Wednesday, July 28, 2010

Optimal Fetal Positioning - Part 3

I've decided for part three not to discuss turning a baby; I'll leave that up to . There is loads and loads of information on that website of ensuring a good positioned baby throughout your pregnancy, and then a lot of techniques on turning babies during labor. So its a good website to familiarize yourself with.

What I do want to discuss is some materials I have found in my home study course for what you can do every day to encourage a baby to be in good birthing position. Most are posture related.

Getting baby in a good position
In previous OFP posts, I talked about how babies just want to be comfortable and gravity generally governs how they are positioned in the womb. The shape of the uterus, pelvis, and gravity are the things that will affect a babies position the most. We can't do a darn thing about the shape of our bodies, but we can do something about gravity.

A baby generally ends up head down because it fits snugly in the uterus and because it is the heaviest part of the baby, thus turning down with gravity. The same goes with a baby's back. They end up anterior (back towards your stomach) because of the same factors. However, it is much easier to affect whether a baby sits anterior or posterior by the way you sit and by your posture. The heaviest part of a baby is the head, but the second heaviest part is the back. Their back is going to want to turn whichever way gravity points. Think about this for a second. If you spend a lot of time reclining back, where will the baby's back want to lie? Down. It will want to turn down, which would be turning posterior. Remembering gravity, the best way to get a baby anterior or keep a baby anterior is to get gravity to turn the baby towards yours stomach. This basically means being uncomfortable at all times!

These are the suggestions in my study course:
-Sit tilted forward. - imagine your uterus as a hammock for the baby.
-Keep your knees below your pelivs. This definitely means not lying back with your feet up in the air. Many doctors and midwives have prescribed lying just like this to help with swelling, but I disagree. It would encourage the baby to turn posterior. Laying on your side with your feet up is a much better option.
-Don't cross your legs! This closes the pelvis in the front and opens it in the back, which is not at all what you want.
-Lie on your left side mostly to keep baby on left side. I find it interesting that every pregnant woman in the world has been told to lie on their left side because of the artery that runs to the lower body. I think baby positioning is just as, or even more important for why we should lie on the left side and NOT on our backs!
-Plenty of pelvic tilts. - This is basically cat/cow, getting on hands and knees and tilting your pelvis forward, only not worrying so much about the cow part, and making sure to tip the pelvis in, not necessarily arch the back up. Pelvic tilts are an excellent pregnancy exercise. It is pretty much the only way to strengthen the abs, it relieves back discomfort, and the tilting action gets the baby to tuck their chin.
-Tailor pose. This is sitting on the floor with knees open and the soles of your feet together. This opens the pelvis and encourages space for the baby.
-Sitting on a yoga ball - This also opens the pelvis and helps the baby engage.
-Sitting on a dinning room chair, backwards - opens the pelvis and tilts the uterus forward.

Basically, we can't sit lady-like or recline. When I relax at home, I just lie on my left side on the couch. At work, I either sit on a ball at my desk, or I set my desk chair to not lean back at all. My book says to be concerned with your posture 6 weeks from due date. It also says that you can't just have good posture whenever you think of it, it has to be a conscious continuous effort.

I believe this concludes my Optimal Fetal Positioning series. I know that there are no guarantees. You could have perfect posture and end up with a malpositioned baby, or you could lie on your back with your feet up all day and have a perfectly positioned baby. There are a lot of factors that go into it. But like most things I have learned, I'd rather prepare and do all I can for a smooth delivery.

Monday, July 26, 2010

37 Weeks

I am technically full term!

Although, I have a feeling we have several more weeks before we get to meet our baby. We were SURE the baby had dropped last week. I had tons of room up top, and my chiropractor said she couldn't feel the head at all. She was sure the baby had dropped too, and got me all excited. Well, at my prenatal on Friday, the baby was all the way up in my ribs. So high that the midwife assistant says "Geez! This baby is so high!" I was like "huh?" because last I heard the baby was "so low"! I asked if they can scoot up and down, but they thought it was more likely the baby was on the move and might have been posterior when the chiropractor felt around. I'm not so convinced.. I swear the baby was low!

