And yes — this is from both my own 3 births, plus watching thousands give birth in the hospital and talking to millions online. It’s something I think about a lot.

I even did a video on it:

Low Pressure

This is the first thing that came to mind. I felt FAR too much pressure to:

• Clean my house (my husband should step it up more — I’m not saying I’m cool living with it dirty)
• Still attend all the functions
• Put myself into labor
• Manage full life postpartum

Those are just the few that came off the top of my head.

But the reality is you’re going a full on human inside of you, let that be your main goal. Allow the rest of your team to come in and do the other things.

And stop thinking you control so much (like labor) it’s just putting too much on you, and you don’t need that. You control a lot less than the world makes you think you do.

Now, this doesn’t mean you lay on the couch all day. Still use movement to your advantage. I was actually really good at doing stretching and some working out, plus my job was pretty movement-filled. But I wish I’d allowed myself more naps without feeling like I needed to do more….

Want to know more pregnancy tips — check out these posts:

• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them
• Mistakes You’re Making That Makes Labor Longer
• 5 Mistakes People Make Preparing to go to the Hospital to Have Their Baby
• 5 Mistakes People Make in Their Third Trimester

Live in a State with Maternity Leave

Clearly, you can’t really control this — but gosh, living in California with paid maternity leave was a world different in Utah where I had very few maternity leave benefits.

I had enough sick days to spread out and pay for my health insurance while I was off.

Lucky me.

I’m just saying when you’re considering where to live, especially if you want a family, this should be part of the discussion. That is all.

But, once you’re pregnant it sort of is what it is…. (and I get that).

Check out my full post on maternity leave.

Taken an Out of Hospital Birth Class

My hospital birth class just sucked.

It really made me a great patient, rather than preparing me for birth or to make choices on possible intervention.

Now, not all birth classes are like that. I taught for my hospital and I really tried to prepare them for both what to expect, and how to manage the hospital chaos. But, I think those types of classes are rare. Most nurses don’t re-design the curriculum (or have mangers who let them)…

I recommend this class. Plus, it prepares your partner too, which is a big win.

Want to know more about birth class benefits? — check out these posts:

• Do You Need a Birth Class if You Plan to Get an Epidural
• Alternatives to Hospital Birth Classes
• How a Birth Class Changes Pregnancy, Labor, Birth & Life With Baby
• 6 Lies You Hear About Birth Class
• Why are Birth Classes So Expensive?
• Do Birth Classes Improve Birth Outcomes? What do the studies show?

Kick Counts

I wasn’t the best kick counter — even though Kaiser gave me a laminated book to do them in (let’s remember smart phone apps weren’t really a thing when I was having babies).

I wish I did them better. I tried.

And honestly, that’s all we can do — but the data makes me realize the outcome could’ve been worse because I didn’t pay as close attention to fetal movement as I should have.

I may have been too busy with the dumb things in #1….

Again, your main job is to grow a healthy baby and monitoring fetal movement is one of the best ways to do that in your third trimester. AND Kick counts is an evidence-based way to do them. Grab my cheat sheet on how to do them here:

As a note, I also wasn’t great about SIDS precautions either. I think we can always look back at our parenting journey and wish we’d been a little safer. I definitely tried though, but I should’ve taken the bumpers off. I knew better.

Use a Midwife

I’m talking a Certified Nurse Midwife.

I just think they’re the bomb. There are SO many benefits to them. Most of all they tend to use less interventions and still have really great outcomes with birth.

I’d love one that is tied in well to an OBGYN office as well. More and more practices are allowing midwives to handle care, and consult an OBGYN or a perinatologist when necessary. But, you can still see them, they can help with your delivery, etc.

It works well for overworked OBGYN’s, and allows us to get better care.

I wish I’d used one, but they weren’t available where we had to have our baby — so, such is life.

If you’re not in love with your doctor, and you’re not past 30 weeks yet — check out a midwife in your area.

Again, a certified nurse midwife — abbreviated CNM — they can deliver in the hospitals and provide REALLY great care!

Check out this video with more info:

Get Induced if Needed

If you know anything about my birth story, I resisted an induction even at 12 days overdue and even when I decided on one I cried and cried.

Wasted life.

I had prodromal labor for weeks, my cervix was 5 cm — I honestly just needed my water broken to have that baby but instead I insisted that nature was the way.

I tried all the things to put myself into labor… but why on earth didn’t I just consent to an induction?

I don’t know — but studies really have proven that they’re safe after 39 weeks. I was 100% miserable being pregnant and thought I was going into labor every night. Plus, my cervix was ripe and ready.

I was dumb, I wanted control over things. Like an angry toddler I thought “I do it mySELF” — but ultimately I needed them to break my water. But oh no, there are more dumb Hilary stories ahead — keep reading!

Want to know more about preparing your body? — check out these posts:

• 4 Things You Can Do to Prepare Your Cervix for Labor
• Best Sex Position to Induce Labor?
• Pumping To Induce Labor? Will it work?
• Does Evening Primrose Oil Induce Labor?

Done Perineal Massage

I tore a lot with my first, although he was a forceps delivery, so it’s hard to know if that could’ve been avoided, but perineal massage has been proven to prevent the larger tears. I think it’s worth the effort.

Although the pre-labor-nurse-me might have felt icky about it.

The labor nurse me would’ve been fine with it.

Go Through a Birth Plan with Partner

I wish I’d thought through what I wanted for birth with my partner.

Honestly, I kept him pretty out of the loop — and he maybe could’ve talked some sense into me about the whole not being induced situation as I sat crying to him that my body wasn’t going to go into labor.

That’s what a partner is for — they’re there to talk thinks over. I wish I’d used mine more, but hey — I’m The Pregnancy Nurse — I’ve got this (spoiler alert: I did not).

We all need a partner, and I have a handy birth plan series for both of you right here:

Checked my Vitamins Better

I honestly just took whatever prenatal vitamin Kaiser sold in their pharmacy — but I wish I’d checked the levels better. The more research I’m finding out about Choline and other vitamins — I just think prenatal vitamins are something I could’ve done better on.

I like this guide from my friend Mckenzie who is a Dietician. She gives you the levels you should be striving for, and some good options to take (even if you can’t keep down those giant pills).

Want to know more about prenatal care? — check out these posts:

• Charlie Horses in Pregnancy: What you can do to prevent them?
• Pregnancy, Tylenol® & Autism: What Expecting Moms Need to Know
• Allergies During Pregnancy: What’s Safe and What’s Not
• 7 Habits of Happy Pregnant Women
• Month-by-Month Pregnancy Timeline & To Do List

Prepare Partner More

I WISH (especially on my first) I’d prepared my partner more about what he could do to help me both during pregnancy and birth.

I wish I’d taken a class that talked to him at all.

They were sort of an afterthought in my birth class. Honestly, it wasn’t all that helpful:

A birth class is a GREAT way to do this (even though so many are bad at it). I recommend this one.

Let them Break my Water Earlier

So, as I said above I was resisting that induction and boy oh BOY did I resist them breaking my water.

I knew as soon as my water was broken I couldn’t just go home — I had to have that baby.

So I didn’t let them do it, even though they asked a few times — I said no.

But, as soon as I let them do it — boom. Baby.

As soon as I let go my own control I had my baby.

Honestly, a life lesson. I’m a controller and maybe they did know best.

My bad. I’d do it differently next time.

Prepare for Postpartum

I’m always horrible at this. With my second baby I moved 10 days after he was born, and a few days before birth my mom said — “You know you can’t lift anything when you guys move” — and I was like — I’d honestly never considered my own safety in that scenario…

And yes, I was a labor nurse.

I just thought I could be superhuman. I wouldn’t bleed. Not me, I’ve got stuff to do.

Buying myself pads is always an afterthought.

BTW, if supplies are on your list of things to get — grab my checklist here:

Want to know more postpartum tips — check out these posts:

• First Poop After Delivery: Make it less-hard (literally)
• Your Guide to Your Postpartum Plan with Free Template
• Self Care During Postpartum & Pregnancy
• C-Section Recovery: Tips You’ll Need
• Postpartum Essentials for a Great Recovery

I just wish I’d prepare better for postpartum because I’m really bad at….

Give Myself Grace / Be Kinder to Myself

I know I went over this a bit at the beginning but these are words I type to new moms countless times during the day.

Please be kind to yourself.

Give yourself grace, this is really hard.

They were words I never said to myself.

You’re 5 days out, you should be driving the kids to school, why are you crying so much?

That’s what I said to myself.

I also wish I’d gone on anti-anxiety meds after my last baby. I was having panic attacks almost daily, but I knew it wasn’t postpartum depression so I thought I should just power through. That was a mistake. It’s not right for everyone, but it would’ve made my transition easier.

