Chandler, Arizona
Sweet Pea ​Births
Sweet Pea ​Births
...celebrating every swee​t pea their birth
...celebrating every swee​t pea their birth
Blog
Redefining Pregnancy and Term Limits
Posted on October 28, 2013 at 12:06 PM |
![]() |
Maybe you heard the news last week that ACOG, “redefined ‘term pregnancy’ to improve newborn outcomes and expand efforts to prevent nonmedically indicated deliveries before 39 weeks of gestation.” Read the News Release HERE While many people around me whooped for joy, I am reserving judgment. I do think it is a move in the right direction to define full term as 39 weeks to prevent an elective cesarean mother from scheduling a cesarean two weeks sooner than the baby is estimated to be ready to live outside the uterus. However, I see a lot of challenges. I suspect that we are going to find that term limits are better saved for politicians, and not healthy mothers and healthy babies. While it doesn’t define ‘early term’ as premature, I am going to wonder
if, in our liability-driven society; if this won’t mean that any infants born
between 37 weeks and 38 weeks, 6 days are going to be under more scrutiny. I wonder if those parents are going to be
pressured to “do” things like we have seen preemie parents of otherwise healthy
babies pressured to “do” things that were against their better judgment. I also wonder if simply renaming the time period between 41 weeks and 41 weeks, 6 days as ‘late term’ is going to be enough. Will a name change suffice to calm down the fears of malpractice, and allow mamas and babies the time they need to get labor started on their own? I would like to think that mothers and babies with healthy, low-risk pregnancies will be allowed to be pregnant as long as the Mother is okay and the Baby is okay. If a family has healthy and low-risk delivery, and a Healthy Mom, Healthy Baby outcome, I can hope that no matter when that baby is born in relation to their estimated due date, that the MotherBaby pair will be left alone to meet, greet and bond without the baby being poked, jabbed, weighed, measured and otherwise. Here’s to hope – I hope that this will mean better outcomes, evidence-based care and an increase in the number of Healthy Mom, Healthy Baby birth stories. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
“When Are You Due?”
Posted on May 24, 2011 at 3:01 PM |
![]() |
One of Dr. Bradley’s sayings was, “It’s Not Nice To Fool
Mother Nature”. There is a whole chapter
of his book, Husband-Coached Childbirth, devoted to that topic, in which he
talks about the concerns he has with trying to rush the process. Did you know your due date was, at best, an estimate? Did you know that only 4% of babies arrive on their actual due date? There is no hard and fast rule for when your
baby is going to make his or her entrance. There is not a calendar or a PDA in your uterus with an alarm that will
ring telling them that it’s “go time.” The current way of estimating your due date is based on a
model that is 181 years old. A doctor
named Franz Carl Naegele who was an ordinary professor and director of the Lying-in Hospital in Heidelberg, Germany devised this method of estimating due
dates. He published it in a “Textbook
for Obstetrics”, intended for use by midwives, in 1830. During the infancy, if you will, of obstetric
medicine, one person published that a woman’s due date was going to be
approximately 280 days, or 40 weeks, after the date her last menstrual
period. This was not based on empirical
evidence, but rather on a common belief of the time. There is a more recent Harvard study published in June 1990
edition of the medical journal Obstetrics & Gynecology that we give to our
students on the first evening of class. It is a retrospective evaluation of pregnancies between April 1, 1983
and March 31, 1984. The conclusion of that study was
that the median estimated due date for primiparas (first-time mothers) should
