BEST pregnancy book ever!

 Move over, What To Expect Books, my favorite book for us preggers is The Natural Pregnancy Book by Aviva Jill Romm.  It's awesome! And it's not just for homebirthers, either.  Any pregnant woman having ANY kind of birth will love this book.  

I am a library sort of person.  I rarely, rarely, RARELY, ever buy books.  I LOVE books, and if I bought them all, they'd be spilling out of my ears. So I just don't buy a book unless I feel I NEED it. I bought this one several years ago, and would buy it again. Nutrition, exercise, and herbs take center stage in this book as Ms. Romm details general recommendations, nutritional know-how, and helpful herbals for common & not-so-common pregnancy issues.  Everything from morning sickness to anxiety to edema and everything in between is covered.  Recipes for nourishing pregnancy teas, iron tonics, and other herbals are included as well.  Herbs that shouldn't be used in pregnancy, as well as the most helpful pregnancy ones, are also included.  In short, it's just what the sorta-a-hippy pregnant lady ordered.

Oh, and just what qualifications does Ms. Romm have to write this book? She's not just some crazy herb lady, people! She's went to Yale, became a doctor, is an herbalist (hello- she's a former president of the American Herbalists Guild), and a midwife.  You can check out more about her on her website. She knows her stuff, and that alone makes this a great book- the info you're getting is real and solid stuff. Which it needs to be, because you can't just go trusting any old anything when it comes to your body and your baby!

And on an unrelated note, my next post will be about the placenta....and what you can do with it!

Varicose Veins STINK

 Yesterday I had appointment #3 (which was super fun- it's like "girl time" with some cool ladies who also happen to be providing me awesome prenatal care).  I'm happy my uterus measured exactly where it's supposed to be- in past pregnancies I've been a week or week and half behind, and that's always depressing to find out your due date is off.  But my due date is right on, and that made me happy!

Anyway, here is the promised post about my varicose veins.  I'm genetically doomed from the start to have varicose veins, but that doesn't mean they can't be managed.  When I'm not pregnant, they are still there, but they don't hurt.  (Varicose veins don't go away- although you can get them surgically "stripped". I have no idea what that means but I may look into it after I'm done with childbearing.)  The hormones that help make your whole body loosy-goosy and more elastic as you prepare to deliver a baby also affect your veins, causing them to bulge more.  And that can make them HURT.  But I have found ways to manage them to where the pain only happens on few and far between days, or even not at all.

Go to any doctor with your varicose veins, pleading for help, and they will hand you a prescription for compression hose.  I'm going to be hugely pregnant in this summer. Who wants to wear compression hose on 100 degree days? Not me.  There ARE effective ways to manage this common problem.

 So what I do is pretty basic.  But it basically consists of four parts: 

physical exercise, nutrition, herbal, and rest.

1) Exercise

 This is the MOST important for keeping my veins from hurting day to day.  I take a 20-60 minute walk or just put on music and dance for 20-40 minutes. If you're laid over by morning sickness or on bed rest, flex your ankles in bed for 20ish minutes. I do have a treadmill, but only use it as a last resort if I really want to walk but can't get out that day.  This gets my blood moving and less likely to pool in my bulging veins, preventing pain.  I exercise at least every other day, but I try to do it every day to really be a step ahead of my veins. If I let three days pass without exercising, my veins will hurt.

2) Nutrition

“Let food be thy medicine and medicine be thy food”- Hippocrates

This is the most important for preventing new varicose veins from developing and current ones from getting worse. I majored in Nutritional Science at college, so this was the natural place for me to start when I was looking for ways to manage my veins. The secret is a compound called rutin. Rutin + vitaminc C = strong vein walls, making the veins less likely to bulge, and become varicose.  I don't take a supplement; rutin and vitamin C are both readily available in regular foods.  They are power partners in fighting varicose veins! 

You can do research to find all the sources of rutin there are, but I eat about a tablespoon of cracked buckwheat 3 or 4 mornings a week, along with a vitamin C-rich fruit.  Buckwheat is a great source of rutin, as are the whitish piths of oranges (which I also eat when I eat my orange; it's an easy way to get rutin and vitamin C at once).  