But, I’m here to say — let other people help. It makes them feel good, and you deserve it. You’re re-populating the earth single-handedly.

And I’m also hear to say that give you a few months and you can be that village that other people so desperately need. We have to be kinder, and more willing to help each other out. Give others grace.

It makes a better world for all of us. I love helping out new moms, it’s one of my greatest joys as a human. Please let me (or someone like me) do it for you.

Be sure to take a birth class that prepares you for realistic expectations postpartum. Far too many of us believe life will be like the photos we see on Instagram. It’s likely not. I recommend this class.

So, those are what I wish I’d done differently. What did I miss? Tell me in the comments!

The post If I had a Baby Again this is What I’d Do Different appeared first on The Pregnancy Nurse®.

I gotta know in the comments — which one of these do YOU believe and did I change your mind? — tell me at the bottom!

While we’re here, no decision is right for every pregnant family, so be sure to talk with your provider about what is best for you — this is just a good, general read that hopefully informs you a bit more on your options!

I also have a Youtube video on this:

Elective Inductions are Bad

Man oh man did I believe this one. I just felt like we pushed mother nature into something she wasn’t up for. But, I changed my mind after I read the ARRIVE trial. It’s a study that compared people who were electively induced at 39 weeks vs those who were not. It showed outcomes for babies were similar, with a slightly lower cesarean rate.

Now, some providers seem to have done a 180 shift and are recommending all pregnant women get induced at 39 weeks — and I definitely haven’t gone that far.

But I do feel like, if a pregnant patient wants to be induced at 39 weeks, they should be able to.

And yes, that means even if there is no “medical” reason.

I feel like often we act like “medical” reasons are the only ones that are valid. And frankly — there’s a lot of good reasons:

• Partner can only be there on a specific day
• Mom/help can only come at a specific time frame
• They just want to plan it (the anxiety of “birth at any time” is real)
• People are uncomfortable

And those are just a few. I just don’t think it’s the medical establishment’s job to decide what’s best for people, as long as they’re choosing something that is safe.

That being said — if you’re going in for an induction, you definitely need to know what to expect. A lot of people think an induction is “the answer” and are surprised by how long and hard it is — so be sure to go through this induction checklist with your provider:

And, if you’re a person who really feels like people shouldn’t be able to choose to be induced, I’d ask you to re-think that statement. Overall, it’s been proven safe and people should be able to choose. The just shouldn’t be forced to do it. Those are two very different things.

One of the biggest lessons I learned is that the choices made during labor matter just as much as what happens before it starts. Things like elective inductions aren’t simply yes-or-no decisions—they come with timing, trade-offs, and options that can change how labor unfolds. That’s why I created The Online Prenatal Class for Couples: to help you and your partner understand common interventions, ask better questions in the moment, and make decisions together with confidence instead of fear.

Oxytocin and Pitocin are the Same

So, I had to take a lot of chemistry to be a nurse (in fact, I got to take biochem twice because I wanted to be so great at). And in terms of chemistry Oxytocin (what’s made by our body) and Pitocin are exactly the same. Yes, there’s something in the Pitocin vial that allows it to be shelf-stable, but the actual active hormone is exactly the same.

I also knew that our receptors on organs in our body can’t tell the difference between the hormone made by our body vs synthetic ones. This is why insulin works so well!

So, I always figured that they acted the same in the body.

But the big difference is that Oxytocin is made in our brain, and is allowed to bathe your brain this feel-good hormone. Oxytocin is the love hormone — and we feel it when we’re falling in love, or just feeling good around other humans. You know that feeling, and we all love it.

It is also the hormone that starts labor (kind of a mean trick, right?).

Pitocin, is given IV and is not allowed to the brain (our body has a protection mechanism called the blood-brain barrier that keeps specific things out of our spinal fluid and going to the brain to protect us). BUT since the Oxytocin is already THERE in the brain it is allowed there.

So you do miss some of those feel-good hormones. However, once labor really gets going, I’m not sure how much of that is present. That’s something I wondered with my own induction.

Beyond that, we pump Pitocin in via IV and it does get ramped up much quicker than regular Oxytocin in our bodies. But, that’s what an induction is — it’s us forcing our bodies to go into labor, and it makes sense that it will happen faster than “natural” labor. But, something important for you to know as well.

Fun fact: During an induction you can still control the Pitocin drip. If it’s going up too quickly or you’re overwhelmed by your contractions you can tell them not to increase it. That being said — if you aren’t allowing them to actually start contractions that help your body go into active labor, maybe you don’t actually want to be induced. So, it’s a balance. Learn more in my post on Pitocin inductions.

Want more information on inductions? Checkout these posts:

• Signs You’re Ready to Be Induced
• Pumping To Induce Labor? Will it work?
• 5 Things NOT to do Before Your Induction
• Inducing Labor at 39 Weeks: Pros and Cons
• 5 Reasons to NOT Get Induced

The Epidural Causes Back Pain

I’d heard this for so long as a new mom and from friends (and oddly, from a lot of men — but that’s a story for another day) so I figured it was true — that the epidural causes long-term back pain.

And is is true that there can be some bruising and pain at the epidural insertion point for a few weeks after birth. The same will be true for your IV site — just because we’ve punctured that area and irritated it running in fluids, etc.

However, studies show that those who got an epidural don’t have any more long-term back pain then those who did not.

I think the epidural gets a lot of the blame for all the back pain caused by:

• Pregnancy (SO hard on our backs to have our center of balanced changed by our protruding belly)
• Labor (and all the crazy positions we get in as we’re in pain)
• Birth
• Postpartum/Life with baby — which includes
  • Positions we sit in to nurse (not a good habit to get into — but easy to do)
  • Carrying the car seat (the worse)
  • Bending over to put baby in the crib, etc
  • Carrying baby (possibly bad front pack carriers too — I had a bad one)

Don’t believe me? I have a whole article with the studies linked about long-term back pain from the epidural.

Now, I don’t believe the epidural is for all patients, and there are definitely risks but I think there are some people out there who really push their own agenda on something like this. It’s important to be aware of it! Want more information on the epidural be sure to check out my guide to epidurals during labor.

Many epidural myths—like the idea that they cause long-term back pain—are repeated so often they start to feel true. For busy couples, trying to sort through conflicting advice can add unnecessary stress. My Online Prenatal Class for Couples focuses on clear, evidence-based explanations and real clinical experience, so you and your partner can feel prepared, calmer, and confident in your choices—without spending hours researching on your own.

Want to know more about pain management in labor? — check out these posts:

• Why People Get An Epidural Even When They’re Not Planning On It
• Why Labor Pain Can Feel So Different For Each Person
• 5 Simple Tips for a “Natural” Labor & Delivery
• 4 Things to Know About Birth Pains
• Is an Induction More Painful than “Regular Labor”

We Don’t Need National Maternity Leave

Confession that I am not proud of: I did not get maternity leave on my first pregnancy, and that really made me feel like no one else should get leave either. It was really tough heading back to work 5 weeks postpartum thinking my uterus was going to fall out on the nursing home floor I worked at ().

Not only was it really hard to leave my baby, my body was entirely NOT ready either (I had a pretty big tear). I carried a lot of pain from that — but somehow in my mind I thought it made me a better mom (coping strategy).

On my other two kids I subsequently got a 6 week leave, and then a 12 week leave (which I split up). And frankly, SO much easier. Sure, recovery from having a baby still wasn’t my favorite, but not having to count every penny was nice.

(BTW, I used California state disability on my 2nd two children — and I believe that states may have to be our answer on this one).

After being in the social media birth sphere for a bit I realized my own bias that because I didn’t have something I felt like no one else should either. That it wasn’t necesary.

But I was wrong. I checked my own biases and I am now a strong proponent of paid maternity leave, and I try to voice my opinion as often and as loudly as I can. I’m embarrassed I ever really felt the other way, but we all are just who we are, and I am grateful we can change our minds. As shown by a few different things in this article.

As mothers, we all have to stand up to make a difference for paid maternity leave. Either through states or the federal government. I hope you’ll join me in that fight and speak with your congressional leaders as often as you can too.

Of course, there is still the tricky situation on when to go on maternity leave << I have a whole post on that.

Birth Classes Don’t Make a Difference

Honestly, in my career someone taking a birth class was the exception.

Most people don’t take birth classes, and I figure their births went alright and maybe birth classes weren’t all that helpful.

Frankly, I also took my own birth class which didn’t really highlight the information I truly needed for a better birth & postpartum recovery, but that’s a post for another day (or watch this Youtube Video to learn more) — so again, my own bias told me maybe they’re not all that important.