be 8 days later than Naegele’s rule, and that multiparas should have an
estimated due date that was 3 days later than Naegele’s rule. Per their study, if you are 41 weeks as a
first-time mother, your baby might just be arriving to the point when he or she
is ready to be born. We ask our students to do a couple of things on the first
night of class. First of all, The
Student Workbook asks them recalculate their due date. We ask them to think about considering that
new date of 41 weeks and 1 day as their “due date”. We then encourage them to start saying they
have an “estimated due date” or a “due season” to take some of the pressure off
of themselves and their bodies. The reality is that your baby is going to come when your body and your baby decide to start
labor, and not a moment sooner. While no one who is or has been pregnant wants to tack on an extra
eight days when they are feeling big, uncomfortable, hot and ready to be done
with pregnancy, you just never know when your baby is going to arrive. Giving yourself eight extra worry-free,
stress-free days might be the best thing for you if you happen to be one of the
moms who will go past her 280-day due date. WHY DUE DATES ARE AT BEST, AN ESTIMATE It is assumed that most women ovulate on day 14 of their
menstrual cycle. If you ask anyone who
has had a difficult time conceiving, they will tell you that this is not always
true. Some women ovulate as early as day
11, and some as late as day 21. This
makes for as much as a two-week difference when estimating a due date. There is a second variable: when was the egg fertilized? Did
you know sperm could live in a woman’s body for seven days? We found this out the “baby way” with our
third child. Just when we thought we had
stopped trying to avoid another summer pregnancy, surprise – I was
pregnant! I joked that Bruss had bionic
sperm until I discovered this little fact. Oops. So back to the point: Once the egg is released, it lives
12-24 hours, but sperm could live for seven days. When do they meet? Only your baby and your body know, and they
are not telling. Here is the third variable: Once the egg is fertilized, it could take anywhere from 6-12 days after
you ovulated to implant. Until it finds
a home in the uterus, cell division is on hold. (If
you think about how IUD’s work, they make the uterus inhospitable for
implantation, therefore it makes it highly unlikely you can establish a
pregnancy with a fertilized egg.) So, if
your fertilized egg does take twelve days to implant, now you have more time to
add on to your estimated due date. There is the also fact that all babies are not created
at equal rates of development. There are
certain milestones in gestation that doctors expect to find, however, not every
baby is going to develop at the exact same rate. Nature’s bell curve deems that some babies
will be ready early, the majority of babies will be ready around their
estimated due dates, and then some of the babies will be ready after their due
dates. Once upon a time, a pregnancy was considered to be"normal" if a baby was born between 37-42 weeks of gestation. With so much variation in the actual process, it is so hard
for me to watch moms go past their due date and wonder if their baby’s are
going to make it without having to be induced. As with all things pregnancy, there is no perfect rule. There are times when a care provider will
start to be concerned because either mom or baby starts to show signs that they
are not physically handling the prolonged pregnancy. If and when we are faced with this possibility,
it falls on us as parents to make an informed decision about how to go forward
