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Monday, 25 November 2013 10:53

Pediatric Massage

We all know how good a massage can feel. It can help decrease muscle tension after a long day at work, minimize headache pain, and help facilitate the healing of soft tissue injuries. So, if it feels good and can help us heal, what about our little ones?  

We can incur tissue trauma at any stage of life, in the womb, during the birthing process, and of course, all the bumps and bruises we get as we learn to crawl, walk, and run. All of this trauma, as small as it may seem, can have physical (as well as mental) effects on the body. These effects can manifest themselves later on in life, creating postural change, undue stress on ligaments, tendons and nerves, and muscle tension, as well as some mental health disorders. Massage Therapy can be very beneficial throughout the pediatric years to help with tissue healing, postural concerns (scoliosis, leg length discrepancies, etc.), latching difficulties, digestive issues, restlessness and insomnia, as well as many other issues.

How does pediatric massage differ from regular massage?  Depending on the symptoms that your child may present with, many of the same techniques can be applied to the infant that would be applied to an adult but with a much gentler touch and treatment intention. Treatments can involve simple Swedish (relaxation) massage techniques, or be more specific. CranioSacral techniques can help a newborn latch onto the mother’s breast or decrease intracranial pressure that may be high due to some birthing processes such as C-section delivery. Visceral (organ) mobilization techniques may be used to help with digestion. These techniques should be performed by an experienced CranioSacral Therapist or Visceral Therapist that has had specific education towards pediatrics.

How do I know if my baby needs Massage? Obviously a newborn cannot express through voice that he/she has an upset tummy or that they are experiencing tension throughout their body. But noticing movement patterns that seem unbalanced from side-to-side, such as one arm reaching higher than another, or excessive arching of the back when being picked up, can be signs of tissue tightness within the body. Latching problems can be another sign that there may be some problem with the palate and/or the muscles that help with latching (possibly due to a difficult/long birthing process, C-section, or breech position). An overly fussy baby can be telling us that something may be uncomfortable also. Our little ones communicate in many different ways without speech. As long as you are attentive and trust your parental intuition, you will pick up on these little communication cues. Even if you think everything is okay, your baby can always benefit from massage.                

When can massage be done on an infant? Massage therapy can be very effective and applied at any time from the moment of birth onwards. Pre-natal massage experienced by the mother can create a more comfortable pregnancy as issues with postural change, mood, and overall health can be addressed. This has a direct impact on the birthing process as a relaxed mother with very little discomfort going into child birth is more likely to succeed at providing a positive birthing experience for her and her baby.

It is also important to note that massage therapy is a great bonding tool for parents and their newborn. Touch builds trust for the newborn towards his/her parents, it helps to comfort, and is a great tool to be used for bedtime routines. Infant massage classes can teach parents the basics of applying massage to their infants and is something I highly recommend.

Pediatric massage can help with a variety of issues and can be done at any time. It is an amazing tool to help parents bond with their child and can be very beneficial with the developmental process of the baby. There are a variety of techniques that can be applied by the parent or massage therapist, and some that need advanced education to help our little ones developmental process flourish.

 

Jason Dvorak, RMT, NSCA-CPT

 

 

Published in Newborn Health
Monday, 18 November 2013 09:20

Running After Pregnancy: Is It Too Soon?

This is a frequent conversation with my pre and postnatal gals.

Question: When can I start running again?

Answer: Probably (read: definitely) not after your 6-week check-up when your doctor "clears" you for all exercise.

(Side note, but docs, can you please use different wording with your postnatal clients when it comes to this? Running is not the same as core activation, breathing, resistance training, etc.)

Postnatal ladies, I need you to be patient with this one, because it will significantly impact your recovery in the short term and health in the long-term. Postnatal exercise is fantastic and I encourage it as soon as you're ready and feeling up for movement. Working on abdominal and pelvic floor activation exercises, retraining your breathing patterns, doing exercises such as squats, lunges, hip thrusts, pulling, and scapular slides are all amazing. They will be extremely helpful in your healing and fat loss journey, if that is a goal of yours.

