Thursday, August 29, 2013

Labor and Birth Myths: Fact or Fiction?

This post will be all about myths surrounding labor and birth! Again, if there's anything that you'd like me to address that isn't covered in this post, let me know and I'll look into it!
  • Routinely pushing and/or laboring on your back is the best way to labor and give birth: FALSE
    • Oh, oh, oh, this could not be more false. Think about it: you want the baby to descend into the birth canal, put pressure on your cervix so that you will dilate and efface, and for your pelvis to open up and stretch so that baby has room to come out, right? So, how does it make sense to lie back (forcing baby and your body to work without the help of gravity), and have your legs together in bed while laboring (which doesn't exactly open your pelvis), and push while supine (which keeps your pelvis closed and again takes away the benefit of having of gravity working for you). The best, most physiological positions for labor and birth are standing, side-lying (with the legs open, usually with the help of your OB/midwife/nurse/doula/partner), sitting on a birthing ball, squatting, and on hands and knees. The pelvis can open wider this way, which facilitates descent of the baby and mother's dilation/effacement, and reduces the likelihood of things like tearing, poor fetal positioning, back labor, and baby getting "stuck." Movement in labor (such as walking, rocking, crawling, and swaying) are also good pain management techniques.
    • Here are some sources on the matter:  http://evidencebasedbirth.com/what-is-the-evidence-for-pushing-positions/ , http://www.birthingnaturally.net/birthplan/options/push.html , http://www.bestchance.gov.bc.ca/birth/preparing-for-labour/comfort-positions-during-labour.html
  • You should not have food or drink while in labor: FALSE
    • This is an old myth. It comes from the idea that a woman can aspirate (essentially vomit and it goes into her lungs, to put it simply and bluntly) if she has to be put under general anesthesia during labor. Good reason, right? Well, not really, actually. The likelihood of that occurring is less than the likelihood of being struck by lightning. And even if your stomach is empty, that is no guarantee that you will not throw up stomach acid (I certainly did in my first labor), which will get into your lungs and cause the real damage if you aspirate. Also, fasting during labor has been associated with longer and more painful labors, maternal exhaustion and low blood sugar issues, and dehydration. IV fluids can help, but they're not the same, and they carry some risks. And the likelihood of actually needing general anesthesia to perform a cesarean is miniscule, due to our modern advances in regional anesthesia (spinal block, epidural, etc), so this notion is quite outdated. 
    • So then, why are we adhering to a practice that has no basis in evidence, and is doing more harm than good? Luckily, policies are starting to change, thanks to recent studies. I personally was allowed to drink as much water as I wanted while in labor with my second (I did not want to eat due to vomiting, and my labor was fast anyway), and it made a world of difference.
    • Good articles and sources with recent studies: http://evidencebasedbirth.com/q-a-food-and-drink-during-labor-9/ , http://summaries.cochrane.org/CD003930/eating-and-drinking-in-labour , http://www.ncbi.nlm.nih.gov/pubmed/21073829 , http://www.sciencedaily.com/releases/2010/01/100119213043.htm
  • Modesty will matter to you when you're in labor and giving birth: FALSE
    • Don't worry, I was freaked out about this, too. I was worried about having my nether regions on display while being checked, pushing, and everything in between. I didn't want everyone in the room (I think there were four nurses, my husband, and my OB in the room with my first was born) staring at my ... you know. But when the time came, I honestly didn't care. I didn't think twice about having my L&D nurse down there helping to stretch me and using perineal counterpressure as I pushed. I didn't even think about it. Second time around, I cared even less. Once you're there, you really won't be thinking about modesty: you'll be focused on dealing with labor and the excitement of meeting your baby.
    • This doesn't need any sources. It's a mom thing :-) 
  • Labor always starts with your water breaking: FALSE
    • Just from my personal experience, I can tell you that this is false. My water has never broken on its own. With my first, the OB broke my water (routinely and unnecessarily) at 6cm, and told me that I had very thick membranes. With my second, my midwife broke my water right before I started pushing in earnest, because my bag of waters was bulging into the birth canal (I had excess amniotic fluid) and preventing my daughter's head from fully engaging. She also commented how think my membranes (amniotic sac) were, and said that they probably would not have broken on their own.
    • Only about 10% of labors begin with the water breaking. Your labor starting will more than likely not be the embarrassing moment in the grocery store that you see on TV, where a mother's water breaks and she's standing there in a puddle of amniotic fluid and screaming that she has to get to the hospital right now. Not only is SROM (spontaneous rupture of membranes) statistically unlikely to happen without noticeable contractions, but when your water breaks, it is unlikely to be a huge gush like that. If you are standing or sitting and baby's head (or any other body part) is blocking your cervix, the amniotic fluid won't be able to escape as well, and you may only notice slight trickling, and it may not even be a steady flow. It may become more noticeable if you lie down, but it still probably won't be the flood most first-time mothers imagine. 
    • Resources on this subject:  http://www.bellybelly.com.au/birth/waters-breaking#.Uh--ej_wa1s , http://www.mayoclinic.com/health/water-breaking/MY01442/NSECTIONGROUP=2 , http://www.parenting.com/article/labor-and-delivery
