to call on our inner strength and climb to new heights. And the journey's pinnacle, as we snuggle our new little babes to our skin, rushed with hormones that fill us with indescribable love, is truly life-changing. It's empowering to look back over the ascent and its challenges and say, "we did it!"
So I named my business Summit Birth Utah.
I'd love to be by your side, supporting you as you discover your strength through birth. To schedule a free consultation to ensure we're a good fit, contact me today!
I've been hearing a lot recently that expectant couples are looking for classes that encourage them to both be involved, together, in the birth experience. Look no further!
Mary Caplin and I are thrilled to offer our Childbirth Class Date Night again on Friday, October 9, 2020, from 7:00-9:00 PM.
This class is a two-hour deep-dive into how to work together and come closer as a couple as you prepare for birth and experience it together. Here's a sneak peek into what the class entails:
Before the class, we'll email you to ask about what you want to get out of the class and what your priorities are. We want to make sure to tailor the information in class to your specific needs! The sooner you register, the sooner we'll be able to plan according to your situation, plans, and preferences.
As the class begins, we'll briefly get to know each other, then start talking about how to prepare for a smooth birth. We'll give tips about what you can do in pregnancy to start preparing your body and your partnership to give birth.
Then, we'll give some ideas about what to do in early labor--and how to know if it's the real deal. We'll talk about the stages of labor and how there are sign posts you can look for, although your birth experience will be unique and not exactly like anyone else's.
Then, we'll break for dessert of local gourmet cookies and tasty ice cream bars, plus cheese and fruit for the healthier crowd. As you snack, you'll keep learning about the emotions of labor and how to communicate together before and during your birth. We'll talk about what to do when the unexpected happens during your birth and how you can come out stronger as a couple if you're thrown a curve ball.
We'll watch a couple of birth videos that show couples having a positive birth experience together, and talk about things they did to facilitate that positive experience. We'll practice some hands-on comfort measures and helpful positions for labor. Then, we'll answer your questions about the "pushing" phase of giving birth. We'll close by guiding you through a couple's massage (both partners get a turn!) and answering any final questions you may have.
Throughout the class, there will be plenty of opportunities to ask your questions and get them answered. It'll be an evening packed with learning and hands-on practice in preparation for birth! Head on over to the Events tab to register!
FREQUENTLY ASKED QUESTIONS
Will we be totally ready for birth after taking this class?
No. We pack in as much information as we can during this two-hour class, but to truly be ready for a positive birth experience, you'll need to spend more time preparing together. We'd love to support you as your doulas and meet with you for two-three more hours during pregnancy. In addition, we recommend physical preparation (we'll talk about that in class), and we'd be happy to tell you about our favorite book recommendations. (As a client, you're welcome to borrow as many books as you can read from the lending library!)
Do you have any promo codes I can use?
Thanks for asking! We are running a special where you can knock $10 off your ticket price for every couple that you refer, until the class is full. If you refer a couple, send us an email at email@example.com to let us know, and we'll refund you $10 when they sign up!
AND the best part? If you choose to hire us as your doulas after the class, your $50 class registration fee can be applied directly to your doula services package!
I'm planning to have an epidural when I give birth. Will this class be useful for me?
Yes! The information in this class will be meaningful for couples planning unmedicated births as well as couples planning to have an epidural. The information we share about preparing for a smooth birth, stages of labor, and some helpful positioning tips are useful whether you're medicated or unmedicated during labor. Some of the information, such as other labor positions and comfort measures, may only be relevant before anesthesia is administered, but remember that you will be without anesthesia for some of your labor--we want you to be as comfortable as possible throughout all stages of labor!
What precautions are you taking to make this class safe in the time of COVID-19?
We want you to be safe and feel comfortable at our class! We're capping the class at six couples, so there will be a maximum of 14 people in attendance (six couples plus two teachers). There will be more than six feet of space between couples, and we'll have hand sanitizer on tap. If we (the teachers) come within six feet of you to demonstrate anything, we'll wear a face covering. Based on the comfort and preferences of class members, we may also wear face shields throughout the class.
