Unless there are risk factors during your pregnancy (ie: bleeding, weakened cervix) exercise/movement, in one form or another, is highly recommended during pregnancy. Always check with your midwife or doctor first, and consider working with someone who is trained in prenatal fitness. Activities like walking, swimming and yoga are ideal. If you had a fitness routine prior to conceiving and you feel well enough to continue, then, by all means, do so! Consistent exercise throughout pregnancy can help in so many ways, including helping with mood, decreasing the chance of excessive weight gain, and having a shorter, more manageable labor. If you did not exercise before conceiving, it should be appropriate to start during pregnancy – but remember to take baby steps and work with a professional.

Weight gain is an important and healthy part of pregnancy. However, excessive weight gain can make a pregnancy more uncomfortable and it can make getting back to your pre-pregnant body and energy level more difficult. Weight gain outside of the healthy parameters could also indicate a medical concern. There is a simple, common sense way to address weight gain during pregnancy, and that is to consciously eat nutritious food, without overeating. I know – duh, right? But, we don’t have to make a science project out of eating – even and especially during pregnancy. If you know your portions are not enough to sustain a sumo wrestler, and ice cream is not on the menu every darn day, then whatever number comes up on the scale is most likely to be exactly what it’s supposed to be. You certainly shouldn’t be looking to diet during pregnancy. Stress, over weight gain or anything else, has pretty significant consequences for you and baby, so just make great choices and enjoy your beautiful growing belly. It’s all temporary.

Labor starts when you have consistent, patterned contractions. Breaking your water is actually a whole lot less likely to happen at the start of your labor than you think, and even if it does, you’re still not technically in labor until those contractions start, continue, and become longer, stronger, and closer together.

SEE ABOVE!

A class (let’s be clear – a Moms On Top class, or one that is equally as comprehensive in all ways) will create a healthy mindset around birth, in addition to providing you with the information you need to develop your preferences for your birth, advocate for what you want, and take control of your own experience. Without knowing your options, you don’t have any. Birth education decreases your anxiety, and empowers you – which affects all parts of your life, especially parenting. The way in which you give birth (how much you know, how much you’re involved, who you choose to be part of your team, your ability to ask questions and make decisions) can influence your feelings about yourself and your confidence going forward… not to mention, the actual safety and health of this profound event for you and your baby.

Most women will sense contractions like a tightening in the abdomen (although sensations can also be felt in the back and even the groin) that starts off mildly and, within seconds, begin to build, getting tighter and tighter, with increasing levels of pain, until it reaches a peak, and then it begins to loosen up gradually as the pain diminishes, until it totally dissipates. Think of the motion like a bell curve or an ocean wave.

You are only a martyr if you walk into your labor with the determination not to have an epidural or any medical intervention, but you have no skills or options for managing your labor. (This is why education is so important!) Lying in bed and suffering in order to say you had a natural childbirth is foolish and sadistic. On the other hand, “just listening to your doctor” strips you of all of your control. You have the intelligence and the ability, in the unique moment of your individual labor, to decide what is best for you. Gaining the knowledge to make these decisions and work with your body eradicates the possibility of being a martyr and being defenseless.

Let’s start with the cons. A birth plan can cause some doctors to feel as if they are being told how to do their job and/or that they are being asked to agree to a “contract” of sorts. Some simply do not believe that what is being asked for – even if the wording assumes a low-risk situation, where the expecting parents are being flexible – is reasonable and safe, especially if this doctor is accustomed to practicing the same way, without any individuality, all the time. The mythical idea that a person who writes a birth plan is uptight and stressed out, and therefore has a higher likelihood of ending up with a C-section, also creates a negative aura. The pros of a birth plan, or a document that lists birth preferences, include the amazing source of communication it provides, and its ability to clearly outline the support expecting parents are looking for at their birth. It helps the team to either find a common ground, or the mom and dad-to-be to change gears, if so desired, to secure that support if it seems obvious that their wishes will not be respected. A birth plan should be viewed as a wedding plan would be. It is not unreasonable in any way to expect your choices for flowers and music, or to have your ceremony on the beach – weather permitting – to be honored, and it should certainly be the same – to an even greater extent – when it comes to your birth choices.

The decision to leave for the hospital has a lot to do with two things: 1- When the idea of being in the hospital feels safer and more comfortable than staying at home; and 2- When you are physiologically close to giving birth. It’s always best not to linger in the hospital for too long, but you also might want to avoid giving birth on the side of the road. So, here’s a good rule of thumb… Learn how your body works during labor so that you can tune in and understand what signals indicate progression. You can then make distinctions, and stay conscious of all the changes, including those that signal the baby’s descent. Synthesize all of this knowledge to recognize when you are in the active phase of first stage labor, coupled with the baby being deep in the pelvis. Factoring in distance, you can now calculate the best time to leave for the hospital!