when faced with that situation. There is also a condition called "postmature". It could be as simple as an error in estimating a due date, in which you could negotiate for time if mom and baby are doing well. True postmaturity means that a baby is seriously ill: the placenta or mother are not supplying the baby with needed nutrients, the baby's skin is loose, the baby starts losing weight, the subcutaneous fat layer is gone and the baby looks like an old, dying person. You can see that there is a cause for real concern in this situation. It is very rare, however, no care provider wants to be the one who waited too long and then has to be the one to deliver a stillborn child. And no parent in their right mind would intentionally harm their baby...hence the ever-so-important questions arise and it is so vital that we weigh all our options carefully. WHAT YOU MIGHT CONSIDER If you find yourself going past your due date, there are
several options you might consider. We
encourage you and your coach to have these conversations with each other and
your care team before you are faced with making an emotional decision. Talk about these options well in advance of
your estimated due date when you are calm, under no pressure to make a
decision, and you still have time to research different options and induction
methods should they become part of your care plan. If your care provider is a midwife: - If you are with a Licensed Midwife, you need to find out
what the state law says about what her practice parameters are. Here in Arizona, midwives can only deliver
babies born between 36-42 weeks of gestation. If you are baby is born early or later than that, you need to think
about a “Plan B” option now before it becomes a critical decision. - If you are under the care of a Certified Nurse Midwife
practicing under the umbrella of a doctor’s office, you need to discuss whether
or not her practice will allow her to care for you past 42 weeks gestation, or
how your state’s laws applies to their care situation. If your care provider is a doctor or doctor group: - Stay healthy and low-risk so more options are available to you. - You could show the Harvard study to your care provider and
see if they will agree to give you an extra two weeks past the 41-1 date, based
on the fact that your due date might have been estimated incorrectly. - You could find and change your care to a care provider who
is willing to give you more time than your current provider. Bradley teachers are a great resource, as are
any relatives or friends who have been in your situation. - You could negotiate to do fetal movement counts,
non-stress tests or biophysical profiles on a schedule you and your care
provider agree to, and agree to consider interventions if you or your baby
starts to show signs of stress. WORKING WITH YOUR BODY - You could try drug-free, non-consumption methods such as
nipple stimulation, thumb sucking, or other acupressure massage points that
stimulate the production of oxytocin, the same hormone your body produces to
cause contractions. (Discuss with your care provider.) - Sexual intercourse could help – semen contains the natural
prostaglandins that medicine tries to mimic with the prostaglandin inserts used
to ripen the cervix. (Discuss with your
care provider.) - You could do some focused meditation and connect with your
baby, encouraging him or her that you are ready for them and that you are
waiting to meet them. - You could continue with staying well nourished and getting
plenty of rest so that when the day does arrive, you are rested and ready
instead of tired and stressed. INDUCTIONS AND INTERVENTIONS There are many different ways to try to “speed things along”
that are stimuli by application or consumption. I am not going to comment on them because I
do not want to bias you or be interpreted as giving you medical advice. I will refer you to Husband-Coached
Childbirth by Dr. Bradley or Thinking Woman’s Guide to a Better Birth by Henci Goer for you to do your own research. It’s up to you and your coach to draw your own conclusions about which
of these you would consider and in what order you would place them on your list
of things to do. I list them in