The class content sounds interesting, but I don't have a partner. Can I still come?
You're absolutely welcome to attend without a partner. If you'd be more comfortable in another setting, we'd be happy to accommodate you with a private class. Just email us at firstname.lastname@example.org.
I can't make it to the October 9th class. When will you be doing this class again?
We offer this class about every three months. If you'll still be pregnant in three months, we'd love to have you come to our next class, which will likely be in early 2021! If your birth is approaching sooner than that, email us at email@example.com about coming to your home to teach a private class.
This all sounds great! Where can I register?
You can register on the Events tab!
This is the fifth and final post in a series about comfort measures for labor that appeal to each of the five senses. Today, we're focusing on the sense of smell! Studies show that aromatherapy can be an effective way to reduce anxiety and tension. This decrease in anxiety can then reduce your perception of pain. Here's a look at some essential oils that can be useful during labor.
Several floral scents have been shown to likely relieve stress and/or lower pain scores during labor. Diffusing lavender, jasmine, rose, or geranium into your labor and birth space can help you feel more at ease and comfortable during labor. Something I've noticed about floral scents is that people often have strong preferences towards or against certain scents. So smell a few and find a scent that you like!
I love the smell of citrus! When I found the picture above of the sliced open oranges, I could just smell and taste their tangy sweetness! Studies show that citrus scents can also be helpful during labor. Specifically, bitter orange (citrus aurantium) may lower pain scores, and both bitter orange and sweet orange peel (citrus sinesis) may decrease stress and anxiety during labor. Sign me up!
Peppermint for Nausea
As much as I love citrus and enjoy floral scents, the essential oil that I use most--hands down--is peppermint. An unfortunate side effect of transition in labor (when your cervix dilates from 8 cm to 10 cm) that many people experience is nausea. The rapid changes--physical and hormonal--that your body goes through during this time often lead to an upset stomach. For many of my clients, when I put a few drops of peppermint oil on a cotton pad and give it to them to inhale, their nausea goes away. It's not always effective, but it's a very handy tool to have on hand!
This is the first in a series of blog posts based on interviews I’m doing with midwives who serve Utah County.
Today's interview is with Roxanna Maurer of Angel Baby Midwifery. Roxanna has been a midwife since she graduated from Utah School of Midwifery in 1998! She lives in Payson, Utah and attends home births in Utah County. Roxanna is a warm, loving, beautiful person—I hope this post captures some of that for you!
Last month, I chatted with Roxanna as she took a break in the shade from landscaping her backyard. She already has a thriving garden, and is expanding it with fruit trees and other plants. She shared her wisdom about the importance of good nutrition during pregnancy.
When Roxanna takes on new clients, one of the questions she asks them is, Are you willing to take responsibility for yourself and your baby? Roxanna says, “I can talk to you till I'm blue in the face. But it's pointless if you go home and don't do anything about it.” This is especially important to Roxanna and her clients since all of her clients give birth at home. “Part of having home birth means I'm willing to take responsibility for myself,” she says. “That means you prepare for the marathon of birth.” And if you’re preparing for a marathon, you can’t be stocking up on candy bars and Diet Coke. Nutrition is critical.
So Roxanna shares a handy acronym to help her clients remember the critical nutrition components they need every day. The acronym was developed by her good friend and fellow midwife, Nikki Sasser. She says, “if you want to be a birthing queen, you need a WHOPPER every day.” And let me tell you, Nikki and Roxanna do not mean one from Burger King! (It’s also great advice for outside of pregnancy!)
W stands for whole grains. Roxanna’s disclaimer about whole grains? “I don't mean General Mills cereal that says whole grain on it because let's just be honest… it's not.” For those who are able to eat grains, she suggests oats, quinoa, millet, and brown rice as some delicious, nutritious options.