Photo #1- Andrea prenatal band squats

(Working core control through band resisted squats, to increase activation of glutes)

However, running, and any high impact exercise for that matter, is a completely different story. What your body has undergone during pregnancy, labor and delivery is no joke. I've said it before, and I'll say it again (and probably continue to keep saying it :)). If you think that running is going to be your best bet for getting back to your "pre-pregnancy" weight, or into your jeans, or even get your abs back, it's just simply not going to be. There are much more effective and safe ways for you to do this, I promise you that. Read this post for your best bets if any of the above is what you're striving for.

I understand that you may love to run and I fully support you in getting back to it. But please, keep reading to find out why I need you to wait at least 3 MONTHS to pound the pavement. To be crystal clear, this is with 3 months/12 weeks of structured postnatal specific resistance training (core retraining, glute/back strengthening, breathing exercises), not just 3 months from delivery day.

1). You are mega sleep deprived. You likely do not have the ability to focus on a million things at once right now, which is what running will take when you're getting back into it. Abs bracing, pelvic floor engaged, glutes firing, diaphragmatic breathing, etc. through hundreds and thousands of steps? Sounds exhausting just thinking about it and I got a full 8 hours last night ;)

2). Your new body is unstable right now.  Not just because of the changes to muscular strength, but also because the hormone relaxin is at an all time high for first few months postpartum. This is the hormone that made it possible for your body to be able to carry a baby and birth it. It makes your soft tissues (for example, ligaments) more lax and therefore, you are far more susceptible to injury. Especially injury to hips, pubic symphysis, low back, and knees.

3). It is essential to retrain your core and floor. Your core muscles are not ready to support your body through repetitive pounding food strikes. It is a recipe for disaster. Your posture is likely not optimally aligned, especially if you are spending long days breastfeeding and carrying your baby. You probably have some degree of diastasis recti (abdominal separation) and your spine is not well supported. Your pelvic floor might not be functioning at 100% and you could be experiencing incontinence symptoms. You will exacerbate these issues with running.

Photo #3- Andrea prenatal dead bugs

(Training the abdominals through dead bugs exercises can be a great place to start)

4). Uterine and bladder prolapse are real things to be aware of. I recommend all my ladies go see a pelvic floor physiotherapist to put both our minds at ease. If you are experiencing ANY issues with urinary and/or stress incontinence, see a PFP so they can give you treatment and exercises to help rehab you. If you're having incontinence with sneezing or laughing, or if you are running wearing a pad because you're leaking, just back up and keep training the basics of core/floor healing.

5). Acknowledge you are in recovery mode and start slow. To get back out there, start building up your mileage slowly. Maybe you start your runs with 1 minute + 1 minute walking, and add 30 seconds to a minute on your run time weekly if it feels good. You will need to keep up your strength training routine as your get into a regular schedule of running. Do not let this fall off.

Good luck, ladies!

JMG

Published in Mom's Recovery

I’ve had excessive anxiety throughout my lifetime so it was no surprise that when I became pregnant for the first time I became very anxious about birthing. I didn’t want to have an epidural and in researching the alternatives I found Hypnobirthing which helped relieve my anxiety around birthing. The course included audio birthing affirmations that I listened to time and again and when it was time to birth my baby I was so calm that the hospital staff thought I had an epidural when I had no pain medications whatsoever.

When I became pregnant with my second child I had recently come through a very difficult time in my life. I had overcome panic attacks and severe anxiety. I was finally feeling great. However, the pregnancy triggered a lot of ‘what if’ questions. I started to get very anxious about the possibility of miscarriage. I had no logical reason to worry about this, but anxiety isn’t usually logical.

I did not want to go back to having severe anxiety and panic attacks and thought affirmations could help. However, the affirmations for birthing didn’t have what I needed. Affirmations for overcoming general fears weren’t what I was after either.  I just wanted audio affirmations for pregnancy. I couldn’t find any that were pregnancy specific so I decided to record my own. I also wrote down a few of my favourite affirmations such as “My baby is healthy and strong” and “My baby is developing according to nature’s perfect plan” and I put these along with a few others on a sticky note next to my toilet so I could see them and reinforce them every time I needed to use the toilet (being pregnant this was rather often!).