But then I started to teach birth classes for my hospital. And then I had patients who had taken my birth class and it was a big eye-opener for me.

• How much they already knew, so they didn’t have to be overwhelmed with information the day-of.
• How much easier it was for them to make choices and not be “bullied” in the hospital
• How much easier they transitioned into life postpartum because they knew what was coming.

And then I started to read the studies on how birth classes effect birth and I was so excited to learn that birth classes:

• Reduces cesarean sections
• Reduces induction rates
• Reduces your need for forceps or vacuums
• Improves birth satisfaction

Which frankly all makes sense. Be sure to read that article if you want more of my thoughts on that.

Many couples worry it’s either too late to prepare or too hard to fit a birth class into an already full schedule—especially when hospital classes are booked out or don’t work with real life. The Online Prenatal Class for Couples is designed for exactly that season: short, practical lessons you can do together, on your time, so you feel prepared, calmer, and confident heading into birth without adding more stress to your plate.

Want to know more about birth classes? — check out these posts:

• Alternatives to Hospital Birth Classes
• How Much Do Birth Classes Cost?
• Best FREE Childbirth Classes
• Why are Birth Classes So Expensive?
• Are Childbirth Classes Covered by Health Insurance? 

Kick Counts are Useless

I believed this for so. long. And, in fact, I didn’t do kick counts until my last baby.

And honestly, the studies on “ten kicks in 2 hours” do show that’s pretty unhelpful as every baby is so different. And, after doing kick counts I am here to say that if it took 2 hours for my babies to give me 10 kicks something was SERIOUSLY wrong and I should have high-tailed it into the hospital for help.

I have a whole article on kick counts (that explains how to do them and goes more into the studies on them) but let me give you the cliff notes (and why this is now a huge soapbox of mine):

• When done correctly, kick counts have been proven to save 1 in 3 still births, that’s 33% of still borns!
• Studies show that it does not increase anxiety but overall increases bonding with your baby
• Often it shows a problem with mom and not baby (but baby shows the effects of the problem) — this can have health benefits for both of you!

Want to know more — check out this video!

And, grab my cheat sheet right here to do them right:

I’m just here to say that a lot of us believe things that aren’t true — and that doesn’t make us bad or dumb. The real measure of a person is if they’re able to change their minds — and expand their thought process to something that might be more true.

So, hopefully these lies of labor helped you realize that maybe some of what you’re thinking isn’t true either. Did any of these change your mind — tell me in the comments!

And I’d love it if you let me hang out with you for the rest of your pregnancy:

The post Lies I Used to Believe about Labor & Birth appeared first on The Pregnancy Nurse®.

I also have a video on this same topic:

What are Charlie Horses?

It’s just a muscle contracting hard in one spot. We’re not exactly sure why they happen (or why pregnancy makes them more frequent), but we know they can be very painful and annoying (especially at night — which is often when we find them).

What Prevents Charlie Horses in Pregnancy?

These prevent leg cramps in most people — but there are some special considerations in pregnancy (which is why you’re here with The Pregnancy Nurse).

Stretch

I am a huge fan of prenatal yoga and one of the BIG reasons is that keeping your muscles stretched can help prevent these cramps. Be sure to focus on lower body — hips, legs, calves.

If it’s really been a problem I might look up a video on just calf stretches that you can do before bed.

** You can actually get Charlie horses all over your body — but calves is the most frequent spot. If you’re having them on other spots stretch those areas. Some people think ligament pains are similar to charlie horses << read that whole article if you think you’re having charlie horses on your abdomen!

I think it’s smart to mention to your provider any big pains that you’ve been having including Charlie Horses — so they can help you improve them.

Listening to your body is such an important part of trying to prevent these. I’m also a big fan of listening to baby — if you’re in your 3rd trimester (or close to it) be sure to grab my kick count cheat sheet to make sure you’re doing them right.

Remain Active

It’s really easy to just do the bare minimum during pregnancy. And I’m not here to tell you to start up a giant fitness program at this phase in your life. But doing what you’ve done all along can be helpful.

Adding a short walk after dinner can help that lower body stay limber. It’s good for you, and might even help you sleep better.

Huge fan of staying active in pregnancy!

Want to know more healthy pregnancy tips? — check out these posts:

• Pregnancy, Tylenol® & Autism: What Expecting Moms Need to Know
• Signs You’re Ready to Be Induced
• What to Do If You are in Pain During Pregnancy
• Avoid Tearing at Delivery: 3 things you can do.
• Allergies During Pregnancy: What’s Safe and What’s Not

Calcium & Potassium.

Muscles use calcium and potassium to work. Adding these into your diet can sometimes help make sure all of that is available to your body. For me, I tried to eat a bananas at least every other day (potassium) and a Tums now and then (calcium). Heartburn or not (although, frankly — often there for heartburn)….

Obviously, there are lots of sources for both of these important minerals, any question ask your provider!

A note on electrolyte drinks:

Electrolyte drinks have gotten a lot of push lately. Some people swear by them. I even have a post on if Gatorade is safe during pregnancy. The reality is that a lot of these drinks have a fair amount of sugar, and maybe too much sodium (which can be a contributor to preeclampsia or hypertension in some people). Personally, I drink filtered tap water, I don’t recommend distilled water (because the minerals are out of that) and try to eat a varied diet.

If I work out hard and am especially sweaty, and maybe craving a sweet drink I’ll add some electrolytes to my water. It’s a rare occasion — more of a treat for getting so sweaty.

As a reminder electrolyte drinks aren’t regulated like drugs. You can’t be sure how much of what is in it and what else they have added. I think we should be more careful with them than we are.

However, our body most often pees out any electrolytes that aren’t necessary — so that’s the good news.

Hydration

While we’re here talking about beverages — making SURE that you are hydated is a huge key.

I know they say 8 giant glasses of water — but honestly, that’s sort of hard to know.

For me, the key is making sure that pee is a nice pale shade of yellow (if you have a white toilet — it gets tougher if your toilet is tinted).

I have some friends who want “clear” urine and I’m here to remind you that your body is always going to excrete bilirubin in the urine (that’s what makes it yellow) and I don’t think that’s a viable goal.

From someone who’s peeked at urine samples from thousands of women — you’re looking for a pale shade of yellow. That compensates for how much you’re sweating (important for a nurse here in Phoenix), and what your body needs.

If that urine is a darker yellow drink up!

I don’t hear this tip a lot, because most people want to pretend that there’s a magic number for everyone. But, I’m here being practical for you (as I can’t remember how many glasses I’ve had at any point). Your body can guide you. Want more practical tips? Join me in here!

Magnesium

I hear this tip a LOT — and I’ve actually started taking magnesium as I take my journey through perimenopause over here. However, I do it under the care of my provider. He was very helpful in talking through the….

Type of Mageniusm — there are a few different types, and they can each have their own benefits/risks. Some can make your stools softer, or too soft. So, be sure to discuss with them how much and what kind of supplement you should be taking (if any). I will say that mine has also sort of chilled me out and helped me sleep better. So, it’s been a win for me (but talk with your doctor).

The Dosage — I know that many providers have feelings about how much is too much — so talk with them!

Some people feel weird asking providers questions like this — but it’s AOK to say “I’ve been having leg cramps and I heard magnesium might help — do you think that’s safe for me and the baby?” Asking question is a PRO move in pregnancy, so starting on small things like this can help you feel more confident as the questions get a bit tougher.

Want to know more about feeling confident & ready? — check out these posts:

• Secret Keys to Labor that No One Talks About
• How to Feel Confident Making Choices During Labor
• The Three Biggest Mistakes Labor Patients Make—And How to Prevent Them
• Month-by-Month Pregnancy Timeline & To Do List

Good Shoes

You may need to bid an fond farewell to your heels for the rest of pregnancy. They can put a lot of pressure on your calves that might make these nightly terrors worse.

Or, at least save them for a special occasion.

The good news? I’ve had these like CRAZY with all of my pregnancies, but they went away afterwards. You can see those heels again once you’re not pregnant.

Compression Socks

Compression socks can help return any extra fluids to your body. They can be a big help in this issue. There are so many cute ones available any more, and you can get a smaller or a harder compression depending on your needs.

Any question about these ask your provider, but I have a whole article on how compression socks can be helpful and when to start wearing them.

Even as a nurse I wore compression socks to work — just made my 12 hour shifts more bearable — even not pregnant! Lots of people wear them, we just don’t talk about them much. They can be really helpful though! I also wear them to Disneyland!

What to do when you get a Leg Cramp?

This is going to focus on calf cramps, but the same things can be true for other muscle cramps.

Flex Don’t Point — You gotta stretch that muscle out. Pointing your toe will make it worse. Sometimes the pain is so much you can’t flex it — so you might need to get out of bed and use your weight to help it flex.