A great example of a good rutin/vitamin C rich breakfast would be hot buckwheat cereal (which I think is really gross, so I just add about about a tablespoon of buckwheat to my oatmeal or cream or wheat), with some strawberries on top.  Some mornings I'm rushed, so I'll just eat a tablespoon of raw buckwheat along with a kiwi, strawberry, or orange.  I buy Bob's Red Mill Buckwheat Cereal- it's already cracked, not whole like buckwheat groats, so it's easier to incorporate in my diet.  You can also get buckwheat seeds and sprout them and eat the sprouts.  

You can get way more creative than that, though- have a sandwich with buckwheat sprouts and red pepper slices (peppers are an amazing vitamin C source). Or use buckwheat flour to make pizza crust and load your pizza with fresh veggies (fyi- vitamin C is destroyed by cooking though, so be sure to eat some fresh veggies or fruits along with your pizza).  Do some research and find out what sources of rutin and vitamin C are out there that YOU like and incorporate them into your daily diet.

There's a lot of ways to get rutin, and that's the key to strengthening the vein walls to keep varicosities from developing: rutin + vitamin C. And you don't have to eat them at the same time to be effective.  

(By the way, buckwheat is a fruit, not a grain- isn't that interesting? It is completely wheat free, and is fine for those with celiac disease, wheat allergies, or gluten intolerance.)

3) Herbal

  I only drink herbal tea once in awhile, but when I do I make sure it has nettles, red raspberry leaves, and oatstraw in it (I get my herbs in bulk and make my own teas), which are all supposed to be good for veins.  Rose Hips are good to add, too. This is the "cherry on top" of my regimen- it's frankly the least important, and it won't save my veins if I'm not doing the first two things, but it's a good way to ensure I'm doing all I can to fight my veins!

4) Prop those feet up and REST

Each day try to find time to prop your feet up with pillows and just rest for about 20 minutes.  Sometimes all the stars will align for me and I'll be able to take a good hour long nap like this.  But even propping your feet up and chilln' for 20 minutes is great for your veins. 

And when all else fails, I put on a compression stocking.

  

During pregnancy #4 (during which I did this little regimen of mine) I only had to resort to compression hose about 4 different days, which was amazing, considering that during pregnancy #3 I wore them every day from 6 months on until I delivered (I didn't do anything to manage my veins during that pregnancy, which was the first pregnancy where my veins became a painful problem that needed attention).  So I consider my regimen working (at least for me!).  If you try any of these suggestions, I'd love to hear how they helped you!

Also, just as a side note, be aware that if you live in a hot climate, your veins will be worse- they come to the surface of your skin to help cool your body (this happens to everyone, but to those of us that have varicose veins it can make it harder for us to manage them).  But considering that I was living in Vegas, with 115 to 120 degree summers during both pregnancies #3 and #4, this regimen can still be VERY effective, even if you are living somewhere super hot or humid.  

A Book You Should Definitely Read!

This book is really, really awesome. True, I am a total history nerd.  Once, for my birthday, all I wanted was to go to the museum by myself. It was this really cool Titanic exhibit. I wanted to read every single plaque and soak in every bit of fascinating history without being rushed along or worrying about my children. And I did. And it was one of my favorite birthdays ever. But you don't have to be history nerd to love this book. Really, I promise.

 One of the reasons why I really liked this book is that it's NOT written by some crazy homebirth fanatic. In fact, it doesn't even promote home birth. Tina Cassidy is a journalist who had a baby, and she ended up unexpectedly having a C-section.  After the dust had settled, she was a bit peeved at her doctor and wondered if the C-section had been really necessary. Well, she asked her doctor, what would have happened if this had been 100 years ago? The doctor gave her a horrific answer of the baby being taken out piece by piece. She was shocked. Was that true? 

Well, being a journalist, she decided to find out.  

This is an amazingly well researched book. She has truly left no stone unturned. I was fascinated as I read about the history of midwives, the coming of age of the medical community, C-sections, and the like.

This book helped push me in the homebirthing direction.  But that was my own conclusion.  At the end of her book, while acknowledging that stats play into homebirth and midwives' favor, Ms. Cassidy confesses that she still couldn't see herself having a homebirth. And that's what is so great about this book.  It simply presents the facts, and every person who reads it walks away with their own conclusions. Herself not converted to homebirth, she is not trying to sway anyone in any direction.  The fascinating history that she has unearthed is in itself wonderful, made more authentic by the absence of a hidden agenda on the part of the author. 