The affirmations for pregnancy that I developed were very helpful. Once I got over the anxiety that I would miscarry, I used the affirmations to help with my overall mood and energy. I decided to share my affirmations with other women who may be going through what I was going through. I professionally recorded Affirmations for Pregnancy and released them on my website and on iTunes. I sincerely hope that they are helping other women as they helped me. 

If you’re new to the concept of affirmations, they are simply thoughts that you are affirming to yourself. They can be negative (as the obsessive thoughts of anxiety often are) or they can be positive. People often don’t realise that the thoughts they are affirming in their minds are very negative.  Take some time to listen to your self-talk. If you identify many negative thoughts, take action to make your thinking work for you instead of against you. Some examples of affirmations that are good for pregnancy are:

  • I choose to feel good during my pregnancy
  • My baby and I are healthy and strong
  • Meeting my own needs allows me to meet the needs of my baby
  • I have the right to make choices about the birth of my baby

I have a list of pregnancy affirmations that I share as a free gift when you sign up to the mailing list on my website www.affirmationsforpregnancy.com. You can print it out and put it somewhere you can see it often. You can also can write your own affirmations.

Some tips for writing your own affirmations include:

  • Be specific about what you want to happen or how you want to feel
  • State your affirmation in the present tense, writing about it as if it is already happening.
  • Even if you don’t believe your positive affirmation at first, stick with it. With practice you will begin to benefit from repeating the affirmation.
  • Say your affirmations aloud. If you can say them while looking in a mirror they are even more powerful
     

 

Affirmations are just one tool that can help with anxiety. You can find more help for prenatal and postnatal anxiety and depression at http://www.postpartum.net/Get-Help.aspx

Published in Pregnancy

Ask any questions that are relevant

  • Is she certified?
  • When did she become certified or why is she not?
  • How many births has she attended?
  • How many clients does she usually take in a month (any more than 5 clients in a month is a red flag)?
  • How much will she charge, does she have a sliding scale, what is the payment schedule?
  • Does the payment change if she is unable to attend or if  you end up needing a c-section? If it doesn't work out can you get a refund or find someone else who might work for you?
  • Does she have other services available like belly casting, placenta encapsulation, photography, breastfeeding services, babysitting, or postpartum services?
  • Does she have a back up, can you meet them?
  •  

Get to know your doula on a personal level

  • Is she married, if so how long?
  • Does she have children, how many, how does she feel about her birth experience?
  • Why did she become a doula?
  • What is her overall philosopy on birth?
  • Did she breastfeed, how long, how does she feel about it?

Build a relationship

You should have at least 2 prenatal appointments with your doula. During these appointments you'll probably go over things she'll do to help you along during labor and if complications arise. Also during these times you should begin to get comfortable with her touching you in case massage, hair stroking, or counter pressure are used to comfort you during labor so you can let her know what you do and do not like beforehand and to build the comfortableness with her. If you would like she may have relaxation techniques to practice too which would be helpful so you know you can completely relax in front of her. Personally, I found an included belly casting session really helped me open up and get comfortable with my doula. 

If at any point you are not comfortable with your doula: First determine if the issue can be resolved and try to fix it. If you think it is something that  will affect your ability to remain comfortable with your doula for future appointments and/or during labor, birth, or postpartum then you should talk to her respectively and tell her you just can't do it; She may know someone else available that you may be comfortable with. 

If you are a doula or want to become a doula: The steps also apply to you but from a different standing point. Try to give your client as much information as possible so that the family can feel comfortable with you; like a friend rather than business. Reassure partners that you aren't there to take their place, but rather to help them help the mother or step in when they need a break. Beware them that you can not speak for them, you are not a medical professional, and can not give medical advice; You are simply there to support the family and help comfort the mother. 

Published in Jessica's Blog

Once you have established and met with your selected care provider, it is time to start thinking about what kinds of tests, screenings, and procedures you do and don’t want. In all likelihood, when you met with your care provider, he or she outlined the general schedule of checkups and tests that are part of procedure. These can include blood panels, ultrasounds, glucose screenings, and many more. Despite what your care provider may have told you, most if not all of the screenings are in fact voluntary. Per the Patient’s Bill of Rights, you may refuse any and all tests and procedures, you may allow some, or you may allow all. What you must now do, is investigate the reasons for these tests and determine if you feel that these tests are necessary to your health and the health of your baby. 