And yes — I’m with you that these absolutely suck. I’m sorry it’s just one more weird pregnancy symptom we could do with out. It does seem like mother nature has it out for pregnant patients!

For some people that stretching will be enough — but for some people the muscle while not contracting as hard is still very painful. If that is the case:

Walk around for a bit — these will help the muscle work out the lactic acid that has built up from it working so hard (needlessly). Grab a little water to help stay hydrated and help wash that out!

Heat or cold can help too — I recommend a microwaveable heating pad so you can fall asleep safely with it on your leg (and it will cool). Make sure that you have ice wrapped in a dish towel so you don’t freeze your skin too. We don’t need that! Personally, I prefer heat — but everyone is different, and I see both recommended.

Also, if you find them common having a quick stretching session before bed can help prevent them.

I am also here to remind you that you can absolutely cherish this baby and the life you’re going to build, and also hate pregnancy and all the weird things (like this) that come upon your body during pregnancy. It’s not cool and we don’t have to love it.

BUT hopefully, the tips in this article will help you manage them better.

Want more tips to manage your third trimester, labor, birth & postpartum better — check this out. I think you’ll find it super helpful!

What are YOU doing for your charlie horses? Tell us in the comments so we can learn together!

The post Charlie Horses in Pregnancy: What you can do to prevent them? appeared first on The Pregnancy Nurse®.

This (or any article on The Pregnancy Nurse) should be taken as medical advice, this purely educational. Please talk with your provider about your specific needs and circumstances.

Watch: Pregnancy, Tylenol & Autism — Clear Answers for Expecting Moms:

FDA’s Latest Statement on Tylenol and Pregnancy

Recently, the FDA released a statement for healthcare providers after a press conference aired, stirring up confusion more than providing real answers. The statement explored the possibility of a link between chronic Tylenol use in pregnancy and neurological conditions like autism. However, it emphasized:

• No causal relationship has been established.
• Some studies suggest there might be an association, but others contradict this.
• Tylenol is often the only medication that has proved to be mostly safe & effective against pain and fevers.

The FDA recommends that providers consider alternatives for routine, low-grade fevers, but Tylenol remains the preferred option since pregnant people should avoid ibuprofen and aspirin

Note: The FDA included aspirin but didn’t mention that low-dose aspirin is prescribed for preeclampsia prevention (which was disappointing).

Want to know more about pregnancy medications — check out these posts:

• Allergies During Pregnancy: What’s Safe and What’s Not
• Home Remedies for a Cold While Pregnant
• Unisom for Sleep During Pregnancy
• What Cough Medicine Can a Pregnant Woman Take? What OTC is safe during pregnancy?
• Can You Take Sudafed While Pregnant – When to talk to your provider.

Breaking Down the Research: Correlation vs. Causation

It’s important to know the difference between correlation and causation. Just because two things happen together doesn’t mean one causes the other. For example: more ice skating injuries in winter don’t mean winter causes injuries — lack of skill on the ice skating rink does. The same critical thinking must be applied here: so far, studies do not prove Tylenol causes autism.

Tylenol Remains the Safest Pain and Fever Option

Despite conflicting headlines, organizations like ACOG (The American College of Obstetricians and Gynecologists) still recommend Tylenol as the safest choice for pain and fever in pregnancy. Tylenol isn’t “category A” (like folic acid, which is always encouraged), but it’s the safest antipyretic and analgesic we have, recommended with provider oversight.

Should You Feel Guilty About Taking Tylenol in Pregnancy?

As both a nurse and a mom, I’ve taken Tylenol during my own pregnancies. So have many of the patients I speak with. Most babies are perfectly healthy. Our main goal is always to create the safest, most stable environment for your baby — balancing avoiding unnecessary medicine with not suffering through high fevers, which can be riskier to fetal health than the Tylenol itself.

What Should You Do If You’re Pregnant and Need Pain Relief or Have a Fever?

• Hydrate and rest first. Many headaches are caused by dehydration.
• Contact your provider before taking Tylenol if you have persistent headaches or a fever above 100.4°F.
• Work together with your doctor to weigh the real risks and benefits.
• Don’t feel guilty if you’ve taken Tylenol — current evidence does not show causation with autism.

Why We Need Better Research on Medication in Pregnancy

One takeaway: research involving pregnant people is limited and hard to conduct. If you’re offered a chance to participate in a safe pregnancy study, consider it! We desperately need more real-world data to guide future recommendations.

Feeling Overwhelmed? You’re Not Alone

Pregnancy comes with enough worries. Added confusion from news reports and social media “advice” is unfair. Trust your foundation of knowledge, team up with your provider, and know you’re doing your best. Let that guilt go!

Frequently Asked Questions About Tylenol® and Pregnancy

• Is Tylenol safe in pregnancy?
  Yes, when used as directed and in consultation with your healthcare provider.
• Does taking Tylenol cause autism?
  Studies do not show a proven causal link, but we hope to study it further.
• Should I avoid all pain relievers when pregnant?
  Avoid ibuprofen and aspirin (except low-dose, if prescribed for preeclampsia). Tylenol remains the safest if needed.

Join the Conversation

What questions do you have about Tylenol in pregnancy? Leave them in the comments below — I’m here to help you get prepared and confident!

[Watch the full video above for more details and support!]

Thanks for being with us here at The Pregnancy Nurse, where we get prepared, not scared for birth!

The post Pregnancy, Tylenol® & Autism: What Expecting Moms Need to Know appeared first on The Pregnancy Nurse®.

But first, how do I know so much about fetal movements? Hi — I’m Hilary — The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of labor and delivery nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. ​ I have explained fetal movement to tens of thousands of families (if not millions at this point) and I know when you should see your provider — so I’m excited to share this info with you!

I also have a video that answers MANY common questions:

What is the Normal Daily Fetal Movement Count?

This is entirely depending on what is normal for you.  Meaning if it normally takes an hour to feel 10 movements, that’s your “norm”.  When it varies a lot from your norm you need to talk with your provider.

But, as with all of pregnancy it’s more complicated than that — so let’s talk more about it.

BTW, kick counts are AMAZING and I have a free cheat sheet right here:

When to worry about fetal movement?

This is the big question right.  If fetal movement is your best indicator of fetal well-being, when should you worry?

First off, babies go through sleep/wake cycles (just like they will when they are born) — so it’s normal for baby to be asleep for a while and not to feel it for a bit.  But, then it wakes up and the kicks begin again.

That’s why it’s so important to do kick counts.  

Here’s the basic process on how to do fetal kick counts (recommended to start doing these after 28 weeks). I have a whole post on when to start doing kick counts.

1. Get comfy laying or sitting down (try to limit other stimulus while you’re doing kick counts, it can be a good “quiet time”).  Meaning, I recommend doing this screen-free for the most part (harder if this takes longer than 30 minutes)
2. Note the time.  Just like it’s 6:49 pm (seconds not needed) — for me I’d have to write this down somewhere, or start a timer because pregnancy brain.
3. Start feeling the kicks.  Count them as you feel them.  You can use an app or your fingers (back in my low-tech days I used my fingers). 
4. Note when you get to 10 movements.  Aka, it’s now 7:15

Kick Count Pro Tips:

• You’re looking for ANY movements (not really just kicks) except for hiccups.  These movements will change as baby gets bigger/the uterus gets smaller for them.  This means turning, shifting, rolling — all of those count.
• Hiccups are very rhythmic small movements — if you’re not sure what they are talk with your provider at your next visit.  Most people are very aware of what they are — just tiny little “bumps” that happy every few seconds for a while.
• I like to do this after I’ve eaten, and I like to have a glass of ice water next to me to perk baby up.  Plus, hydration is the best. If you notice a time that baby often moves a lot, that’s a good time to aim for (simply because they will take less time).
• A lot of people like to use an app like the count the kicks app (or many popular pregnancy apps also have a kick count option.

I see a lot of people saying how to do kick counts WRONG online — so make SURE you follow the rules (don’t forget that cheat sheet you can download right here):

What time of day to do kick counts?

I think it’s best to do them at a time where you feel many movements already.  I chose to do mine after dinner — it made it real fast to get them to move 10 times.

What is the normal daily fetal movement count in the third trimester?

This is the big question — you hear your friend only takes 10 minutes to get their kicks in, but yours takes an hour — is that OK?  Most professionals say you want to feel those 10 movements in 2 hours.  So, if you’re doing it in under 2 hours and you’re able to feel at least 10 minutes movements, that’s a good sign.  Average is probably under one hour though — but it really only matters what YOUR average is.