So what are you waiting for? Get reading!

It's a GIRL!!!

Holy cow, we're going to be the parents of 5 GIRLS!!!  

My four girls were ECSTATIC, to say the least. Boys are apparently not welcome here. My hubby was, honestly, a little shocked! He's not sad that he's having a daughter, but kind of bummed that he'll never have a son. ('Cause this is it, folks.  The baby factory will be closing!)  Today at church, a teenage boy gave a short talk on his weekend campout with his dad. Rod told me later he was thinking, I'll never get to do that. And he was a little bummed. There are no father/son campouts in his future. 

So I found this consoling article for my hubby called 7 Scientific Reasons To Have Daughters. Check it out! Among the list is the fact that for each daughter a man has, he lives a little over a year longer.  So my hubby just added about 6 years to his life! Not bad, eh?

Exercise during and after Pregnancy

Part of the midwifery model of care is that you have an obligation to do all you can to prepare yourself for delivering your baby.  Keeping your body fit is a big part of that. 

I try to exercise almost every single day (except Sundays), but when I'm pregnant I'm especially diligent about it. I have to be.  I have varicose veins BAD on both legs and when I don't exercise, those veins hurt and throb.  Doing some sort of cardio workout is essential every day to get my blood moving. And it makes a WORLD of a difference in managing my veins. (I'll do a whole post on my lovely veins later- I know, you can't wait!)

Now, when I say "workout" you may be envisioning me running, going to the gym, or pumping iron in my garage for an hour.  Umm...no. I don't do any of that.  I refer you to the picture at the top of this post.  That's a little more my speed, especially when I'm pregnant.

And that's fine. As long as I'm doing something, I feel great and my body feels great.  I don't have to kill myself to get that great feeling or to get results. I know a lot of people of all ages who run- they run for fun, they run marathons, they just love it.  I am not one of those people. I hate running. With a passion. I used to like going to the gym, but with so much going on in my life (read: 4 kids), it's a headache to try to figure out how to get myself there. Plus it can be expensive.  And I'm cheap. And lazy.  When my hubby gets home from work, the last thing I want to do is run out to the gym.  I want to be home, I want to to chat, I want to curl up with him and read a book or watch some Jimmy Fallon. We have a bowflex in our garage and try as I might, I can never consistently stick with it.  It's just too boring. And in the winter it's cold out there, and in the summer it's hot.  You get the point- I need to be doing something I like or it doesn't happen at all.  

So what works for me? A few things, actually:

Dance workout. For years I've had a playlist (that I change or update periodically) of music that I dance to. To add a little more intensity, I'll use a step-stool and some light hand weights for some of the songs, but mostly it's just me getting my groove on.  And I work up a sweat. And I love it! The great thing about this workout is that the intensity is flexible- I can really work hard and dance for awhile, or I can keep it shorter and do less intense songs.  But I always have fun, and that's why this workout has stuck  for years and years, pregnant or not. There's actually a few websites out there that list songs according to beats (of your heart) per minute. Just google "running songs".  But make sure you put on songs you like, or you won't be motivated to move!

Walking.  I love to walk around my neighborhood. We have lots of hills, and that makes it even better. A good, fast-paced, hour walk is one of my favorite workouts ever.  It clears my mind and rejuvenates me. Once, I passed two teenage girls that totally started snickering at me and my power-walking. And I just thought, oh, just wait, ladies.  Give yourself 15 years and you'll be right here with me!

Swimming. I'm not doing this right now, because it's still cold, but lap swimming is awesome, especially for us preggers. I swam competitively for years, and it's just a great whole-body workout that tones and gives you cardio at the same time.  Not to mention puts great all-over pressure on my varicose veins at the same time.

This next one is going to make me sound like an old lady.  But I love Walk Away the Pounds with Leslie Sansone.  There's a gazillion different ones, but the link shows you to the only one I have. I did it this morning. Sometime I'll try some of her other ones. This is one I only do  when I'm pregnant, or in those first few postpartum weeks.  It's a great workout to get you moving when, well, you can't seem to do a whole lot.  I grow out of this workout when I'm fully back in shape, but when I'm pregnant and/or postpartum, it's just what the doctor ordered.