Everything looks good. I am measuring about three weeks behind, so we think we'll have a small baby. Mary Anne says that is perfectly fine because I'm not that large myself. Plus, those measurements have a +/- 2 cm curve. I can feel a small baby though. He/She feels so very bony. The other day I could even feel tiny shoulders!

I am having lots of Braxton-Hicks. I've had them for weeks, but I suppose they are getting stronger and I have them more often. I don't have anything to compare them to, but they feel quite strong, to me. I'm excited about that, because I think that means they are efficient and doing their job!

My hip and pelvic pain has actually gotten quite a bit better. I have almost completely stopped exercising. (Which, I do not condone, btw!) The Friday before last I slipped in the gym bathroom after I got out of the pool and I aggravated my hurt pelvis so much that I felt like I had been injured the next day. Like literally hit by a car. I didn't exercise again until last Thursday, which was almost two weeks later. I went swimming, and even that hurt. But since Friday, my pelvis has felt better than it has in months. So, I'm just going to take it easy.

Other than that, I was sleeping ok, until just recently. I'm waking up around 4am and not being able to go back to sleep. That's the worst. Probably worse than pelvic pain because no sleep makes you feel yucky EVERYWHERE!

At any rate, we are preparing for the arrival of our new one. Which involved steam cleaning the carpets (twice), stocking the pantry, and organizing everything we'll need at home and to take to the birth. I think we'll be ready! (As long as its not tonight.. I don't think we're that ready!)

Tuesday, July 20, 2010

Tasty Tuesday - Pan Fried Chickpea Salad

I absolutely love this recipe. I don't have a picture, but do visit 101cookbooks for Heidi's picture and recipe. I made this salad when I was visiting family in Texas last year and my then 1.5 year old nephew couldn't get enough of it! So don't deny your children of it just because it has curry!

Pan Fried Chickpea Salad
1 tablespoon olive oil, or coconut oil
2 cups cooked chickpeas or 1 can, drained and rinsed, pat them completely dry with clean dish towel
1 cup of chopped leeks
1 medium clove of garlic, minced
zest of one lemon
1/3 cup plain yogurt or Greek yogurt
1 1/2 teaspoons Indian-style curry powder (I use a bit more than this)
1/4 teaspoon fine grain sea salt
1 or 2 tablespoons warm water
1/2 cup of loosely packed fresh cilantro, chopped
1/2 cup red onion, chopped

Heat the cooking oil in a large skillet and add the chickpeas. Saute over medium-high heat, stirring occasionally, until they start getting a bit golden in color. Stir in the leeks and cook until the chickpeas are more golden and the leeks have browned a bit as well, roughly 7 - 10 minutes total. At the last minute stir in the garlic and the lemon zest. Remove from heat, and set aside.

While the chickpeas cool (you can serve this at room temperature), make the yogurt dressing by combining the yogurt, curry powder, and salt in a small bowl. If you need to thin it out a bit, particularly if you are using Greek yogurt, whisk in warm water a tablespoon at a time. Taste, adjust, and set aside.

When you are ready to serve the salad, toss the chickpea mixture with most of the cilantro and most of the chopped red onion. Add about 1/2 of the yogurt dressing and toss again. If you like more dressing, keep adding until you are pleased. Sprinkle with the remaining onions and cilantro.

Note: Sauteed chickpeas develop a wonderful, nutty flavor and get a bit of a crust on them. They are absolutely fabulous cooked this way! Just be sure to dry them well so they will fry up nice. If they are wet, they'll just cook and get soft.

Thursday, July 15, 2010

Optimal Fetal Positioning - Part 2

Part 2, of OFP is what I have learned of how to discover your baby's position. It can only be successfully done the last two months of pregnancy.

Vertex or Breech?
An overwhelming majority of babies end up vertex (head down) with no effort from the mother. Babies are just tiny people who just want to be comfortable. Head down happens to be the most comfortable position because of the shape of the uterus and the shape of the pelvis. Their little heads fit perfectly in the low uterus and pelvis. Also - Gravity! The head is the heaviest part of a baby and therefore tips down.

Fortunately, you do not need an ultrasound to learn if your baby is head down! I have discovered four ways to tell that my baby is vertex. First, my midwife and my chiropractor can feel my baby's head just above my pubic bone. I actually can not feel this, and Patrick is too afraid he'd poke an eye out, that he hasn't felt for the head, but I know both of my care providers can identify a head within 2 seconds of feeling. This is sure to be the head because a butt is not going to fit nice and compact just above the pubic bone.