But again, the big question is what is normal for YOU as you count kicks.  If it takes 10 minutes normally, and 2 hours the next day — that’s an issue and you need to talk with your provider asap (and if you can’t get hold of them go to the hospital).  But if it takes an hour today, and then an hour and 5 minutes tomorrow that’s pretty similar.

The hospital wants to see you if you’re not feeling baby move.  I get just as nervous when patients come-in saying they haven’t felt baby move and I want to get that baby on the monitor as soon as possible.  I am really serious about this, don’t feel weird about it.

Prefer video — I have the basics in here too:

What does it mean if there is increased fetal movement at 38 weeks?

I have a whole post on increased movements before labor (and if it can be a sign of labor).  The theory is that baby may shift more as they get into the birth canal.  Also, sometimes you feel baby more as they get bigger.

However, if baby’s movements really seem drastically different (honestly crazy amounts MORE or any less) always call your provider.  Remember, fetal movement is your best indicator of fetal well-being.

We talk about those tests they can do on baby plus all the signs of labor in The Online Prenatal Class for Couples. It really can help any anxiety you have about baby or delivery with rock-solid information for both of you!

When to worry about fetal movement in the second trimester?

Kick counts aren’t actually recommended until you enter your third trimester (about 28 weeks).  Prior to that fetal movement just isn’t as consistent for most people.  Some days baby will feel crazy, but they may move position a bit and then you don’t feel much the next day, and all of that can be normal.

However, if you ever feel like fetal movement is really different do call your doctor!

Fetal movement at 24 weeks what is normal?

At 24 week some people will have just started feeling baby move (this is often due to a posterior-lying placenta that cushions you from their movements).  Some people will feel baby moving like crazy for weeks. Because it is so different for for each person it is just not possible to pinpoint “normal”.  And, like I said above as baby shifts position in the uterus (because there’s still quite a lot of room in there) it can change day to day. 

As your baby gets bigger the movements will become more consistent.

What does baby movement feel like?

It varies from person to person but early on most people describe it as a “flutter” (honestly, not that different from gas).  Then it moves to smaller kicks and then advances from there.

All of pregnancy (including simple movements) can be a bit confusing — so join me in my tailored-to-you pregnancy newsletter — you can pick where you are and I’ll send you info JUST for you:

When can you feel baby kick from outside?

Everyone pictures that magical moment when your partner can finally feel baby like you can — and darn it, it DEPENDS (seriously, I get that this is the worst answer).  It depends on how your uterus is lying, where the placenta is, and how your body fat is located around the uterus.

That day WILL come though, and sometimes my husband would watch my stomach feeling like an alien had taken me over — frankly, he wasn’t far from wrong.

This is another good thing to do with your partner.

How many times a day should i do kick counts?

Just once.  You should monitor for fetal movement all day long.  But that’s not really possible to concentrate on baby all day long — so kick counts are a special time for just the two of you (or three+ of you if you have multiple babies in there). I actually think it’s a great time to bond with baby too!

How to wake up baby for kick counts?

It can be off-putting to have baby move like crazy all day long and then you sit down to do kick counts and they’re quiet.

Personally, that’s why I always did them after a meal when my blood sugar was up and with a cold glass of water.  That ice water sits in the stomach which does transfer to baby and the coldness wakes them up most often.

However, if baby truly isn’t moving you need to call your provider.  On your way to the hospital you can always drink some ice water to see if baby perks up….

What are the reasons for decreased fetal movement?

Who really knows, babies are weird.  But here are a few reasons for it actually being less movement or feeling it less:

• Baby’s position (if they’re kicking towards your back you may not feel it as much)
• Not eating or drinking throughout the day (that’s why taking care of yourself is so important).
• Something being wrong with baby, or baby not getting the blood flow they need — this is clearly what we’re watching for.
• Maternal illness (like a flu or something)

I am shocked by how many moms come in saying their baby hasn’t moved and they haven’t eaten anything for HOURS. Making sure you’re giving baby the fluids and nutrition is such an important part of your pregnancy. It also rules out not eating as a factor in why baby isn’t moving.

I think this is so important important I actually added a nutrition section to The Online Prenatal Class for Couples just for this very reason.

This all to say that if baby is moving less you need to contract your provider and if you’re feeling more worried go to the hospital (I would still call your provider on your way and drink a glass of ice water).

So, What do fetal kick counts do?

A study showed that when providers promote kick counts there was 26% less. Kick counts can prevent stillbirths. That’s why I love them so much. I talk more about that in my post on when to go to the hospital for decreased fetal movement on my sister site.

When to go to hospital for decreased fetal movement?

If baby is moving less you need to go to the hospital (can I say this enough?)  I just did a post on if you should go to the ER or to labor and delivery, but you can always show-up to the ER and they can send you to the right spot.  However, it’s a good question to ask your provider at your next appointment.  You can also call the hospital to see if they do tours.  That’s something they usually address on the tours (as well as where to park).

So, as we tie-up this post on fetal movement- a few things:

1. Everyone feels fetal movement differently — don’t compare yourself to others.
2. If baby’s movements have changed you should contact your midwife or obstetrician.
3. If you’re not feeling baby move (and you normally feel a good amount of movement in your third trimester) go to the hospital asap.
4. Kick counts prevent stillborns. The end.

These are hard and fast rules. I am not kidding to say that we take fetal movement just as seriously as you do at the hospital. There is no nurse wondering why you came in. We’re glad you’re there.

All of this can be kind of scary, but The Online Prenatal Class for Couples can really simplify it for you in just a few hours.

And, if you’re not quite sure you’re ready for that whole thing, check out my free prenatal class. It’s your first step toward getting in the driver’s seat of your birth.

The post Normal Daily Fetal Movement – Kick Counts appeared first on The Pregnancy Nurse®.

This (or any article on The Pregnancy Nurse) should be taken as medical advice, this purely educational. Please talk with your provider about your specific needs and circumstances.

Before we get started, make SURE that you understand what you’re in for when you get induced. Many inductions fail mostly due to unmet expectations around birth — and I don’t want that for you, so I created this induction checklist that you can go through with your provider when you’re making your choice:

Your Choice

I want you to remember that induction is YOUR CHOICE. Your provider may say dumb things like:

• We’ll schedule you to be induced at 39 weeks
• I won’t let you go past 37 weeks with that blood pressure
• It’s time to schedule your induction

But that’s just them, being dumb — and not using their words right.

Induction is always your choice

I never want you to feel forced into an induction.

When you’re feeling pressured (or forced) into an induction, that’s the time to pause and get some questions answered. Hopefully this article will help answer a lot of those questions.

Pro Tip: inductions aren’t something that we do to save someone’s life right now. We a C-section if that needs doing. Inductions are something that take time, which means you have time to get your questions answered.

Ok, onto the signs you’re ready to be induced:

What’s Your Cervix?

You may have heard some smart talk like:

• Your cervix isn’t a crystal ball
• Your cervix doesn’t tell you anything
• Cervical exams are meaningless

But, as a nurse with experience since 2001 seeing inductions, I’m here to tell you that your cervix can tell us a lot.

Mostly, it tells us how ready your body is to go into labor.

Caveat: Bodies are weird, and some cervixes dilate very quickly (surprising us) and some just say where they are no matter what they do (surprising us) — so this is an art not a science, and bodies do what they want to do.

While providers just “know” after we check a cervix — we articulate that with something called the Bishop Score.

Honestly, every facility sort of has a different “scoring metric” — I like this one, but it just gives you an idea of what we’re looking for…. These are the usual things (want more info on the bishop’s score — see this)

• Dilation
• Effacement
• Station
• Position
• Consistency

Let’s give some examples:

If your cervix is closed thick and high (what most people’s cervix is until it starts to prepare for labor) — your score would be:

• Dilation 0 points
• Effacement 0 points
• Station 0 points
• Position 1 point (your cervix was easily reached)
• Consistency 0 points (your cervix was hard)
• Giving you a total of 1 point. This shows your cervix is likely not ready for labor, and it’s going to take a while.

Let’s say your cervix is 3 cm, 80% effaced and baby is -2, cervix is mid-position and feels “medium” (between hard and soft) This is a very normal “due” cervix…

• Dilation 2 points
• Effacement 3 points
• Station 2 points
• Position 1 point (your cervix was easily reached)
• Consistency 1 points (your cervix was hard)
• Giving you a total of 9 points (out of 13). This is a decent score. In our experience, your body could tolerate an induction pretty easily.

As a provider I very much know there is a BIG difference in an induction on someone with a 1 point bishop score, vs someone with 9 (or more) points.

Many facilities don’t offer an elective induction on lower bishop scores (the # depends on the facility). Likely it just takes too long, and in their experience those patients may be more likely need a cesarean.