  • You need to go to the hospital the second you start having contractions: FALSE
    • "Come to the hospital once your contractions have been 3-5 minutes apart and longer than 30-45 seconds for at least an hour." Ever heard that? I did. And that's what I did. I arrived at the hospital for my first at only 3cm dilated. And I then got stuck in bed, unable to move, vomiting uncontrollably, and ended up with all kinds of interventions that I didn't want (iv fluids, continuous monitoring, blood pressure cuff, stadol in my iv, anti-nausea meds, and an epidural). Evidence suggests that if you want to avoid interventions and you are low-risk, you should stay home as long as possible before heading to the hospital (or birthing center, or before calling your midwife if you're having a home birth). The rule of thumb is that if you are having trouble walking and talking during contractions, or you are starting to sound "grunty" during intense contractions, you should get going. 
    • If you live a good distance from the hospital and you're worried about making it there in time, call your doctor/midwife, and they can help you decide if you should go in yet or not. But remember, early labor, especially in first time moms, can last for hours (even days for some), so heading to the hospital too early, just to be told you haven't progressed enough to be admitted (or aren't in active labor at all), can be a big disappointment. It's much more comfortable to labor in your own home, where you can eat, drink, bathe, shower, sleep, and do things your way while in early labor. Going in too early can mean taking the control out of your hands, and putting you on the hospital's timetable (which may not be evidence-based care). 
    • Also, if your labor stalls at any point (which is perfectly normal), you may be diagnosed as a "failure to progress," and your labor could be augmented, or you could be sent in for an unplanned cesarean, whereas if you labor where you're more comfortable and off of the "hospital clock," you might be able to wait it out and give your body the time it needs and not fall victim to a doctor's "failure to wait." If such interventions are things you want to avoid, it's best to stay home as long as possible before you head up to the hospital.
    • Some sources: http://www.babies.sutterhealth.org/laboranddelivery/labor/ld_when-hosp.html , http://pregnancy.familyeducation.com/labor-and-delivery/signs-and-stages-of-labor/35965.html , http://pregnancy.about.com/od/laborbirth/f/goingtohospital.htm
  • You are in active labor at 3-4cm dilation, even without effacement, regular contractions, etc.: FALSE
    • I wasn't. I walked around at 4cm dilated and 60-80% effaced, with prodromal labor, for weeks with my second before I went into real, active labor. Some women dilate as much as 6cm before active labor starts. If my midwife had gone simply off of my dilation and had augmented/induced my labor, my daughter would have been born too early. Some women take longer to dilate. Some dilate faster. Some aren't in active labor until more like 6-7cm. The definition of active labor has to be flexible, because no two women are going to dilate at the same rate. Dilation in and of itself isn't the "be all, end all" deciding factor in labor. 
    • I blogged about this, and had some good sources in that post, so I'll just link it here as my source: http://mamadoulayourway.blogspot.com/2013/08/cervical-dilation-and-effacement-prior.html
  • Medications (epidurals, iv pain meds, pitocin, etc.) in labor don't affect the baby: FALSE
    • I have blogged about this one recently. Think about it this way: if you would avoid medications in pregnancy, because they might affect the baby, why are medications in labor any different? Labor meds like pitocin, morphine, stadol, demerol, and epidurals are much stronger than tylenol and the like, and carry more risks. Medications don't stop crossing the placenta and getting to baby just because you're in labor.
    • Just going to link my blog post here, because I had good sources cited there:  http://mamadoulayourway.blogspot.com/2013/08/medications-in-pregnancy-vs-medications.html
  • The pain of labor serves no purpose: FALSE
    • I'm not going to lie: birth hurts. There's no way of getting around that. I know that everyone has different perceptions of pain, and what might be the worst thing in the world for one is a breeze for another, but it is exceedingly rare for a woman to say that her labor didn't hurt, and that she experienced no discomfort or anything at all (and I don't really believe the ones who say it, either, do you?). But the pain really does serve a purpose, even if it just means that you're refusing medications and avoiding those risks.
    • Second (after avoiding the risks), natural labors tend to be shorter. Mothers refusing pain medications tend to move around more in labor, which (as discussed above) helps baby to put more pressure on the cervix, which facilitated dilation, and the pelvis has an easier time opening. Without the numbing effects of an epidural, women can push more effectively, which shortens the pushing phase, too.
    • Recovery tends to be faster. The endorphin and oxytocin release after a spontaneous, unmedicated labor plays into that, as does the lack of medications coursing through the body. Fewer interventions usually means less to recover from (iv's, effects of medications, episiotomies, etc.)
    • There are fewer effects on the baby, and babies born without medications are often more alert, have higher APGAR scores, and breastfeed sooner and more easily.
    • Sources:  http://news.bbc.co.uk/2/hi/8147179.stm , http://naturallysavvy.com/Nest/the-benefits-of-natural-childbirth
  • Medical interventions (in non-emergent situations) always improve outcomes for mom and baby: FALSE
    • Let's just refer back to that table I'm so fond of for this, shall we? 
 