Fit2B.us is a great online pilates/yoga studio. And it's super cheap (and modest!).  All their workouts are tummy-safe (plus there's lots of diastasis-awareness material on the website) and they have a whole section for new moms and pregnant ladies.  Eventually, I will grow out of this website too, but it's perfect for me right now.  Not just because I'm pregnant, but because I'm new to this whole pilates/yoga stuff. I actually started this a few months before I became pregnant.  Whenever I do a pilates workout on this site, I always follow up with a few back exercises.  Lower-back stuff is crucial, crucial, crucial.  Your tummy muscles need your lower back to be strong, and I've found that unless I'm taking care to do specific back exercises, my lower back can hurt after I have my baby.

For post-baby time, I like the book Baby to Bikini.  If you're one wanting a step-by-step, week-by-week program for getting back into shape after you have your baby, this one is a good place to start.  It gives you a plan for the first 6 months.  Simple but effective. I've never followed it for the whole 6 months, but it has given me a good understanding of what exercises are safe after baby, and what ones should wait.  Not to mention a whole slew of exercises to pick and choose from.

So that's it.  Nothing magical or too hard.  Even when I'm fully back in shape, I still don't run or go to the gym.  Because I hate those things.  Dancing & walking are my mainstays, then everything else changes according to what I feel like doing and what my goals are. Currently, I'm getting more interested in pursuing pilates and yoga and want to make that a bigger part of my overall workout plan, even more so after I have my baby.  I like hiking and biking, too, so sometimes those play into my schedule. Or I'll try out a workout video from the library or from youtube (youtube can be hard, though- I have 4 girls and do NOT allow skanky workout videos playing in my home.  So most youtube workout videos don't make the cut around here). Change it up and keep it fun and interesting. And don't be fooled into thinking you have be killing yourself or doing something you hate to benefit your body.  Nothing could be further from the truth.

A few postpartum words: find out what a diastasis is and how to check your tummy for it and heal it.  This is muy importante.  Do NOT do sit-ups, crunches or anything of the like until you get your tummy healed.  There's a lot out there now about diastasis, so go do some research.  Second, plan on splinting for at least a few weeks.  You can buy a splint (Fit2B.us has a few links to different ones) or just use a stretchy piece of long fabic (I've done this and it works great. I'm cheap, remember?).  When a woman has a baby, she should be handed a bunch of diastasis-awareness material along with all those free formula samples. Remember, there's  no reason why you can't look amazing after you have a baby! 

So go kill it, ladies!

Appointment #2

Yay! Heard my baby's heartbeat today! And just, for good measure, I recorded it. Excuse my belly.

That's a hand-held doppler she's using.  And it's my midwife's assistant, Tiffany, who is finding the heartbeat.  Baby was super cooperative- Tiffany found the heartbeat right away- so I rewarded him or her with a grilled Italian from Capriotti's. For the baby, of course.   Next up is my ultrasound in a few weeks! Whoo-oo! How does that work, you ask? My midwife, Sherry, refers me to an imaging center and the imaging center calls me and sets up an appointment.  My insurance will cover the cost of the ultrasound.  It was fun, too, to chat more with my midwife and get to know her better.  She's super cool, and we're definitely forming a friendship. 

I love getting my half-way-there ultrasound.  It's so exciting to see your baby and a) see that's it's growing alright and b) find out the gender.  We have four girls, so statistically, we're headed for another girl.  After you have three of one gender, it's not 50/50 anymore.  You're actually more likely to keep having the SAME gender. Wierd, huh?  So in about three weeks we'll find out if that's holding true for us or if we'll break the mold.  We're excited either way.  Although, if we end up with another girl I am SO calling my hubby Tevye (as in Fiddler on the Roof) or Mr. Bennet (as in Pride & Prejudice).  There are so many great Fiddler soundbites already rolling around my head....

A 31% C-section rate? What the heck, people?

So recently a friend shared this article about having a C-section on the source of all essential knowledge, Facebook. Never having had a C-section, I was fascinated and totally freaked out.  

Ok, so you just read it right? I realize this is just one lady's experience- definitely not the final word in how C-sections are.  As with any birth experience, it's a varied as we are as individuals.  