alphabetical order: - Acupunture - Amniotomy (artificial rupturing of the membranes) - Castor Oil - Enema - Herbs - Mechanical Dilators - Oxytocin - Prostaglandin E2 inserts - Stripping/sweeping of the membranes - TENS machine BEST WISHES I hope and pray that if you are reading this, you are doing
so to gather information instead of reading it as one of your last resorts
looking for answers. There is no right
or wrong answer, just the one that works best for your peace of mind and for
the best outcome anyone could want: Healthy Mom, Healthy Baby. If you are looking at this because you are facing tough
decisions, do not hesitate to drop me a line ([email protected]) and ask us to pray for you. I am a believer in the power of prayer, and
we will add our prayers to yours and ask that God’s will be done for you and
your baby. Disclaimer: The
material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical
advice. The reader should always consult her or his healthcare provider to
determine the appropriateness of the information for their own situation. This blog contains information about our classes available in
Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy
of Husband-Coached Childbirth®. References: Husband-Coached Childbirth, Dr. Robert Bradley, 2008, pgs
16-42 Thinking Woman’s Guide to a Better Birth, Henci Goer, 1999,
pgs 49-74 Obstetrics & Gynecology, Vol. 75, No. 6, June 1990, pgs
929-932 The Bradley Method® Teacher’s Manual, 2010, page 120 http://www.americanpregnancy.org/gettingpregnant/understandingovulation.html http://www.transitiontoparenthood.com/ttp/parented/pregnancy/duedate.htm |
Categories
- Why we chose the Bradley Method� childbirth classes (14)
- Birth center (34)
- Birth Centers Phoenix AZ area (8)
- Birth place options (36)
- Bradley Method� outcome (44)
- Managing or coping with natural labor (33)
- natural labor coping mechanisms (35)
- Natural labor coping techniques (35)
- Pain management (23)
- Pain management natural labor (18)
- The Bradley Method� pain management (19)
- First stage labor (29)
- Birth plans (72)
- The Bradley Method® (68)
- Birth Story (33)
- Bradley Method® birth story (16)
- Birth Circle (9)
- Midwife (36)
- Midwifery Care (32)
- Cesarean Birth (35)
- Cesarean Surgery (27)
- Doulas (50)
- Second Stage Labor (21)
- Acupuncture (5)
- Parenting (63)
- Use of vacuum extraction (1)
- Breastfeeding (232)
- Chiropractic Care (10)
- Webster Protocol (3)
- Breastfeeding support (154)
- Information Center (101)
- The Bradley Method® classes (57)
- Placenta Encapsulation (11)
- Postpartum Depression (31)
- Breech presentation (8)
- Breech turning techniques (6)
- ECV (6)
- External Cephalic Version (6)
- Infections and Pregnancy (7)
- Bradley� Coaches (47)
- Coach's Corner (14)
- Coaches (47)
- Coaching (39)
- Exercise (18)
- Modern Mommy Boutique (10)
- Nursing and Maternity Bras (4)
- Transition (11)
- Postpartum Plan (29)
- Grief Counseling and Support Services (3)
- Miscarriage or Stillbirth (8)
- Pregnancy Loss (4)
- Variations and Complications (17)
- Going to your birthplace (9)
- Homebirth (58)
- Hospital Birth (57)
- Informed Consent (29)
- Patient Bill of Rights (2)
- Dehydration and Pregnancy (5)
- Fluid Retention (3)
- Heat Comfort Measures (7)
- Hyperthermia and Pregnancy (2)
- Pre-term Labor (4)
- Swelling in Pregnancy (2)
- Full term (9)
- Past due date (6)
- Postdate (7)
- Postmature baby (2)
- Crying (8)
- Newborn Care (23)
- Fussy baby (11)
- Support Groups (17)
- Pregnancy (69)
- Avoiding harmful substances (32)
- Toxins, pesticides, chemicals and pregnancy (18)
- Starting Solids (14)
- Drinking during labor (11)
- Eating during labor (12)
- NPO (2)
- Nutrition (37)
- Due Date (9)
- Planning for Baby (34)
- Child Spacing (3)
- Sibling Preparation for Newborn Arrival (9)
- Breastfeeding 101 (24)
- Debbie Gillespie, IBCLC, RLC (8)
- Circumcision (2)
- Lactivist (3)
- In Their Own Words (36)
- NIP (25)
- Nursing In Public (28)
- Childcare (17)
- Infant Classes (5)
- Photographer (5)
