"Due Date" Blues
-by Pamela Hines-Powell, CPM, LM
This is the time in the pregnancy where it becomes
a real pain in the ass to be a pregnant mama.
Everyone calling your house, asking if you've
had the baby yet. Have they forgotten that you
told them you would call them right away when
you did have the baby? "Oh, I'm sorry, Uncle
Fred, we had the baby two weeks ago and just completely
forgot to call anyone..."
Within the medical model of (s)care, the placenta
is viewed as an organ that has an expiration date.
Just completely fails at a certain date. We know
from studies and experience that this is not true.
A placenta CAN start to deteriorate at any point
in the pregnancy- usually from poor nutrition,
smoking, or unknown causes. For normal, healthy
pregnant women, the placenta is an incredible
ever-changing organ specifically designed to meet
the needs of the baby. I trust that
our bodies are wise and know exactly when the
perfect time for birth is. Our western model
of medicine does not have that same trust.
This does not mean that I am naive. That I don't
realize that these babies that go longer sometimes
need to be watched a bit closer in labor. The
vast majority of the time, things are beautiful
and go well without any help from me.
What is the DUE DATE, really? It's an approximation
of gestation. What influences gestational length? Many
things COULD influence it- we don't know for sure.
Sometimes familial history, baby's health, mother's
health, etc.
What I do know is that most women aren't able
to find out how long their babies "cook"
for- they are routinely induced on their due date,
sometimes before. This is not a fault necessarily
of our medical system. Women ask- BEG- to be induced.
They need to know in their last month of pregnancy
how far dilated they are. Family and friends now
have enough information about labor/birth that
they ask. Just like asking if people are having
a boy or girl- it's just expected that after you're
prenatal you'll be able to report to Aunt Susan
the condition of your cervix. Most women
(or their partners) in their last month of
pregnancy don't touch their vulva/vagina as often
as their care providers do! This should be reversed-
less touching by those not intimately involved with
them- more touching in loving, feel-good ways
by themselves and those that are in love with
them!
Besides, what the cervix looks like doesn't matter.
I've seen mamas at 5cm for weeks. I've seen women
be closed and thick one day, then start labor
the next and have a smooth, fast labor.
It's no indication of WHEN that twinge will turn
into the "real thing".
Since so many labors are started for convenience,
many people get freaked out if a woman is over
her due date. There must be something wrong, they
chatter amongst themselves. "How long will
you let her go?" is a common question I'm
asked by relatives and friends. Like it's
my journey- like I dictate when labor starts. I
usually smile and remind them that the baby is
doing fine, and that mom is healthy. We cannot
ask for anything more than that- and we are grateful
to have that.
The longest I had a client go? Well, we
weren't completely sure of her dates, but if we
went by her one and only period (she was nursing),
then it was five weeks past the due date. However,
after the birth and all (from looking at her baby),
I would guess she was only a week over. It's pretty
rare to have a mama go a full four weeks or more
after the due date. Not unheard of, just rare.
Usually it's a dating issue. This mama labored
beautifully and had a VBAC at home- after being
told she had a pelvis that was too small to birth
a baby (and this baby was only six ounces less
than her big brother).
That five weeks, though, was not easy. We ended
up doing some testing and a biophysical profile
at week three- which revealed all was well. The
nurses at the hospital, however, were flipping
out. They couldn't believe it...even after I explained
the whole dating thing and her nursing - that
we weren't sure about the dates. The physician
we scheduled the testing through spoke to me on
the phone at the nurse's station... "Get
out of that hospital now before all hell breaks
loose! Don't stay any longer!" We had
the doc on our side- and managed to slide out
peacefully.... but not without two nurses tentatively
asking me, "How much longer are you going
to let her go?"
Self-nurturing is important these last weeks.
Massage, baths, going to movies, crying, laughing,
and spending time with friends and your partner
are important. So is not answering the phone. Having
a blessingway. Making a belly cast. Getting a
facial. A haircut. It's all about self-love and
savoring those last few days/weeks where your
baby is much more portable and easy to carry about.
I usually call my past dates clients a couple
times a week, aside from our regular prenatals,
to check in. I make sure, usually from their partners,
that they are releasing emotion (although, most
of the time, the tears flow easily at the visits
when asked) and that there is no undue pressure
from the outside about the dates. We go over conception
dates, last menstrual period dates, and varying
ways to determine due dates beyond the typical
common method (Nagle's Rule). We play with baby
through palpation more at the visits. I listen
to baby longer, expecting rises in the heart rate
with movement and some variability in the rate.I
make sure mom is feeling safe and supported- and
that there is no underlying fear holding her back.
We wait together. My family waits...
Still, I think I have the easiest time waiting.
My back doesn't ache, I don't have heartburn,
I'm not looking microscopically at the toilet
paper for plug or bloody show, and my feet aren't
swollen. I don't have the cashier at the grocery
store tsk-tsk'ing me when I come in STILL pregnant.
Pamela Hines-Powell, CPM, LM
Circle
of Life Midwifery
Salem, Oregon
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