Before I go on, let's set the record straight:  C-sections save lives.  Of babies. Of moms.  There are so many birth scenarios that have turned out happy because of C-sections.  And I am grateful that should something go awry, this option if available to me to save my life or my baby's life. I know many women who had no other option; some knew they'd have to have a C-section from the get-go, while some had C-sections as a last-minute emergency.  And, thankfully, I get to have those wonderful people (and their cute kiddos) in my life.  C-sections are nothing short of a wonderful modern miracle! 

That said, a 31% C-section rate in this country is nothing short of embarrassing. (And to think it was less than 5% in the early 1970s!!)  Only 5.2% of planned homebirths end in a C-section at the hospital. Hate to say it OB/GYN's, but midwives are kicking your trash here. Really, we're supposed to believe that almost 1 in 3 births is an essential C-section? Let's take a look at a few facts:

• The WHO (World Health Organization) says that no country is justified in having a rate over 10-15%
   
• Rates above 15% have been shown to do more harm than good (Althabe and Belizan 2006)
•  
• Countries with the lowest rates, like Nigeria (1.8%) and Ethiopia (1.0%), are typically poorer third world countries without the facilities or medical sophistication to do C-sections for any other reason than a last ditch effort to save lives.  C-sections done in these countries also are much riskier to the mother and baby
•  
• Other industrialized nations have rates similar to the U.S's.  Almost all European nations have rates in the teens and twenties (Italy is the highest in Europe, at 38%, Finland near the lowest at 16%).  South America and several Asian nations have rates higher than the U.S. (Holy Cow, Brazil! You're at 45%!) This C-section epidemic isn't unique to our nation.

  (These figures are from a 2010 study by the WHO, see the whole thing here- scroll to the bottom to see the tables). 

So, what's going on?  This article outlines a few reasons for the crazy rates. (And this isn't some hippy article, by the way. It's intended to be read by health care professionals and patients alike. Check it out for yourself.) In summary, it says:

• Low priority of enhancing women's own abilities to give birth: "Care that supports physiologic labor, such as providing the midwifery model of care, doula care providing continuous support during labor, and using hands-to-belly movements to turn a breech baby reduces the likelihood of a cesarean section" Side note- I've heard a lot of wonderful things about CNM's (certified nurse midwives- they usually work under an OB/GYN) that deliver in hospitals that have embraced this midwifery model of care, to the benefit of their patients. Many are supportive of the presence of doula's, the desire for a natural birth- and even water births in some cases.
• Side effects of common labor interventions: "Current research suggests that some labor interventions make a c-section more likely" (i.e. labor induction for a first-time mom)
• Refusal to offer the informed choice of vaginal birth: "...many women with a previous cesarean would have liked the option of a VBAC, but did not have it because health professionals and/or hospitals were unwilling (Declercq et al. 2013)"  Side note- according to the Mayo Clinic, 75% of VBACs are successful. Them good odds, ladies.
• Casual attitudes about surgery and variation in professional practice style: "Our society is more tolerant than ever of surgical procedures, even when not medically needed."
• Limited awareness of harms that are more likely with cesarean section: "Cesarean section is a major surgical procedure that increases the likelihood of many types of harm for mothers and babies in comparison with vaginal birth."
• Incentives to practice in a manner that is efficient for providers: "Many health professionals are feeling squeezed by tightened payments for services and increasing practice expenses. The flat "global fee" method of paying for childbirth does not provide any extra pay for providers who patiently support a longer vaginal birth. Some payment schedules pay more for cesarean than vaginal birth. Even when payment is similar for both, a planned cesarean section is an especially efficient way for professionals to organize their hospital work, office work and personal life. Average hospital payments are much greater for cesarean than vaginal birth, and may offer hospitals greater scope for profit."  

 So that last reason- for profit- really irks me. What the heck, medical professionals? That feels a little like a betrayal.  Whatever happened doing what's in the best interest of your patients, not your vacation schedule? You're going to subject a patient to a whole slew of new risks because you want to speed up their delivery and get a fatter paycheck? Not cool, people, not cool.

Again, I recognize that C-sections save lives.  Lots of lives. But only in about 5-10% of cases. Heck, for all I know this pregnancy might end in a C-section. And that's okay. If that happens, I will feel that I am in that 5-10%. And at least I won't be wondering if I was just taking 'too long', and my doctor had a hot date to get to.