Secondly, you can easily find your baby's bottom by feeling around the upper part of your uterus. I can almost always identify the butt by giving a good feel on either the upper left or upper right side of my uterus. You can tell if this round body part is the head or butt by giving it a push. If you push on this lump, and you can feel the entire baby move (I often feel a push on my bladder, or pressure down low from pushing the baby) then its a butt. If you push on a bottom, the whole baby will move, if you push on a head, the head will just loll back and not move the whole body.

Third, I can identify my baby is vertex, and left lying by where I feel kicks. Kicks are much firmer and stronger than hands, which wiggle. I feel all kicks either in my right ribs or just below my right ribs. I think my baby is small, though, so a larger baby's feet might be wrapping around and you will feel kicks lower and further to the side of your body.

And finally, where the heartbeat was heard last will tell you the position of the baby. Mary Anne can find the heartbeat low on my abdomen on the left side. This shows a vertex, left lying baby.

Left or Right lying baby? Give a Feel.I can most always figure out what position my baby is in while feeling my belly while lying on my back. Lying flat on a bed or the floor, put your right hand flat against the right side of your stomach (so your palm will be against the side of your belly) and push on the left side with your left hand. With the hand that is pushing - do you feel a lot of resistance? Does it feel rather soft? Now switch, put left hand on left side and push with right hand. You should be able to tell which side has less "give". You can most likely determine what side the baby is, this way. You can also often feel the back of your baby when you are doing this.

Another way is where the heartbeat is heard, as mentioned above.

Anterior or Posterior
Now that you've discovered if your baby is vertex, and which side of your body she is lying, you can find if she is anterior or posterior. If you clearly felt the back with the method above, then she is most likely anterior. If you think about how a posterior baby is positioned, you can visualize that her back will be toward your back and so you may not be able to feel her back so well. Also, where you feel kicks and wiggles is a good indication. If you feel a lot of kicking and punching out towards the front of your belly, or can see feet pushing out like popcorn towards the front of your belly, she may be lying posterior.

I think its easier to tell when the baby is NOT posterior as opposed to when the baby IS posterior. If you can clearly feel a back, and can feel kicks in or under your ribs, or if you feel kicks way out to the side of your body, then the baby is more than likely anterior.

If you need a visualization, hold a stuffed bear or baby doll upside down against your belly as if it were your baby in utero. Head down, bottom to one side, feet to the other side rotate the bear posterior or anterior and see where the feet go. So when you feel kicks you can think about the stuffed bear and determine the baby's position.

Sunday, July 11, 2010

Book Review - The Birth Partner

The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and Other Labor Companions
by Penny Simkin

I did not read this book since I'm not the birth partner- Patrick did! So he's going to provide the book review....

Hello everyone! After some encouragement from Courtney, we borrowed The Birth Partner from the local library. As the birth partner, I am called to be the major support system for my wife, a role I cherish and hope to fulfill to the best of my ability. With help from The Birth Partner I am better prepared to actively take part in our baby's birth.

This book is extremely detailed and has given me a great deal of insight into what I must do as the husband and father. For instance, when mom is beginning her pre-birthing waves (contractions), it is imperative to keep track of pressure wave frequency and length. As the pre-birthing waves continue and become more frequent, if the birth partner has done his job, you can avoid an unnecessarily early trip to the birthing center. Depending on your situation (hospital, birthing center, home birth), timing can be extremely important. If you arrive too early, mom can become discouraged by what would appear as a lack of progression, when in fact it's just not the right time. As time goes on, things can get stressful, and unwanted interventions could begin. On the other hand, if the birth partner (that's me) has diligently monitored mom's pressure waves and follows the suggestions listed in The Birth Partner, we can avoid a potentially stressful situation. This will lead to a happy, low-anxiety birthing time. And mom, dad, and baby can meet each other in a comforting welcoming environment.