First, it is advisable to cease and desist with the phrase, “Am I ALLOWED…” As Cristen Pascucci, from ImprovingBirth.com states, “It’s time to change our language to reflect the legal and ethical reality that it is the patient who chooses to allow the provider to do something– not the other way around.” Once you are aware of evidence-based care, and policies that are not evidence-based, like being told you cannot get out of bed, or having food and drink withheld, you may respectfully and lawfully refuse to follow this protocol.

As with the answer to the question above, you do not ever have to feel pressured to do anything you do not feel comfortable with, or anything that doesn’t make sense to you. Getting educated opens up a new stream of consciousness. Once you understand what the evidence proves to be best care, and how it differs from routine care, you may start by asking questions like, “What are the benefits/risks/alternatives?” “What if we do nothing?” Vaginal exams at the end of pregnancy may reveal changes to the cervix, but this information ultimately does not disclose when labor will begin or how long it will last – revelations many assume will come from this procedure.

If you are not receiving the support you expect and deserve for your personal preferences outlined in a well thought-out birth plan, written with reason and flexibility, based on your status as an informed, educated consumer, then you might consider consulting with other practices. It is rarely too late to make changes to your birth team.

Birth doulas serve such a significant role. Their involvement during the labor and birth process has been researched extensively and the findings have shown shorter labors, decreased anxiety, decreased c-section rates, better infant outcome, and higher satisfaction. Midwives and doulas have some overlap a bit in their roles as they pertain to lending support, but they have very different responsibilities. A midwife is a healthcare provider (like a doctor), while a doula is more like a coach, who does not perform clinical procedures like taking blood pressure, doing vaginal exams, or administering medication. Having the ‘right’ midwife and the ‘right’ doula working together to guide you through labor, can be a magical combination.

This is tricky for sure. Of course, it is best to schedule prenatal visits with the practitioner who hears you and supports you. Although there is no guarantee that other doctors/midwives in the practice will be influenced by the one you connect with, it’s worthwhile asking them to discuss your case and your wishes the next time they meet in a formal professional manner. Having a birth plan seems like a good way to inform all who might attend your birth of your wishes. However, these wishes still need to be respected and supported. Advocating and securing support prior to labor is optimal, but you certainly can, and should advocate for yourself and the birth you want, in the moment, with whomever is attending.

Vulnerability is normal and expected during your birth experience. Sheer emotion, combined with physical pain, can certainly intensify this feeling. Most informed, prepared women are still able to advocate for themselves throughout labor. At times when you might feel particularly overwhelmed, it’s great to have your partner step in and take the reins. Doulas can also be very effective in helping you and your partner communicate throughout labor and birth, and immediately postpartum.

The best time to take a class is as early as possible, especially when you have the opportunity to have an ongoing relationship with your instructor. You will begin to gain both evidence-based information and a sense of your unique values around birth. Each will serve you in developing and then communicating with your midwife or doctor.

Education brings about many “aha” moments for expecting parents – things they never thought about, and/or the opposite of what they once assumed to be the best and safest way to have a baby. It is really important to remember that, although starting your education process early on is ideal, you are NEVER too late to get informed and work with a birth coach! Moms On Top provides a variety of options, and Gail will always accommodate anyone who seeks to be educated. Because of the personal attention offered the calendar does not fully dictate your ability to become prepared and feel confident for your birth.

A Moms On Top course does not strictly adhere to one particular “method”. It is an independently taught class – not based in a hospital with institutional agendas, and not limited to a general concept. The curriculum is comprehensive and evidence-based. Most important, the objective is for the unique needs of each person and couple to be addressed as the information is being conveyed. There is never a time in which generic material is dispensed without personal coaching. Another special feature is the emphasis on advocacy and the practical use of the instruction. To simply gather information without being able to apply it in the moment of your unique circumstances, would be pointless. Gail’s focus is to provide the tools and help you to use them in the ways that you determine are individually best for you.

This is a great time to start integrating birth books into your collection of pregnancy books! Here are some recommendations:

• The Ultimate Birth Experience – Gail Janicola
• The Birth Book – William and Martha Sears
• Your Best Birth – Ricki Lake and Abby Epstein
• The Thinking Woman’s Guide to a Better Birth – Henci Goer
• A Good Birth, A Safe Birth – Diana Korte