Now I know what you’re thinking; “Why wouldn’t I do what they tell me?” Ask yourself this; “Do I need to be screened for gestational diabetes even though I truly eat healthy, exercise daily, was at a healthy pre-pregnancy weight, and have no history of high blood pressure or diabetes?” 

Food for thought: American medicine is based around fixing health problems. While I’m not here to bash American culture or medicine, I want to point this out because many OB practices follow the guidelines of the ACOG for prenatal testing. This is not necessarily a wrong; however, it is a procedure that has been set up in an effort to streamline care and try to avoid mistakes in the world of drive-thru care. By testing all patients for gestational diabetes, an OB has one less thing to inquire about when seeing a patient and can focus on other things such as weight gain, blood pressure or urinalysis. The lesson? Ask yourself if the testing is necessary to ensure the health of you and your baby. Ask yourself if you feel that doing this testing will ease your mind about your pregnancy and allow you to continue your healthy lifestyle. I don’t want to discourage you from tests, I want to encourage you to educate yourself and make the best decision for you and your baby. Nothing beats an informed mother’s intuition and judgment when it comes to the best interest of her kids.

The most common tests that are considered “standard” for prenatal testing are outlined below. Some of the links are directly to the ACOG website in an effort to help you understand their perspective. Other links are to outside sources, since ACOG didn’t have a direct FAQ sheet available.

Some of these tests have low risks like urinalysis. In reality, peeing in a small cup only poses a risk to a woman in her third trimester that is having trouble getting the cup underneath her and may topple over. Others such as amniocentesis and CVS pose the risk of loss of pregnancy. STD’s can cause birth defects and risks to pregnancy, so if you are at high risk or do not know your STD status, this can be important because it may be in the best interest of your health and the health of your baby to get treated appropriately. 

It is important to remember, that there is tons of information out there for you to use to make an informed decision about these tests. I have provided some links to information about these tests within this article, but there is tons of great info available. I would encourage you to talk to your care provider about the tests they want you to have and why. Be prepared before you have this talk with them to ask questions; don’t accept an answer of “because it’s necessary” as fact. The more informed you are before engaging this conversation, the more informative answers you will receive from your care provider. If the conversation goes well, he or she will hopefully be glad that you are invested in a healthy and informed pregnancy and provide you with information that will help you come to a decision. If you find that your provider is defensive or argumentative, it may be a warning sign that your choices will not be respected when it comes time for labor and delivery. Another resource for information is other like-minded mamas. There are a bunch of great blogs and Facebook pages (including but not limited to Birth Without Fear, Mamas and Babies, Mama Birth) for moms and moms-to-be to get information and talk to other mothers who have made informed decisions about selecting tests. Sometimes it helps to hear the point of view from another person who has been in the same situation, though keep in mind the differences between personal opinion and advice from a medical or birth professional.

I know I sound like a broken record when I constantly say that you need to educate yourself and make the right choices for you, but I also know that our society continues to send a message to pregnant women that pregnancy is a risky endeavor that should be closely managed. If pregnancy was so risky, how is it that we have been doing this for thousands of years without the help of medical interventions? We wouldn’t be here if pregnancy was risky all the time. Are there times where women are at a higher risk of complications? Sure, but we don’t need to approach pregnancy as inherently risky. Trust that pregnancy, the natural process of procreation that has brought the world to a population of 7 billion and counting, is inherently safe. Besides, that glucose drink for gestational diabetes is nasty!

Go back to: Step #2: Establishing Support

Go ahead to: Step #4: Developing a Birth Plan

Go to: Birthing Methods Main Menu

 Prenatal care with a midwife follows a similar schedule of meetings (monthly, bi-weekly, weekly,) and involves some of the same testing that the OB performs.  The major difference between an OB and a midwife is the length and intimacy of the visits.  A close friend of mine (we’ll call her Audrey) who is planning a homebirth and employs a midwife told me that she feels much more comfortable with her midwife when compared to her OB.  At 30 weeks pregnant, Audrey switched to a midwife when she decided to have a homebirth.  Even if you are planning on delivering in a hospital you can still see a midwife, and many certified nurse midwives are associated with OB/GYN practices.  Audrey said that she always felt like just another number in the OB office, and that she didn’t feel like she could ask questions, or that when she did, she was treated as if she shouldn’t be asking questions.  In choosing a midwife, it is important to check for credentials which will indicate levels of education and experience.  The best way to find a midwife is ask for recommendations from other women.  You can also visit this site where you can type in your location and find locations that have a midwife on staff.