The Birth Partner starts with your role during pregnancy. This importance of making sure mom gets the calories, protein, and water her changing body needs. From there, you enter your role during pre-birthing waves. This section includes information about comfort and how you can help mom during this important time. It breaks down what she might be feeling, what you might be feeling, what you must do to make sure mom is as comfortable as possible, and what your doula does, if you've hired one. The doula sections were very helpful, because it gives the birth partner information on how an experienced doula would handle any point during the birthing time. Next up, birthing time. The Birth Partner outlines what you need to do as the husband in all situations. This information is invaluable, because you will be the one who needs to field any questions and handle any situations, because mom is a little busy... Finally, the books tells you what to do once the baby arrives and how to handle the first few hours and days, including infant care and breastfeeding.

If you're getting close to your birthing time and you want to make sure you're prepared as best you can be, I recommend reading this book. It's an easy and informative read, with a lot of useful resources you can keep on hand when the birthing time begins. I was out running with a friend the other day, and he told me when it comes to your birthing time and being a parent, you can pretty much throw the books out the window. That may be true, but I believe you don't want to go into a test without having studied before hand. Plus, the book gives tools of what to do during unexpected circumstances. This isn't just an idealized to-do list, but better prepares the birth partner to handle all types of situations, hopefully keeping the "oh crap" moments to a minimum. I now have knowledge of labor and normal progression, so I won't be just an ornament in the room, but a true helper. So, dads, read this book, be prepared, love on your wife, and enjoy a glorious and exciting birthing. It will only be the beginning of the most life-changing, important experience of your lives.

Wednesday, July 7, 2010

Optimal Fetal Positioning - Part 1

There are good positions and there are not so good positions. A smooth labor and delivery depends highly on the baby being in a good position. A pregnant woman can affect and change the position of her baby with normal everyday posture and few simple daily exercises. This is really something to pay attention to, as I know I want the best birthing I can possibly have.

I think I'll write this in a three part series, considering there is so much information on the subject. In part one, I'll go over the different positions, which is best and why. Part two will address how to figure out what position your baby is in (you don't need an ultrasound to tell you!), and Part three will be how baby gets to the proper position in the first place, what YOU do everyday to affect baby's position, and how to move your baby, if need be.

But first, my disclaimer: I'm just a normal person with a desire to have the best birth possible. The information I want to share is based on my research, largely found at

Part 1 - What is Optimal Fetal Positioning (OFP)?

The best fetal position for birthing is Left Occiput Anterior (LOA), or Left Occiput Transverse (LOT). This basically means that the baby is on the mother's left side, head down, and is either facing the mother's back or facing the mother's hip. Having an LOA baby allows for an easier birthing than other positions because the baby's head is usually tucked to fit easier through the pelvis and birth canal, the baby's back curves most effectively in this position, allowing the baby to slide down easily, and LOA makes engagement (settling deep into the pelvis) likely, which is what starts labor. The difference between an LOA and an ROA (Right Occiput Anterior) baby is that the uterus naturally tilts to the right, and a baby sitting ROA is more likely to go posterior due to gravity. So, a baby who is on the right needs to turn 180 degrees to get into birthing position, while a baby on the left only has to turn 90 degrees. Turning the 90 degrees from the left side is much more easily done, working with contractions, gravity, and the shape of the uterus and pelvis.

Left Occiput Posterior (LOP) or Right Occiput Posterior (ROP) means that the baby is sitting on the mother's left or right side, with his back to your back. LOP or ROP babies have a hard time engaging in the pelvis because their chin usually does not tuck (because of the shape of the uterus), thus not presenting the smallest part of the head first. This prevents the baby from dropping and engaging the cervix, which could delay spontaneous labor. Baby's back against the mom's back also causes back labor as the baby is not "pointing" in the right direction and all the force of the contractions are going into the mom's back.

We all know what breech means - the baby's head is up. Although, in modern days, this is an automatic C-section, an experienced midwife could deliver a breech baby. Although difficult, there are ways to turn a breech, which will be Part 3.

There is also transverse, which means the baby is laying horizontal. I don't think that even needs an explanation of why that is bad news!

A pregnant woman should really start being concerned with OFP six weeks before the due date. Before this time, the baby is still flipping and swimming around. After this time, the baby does not need to be totally still, but should spend a good majority of its time in the correct position. The bigger the baby becomes, the harder it will be to move, so being in the correct position about a month out from birth makes things easier.