While the ARRIVE trial didn’t take bishop score into their metrics, they did show an elective induction regardless of your bishop score doesn’t increase cesareans — but many people say their experience differs — I think both things should be acknowledged by patients (experience & the data). Want to know more about the arrive trial? I have a bonus video in here on it.

I think that knowing what your cervix shows is important before you head in for an induction. Most often providers want to check it so they know the medications they’ll order, etc. (cervix under 3 cm usually needs some cervical ripening first).

Want to know more about inductions — check out these posts:

• Pumping To Induce Labor? Will it work?
• 5 Things NOT to do Before Your Induction
• Pitocin to Induce Labor
• Inducing Labor at 39 Weeks: Pros and Cons
• 5 Reasons to NOT Get Induced

What is the Reason?

Now, we’re going to talk about OUR reasons here in a second — but I want to know why your provider wants to induce you.

Now induction reasons can really vary, including:

• Your blood pressure is too high, you might have a stroke
• I induce everyone at 39 weeks

As a reminder, providers don’t “induce us” — we CHOOSE to be induced, but I digress….

And then everything along that spectrum.

Honestly, there are very few black and white reasons in the land of induction. Many of them are things that we see “trending” towards something, and we figure we should give you the option to get the baby out.

However, if we go back to Sign #1 and you realize your bishop score is LOW — you might want to try some cervical prep on your own before getting induced.

OR, you decide — yeah, I think I’d rather not have a stroke, let’s do this.

You’re balancing what your provider is seeing (remember, they’re the expert in the room, but not the one that makes decisions) vs what you’re hoping for from your birth.

You’re not a horrible person to want to wait and get a bit more testing, or talk more about what your doctor is seeing beyond the test results.

For instance:

Your blood pressure is always high when you get back to the room, but settles nicely as your appointment progresses. Your provider thinks you should get induced, but you would prefer to get a blood pressure cuff and monitor it at home for a few days. You really don’t think your blood pressure is high, but you respect whey your provider would say that.

Your provider had an ultrasound done that showed your baby close to 8 pounds at 39 weeks. They encourage you to get induced so baby doesn’t get too big that you need a cesarean. You prefer to not get induced, so you probe your provider more about what they’re seeing as they monitor your belly from the outside, and consider getting another ultrasound in a few days. FYI, I have a whole post on what to do if your provider says you have a big baby that you might find helpful in this instance (that happens a lot).

You have gestational diabetes, and your blood sugars have been well-controlled. Your provider says they induce ALL diabetics by 39 weeks — but you know it’s your choice (not theirs). You ask them to check your cervix, and maybe order a size ultrasound as you make your mind up as to when you’re ready to be induced.

Again, in ALL of these instances, you’re pausing, asking questions, and deciding what’s right for YOU.

BTW, if you have NO idea what’s right for you — grab my birth plan tips here — it’s going to help you get clear on what’s important for your birth:

I don’t want you to think that I’m blithely typing here that you can just refuse any induction without consequence — we’re going to get to that, but I want you to remember that you get to make the choice (and also have the consequences). Keep reading!

Coping with Pregnancy

While we have mostly ignored this entire part of pregnancy, I think it’s important to think about how you’re coping with pregnancy, as it brings a lot to our bodies & our brains. Things like:

• How much pain you’re in daily
• Other health conditions it is exacerbating
• How you’ll manage other kids when you go into labor
• The relentless nature of prodromal labor that happens every night and you’re just over it.

All of these are valid.

Yes, there are people who will tell you to just tough it out — but the reality is that the arrive trial did show that a 39 week elective induction is safe. While there are always risks with an induction, there can also be risks to staying pregnant, including risks to your mental health.

I am not here to say that those reasons aren’t valid as well. They are. But, they have to be balanced, and you have to be aware of what you’re getting into.

So, you’re in a lot of pain, but they check your cervix and it’s still closed thick and high. You realize that being induced will not be a “quick fix” so you decide to take off work early and be as kind to yourself as you can.

Or, you’re 40 weeks, you have prodromal labor every night that toys with your emotions, your cervix is 4 cm, 90% effaced and baby is 0 station — you might realize an induction would stop you having to wonder every night if tonight is the night.

The key to all of this is balancing:

• How ready your uterus and cervix is for labor
• The important reasons your provider might be giving you
• Your mental health & how you’re managing life right now.

There are other factors, but I think these three are often what it boils down to.

Want to know more about induction?– check out these posts:

• What to Expect at A Foley Bulb Induction
• What Happens if Your Induction Doesn’t Work?
• How to Prepare for an Induction
• 6 Things to Know About Your Fetal Growth Ultrasound
• How to Ask Your Doctor to Induce You

But, right now I want to talk about:

The Case for Induction

People often get frustrated that providers want to induce so quickly. And I get that, I refused an induction on my 3rd baby until my cervix was VERY ready, but honestly I’m not sure she’d ever have come out if I hadn’t been induced.

But, there is a case for induction.

Many of the things I’ve talked about can increase your risk for still birth.

For a moment I want you to remember the devastation that a provider feels when their patient has a stillbirth. They think back to what they did wrong, how they could prevent it — and I bet you can understand how they want to avoid it at almost all costs.

As you head past week 39 your risk of stillbirth increases exponentially every day. Your placenta has a “shelf life” — and this is well known and studied.

Big babies can get caught in your pelvis with devastating consequences that we try to avoid at all costs. Which is why we take an ultrasound that is large very seriously. Even though ultrasounds can be off, they are often our best indicator of how big baby can be.

Provider see patients just miserable at the end of their pregnancy and they want to help them — so they offer inductions.

There are REASONS providers — the experts in the room — offer inductions, but it’s always you to balance those reason, what your body is showing and what you need.

It’s really easy to say early on “I won’t get induced” but as you see baby isn’t’ growing in the womb, or your blood pressure is out of control — you realize that you need the tools and skills to make choices in the moment. It’s just not a choice you can make earlier.

(You can, however say you’d prefer not to be induced — that’s fine, and important to know about yourself).

Why NOT to get induced? Overall, there is more risk and you do have a higher chance of a cesarean with an induction — but all that data must be taken (by an expert) and used for YOUR pregnancy and what your risks are at this point.

In order to make choices at the time you need:

• A provider you trust to be an expert
• A foundation of knowledge to draw from as you learn what’s going on (I recommend this one)
• Confidence that you know how to balance both what you need & what’s going on.

Honestly, I hear so many people saying their provider “forced” them to be induced because they ultimately didn’t want to make the choice, so they left it to the provider.

That brings on birth trauma, and a slew of other feelings.

Studies show that when you’re engaged in your care, and are making choices yourself (with their guidance, obviously) you’re much more likely to have a positive birth experience.

You may not feel confident — but I really recommend this to help you get that way and learn more about the choices you’ll have to make during labor, birth & postpartum.

So, take back the reigns, make the choice that suits you, and remember you can always change your mind (on most things) if things change.

Are you planning on an induction? Tell us in the comments!

The post Signs You’re Ready to Be Induced appeared first on The Pregnancy Nurse®.

While you’re here be sure to grab my organized before delivery checklist:

The first question:

Is it safe pain?

Some pains should be sending us right into the doctor’s office, or into the hospital.

While it’s definitely important to talk with your provider about what to watch for YOU in your situation, here are a few questions to ask:

Are these contractions, and am I before 36 weeks? — if so, call provider or go into L&D

Has this pain suddenly gotten worse? That may need to trigger a phone call — especially if it lasts long

Does the pain have any other symptoms like a fever, burning when you pee, sudden fatigue or shortness of breath etc — if so, that triggers a call to your provider or a visit to L&D.

Again, I’d encourage you to ask your provider about problem signs specific to YOU and YOUR pregnancy.

While there are a lot of very NORMAL pains of pregnancy, it doesn’t mean we can’t work to make them better.

Want to know more about pregnancy pains? — check out these posts:

• Bladder Infections in Pregnancy
• 5 Fixes for Groin Pain During Pregnancy
• Sleeping During Pregnancy: Tips by Trimester
• What Does Round Ligament Pain Feel Like
• How to Sit in an Office Chair During Pregnancy

Ok, now that we’ve gotten past that part — it’s important to ask yourself:

Do you want to know if this is NORMAL or if it needs to be FIXED?

I think (once we know it’s “safe”) this is the most important question to ask yourself.

Some pains aren’t that bad — but you worry something is wrong. Things like cramping, short stabbing pains that are tolerable but it sort of feels like your uterus is ripping out of your body….

So, if that’s the case ask your provider if they’re normal.

However, some of the pains we have are affecting our day to day life and can really be problematic.

At that point you want a fix, or at least an attempt at a fix.