H stands for hydrate. Roxanna recommends drinking half of your weight in ounces of water. So if you weigh 160 pounds, drink 80 ounces of water every day. Coconut water is also a great source of natural electrolytes—like Gatorade, but “with all the good stuff and none of the junk.”
O is for omegas. Roxanna uses the acronym BACON to remember sources of healthy fat and omegas. Butter, Avocado, Coconut, Olive oil, and Nuts.
P stands for proteins. As your blood volume increases during pregnancy, it’s important to have adequate amounts of protein. Iron and B vitamins are also critical in promoting healthy blood quality during pregnancy and having the necessary stamina for labor, birth, and early parenting, Roxanna says. (Vegans or vegetarians may need to take a B-vitamin supplement, as B-vitamins are typically found in animal products.) What sources does Roxanna recommend for protein? Beef, chicken, fish, eggs, lentils, beans and rice, nuts and seeds, protein powder drinks.”Those are a variety of ways of getting proteins in your diet.”
The second P in the WHOPPER acronym is probiotics. Probiotics “colonize the gut and break down the food.” Roxanna recommends Standard Process’s Lactic Acid Yeast as a probiotic supplement.
E stands for enzymes. Probiotics help break down the food, and enzymes continue the process. “That's the purpose of enzymes, to help you digest your food effectively,” Roxanna says. A healthy diet only does you good if your body is able to adequately digest it! Multizyme from Standard Process and TerraZyme from doTerra are options for enzyme supplements.
Lastly, the R in WHOPPER stands for the Rainbow. Eating a rainbow of healthy foods invites lots of beneficial vitamins and minerals into your diet. Go through the rainbow, and try to incorporate foods of every color. Red berries and cherries or beets, orange pumpkin, yellow squash, green salads or smoothies, blueberries, and purple plums or grapes… you get the idea!
And there you have it! Roxanna’s WHOPPER for birthing queens! Changing habits and sticking to a healthy diet can feel overwhelming, but you can do it! Check out my Top 5 Tips for Healthy Eating During Pregnancy. And to encourage yourself, here’s Roxanna’s tip: “Take a picture of success that you've had in your life and hang it in your mind.” Keep going back to that success in your thoughts; refer back to it. As you recognize other successes you’re having, “bring that into your success gallery, and refer to that. I was strong here. I can be strong here. And if I'm strong here, what else can I do?”
Pregnancy, birth, and the postpartum time are full of decisions: choosing a care provider for your pregnancy and birth; defining and communicating your birth preferences; making choices about newborn medical procedures, feeding, and care; and more! Each of these choices is affected by a variety of factors!
As a doula, I love supporting my clients through the process of making their own informed, empowered decisions. I love watching my clients research their options, consider all the relevant factors, and move forward with the best choice for their family and circumstances.
One of my absolute favorite tools for informed choice is the BRAIN acronym.
The BRAIN acronym guides parents through each part of making a choice. For each choice, it invites you to consider:
Benefits: What are the possible benefits of making this choice?
Risks: What are the potential risks of making this choice?
Alternatives: What alternatives can we consider? (For each alternative, you can go through the BRAIN acronym again!)
Intuition: What is my intuition telling me is the best choice for our family?
Nothing: What if I do nothing?
Let's walk through an example of how to use this acronym. Let's say, for instance, that you're trying to decide where to give birth. The BRAIN acronym works best if you choose a potential decision and work through the acronym, and then do the same thing for each alternative choice. For this example, you may begin by considering the decision to give birth at a birth center. You'd start by looking into the options near you. (In Utah county, you can check out Utah Birth Suites, Two Leaves Midwifery, and Birthing Your Way. The Draper Beautiful Mountain Birth Suites birth center is also right on the border between Salt Lake and Utah counties.)
Next, consider the BENEFITS of giving birth at a birth center. Perhaps you like the homey feel of a birth center (compared with a hospital). You may appreciate that a birth center offers a large tub, spacious rooms to labor in, and places for your family or friends to wait. During COVID specifically, birth centers are much less likely to restrict the number of support people you can have with you during your birth. There are also fewer routine interventions and procedures done in a birth center (compared with a hospital), and you're more likely to know everyone in the room. You may also want to read this blog post about the evidence on birth centers and ACOG's Statement on Birth Settings, which lists accredited birth centers as one of "the safest places to give birth." Throughout your research, you'll find other benefits to list as you consider making this choice.