There is an entire book on optimal fetal positioning, how to ensure your baby is in the correct position, and how to move your baby. I have not read it, but I heard it is really great. It is Sit Up and Take Notice by Pauline Scott.

I'll now start working on how to know your baby's position. Stay tuned for Part 2!

Tuesday, July 6, 2010

Tasty Tuesday - Garden Stuffed Tomatoes

I made up this recipe, and if you know anything about my cooking, you know I don't measure or time anything, so this is a good guess at proportions of what goes into stuffed tomatoes.

Garden Stuffed Tomatoes
This recipe makes 2 stuffed tomatoes. Adjust as needed.

1/2 Zucchini, diced
1/2 Onion, diced
2 cloves garlic, diced
2 large round tomatoes
1 cup corn
1/2 cup dry quinoa or bulgar or other grain
Cheese - Italian Mix
pinch of dried thyme
pinch of dried parsley
fresh basil
salt & pepper

Preheat oven to 375 degrees.

Cook quinoa in 1 cup of salted water or vegetable broth until liquid is absorbed and the grains are tender. (They will release little curly-q's when cooked).

Hollow out two large tomatoes, keeping the insides, juice and all, and dice the insides. Cook the hollowed out tomatoes in the oven for 10 minutes. Meanwhile, saute onion in a splash of olive oil until tender. Add all the veggies, including tomato dices and their juice. Add spices. Saute until all the veggies are tender and the tomato juice has reduced, then add the cooked quinoa. Stir to combine and remove from heat. Add about 1/4 cup of cheese (or however much you like) and stir to combine. Remove tomatoes from the oven and stuff with the vegetable mixture. Top with more cheese. Crank up the oven to broil, and broil until the cheese is bubbly.

You will have leftover vegetable mix, enough for another tomato, if you wish, or just eat it on the side!

Thursday, July 1, 2010

Books I Love: Ina May's Guide to Childbirth

Ina May's Guide to Childbirth
by Ina May Gaskin

I read this book many months ago, and have actually been stalling writing the review. Only because this book has to be the single most important book on childbirth out today. I just don't think I can adequately review the book, or convince you enough to read it!

Ina May Gaskin is the nation's leading midwife, and the woman who basically brought midwifery back to America after several decades of hospitals having the monopoly on childbirth. She has almost 40 years of real hands-on childbirth experience and she shares her vast knowledge in Ina May's Guide to Childbirth.

The first half of the book is all birth stories. Ina May stresses that in a country filled with dramatic childbirth stories (after all, a nice, calm birth does not make for good drama television) American women rarely hear positive birth stories. Half the book is filled with real women and real stories of all types, meant to be inspirational. They certainly are! However, this is not what makes the book so fantastic. The second part is the "must read" in my opinion.

The second half of Ina May's book is the actual how-to for a natural birth. She doesn't spend her time trying to convince the reader to have a natural birth, she simply tells you how to have a natural birth. One thing I particularly liked about this book is the intensive research she did. A good majority of her guide is from personal experience, but each chapter is thoroughly researched in both the medical and midwifery community. She has a list of references at the end of each chapter that range from medical books from the 1800's to current articles from the American College of Gynecology and Obstetrics. She provides and in-depth look at childbirth and how the body actually gives birth, not just in today's medical mind, but dating back to the earliest birth accounts she can find.

Ina May explains how the body works, what actually happens in the body during birth, and how to work with your body to have a more efficient birth. One of my favorite chapters is actually an explanation of how the cervix functions; how it dilates and what you can do to promote its progress. I found this to be extremely informational, and look forward to practicing the practical ways of helping the cervix to open during birth. She provides a chapter on modern medicine and how each of these interventions may prevent a normal birth from progressing normally. She provides birthing positions that have been used effectively throughout the world and throughout the generations, with an explanation of why the positions work much better than the flat on your back, knees to your ears position.

Reading this book will not only prepare you for your birth, but will present information that you will carry with you for the rest of your life. Many, many other books and resources quote Ina May - so go straight to the source! You will end the book feeling accomplished already!

I first got this book from the library, then quickly ordered it so I would have my own copy. I plan to re-read it in the next several weeks to refresh my mind on her various techniques to open, relax, and work with my body. I can not stress enough how much every single woman of childbearing age should read this book. You can probably get it from your library, but I promise you'll want to buy it!