 
Audrey goes to her midwife’s home office and spends about an hour at each visit.  She still has her blood pressure, urine, and weight checked, but it is in an intimate and relaxed setting, and she doesn’t feel like just another patient.  They chat about how Audrey is feeling, any new thoughts or emotions associated with her experience thus far and there is an opportunity to ask as many questions as she has.  She also said that the midwife carefully explains all of the risks, benefits, and reasons for various tests so that she can make an informed choice about the necessity of the test.  The midwife encourages Audrey’s husband to be involved so that he may better understand the process of pregnancy and how Audrey is coping with it.  Since switching to a midwife, Audrey says the process of pregnancy has been much more enjoyable and less stressful due to the intimacy and relaxed tone with the midwife.
 
Midwives will utilize the same tests as an OB; however, they tend to use the tests as reactive rather than proactive measures.  This is not to be misinterpreted as midwives being irresponsible by not testing unless necessary, it is simply that many midwives feel that some tests are not necessary to ensure the health of mother and baby.  For example, a healthy mom experiencing no complications in pregnancy may chose to decline glucose testing in the absence of gestational diabetes risk factors.  Most OB’s will insist, (though you have the right to decline testing and treatment) but most midwives who are confident in your overall health will not insist you take a test unless there are risk factors or history that suggest tests would be beneficial.  
 
If at any point in your pregnancy (even right before or after your due date), you are not happy with your care provider, SWITCH!  You have the right to the care you believe you deserve and you have every right to switch providers at any time.  If you are considering switching providers, look for the next article titled “Switching Providers” for tips on how to successfully switch.

Go back to: An Introduction to Birth in the Hospital

Go ahead to: Step #2: Establishing Support

Go to: Birthing Methods Main Menu

In choosing a hospital birth, it is likely that you first choose a prenatal care provider who is connected with the hospital you were told you would be birthing at (this was surely the case for me.)  It is essential that you now learn as much as you can about your care provider’s practices regarding prenatal care and testing, labor, induction, and c-section practices.  Regardless of the type of care provider (OB or midwife,) it is imperative that you find out what expectations and philosophies they have regarding your pregnancy and delivery to ensure that your views are congruent with the views of your provider. If you have not chosen a care provider, but know you want to deliver in the hospital, the process of getting to know an established care provider can be applied to identifying a potential care provider.  

This is part 1 of 2.  Part 1 will describe how prenatal care with an obstetrician will typically proceed; based on my experiences during two pregnancies with the OB/GYN office I have been seeing since I was a teen.  Other women I have talked to who used an OB and delivered in a hospital, report similar experiences. It is also important to note that in the day and age of doctors trying to see as many patients as possible, some offices (such as mine) will have you rotate through the doctors within a group practice.  This is done because when you go into labor, the doctor who is on call may not be your doctor.  The more you are familiar with each doctor, the easier the process of labor and delivery will be once the time comes.  Even if you have only met the doctor that delivers your baby once, you will know their face and at least have had an opportunity to meet them.

 Prenatal Care with an Obstetrician

 Prenatal care can be as little or as much as you would like.  Generally, prenatal care with an OB will follow a standard pattern of monthly visits until about 28 weeks, increase in frequency to every two weeks through week 36, and then increase again to every week until delivery.  These visits usually include weight, blood pressure, urinalysis, fundal height, and listening to the baby’s heart via Doppler.  You can expect these visits to be about 5-15 minutes depending on your OB and whether or not you have any concerns or questions.  While not every OB has the same procedures or schedules, in general most OB’s will follow this general guideline for visits and tests.  The American College of Obstetrics and Gynecology has a FAQ sheet about the standard tests for pregnant women that can be found here.