    •  So basically, very very false. Modern interventions have gotten us a 1 in 3 induction rate (which is not supported by evidence), a 1 in 3 c-section rate (also not supported by evidence), and procedures that are also unsupported by evidence are routinely practiced, and they do more harm than good.

  • If your labor stalls or slows down, that automatically means something's wrong and you need a c-section ("Failure to progress"/The Friedman Curve: FALSE
    • Oh my, is this ever false! This goes back to the "one size fits all" box that care providers try to stuff women into regarding birth timelines. No two women will dilate at the same rate, and there are often natural "plateaus" in labor with little to no cervical change, and these women are often mis-diagnosed as a "failure to progress" and sent to the OR for a cesarean (even though mother and baby are still doing fine), when really, all they need is more time. The Friedman's Curve (which is the method most care providers adhere to when it comes to dilation) is over 60 years old, and based on a study that only included 500 women. 500. That is not a very big sample size, especially by today's standards, and the study is very outdated and frankly incomplete.
    • Here's my new favorite article on this matter. It contains lots and lots of other sources for good information:  http://evidencebasedbirth.com/friedmans-curve-and-failure-to-progress-a-leading-cause-of-unplanned-c-sections/
  • You have to do everything suggested to you, you don't call the shots in your labor and hospital policy trumps maternal autonomy: FALSE (mostly)
    • Sadly, this is becoming less and less of a myth. It should fall to the mother to call the shots when it comes to her body and her baby, but more and more moms are falling victim to hospital policies, insurance demands, and doctors who don't practice evidence-based care. Mothers should have autonomy when it comes to birth, but in some places, that is not the case. In an ideal world, this is a truly false myth.
  • L&D nurses/your midwife or doctor/your partner serve the same purpose as a doula: FALSE
    • No. Way. Labor and Delivery nurses, more often than not, will have other patients besides you to care for, and will not be able to stay in the room with you at all times and provide the individualized comfort measures that your doula can, nor will they know or be guaranteed to respect your birth philosophy. Even the very best of nurses may not agree with you, know the techniques you'd like used, or have the time to devote to you.
    • Your partner should be a good supporter, but it's a lot of pressure to put on someone who is also as invested in the experience as you are. A doula can be just as helpful to your partner as to you, the laboring mom. Your partner will most likely not have the experience and education that your doula will have, either, and therefore may not be as effective an advocate for your rights should anything go awry.
    • Your OB or midwife, like the L&D nurses, likely has other patients to tend to, and will not be able to give you constant support like a doula can.
    • The long and short of it is, your doula is there to focus on you and your partner, and do whatever you ask. She only has you to focus on; no other patients, nothing.  
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Tuesday, August 27, 2013

Medications in Pregnancy Vs. Medications in Labor: Why is One Frowned on, but Not the Other?

