Tuesday, September 12, 2006

Prenatal care

One question that I often hear when people learn I am giving birth at home is "but are you seeing a doctor or a midwife for your pregnancy?" The short answer is no. This post is the longer answer about what prenatal care means when you're not seeing a professional.

First, true prenatal care is NOT going to a doctor once a month to be weighed, measured, and examined. Prenatal care is how well you take care of yourself in between those visits. This includes eating an excellent diet, exercising, getting enough sleep, eliminating stress, and taking the initiative to remain healthy.

So, what do I do to take care of myself?

1. I try to eat a whole foods diet, focusing on adequate protein, calories, whole grains, fruits and vegetables, fluids, and salt. We rarely eat processed foods or sweets (except very dark chocolate, which is actually good for you! My favorite is 86% cocoa, although 70% is quite good as well).

2. I exercise regularly. I walk at least 2-3 miles per day, thanks to my lovely Dalmatian Zeke. We go down to the bike path every morning for a brisk 2 mile walk. He runs off leash, chases ducks and deer, and splashes in the creek. I usually go on a shorter walk or two with him in the afternoon or evening. I also swim 3/4 mile (24 laps) three times a week.

3. I take good quality prenatal vitamins and some supplements. I don't feel this is truly necessary, but it's a good idea unless you can eat all organic, free-range foods. I use Rainbow Light's Complete Prenatal System. They're big, green, and smell like grass. Mmmmm. I also take fish oil capsules because we don't have access to good seafood here in the Midwest. (Read Michel Odent's fascinating article on the role of fatty acids from seafood.) I took vitamin B6 supplements during my first trimester. I didn't really get sick at all--just a few weeks of feeling blah and "off." Was it the B6? Who knows...

4. I keep track of my uterus' growth by measuring fundal height. I note how my fundus is growing in respect to certain landmarks--3 fingers above the belly button, etc. I also get out my handy dressmaker's measuring tape and measure in centimeters from the pubic bone to the top of the fundus.

5. I listen to the baby's heartbeat and placenta with a fetoscope. I bought the cheapest model I could find for $13 and was able to locate the heartbeat around 16 weeks. I usually count the heartrate when I listen. So far it's been consistently in the 150s. It's fun to locate the placenta; it makes a swooshing/rushing noise in synch with my own heartbeat. Last I checked, mine was on my left side about waist high.

6. I weigh myself occasionally. So far I have gained about 18 lbs (as of 28 weeks gestation). Most of the weight gain occurred while I was in France over the summer.

7. I pay attention to the baby's movements and enjoy the acrobatics. As the pregnancy advances, I've noticed more distinct kinds of movements: kicks, punches, rolls, stretches. This baby likes to move its hands on my lower left side, and kick on my upper right.

8. I checked my hemoglobin level 2 weeks ago. It had fallen from 13.6 pre-pregnancy to 12.9. A stable or rising Hg level is the earliest indication of an inadequate blood volume expansion (due usually to inadequate nutrition), which if unresolved can lead to metabolic toxemia. I was reassured that my blood volume had expanded, although I am still vigilant about my nutrition.

9. I sleep as much as my body needs. I can usually get enough at night, despite waking up several times to go the bathroom, but I take naps if I feel the need.

10. I check my blood pressure occasionally, perhaps twice so far. I haven't checked it since I went to France, so I might again out of curiosity. Blood pressure can fluctuate tremendously depending on a woman's environment and stress level, so it's not something I am terribly concerned about monitoring.

11. I read, read, read. I love my textbooks by Anne Frye (Holistic Midwifery vols 1-2 and Understanding Diagnostic Tests). I talk to my midwife friends if I have questions. I search the internet. Most of all, I enjoy my pregnancy and the sense of discovery that comes when you take care of yourself, rather than waiting for someone else to tell you if you're healthy or not.

12. I keep track of these things, and more, on these nifty "Moon Charts" that I made. They're loosely based on fertility charts from the book Taking Charge of Your Fertility, but with lots of extra columns added for pregnancy stuff. I just started my 8th moon chart (they are 4 weeks each).

7 comments:

  1. Very cool post, Rixa! Sounds like you're having a lot of fun! I am a regular swimmer, pregnant or not, and it feels especially wonderful the more preggo you get!

    Could you help me understand the hemoglobin bit? I'm about to go and get my first blood test, though I don't think they have my pre-pg values, but 6-7 weeks shouldn't make a big diff, right? So my question is, my memory is vague, but I thought they check to make sure it stays high enough -- but you say there should be a decrease. Not necessarily a contradiction, but I wonder about the values and ranges and stuff.

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  2. You don't need a pre-preg value. Most midwives do the initial test early in pregnancy, by about 12 weeks. I just happened to have mine tested before I got pregnant (as part of IVF stuff).

    Hemoglobin is kind of complicated, and the numbers mean different things depending on who you talk to. If it's extremely low (ie anemic) then you'd want to increase your intake of iron-rich foods, since a super low Hg level can make it more difficult to recover *if* you hemorrhage. It doesn't make it more likely that you will, just more dangerous if you do.

    But on the other hand, you do want to see your Hg levels drop a point or so by 24-28 weeks. This indicates that your blood volume has expanded and thus that it's sufficient to nourish the baby and placenta. You can read more about it in Anne Frye's books. Really fascinating explanation. She has more info about specific numbers and such.

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  3. I know this is quite an old post (I found your blog through the unassisted birth LJ community), but could you share your Moon Charts? I've been charting my cycles for years on fertilityfriend.com, but I'd love to see yours.

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  4. I will see how I can post them...they are Word documents. Keep posted for updates.

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  5. Hi Rixa, I know this is an old post but I am curious about your take on prenatals. I have been looking up the ingredients in prenatal vitamins lately. After trying to get pregnant for 3 years I switched vitamins (I was taking the Rainbow Light's) and got pregnant the first month after stopping them. Many of my friends who are also "natural foods" supplement users have had similar long term issues with pregnancy and miscarriage. One of the ingredients in the Rainbow Light formula is rutin. I basically plugged in each ingredient name and "pregnancy" and did an internet search. It appears from many different sources that rutin is an abortive and often used for birth control. I was amazed at many of the search results from midwives and medical studies explaining the ingredient is unsafe during pregnancy. I am just wondering if you have come across any information regarding the additional elements in prenatals that may be doing more harm than good. Thanks for such a great blog! I really enjoy it and admire what you are doing.

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  6. Rixa, I had a client today (that reads your blog regularly) mention that she was concerned about Rainbow Light prenatals because of a post one of your readers made about them causing miscarriages. I am a huge fan of Rainbow Light so searched for this post and found the post about RUTIN. I am unfamiliar, but Wikipedia does give some information here: http://en.wikipedia.org/wiki/Rutin. None of that seems concerning and I'd like to write Rainbow Light and ask more specifically about the ingredient; however, as I look at the bottle I have here in my office, I don't even find that particular element listed on the label. I noticed you didn't respond, but I was curious if you were aware of any other moms with similar circumstances or thoughts?

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