- Epidural (15)
- Depression (12)
- Allergies (3)
- Dairy Allergy (2)
- Breast Pumps (19)
- Postpartum Doula (11)
- Jaundice (2)
- Newborn jaundice (1)
- RSV (4)
- Postpartum (55)
- Labor Marathon (20)
- Labor Sprint (17)
- Belly Cast (2)
- Maternity Keepsake (1)
- Natural birth (34)
- Obstetrical Care (16)
- Engorgement (2)
- Uterine Rupture (3)
- Berman's Law (1)
- Back Labor (3)
- Healing (8)
- Hearing Screen (1)
- Perineum (4)
- Herbalist (2)
- Tandem Nursing (5)
- Breastfeeding Challenges (91)
- Tongue Tie (2)
- Tongue Tie Procedure (2)
- Bradley Day Family Picnic (5)
- Cephalo-Pelvic Disproportion (3)
- CPD (3)
- Failure to Progress (10)
- Fetal Distress (2)
- FTP (5)
- Pain (4)
- Prolonged Labor (3)
- Baby games (4)
- Playing with baby (5)
- Sensory games (2)
- Cesarean Support Group (16)
- Baby blues (8)
- NAP (5)
- Natural Alignment Plateau (6)
- Baby-led weaning (2)
- BLW (2)
- Comfort Measures (15)
- Flower Essences (4)
- Relaxation practice (4)
- First Foods for baby (2)
- Babywearing (21)
- Nursing (31)
- Sling (2)
- Soft-structured carrier (1)
- Wrap (2)
- Weaning (2)
- Co Sleeping (6)
- Family Bed (6)
- Relaxation (6)
- Meet the Doula (24)
- Bradley Method® (37)
- Bradley Method® for next baby (4)
- Bradley Method® for second pregnancy (5)
- Bradley™ classes and the next baby (4)
- Bradley™ classes for next pregnancy (3)
- Bradley™ classes for second pregnancy (3)
- Next baby (5)
- Next pregnancy (7)
- Repeat Bradley™ classes (1)
- Bedtime Routine (5)
- Children's Books (3)
- Breast Pumps and Workplace (10)
- Breastfeeding in Public (37)
- Communication (8)
- Labor Support (25)
- Amniotomy (5)
- AROM (6)
- Artifical Rupture of Membranes (5)
- Bag of Waters (5)
- Premature Ruptture of Membranes (4)
- PROM (4)
- ROM (4)
- Rupture of Membranes (4)
- La Leche League (8)
- Nursing Strike (2)
- Galactogogues (1)
- Increase Breastmilk (2)
- Milk Supply (2)
- CIO (4)
- Cry It Out (4)
- Teething (1)
- Hyperemesis Gravidarum (1)
- Morning Sickness (3)
- Nausea (2)
- Eclampsia (1)
- Healthy, Low-Risk (16)
- Pre-eclampsia (5)
- Rights for Homebirth (6)
- Traditions (2)
- Midwifery Scope of Practice Committee (5)
- Scavenger Hunt (1)
- Sweet Pea Births (5)
- Cassandra Okamoto (6)
- Mommy-Con (9)
- Phoenix Mommy-Con Mini (2)
- Vaginal Birth After Cesarean (18)
- Vaginal Birth After Multiple Cesareans (10)
- VBAC (21)
- Monitrice (1)
- Baby Concierge (4)
- First Birthday (1)
- Oxytocin (2)
- Warning Labels (3)
- Inside Look (19)
- Induction (12)
- Induction of Labor (8)
- Labor Induction (11)
- Episiotomy (3)
- Info Sheet (22)
- Information Sheet (22)
- Augmentation (4)
- Labor Augmentation (9)
- Cord Clamping (2)
- Delayed Cord Clamping (2)
- Immediate Cord Clamping (2)
- Birth Mantra (19)
- Rally to Improve Birth (4)
- Eye Drops (1)
- Eye Ointment (1)
- Eye Prophylaxis (1)
- Neonatal Eye Drops (1)
- Neonatal Eye Ointment (1)
- Neonatal Eye Prophylaxis (1)
- Wordless Wednesday (37)
- Big Latch On (1)
- Blog Carnival (3)
- IBCLC (11)
- Lactation Consult (3)
- Lactation Consultation (3)
- WBW2013 (1)
- World Breastfeeding Week (51)
- Thoughtful Thursday (3)
- Family Fun (18)
- Weekend Activities (1)
- Upcoming Events (81)
- Breastfeeding Awareness Month (76)
- Sleep Sharing (1)
- Newborn (12)
- Newborn Procedures (3)
- Preemies (4)
- Twins (1)
- Vitamin K (1)
- Vaccines (3)
- Fertility (10)
- Premature Baby (4)
- Babymoon (4)
- Green Nursery (4)
- Gowning (1)
- Affirmation (20)
- Birth News (5)
- First Trimester (1)
- Membranes (3)
- Stripping Membranes (2)
- Sweeping Membranes (2)
- Fear-Tension-Pain Cycle (2)
- Third Trimester (2)
- Baby (26)
- Infant Care (9)
- Contest (1)
- Family Fest (9)
- Giveaway (1)
- Birth (33)
- Nursery (3)
- Bradley® Dads (3)
- Mantra (8)
- Waterbirth (3)
- Essential Oils (1)
- Gestational Diabetes (1)
- Q&A with SPB (23)
- NICU (3)
- Placenta (4)
- Birth Story Listening (1)
- Meditation (3)
- Birthing From Within (3)
- Ask the Doula (1)
- Monday Mantra (4)
/