I think I still have the paper my midwife gave me in my second pregnancy that lists the medications that are safe to take during pregnancy. The strongest one listed is Tylenol, followed by antacids and some nausea medications. I remember being told to call with any questions regarding unlisted medications and homeopathic remedies, because some are unsafe during pregnancy and could potentially have side effects for me or the baby. I was also instructed to limit my caffeine intake, eat a balanced diet, cut out alcohol (except for the occasional sip), avoid fish that might contain mercury, not lift anything heavier than my toddler, and to be sure to get plenty of rest (especially once I started experiencing prodromal labor at 37 weeks).

And you know what? That was all good advice! It is best to not smoke, drink, have caffeine, eat questionable fish, and lift anything too heavy while pregnant. It's best to avoid most medications and herbal treatments, because they carry risks. Why risk anything while carrying a child, right? Sure, I may have had a sip or two of alcohol here and there, I had small amounts of caffeine, and getting enough rest was next to impossible with a huge belly, a toddler to chase, a household to run, and the process of house hunting/packing/cleaning/moving, but I still took it easy as much as I could and didn't take any real chances, because my health and the health of my baby came first.

So why, then, if we take all of these precautions during our pregnancies (who avoided mayo and lunch meat while pregnant?), why then do we accept all kinds of medications and procedures and the like during labor? Why is that somehow okay? Why is it that we will endure endless headaches, backaches, and the like during pregnancy and not take anything too strong because of the potential risks, but we're so quick to induce, take pain medications such as epidurals, routinely have iv's, and so on, without talking about the possible risks? Why is one a no-no, but the other is just fine?

Do you know the risks of having an epidural as well as you know the risks of, say, drinking alcohol during pregnancy? At least 60% of women in labor will have an epidural, but I wonder how many of them know what the risks are, how likely they are to occur, and what effect they can have on the path of their birth experience. They aren't a miracle drug that takes away the pain with no consequence. If you would check into medications during pregnancy, why not those used in labor?

Then there's pitocin. Did you know that it is not indicated by the manufacturer for use in elective inductions? Do you know why? Do you know what risks it carries to both mother and baby? If you refuse vaccinations for your child because you are concerned about vaccinations causing autism and such, you should also look into the recent studies that are showing a possible link (at the very least an association) between pitocin and autism. Is it definitive? No (but neither are a lot of the studies/findings linking vaccinations to autism, etc). If you're concerned about taking anything stronger than Tylenol while pregnant, and you intend to not vaccinate, you should at least look into pitocin, too. The risks are greater than most doctors would lead you to believe.

The same goes for any medication used during, or to induce, labor. Prostaglandins like cervidil (the use of which is contraindicated in patients who are already receiving intravenous oxytocic drugs such as pitocin), cytotec (which the manufacturer recommends against using to induce labor), stadol (which carries a slight risk of infant respiratory distress and will make you loopy), demerol (which can also depress the fetal respiratory system), and nitrous oxide (which is essentially the laughing gas your dentist uses to get your through dental procedures, and can cause dizziness, decreased memory, and even unconsciousness).


Medications don't magically stop crossing the placenta and affecting baby just because you are in labor. The hypocrisy of doctors handing out pamphlets of all the foods, medications, and activities you should avoid during pregnancy and why, but then turning around and pumping you full of drugs once you're in labor (or to start/augment it) without discussing the side effects or offering alternative, natural, risk-free forms of pain management (such as walking, massage, acupressure, water immersion, etc.), is astounding.

You have to do your research before you go into labor. Know what the risks are. Know what side effects any drugs in labor may have. And then, once you're there, you can decide for yourself if the benefits outweigh the risks, with all the pertinent information in hand. But I repeat: if you're so terribly worried about taking anything during pregnancy and/or vaccinating your baby, you should think twice about things like pitocin, epidurals, and other forms of pain management and labor induction/augmentation. The risks are real, and you should know them so that you can make the best choice for yourself and your baby.
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"Watch Your Language!!" Word Choices Regarding Birth Really Matter

"Well, I guess we'll let you try..."

 "Just section her..."

 "We won't allow you to go past 39 weeks..."

 "She's a FtP (Failure to Progress)..."

 "Pit (pitocin) her, she's not dilating fast enough..."

 "You have to have continuous monitoring, it's policy..."