After thinking through the BENEFITS of birthing at a birth center, research the RISKS. Think specifically about your situation and the potential risks of birthing at a birth center. If you have a high responsibility pregnancy (what some may call "high risk"), a birth center may not offer access to medical care you need. If it's likely that your baby or babies will need additional medical care at birth, a birth center doesn't have immediate NICU access. If you are planning to use epidural anesthesia during labor, this option isn't available at a birth center. And you won't stay for 24-48 hours after giving birth, but will head home within a few hours of giving birth. What other risks might be important for you to consider?
After thinking about the RISKS, ask yourself about ALTERNATIVES. Alternatives to birth centers include hospital birth and home birth. Some inns/hotels are also open to having clients give birth there (Aspenwood Manor in Provo is a beautiful option that is very open to this!) Again, for each of these possibilities, you'll want to go through the BRAIN acronym again!
Next, tune into your INTUITION. You are the only one who knows all of the factors in your unique situation. Do the work to familiarize yourself with the options and their benefits and risks, and then trust your intuition. Reflect, ponder, meditate, pray. Talk it through with your spouse/partner/doula/friend/mom/aunt/yourself. And trust that you can make the right decision for your family!
The last letter of the BRAIN acronym doesn't really apply in this scenario: doing NOTHING in your decision-making process about birth location would eventually lead to an unplanned home birth, which isn't a great option. (Planned home birth can be, though--stay tuned for an upcoming post about that!) In other situations, though, NOTHING, can be a worthwhile option to consider. Rather than consenting to having your water broken, you can choose to do NOTHING to intervene. NOTHING can also mean letting NATURE take its course, which is an option you'd want to carefully consider.
I hope that example exercise was helpful! I love that the BRAIN acronym is applicable for everything from choosing a care provider to induction to anesthesia to breastfeeding to potty training to choosing a preschool and beyond! It's a great tool for parenting!
I love that this acronym recognize and invites YOU to be the actor, the decision maker, the researcher (in consultation with care providers, medical experts, and others as needed) in your own story. Whenever there's a choice to be made, ask yourself: What are the Benefits, Risks, and Alternatives to the proposed choice? What is my Intuition telling me? What if I do Nothing?
3-5% of Americans are vegetarian, and I'm one of them!
(Well, strictly speaking, I'm a pescatarian. I do eat fish.)
People have a variety of reasons for choosing vegetarianism, from ethics to environmentalism to religion to health to personal preference. But when you're growing a whole new person, you may wonder: is it still safe and healthy, for both my baby and me, to continue being a vegetarian?
The answer is yes! You can continue being a vegetarian and still meet all of your and your baby's nutritional needs. It may take some careful planning and thoughtful eating, but you can do it!*
Just keep these guidelines in mind:
Be sure to get enough iron.
Iron is important for your red blood cells to do their job of circulating oxygen throughout your body! Eating a diet rich in Vitamin C will help you body absorb iron more efficiently. Vegetarian sources of iron include:
Track your sources of vitamin B12.
Vitamin B12 is crucial to the healthy function of your nervous system, among other roles. Since vitamin B12 is found almost exclusively in animal sources, you may need to plan carefully to make sure you're getting enough.
Vegetarian sources of vitamin B12:
Protein is important!
The American Pregnancy Association recommends 75-100 grams of protein per day during pregnancy. There are plenty of vegetarian sources of protein, so make sure to include them in your diet! Here are some ideas to get you started:
Choose a variety of healthy foods.
Vegetarians and non-vegetarians alike should follow this advice: eat a balanced range of healthy food choices throughout your pregnancy. Limit unhealthy snacks and eat a rainbow of delicious, nutritious foods!