Your first pregnancy visit to the OB will likely include a pap smear, STD testing, and a pelvic exam.  A full blood panel will also be requested, though this is often done through a lab and not in the OB’s office.  Many OB’s also have you meet with an obstetric nurse to discuss your prenatal care plan, genetic testing, dietary restrictions, exercise recommendations, basic labor expectations (when to call the office, when to go to the hospital, what indicates an emergency,) and answer any questions you may have.  You may also receive insurance paperwork to fill out and mail to the hospital prior to labor to speed up the process of being admitted when you go into labor, since you likely won’t be interested in filling out paperwork and searching for insurance cards in the midst of contractions.  

Most OB’s will request 2 ultrasounds, one at around 9 weeks to determine gestational growth to and modify your EDD accordingly, and one at around 20 weeks to identify any abnormalities in development, as well as determine the sex of the baby if you so desire. Subsequent ultrasounds may be requested depending on risk factors, or when you are nearing your EDD if you do not wish to be induced if your pregnancy exceeds your EDD.
 
At your initial appointment, you will have been given information about various genetic screenings including one for Down Syndrome.  Many of these tests must be done within a certain time frame during the gestational period so it is important that you read this information carefully, ask questions, and make decisions accordingly.  You may need additional appointments for these tests outside of your regular checkups.  I personally chose to decline the genetic testing because my pregnancies were planned and I had no risk factors.  If I discovered that my baby had a genetic disorder, I would not have chosen to terminate the pregnancy, (which some people do).  Secondly, if my baby did test positive (mind you there is a potential for false-positives,) for a genetic disorder, I would have spent the rest of my pregnancy worrying about it.  Ultimately I was going to love this baby no matter what happened, so I chose to decline the testing because knowing ahead of time wouldn’t have changed anything other than my stress level.
 
Other standard testing includes be a gestational diabetes screening test around 25 weeks which involves drinking a vile (I’ve never heard a mama say this stuff was anything less than revolting) bottle of liquid, waiting an hour and then having your blood drawn.  The last standard test is the Group-B Strep test which involves swabbing your vaginal and anal area for culture.  If you test positive, the OB will recommend antibiotics for you during labor and delivery to reduce the risk of transmission and infection of your baby.  
 
Once you have met with your OB for your initial prenatal appointment, you will have a lot of information to digest.  It is important that you begin thinking about the information you were given and decide what you feel is best for you and your baby.  While you may meet with opposition, you as a patient have the right to decline all of this testing.  Your OB may insist that these tests are all imperative to prenatal health, but this statement is misleading.  These tests will help your OB identify risk factors, (urinalysis provides protein levels which may indicate preeclampsia when combined with high blood pressure) and decide if a course of action should be taken in an effort to protect the health of both you and your baby.  This does not necessarily mean that refusing certain tests puts you or your baby at a higher risk for complications.  While OB’s are highly trained in the mechanics of birth, in an effort to be overly cautious they may recommend courses of action that could lead to an increased risk of intervention.  It is important that you ask your OB to explain testing and subsequent courses of action if you do not understand the risks and benefits.
 
Other considerations for choosing an OB for prenatal care include induction recommendations and methods, c-section recommendations and rates, and suggestions about pain management during labor.  Even if you have not fully explored your views on these matters, obtaining your OB’s feelings about these potential situations can help to inform your choice to remain with your OB or switch providers.  The links in this paragraph are to the FAQ’s from the ACOG website.  It is important to note that just because the ACOG has a stance on a situation, doesn’t mean that all OB’s strictly follow these.  For example, the ACOG does not consider a pregnancy as being post term until 42 weeks; however, many OB’s will offer stripping of your membranes as  or even recommend induction as early as 38 weeks, which could be a full 4 weeks before your baby is ready to be born!
 
If you’re not sure if an OB is right for you and would like to consider a midwife, please read Choosing a Provider Part II: Midwife, where I describe having a midwife as your prenatal care provider based on research and the experience of a close friend of mine after leaving her OB for a midwife.
 
If at any point in your pregnancy (even right before or after your due date), you are not happy with your care provider, SWITCH!  You have the right to the care you believe you deserve and you have every right to switch providers at any time.  If you are considering switching providers, look for the next article titled “Switching Providers” for tips on how to successfully switch.