 "Your pelvis is too small, you are incapable of natural birth..."

 "You can't opt out of that, it's routine..."

 "Your last birth was a failed induction turned section..."

 "You didn't..."

 "You shouldn't..."

 "You can't..."


Ever heard any of this from your doctor? Know someone else who did? It hurts, doesn't it? "Sticks and stones" doesn't apply to birth. Childbirth is one of the most powerful experiences a woman will ever have, yet such little respect is shown by our doctors to the actual experience of it, that such language has become commonplace. That doesn't make it less painful to hear, from doctors or fellow moms.

"How many moms do you know who had a cesarean birth?"

Do you see what I did there? I called it birth. Because that's what it is. See what a difference that made? It made it personal. It made it acceptable. It softened the whole sentence. You never know how someone really feels about their birth experience. And words really can hurt them if they're not happy with the way things went. So when we talk to other moms about birth, maybe we should try to be more sensitive in terms of our language, and show some respect. Because even if they did choose it, hearing their choices belittled with such derogatory language is hurtful.

It's even worse in the medical world. The labels that are given to women (failure to progress, fauliure to descend, failure to go into spontaneous labor, "attempting" VBAC/ToL, "Pit"-ing women who aren't dilating fast enough, etc.) are downright insensitive. Who wants to hear that they are a "failure" at something that "should" come completely naturally: giving birth? Have you ever had a doctor say they wouldn't "let" or "allow" you to do something, or that they would "require" a certain procedure or policy, even if it was directly against your wishes? Has a friend ever told you that something along those lines was said or done to them? How did it make you/them feel?

Whose birth experience is this, anyway? Whose body are we talking about here? What right do they have to tell you that you "can't" go for a VBAC, or refuse an iv or continuous monitoring, or move around in labor, or anything else you might want to do? If you are willing to accept the consequences of your choices, then the fault is out of their hands if anything goes wrong, so why the limitations? Why this language of "let" and "allow" and the like? It's destructive, it does nothing to facilitate confidence going into birth, and it is often the reason that women allow themselves to be bullied into a birth experience they don't want, because it's their "only option."

So let's be mindful of our words. I know I need to be conscious of mine sometimes, too. Words can indeed hurt you. So if we change our mindset and watch our language with each other, and insist on the same from our care providers, things will get better. These birth experiences are ours, so we should be in charge and own them, even just with our choice of words.
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Tuesday, August 13, 2013

Pregnancy Myths: Fact or Fiction?

    In this post, I'm going to address some of the most common myths surrounding pregnancy that I've heard, both lighthearted and more serious. If, after reading this, you think of any myths I've missed, feel free to comment and I'll do the research for you! Enjoy!
    • If you have lots of heartburn in pregnancy, it means your baby will have tons of hair: PLAUSIBLE
      • This was completely and totally untrue for me. I had very little heartburn in my first pregnancy, and absolutely constant, horrible heartburn in my second, and my girls were born with about the same amount of hair. In fact, my second had a bit less hair, and she was the one who gave me such awful heartburn. So in my case, this myth is totally false. HOWEVER, there have been studies done that seem to say that this myth has a scientific basis in fact. Apparently it has to do with estrogen levels causing the esophageal sphincter to relax, which causes heartburn, and estrogen also appears to be responsible for hair growth in the baby. So heartburn isn't caused by hair, or hair by heartburn, but there is a hormone present that can cause both. The only significant study I've found on this only included 64 women, and it's still not definite that if you have heartburn you'll be guaranteed to have a baby with lots of hair, but there may be a correlation between the two. 
      • Here are the articles I found about this: http://www.cbsnews.com/2100-500202_162-5276102.html , http://voices.yahoo.com/pregnant-mothers-heartburn-expect-babies-451594.html?cat=25