Always talk with your care provider.
As a doula, I love to provide informational support to my clients. However, I'm not a medical care provider, and I don't know your unique medical history. Be sure to have conversations with your midwife or OB about your diet and health throughout your pregnancy!
Now you have the Reader's Digest version of being vegetarian during pregnancy. If you decide it's the right choice for you, please do more research and make a plan for meeting your nutritional needs! You can start with the references listed below.
*Note: Some people may choose to take a break from vegetarianism while pregnant. If your intuition tells you that's the right choice for you and your baby, then do it!
Your Vegetarian Pregnancy by Dr. Holly Roberts (available in my lending library)
So, your due date has come... and gone...
First of all, let's be clear about EDDs, or Estimated Due Dates (also called Estimated Date of Delivery). You can tell from my italics that the term estimated is critically important in understanding due dates!
Where do due dates come from?
An EDD is calculated as 280 days past the first day of your last period. EDDs can also be determined by measuring your baby during an early ultrasound, which is a more reliable method.
Here's the thing about EDDs calculated as LMP (last menstrual period) + 280 days. There's lots of room for error with that approach. Many women misremember the first day of their last period and do their best to guess. Even if you're sure of your LMP, using this day to calculate a due date assumes that you ovulate on day 14 of your cycle and have 28 day cycles. The whole idea of EDD = LMP +280 days is also based on little sound evidence. Back in 1744, Dr. Boerhaave, a professor from the Netherlends, looked at data from 100 women and concluded that most people gave birth within about 280 days of their LMP (although he didn't specify whether LMP meant the first or last day of the menstrual period. In 1812, Dr. Carl Naegele further popularized this process of EDD calculation, but he used the last day of the period as the LMP. In the 1900s, obstetric textbooks started using the first day of the period as the LMP.) So the very process by which due dates are determined isn't very specific, and is based on very limited data!
It's tricky, then, if we take an EDD to mean much more than an estimate of when baby might arrive. As Rebecca Dekker of Evidence Based Birth concludes,
"Based on the best evidence, there is no such thing as an exact “due date,” and the estimated due date of 40 weeks is not accurate. Instead, it would be more appropriate to say that there is a normal range of time in which most people give birth. About half of all pregnant people will go into labor on their own by 40 weeks and 5 days (for first-time mothers) or 40 weeks and 3 days (for mothers who have given birth before). The other half will not."
Instead of fixating on a due date, you may prefer to refer to your EDD as a "guess date," or think more about your "due month" than a specific day.
Now that we have a better idea of where due dates come from and what they do--and don't--mean, let's talk about being "overdue."
As evidenced above, there's nothing magical about the 40-week mark. It's actually more likely that, if you wait to begin labor on your own, you'll give birth a few days past your EDD than on the due date itself. Babies aren't considered "late term" until you reach the 41 week mark, and "post term" doesn't apply until babies are past 42 weeks gestation. Induction for being "overdue" isn't recommended until you're at least 41 weeks pregnant.
It's almost as if pregnancy is trying to teach us the vital parenting skill of patience.
So, what's the takeaway?
Pregnancies aren't like final projects or rent due dates. No points are deducted or fees added for going past your due date. A due date just gives an estimate of when your baby is likely to be born, but really doesn't mean anything definitive. My advice is to schedule a week full of pampering and things to look forward to on your due date and the few days past it. Plan on getting food from your favorite restaurant, going for a walk in your favorite spot, connecting with friends or family. Practice some of those comfort measures that will come in handy during labor. Snuggle up with some great birth books. And know that your baby and your body will work together to signal when it's the right time for baby to come!
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This whole business of calculating due dates and going past your due date is really quite complex. Now that you've been introduced to the topic, I recommend digging into it more with these two articles from Evidence Based Birth: The Evidence on: Due Dates and The Evidence on: Inducing for Due Dates.
Hi, I'm Sara. I'm a birth + postpartum doula serving Utah county. I'm a twin mom (plus one!), natural VBACer, and birth lover!