This is your reminder that your provider is really there for your health and safety, but does not know all the tips to fixing all the aches and pains of pregnancy. They will need to refer you out, and likely it will take some work on you end to get an appointment and then do the stretches they recommend. This isn’t a quick fix — but you may be wanting to seek for help. And honestly, it may not get all that much better, but if it’s worth a try for you, it should be worth a try for them.

They may have a “first line” of defense to help you in the office — things like some specific stretches to try, a pregnancy belly band, heating packs, in specific spots, etc. Often providers will try those first to maybe fix the problem and safe you the time/effort of finding someone else.

However, sometimes you do need someone else!

People they can refer you to help (there is likely more than this, but these are what I thought of first):

• Physical therapy
• Chiropractor
• Massage

I hear some people saying they went to the physical therapist (one visit) and say “it didn’t help at all” and that’s not what we’re even hoping for with this. It’s likely going to take:

• Changes in your lifestyle, how you do specific movements may need to change and adjust
• It may take multiple visits
• Visiting a few of those people (aka Physical Therapist and a massage therapist)
• You doing work on the days you’re not going in.

I recently had a pretty bad issue, and I was shocked that it took almost a full week of doing the stretching (which hurt a LOT) for it to really show improvement, but then it rapidly started to get better and I felt better by about 10 days in.

I sort of just had to believe she knew what she was doing…. which was hard for this nurse.

And now I do those stretches a few times/month to stay limber, and not have the problem again later on.

However, I know a lot of people feel like…

My Doctor Ignores My Pain — What do I do?

You have to remember that doctors are busy, and the reality is that almost every patient that comes to see them (especially anyone in the third trimester) is experiencing pain.

There is no way for them ascertain how much the pain hurts (and if you’re willing to put the work in to fix it as I mentioned above) and if it’s working taking the time to get you into someone else.

The words that I think really help are:

This is really affecting my daily life, I’m not able to do the things I need to do — who can help me?

I know that sort of sounds dramatic — but I think sometimes it takes that type of talk to make things happen, unfortunately.

If me helping you know the words to say helps you out — check out this. It has a whole provider communication video that can help like this!

Hopefully, when you use words like that your doctor will take the time to see what they can do.

Keep in mind that if you come to the next appointment and haven’t made your appointment with the provider or done their stretches, that makes them wonder if referring you to someone really helps — so I can only strongly recommend you start the ball rolling on your end.

The other bad news I hear a lot is that physical therapists in their area are booked. I’d still encourage you to make an appointment, and maybe call around to see if there is anyone else they could recommend.

It’s tricky because I think a chiropractor can be VERY helpful, but some chiropractors practice so far out of their practice (aka, let me talk about how to deliver your baby) it’s hard for OBGYN’s to refer them out. But, I wouldn’t hesitate to send you to a good one, they are great and manipulating your bones and I think can even be a great compliment to a physical therapist.

You want to look for a chiropractor who is trained in the Webster method. That’s a special certification for pregnancy help (as far as I understand it

And honestly, if you don’t need a referral, you might just start asking around to see if anyone you know has one they liked…. Just know it sometimes takes a few providers before you find the one that’s right for you.

Let me just summarize it in a few points:

1. Decide if you want to know if it’s normal or if you need a fix.
2. Try the first line of defense and see if those are helping
3. Ask your provider for a referral out to get more help if necessary.
4. Be aware that not all pains can be fixed, but hopefully someone can help you manage it better.

Honestly, learning how to navigate the healthcare system is hard. It’s almost like a foreign country.

The bad news is that the hospital will also be quite tricky — which is why everyone needs to get a birth class in.

I recommend this one. It can be done in just a few hours and is such a good foundation for moving through the rest of your pregnancy, labor, birth and life after baby!

The post What to Do If You are in Pain During Pregnancy appeared first on The Pregnancy Nurse®.

Before we get started, prodromal labor is definitely a great time to pack those bags. Grab my hospital packing list here:

We’re only talking about TERM labor (after 36-37 weeks). Anything prior to that is PRETERM labor, and even if it’s “prodromal” we don’t want it to progress so please contact your provider or head into the hospital if you’re experiencing labor signs. There are things we can give you to stop it to allow baby to develop more in the womb!

What is Prodromal Labor?

I see a lot of people saying that it’s “false labor” — and while I wouldn’t really categorize it as “true” labor it isn’t to say that our contractions aren’t doing anything.

Sometimes they are — and we’re going to talk about that next — but usually prodromal labor is when your contractions get going for a bit and then either space out or peter out and go away.

It. is. wildly. annoying.

I get it, it feels like our body is attacking us, and I think prodromal labor is a reason a lot of people ultimately ask to get induced because it just feels like false start, after false start.

But, what if I was here to tell you that’s just the last few weeks of pregnancy?

You’re likely going to have a LOT of false starts. Maybe prodromal labor is just part of the fun. Maybe we ride the waves, and don’t really think anything til’ the contractions progress.

Remember, heading into true labor you’ll see:

• Stronger (more painful)
• Closer together
• Most often lasting longer.

Often those prodromal labor contractions don’t last a full minute — and they’ll slowly get closer to 60 seconds.

I know that is easier said than done, but I see so many people trying to PUSH their body into labor online doing fruitless, and often painful, things to push themselves into labor.

Wishing those things worked — check out these posts (and the studies that debunk them):

• When Should I Start Drinking Raspberry Leaf Tea?
• What is Stripping Membranes? (Membrane Sweep)
• Sleeping Positions to Induce Labor: Best Positions to Dilate
• Why Does Eggplant Induce Labor?

What about those contractions that do nothing?

So, when you’re dehydrated your uterus is “irritable” meaning it’s just sort of cranky. Most people just feel cramping and kind of gross.

But, dehydration is definitely a part of what people call prodromal labor… which begs the question…

Can You Avoid prodromal labor?

The main thing is to make sure you’re drinking enough water. I tried to do that mostly before dinner so I wasn’t peeing all night.

However, a BIG time for prodromal labor is that bedtime hours. SO often people will have contractions, likely after a long day of hauling their body around and not being as kind to ourselves as we should (definitely guilty of that here).

That happened to me, so I’d drink a big glass of water just to make sure that wasn’t the culprit (because even if I was peeing, at least I wasn’t in fruitless pain, peeing).

I would often have patients feel like if they didn’t drink water it could push them into labor — but instead you’re just making that uterus (and likely you) more irritable — so make sure you stay hydrated.

Another tip — while not exactly avoiding it is to just sort of ignore it.

You can treat the “symptoms” aka —

• Take a warm bath (or shower) to help you relax
• Use a heating pad if it hurts somewhere in particular (just not over your belly)
• Do some light stretching to help those tight hips

But the more we play into “is this it?” the worse it ends up being for us.

My tip is to ignore it as long as you can…. and once you can’t really ignore it, maybe it is it!

What to do in early labor to help labor progress?

Besides ignoring it, and treating the symptoms is what I ALWAYS call-in the first line of defense…

A lot of people love the miles circuit. However, there is no evidence on it (or, frankly studies) and if you’re hating some of the positions I 100% tell you to stop. But, some of them might feel good, and I think movement is always a good thing, if it’s feeling good.

I’ve heard a lot of anecdotal evidence about curb walking as well — especially in early labor.

My tip — get on a phone call with a good friend, and do 30 minutes of it, making sure to switch sides every 5 minutes or so. BUT, if it’s really hurting, stop.

Remember, going into “true” labor there has to be an agreement between:

• The baby — it’s developed enough to come
• Your brain — you’re in a safe space to let this happen
• Your uterus — it’s time to get that baby OUT

Of course, this system doesn’t always work perfectly (looking at you preterm labor) but that’s the basic idea of thought.

Want to know more labor tips — check out these posts:

• Avoid Tearing at Delivery: 3 things you can do.
• Why Labor Pain Can Feel So Different For Each Person
• 5 Simple Tips for a “Natural” Labor & Delivery
• Mistakes You’re Making That Makes Labor Longer
• Is an Induction More Painful than “Regular Labor”

Anything else you can do?

Studies don’t show a single thing will kick you into labor ASAP…. but there are things you can be doing in your last month of pregnancy to prepare your cervix. I have a whole post about it, including more info on the studies behind all four things:

In case you’re just curious, but don’t want to really click through the 4 things are:

• Sex
• Pumping
• Primrose Oil
• Dates

Again, the idea is to start these things a few weeks before your due date — with the consent of your doctor. Some of those things are NOT good for everyone, especially anyone with mental health concerns or platelet issues needs to be careful with primrose oil. Be sure to talk with your provider before starting them (can I say that enough?).

Plus, I’m pretty sure I wouldn’t do all of them. Pick and choose which ones seems appealing or doable in your already busy and very tiring life during that last month of pregnancy.