    • Pegnant women are ticking time bombs for a million problems, no matter how healthy they are: FALSE (sort of)
      • In a healthy, low-risk mom, it is extremely unlikely that she will encounter any complications in her pregnancy and birth. To treat symptoms that aren't there "just in case" they pop up is more likely to cause problems than prevent them. According to the WHO (World Health Organization), only about 15% of pregnancies worldwide really need emergency obstetrical care because of "risks that are difficult to predict." That means that you have at least an 85% chance of nothing at all going wrong, no matter where in the world you give birth. In a developed nation, with access to good prenatal care, your chances of a having successful, healthy pregnancy and birth can do nothing but increase.
      • All that being said, problems can arise in the best of situations, so this is why it's good to be cared for by a doctor or midwife. Keeping an eye on your health, in the unlikely event something should go wrong, is different from insisting on test after test, policy after policy, for women who show no signs of needing them. Assuming the worst will happen does nothing but create fear. But trusting nature isn't enough; nature isn't perfect. Good prenatal care, with a watchful eye there to catch any legitimate issue before it becomes an emergency, is what's needed.
    • There's no need to worry about forming a birth plan and/or discussing it with your care provider till you start approaching your due date: FALSE 
      • This could not be more untrue. An integral part of ensuring that you receive evidence-based care that is tailored to you, and achieve the birth experience you want, is first knowing what you want, and having a supportive care provider! How are you going to know if you have a supportive care provider if you don't talk to them about your wishes before it becomes an issue? The last thing you want is for them to pull a bait-and-switch on you at the last minute, so check their c-section/induction/etc. rates, ask them about their birth philosophy, educate yourself on how to best achieve what you want out of your pregnancy and labor, and make sure you and your doctor are on the same page before you reach a critical point. This is why you interview doctors. You re hiring them to perform a service for you, and if you are not comfortable with them for any reason, or your birth philosophies don't match up, you need to know that ahead of time, before you get in too deep. No references are needed for this; it's just common sense.
    • You should  never eat sushi, cold cuts, mayo, etc., or have ANY caffeine or alcohol, while pregnant: FALSE(ish)
      • The general rule is "everything in moderation." Yes, there are fish you should avoid while pregnant (and in childbearing years) due to the risk of high mercury levels. However, pregnant women in coastal and island nations have been eating raw fish since their cultures began, and they give birth to perfectly healthy babies. Should you be sure that your fish is fresh? Yes. Are there precautions you can take to protect yourself and your baby? Absolutely. Should you avoid sushi altogether with no exception? No. Want a personal story about it? I ate almost nothing but sushi throughout my second and third trimesters with my first baby (can you say cravings?), and she's just fine. Does that mean everyone will be? No. It just means that it's not a definite issue. Like anything in life, exercise caution.
      • Reference: http://www.babymed.com/food-and-nutrition/how-safe-it-eat-sushi-or-raw-fish-during-pregnancy
      • The same goes for mayo, cold cuts, and most anything else food-wise you hear about during pregnancy. The risks people talk about are still present when you're not pregnant, and they are so small that if you simply make sure your food is fresh and properly stored, you really don't have much of anything to worry about. Now, you probably should avoid unpasteurized cheeses and such (bacteria), but really, there are far more important things to be concerned with during pregnancy. Again, a personal story: I ate both mayo and cold cuts while pregnant with both girls, and again, both are fine. Be safe, be smart, be hygienic, and you've probably got nothing to worry about.
      • Then we come to the caffeine debate. Most experts agree that 150-300mg a day of caffeine won't have much of an effect one way or another, and is safe during pregnancy. My story? I drank coffee and sodas with caffeine while pregnant. Every now and then, I might have had a little more than the "recommended" amount. And my girls are fine. Everything in moderation, as I said before. 
      • Reference: http://americanpregnancy.org/pregnancyhealth/caffeine.html 
      • And last, but not least, alcohol. There is no amount that is agreed upon by medical professionals to be "safe," but 1 in 8 women in a recent CDC study admit to drinking a little during pregnancy. I did it myself, very rarely and moderately, and once again, my girls are perfect. Do I think that automatically makes it okay for everyone? No. I was very healthy, with no real complications that could have been worsened by 1/4 a glass of wine once a month. It was my choice. It really comes down to that: mother's choice and extreme moderation, in this case.