*Since this article focuses on obstetricians, all links in this article are directly to the ACOG website patient FAQ’s sheets.  You can also access the ACOG website directly at www.acog.org.  

Go back to: An Introduction to Birth in the Hospital

Go ahead to: Step #2: Establishing Support

Go to: Birthing Methods Main Menu

 Step 3: Get Any Prenatal Tests Deemed Necessary by You Throughout Your Pregnancy 

These tests can include: pap smear, blood work, glucose tolerance, ultrasound, etc.  You know your body and your baby better than anyone else.  If you feel you need to get something tested, do it.  If you're not comfortable with a test, don't do it.  Above all, research any tests you are considering and determine if the benefits outweigh the risks (if any).  

If you are UP'ing, some of these tests may not be available to you as it depends on your insurance and location. You may want to consult with a medical professional or insurance to see which are available to you.

This is an extensive list of common prenatal exams medical practitioners do. Some are important and and some are optional. Once again, only do what you are comfortable with.
 
Here is an additional resource to read over on Prenatal Tests.
 
Here is the story my unassisted birth with my twin girls.

 

Go back to Step #2: Establishing Prenatal Schedule

Go to the next step Step #4: Educate Yourself Then Educate Yourself Some More

Go to Birthing Methods Menu

Schedule regular prenatal visits with a medical professional if you chose a care provider or make plans for your own care if you are doing an unassisted pregnancy.

If you close to a medical professional to oversee your pregnancy:

  • Ensure you feel comfortable with the care provider as this is someone you are trusting with your baby.
  • Feel free to ask any question as this is your opportunity to educate yourself for your unassisted birth, beyond your external research. 
  • Schedule your regular appointments and attempt to keep records of your own. Often a doctor can photocopy the results for you or ask the front reception. This will help build your medical binder for when you do give birth and should child services ever visit you as this can occur when they get wind of unassisted birth plans.

If you are choosing unassisted pregnancy:

When choosing an UP, you can do many of the same things they do at regular prenatal visits such as weight, blood pressure, fetal heart tones, etc. If you want a UP, information can be found and supplies can be purchased here: http://www.unhinderedliving.com/prenatal.html

No matter which option you chose, it is important to get a a formal record that you are pregnant as this makes it easier when it comes time to obtain a birth certificate. 

Here is the story my unassisted birth with my twin girls.

 Go back to Step #1: Establishing Prenatal Care

Go to the next step Step #3: Get The Proper Tests Done

Go to Birthing Methods Menu

Step 1: Choose whether you want an OB, midwife, general practitioner, or if you want an unassisted pregnancy (UP). 

 

This is a personal decision and any of the above options are great, even if you are planning an unassisted birth. Ensure you feel comfortable with your care provider, whomever it is.

If you choose OB, general practitioner or midwife:

It is up to you to decide if you want to tell people (particularly an OB) of your decision to give birth unassisted.  If you do decide to tell people, they may try to intervene or otherwise cause stress for you during pregnancy, labor, and/or birth. This stress is entirely unnecessary so use your judgement wisely on whom you tell, especially care providers.

Many moms who chose an OB, general practitioner or midwife, leave out the part of giving birth unassisted and continue the care throughout the pregnancy until the very end. This often gives the mother piece of mind in her prenatal care and relieves the stress the practitioner may place on the mother if they knew about the impending unassisted birth.

I find many moms who plan an unassisted birth, are very in touch with their bodies and have made the conscious, educated decision to birth in this manner. The presumptions of the care provider are not often true about a mother who decides to birth unassisted so often the advice to avoid unassisted birth does not apply. 

If you chose unassisted pregnancy:

Ensure you are comfortable with this decision and do your due diligence. Educate yourself! When doing an unassisted birth, you can do many of the same exam as the care provider. Look at Step 2 for more on unassisted pregnancy. 

A note here: I strongly urge you to get your partner on board with any decision you make at this stage for your care. They are concerned with your well being and the baby growing inside of you.

Here is the story my unassisted birth with my twin girls.

Go to the next step Step #2: Establishing Prenatal Schedule

Go to Birthing Methods Menu

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