      • References for this: http://www.medicalnewstoday.com/articles/262063.php , http://www.theguardian.com/lifeandstyle/2013/jun/18/drinking-moderation-pregnancy-baby-development , http://www.cbsnews.com/8301-204_162-57589867/moderate-drinking-during-pregnancy-may-not-harm-babys-neurodevelopment/ ,  http://americanpregnancy.org/pregnancyhealth/alcohol.html , http://www.sciencebasedmedicine.org/alcohol-and-pregnancy/
    • Stress is "bad for the baby," and your mood directly affects baby's development: PLAUSIBLE
      • Everyone know that stress is bad for you. In anyone, it can cause anxiety, depression, and any number of physical symptoms. Of course that's going to affect a pregnant woman, whose hormones are insane anyway, even more. Some studies suggest that babies of moms who experienced extreme stress while pregnant may have a higher chance of asthma and allergies, so it is plausible that your stress can have an effect on your growing baby. Ask your friends and family to respect your condition and not stress you out, try to remove as much stress as you can from your life (easier said than done, I know), and take time every day to do something just for you.
      • References for this:  http://www.naturalnews.com/023611_stress_pregnancy_asthma.html , http://www.medicinenet.com/script/main/art.asp?articlekey=51730
      •  It also seems likely that severe moodswings can indeed have an effect on babies in the womb, too. Hormonal changes from these intense shifts in emotion can reach baby, apparently. Common sense again comes into play here. If you are under intense stress or experiencing moodswings, try to make time for yourself every day. Don't forget to indulge, because you matter, too. And while you are your baby's home, you (and your emotional state) are of utmost importance. Do I think this means that you should be as serene as a pond on a day without wind at all times? Um, no. I've been pregnant twice. That is utterly impossible. Just try to relax when you can.
      • Some sites with more information:  http://news.bbc.co.uk/2/hi/health/1517520.stm , http://www.world-science.net/othernews/111117_depression.htm , http://www.livescience.com/17126-pregnancy-mothers-mental-state-baby-development.html
    • Cocoa butter prevents stretch marks: FALSE
      • This comes down more to your genetics than anything. If you have very dry skin (like me), you're more likely to develop stretch marks in pregnancy than someone with more elastic skin. Stretch marks are caused by the skin being stretched quickly, giving the skin insufficient time to adjust, and so the marks form. Here is a good article that details the science of stretch marks. 
      • As far as cocoa butter goes, well, it can't hurt, right? Using lotions, bio-oils, and such can help improve your skin's elasticity and ability to stretch, but some women are just doomed to sport the marks. I'm one of them. I applied high-quality cocoa butter, gifted to me by my grandmother (who herself gave birth to 5 children), at least twice a day while pregnant with my first. It didn't help. I still developed huge, red marks, mostly on the lower left side of my belly where my daughter most liked to rest herself. I didn't get very big in my first pregnancy, so I didn't get a lot of the marks. The second time around, however ... It was bad. I still used my cocoa butter, mostly to ease the terrible burning and itching of my skin as it stretched, but I still got awful stretch marks all over my belly and thighs (I got bigger the second time around, which is totally normal). There were times when I thought my daughter was going to burst out of my belly, the skin just couldn't stretch anymore! So no, cocoa butter won't "prevent" them if you're genetically predisposed to them (ask your mom about hers, for some insight into what yours might look like), but hey, it's not going to do any harm, so you might as well give it a shot.
      • Here are a couple of articles on the matter:  http://www.foxnews.com/story/2008/08/06/sorry-ladies-cocoa-butter-does-not-prevent-stretch-marks/ , http://www.foxnews.com/story/2008/08/06/sorry-ladies-cocoa-butter-does-not-prevent-stretch-marks/
    • Ultrasounds are perfectly safe and have no adverse side effects or risks: FALSE (to a point)
      • Ultrasound scans are made up of high frequency sound waves, used to create an image of something within your body. It's sound; shooting sound waves at a tiny baby in your womb. If you really think about it that way, it makes sense that there might be some risks involved. What are those potential risks? Studies say that prolonged ultrasounds can cause neurological damage, that the thermal aspect of ultrasounds (sound waves that don't bounce off the baby and are instead absorbed) can heat up fetal tissue dangerously, and, well, they're loud! The noise level of an ultrasound, as perceived by the growing baby, has been compared to that of a train. Not exactly pleasant, that's for sure. Both of my girls wriggled away from the "wand" they use to perform the ultrasound, as if they didn't like it. I always thought that they just didn't like the prodding, but now that I've done more research into what ultrasounds are and how they work, it's gotten me thinking.
      • Now, this isn't to say that all ultrasounds are inherently dangerous and you should always avoid them, no matter what. The point being made is that you should avoid unnecessary ultrasounds when possible, because they are not risk-free. If the risks outweigh the benefits (suspected serious problems that need to be checked out), that's a different case entirely. But begging your OB/midwife for extra ultrasounds so you can see the baby more often, or going to one of those "clinics" that does keepsake ultrasounds, probably isn't the best idea. Not only are the people in those clinics not adequately medically trained, but any unnecessary exposure, even at the hands of a certified ultrasound technician, is too much. Just as you would try to avoid an x-ray while pregnant unless it was necessary due to the potential risks, the same discretion should go for ultrasounds.
      • Here are a few of the sources I found on this: http://www.greenhealthwatch.com/newsstories/newslatest/latest0701/ultrasound-hurt.html , http://www.midwiferytoday.com/articles/ultrasoundwagner.asp?q=ultrasound , http://www.midwiferytoday.com/articles/ultrasoundrodgers.asp , http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/modernmedicine/modern-medicine-now/fetal-ultrasound-how-put-safety-first
    • You can't refuse anything your doctor suggests. Anything you doctor says is absolutely set in stone. You don't call the shots, and all prenatal tests are mandatory. Blind trust in doctors and just "being a good patient" is the best way to go: FALSE
      • This. Could. Not. Be. More. False.
      • You have the right to refuse any tests or procedures your doctor suggests. If you have to sign an AMA (against medical advice) form to get them to stop pestering you, so be it. It is your body, and your baby, and you call the shots. If it were anything other than pregnancy, this would not even be in question. Doctors cannot perform any procedures on an unwilling patient, period. You may have to look into laws in your area if it comes to more serious issues like VBAC and RCS, but the right is still yours.
      • Blind trust in doctors has gotten us a cesarean section rate of over 30%. It got us twilight sleep, thalidomide, a 1 in 3 induction rate, and 2 out of 3 women receive drugs to artificially start or augment their labor. (See this previous blog post of mine.) You don't have to be a "good patient" to get good, evidence-based care. You just have to find a care provider whose views on pregnancy and birth are in harmony with yours. Easier said than done, but as I've said before, you are hiring them, not the other way around.
    • You can't switch care providers after (x) weeks of pregnancy: FALSE
      • Well, this might have a little basis in truth. Some care providers won't accept new clients after they reach a certain point in pregnancy, but that is not the norm. It is never too late to shop around and see what your options are, if for any reason you become dissatisfied with your current care provider.
    • Weight gain requirements and limitations are a general rule and the same for everyone: FALSE
      • First, I'll start with my stories. With my first, I lost 8lbs in my first trimester, gained those 8lbs back in my second trimester, and gained 8lbs more in my third trimester. I was only 8lbs above my pre-pregnancy weight when I gave birth. With my second, I slowly and steadily gained 16lbs. I was told, based on my height, BMI, and pre-pregnancy weight, to expect to gain 25-30lbs both times. I didn't, and my girls were born picture-perfect and I was completely healthy. I have know women who gained exactly their recommended amount, some who didn't gain anything at all, and still others who gained 50lbs or more, and all had healthy babies. What is normal for one woman or pregnancy is not going to be the same as anyone else. Genetic factors do come into play, but they, like everything else, are not a guarantee. As long as mother and baby are healthy, the mom's diet is balanced and she's exercising appropriately, baby is growing well, and everything else looks good, weight gain alone doesn't have to be much of a concern. 
      • References: http://www.marchofdimes.com/pregnancy/weight-gain-during-pregnancy.aspx , http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/Weight%20Gain%20During%20Pregnancy.aspx
    • You will show sooner, and get bigger, in subsequent pregnancies than you did in your first: TRUE
      • Yes, I am dealing with a "myth" that is (often) true! Once your body has "been there, done that," especially if your pregnancies are close together, you're probably going to start showing sooner. Your uterus has stretched and grown to accommodate a baby before, so it grows much faster and easier the second (and third, and fourth) time around. Also, your abdominal muscles may be more stretched out and lax, which allows your belly to "pop" sooner. There are exceptions, of course, such as moms who have very toned abdominal muscles, or whose pregnancies was spaced out further (which gave their bodies more time to recover), etc. But the general rule is that any subsequent pregnancies will become "visible" sooner, and you're more likely to appear "bigger" as well.
      • And my sources: http://www.babymed.com/pregnancy-symptoms/why-am-i-showing-so-early-pregnancy ,  http://pregnancy.about.com/cs/secondpregnancy/a/aa051997.htm , http://pregnancy.amuchbetterway.com/your-second-pregnancy
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