Hey, if you’re in your 3rd trimester don’t miss my prep pack:

What to do in early labor?

It’s a great question, and one that I see a lot of people get wrong.

Let’s start off with what NOT to do:

• Obsessively time the cramps (especially if they’re not painful enough to take your breath away)
• Call everyone you know and say you’re in labor.
• Lay in bed in one spot just feeling miserable

Honestly, there is an art to early labor at home. I think it’s one of the most important thing to set your hospital birth up for success — because, as an L&D RN I firmly believe that the BEST place for you to be in early labor is at home — not the hospital. It allows you to stay comfortable, and likely progress with less issues due to that comfort.

I have a whole chapter on those early contractions, and what to do at home (and what partners can do to help) in here. I can’t recommend it enough, you need that lessons, along with the rest to really have an amazing birth.

Even if you think you’re in early labor it’s not too late for that class. Because it’s only 3 hours you really do have time to get started — great news, right!

However, since you’re here — let me give you 3 things to do:

Rest: So many people are busy doing that miles circuit and getting miserable they ignore the fact that rest is such a benefit as your body is heading into an important job. I can promise you that true rest isn’t going to stop your body going into labor (I’m talking about sleeping — not laying their “resting your eyes” — like my mom used to do).

Eat: I’m not talking a full steak, I’m saying every couple of hours fuel your body with a snack that includes both carbs and protein. I have a whole nutrition bonus video in here that helps with that too.

Move: When you’re not actually sleeping move your body. Now, that can be turning side to side if you’re feeling miserable, or it can be getting on all 4’s and cleaning your shower depending on your energy level.

One of the best things partners can do in early labor is to get those snacks already and help you move every 30 minutes or so (and help you clean that shower if you’re trying that). Partner tips are in there too!

My three other tips:

1. Don’t get frustrated with yourself, it will come — patience is hard, but a real need here.
2. If you’re just miserable and want labor to come, talk with your provider about an induction (if you’re past 39 weeks) — I’m glad we have that choice
3. Be kind to yourself. This is confusing and miserable and you deserve credit for moving through it.

The good news is that baby should be here soon!

I want you to have the best birth you can hope for — come join me in The Online Prenatal Class for Couples where we prep you for your upcoming hospital birth (plus laboring at home, and managing life postpartum) in just a few hours. It truly is the EASY way to do it!

What are you going to try in this article? Let me know in the comments!

The post Prodromal Labor: What is it and how to avoid it? appeared first on The Pregnancy Nurse®.

Before we get started, this is the #1 way to feel confident about birth WITH your partner. You won’t be pregnant forever (even if it seems like it), get going!

Start Asking Questions at Your Appointments

Maybe you feel confident right NOW at prenatal appointments, or don’t really have questions — but now is the time to start getting confident asking questions. Ones like:

• Is there a brand of prenatal vitamins that you recommend?
• Should I be taking aspirin, why or why not (most important before 20 weeks) — and should I stop before birth?
• I would prefer not to have an IV at birth — is that something you are comfortable with?

The questions can be all sorts, and I really think that once you hit 20 weeks, it’s an awesome time to start talking about things you’re hoping for at your birth. That way they can get to know you better, and you can get to know their communication style.

Build Confidence in Other Situations

As a mom to adult kids, I see how tough communication can be for them.

They’re in SO much pain when they ask someone a question at the store, book an appointment or HEAVEN FORBID have an telephone conversation with someone.

If you find that it’s hard for you to have these types of conversations, I can guarantee it won’t be better once you get into the hospital and you feel extra lost and concerned about your pregnancy.

Have these types of conversations more often. If you can make a phone call instead of an email, try it.

If you’re at a baby store and you’re wondering about a few products, ask the staff.

Build your confidence about learning from others, communicating your needs and them making the choice that’s best for you.

I know this sounds simple, but it’s HUGE in the labor room. Far too often I hear people say they were “pushed” into something, when in reality they were offered something and didn’t know how to get more information to make a choice themselves…

Want to know more hospital tips? — check out these posts:

• How To Have A Natural Hospital Birth
• Hospital Policies You Can NOT Say No To.
• My #1 Tip for Hospital Birth
• How to Time Going to the Hospital in Labor
• When Will the Hospital Admit You For Labor?

Think About Your Options

So many people make a birth plan thinking that’s a “plan” but in reality I think creating a birth plan together just allows you some time to think about options, and what’s important to you about your upcoming birth.

I actually have a series called Birth Plans Made Easy that I think will really help you make yours in the RIGHT way:

You might be wondering what the “wrong” way is…? Good question. I think the wrong way is to think of it as an actual PLAN. I much prefer birth preferences, or hopes…. you’re just thinking what you’d wish if circumstances allow it.

When you’re too tied to that plan, I’ve just seen it go awry….

Often on social media I’ll see people say “they didn’t follow my plan at all” and it’s really just there to help us know what you HOPE for, it’s not “orders” for us and we definitely have discussions with you before following the “plan”.

Things change a LOT during labor, and you have to be willing to be flexible.

Get Prepared

Just like in school, the main way you feel confident is to STUDY.

And, just like in school you need to study ALL of it. So many people think:

“Oh, I don’t need the cesarean part, I’m not having one of those” when in reality — the “test” (aka, labor) is whatever mother nature gives you, not what you’ve prepared for.

Here are a few things I hear a lot:

I am going to my prenatal appointments: Sad news, these are really more to make sure you’re healthy, less to to prepare you for birth. Your provider just doesn’t have the time to really go through it with you, plus make sure you’re healthy.

And honestly, they’re often just not great teachers. You want to take a class from a great teacher!

I’m watching stuff on social media –– not saying that’s bad, but social media makes it REALLY easy to cherry pick what you want to know about. And in case you haven’t heard it before, a LOT of the videos on social media are just WRONG. People had something happen ONCE and then act like that’s how it “always” happens.

I just had a video pop-off that just said most people aren’t bothered by the things everyone freaks out about on social — and I had SO many comments agreeing!

I should also mention that you’re going to spend a TON of time watching social media videos, and still not get totally prepared.

A course puts it all in one spot so you don’t waste your time….

Oh, and what are the chances your partner is watching those same videos? May I just suggest you want a teammate — not just a cheerleader in your corner. Get them prepared with you, and it will pay off BIG.

I only need to learn about pain. Honestly, if pain is your only issue, it’s easily solved in the hospital. Getting prepared to:

• Make choices in labor
• Know what to expect from your body both during birth but also especially during postpartum
• How to take care of yourself after baby

will be huge for you! It’s so easy to forget ourselves, but you matter SO much in this equation, and preparation will pay-off!

It’s too expensive! I agree, many of the birth classes out there are FAR too expensive! Which is why I love sharing this very affordable option. You might even be able to get your insurance to cover it, and you can use your HSA funds to pay for it.

Let me finally say that there is no one who wants you to feel more confident in the labor room than your nurse. She’s there, cheering you on to get the birth you’re hoping for and wants to support you in making the best choices for you at the time.

What are YOU doing to feel confident about your upcoming birth? Tell us in the comments!

The post How To Build Confidence For Your Birth Experience appeared first on The Pregnancy Nurse®.

The Bad News:

The bad news is that we really can’t prevent all tears at delivery. There is a lot that goes into it, but no study seems to show any tactic that decreases first and second degree tears.

These are the smaller tears (as one who has experience with a variety of degrees a second is MUCH better than a 3rd or 4th) — they heal better, and are much less likely to have complications.

But, people who are out there saying that they can prevent ALL tears just aren’t true.

SO much has to do with the size of the baby’s head, how well your tissues stretch (which is often genetic), possibly baby’s position… and while we can try to help those (like, marrying someone who had a small head as a baby), we can only do so much.

Tears can be a very normal part of birth.

As I said above I WISH I had been better prepared on what to expect after my first baby both in how it would feel, and how to help myself heal. The birth class I had taken proved to be entirely useless in that arena.

The Online Prenatal Class for Couples is the birth class I wish I had. It is very realistic about what to expect postpartum, and gives you hands-on demonstrations on how to help yourself heal after baby. SO helpful — everyone needs it. PREPARE FOR POSTPARTUM like you prepare for birth (maybe even more).

Want to know more about delivery — check out these posts:

• 5 Simple Tips for a “Natural” Labor & Delivery
• 4 Things to Know About Birth Pains
• Mistakes You’re Making That Makes Labor Longer
• Do You Need a Birth Class if You Plan to Get an Epidural
• Is an Induction More Painful than “Regular Labor”

Perineal Massage

Perineal massage has been proven to help prevent larger tears and episiotomies at delivery. The studies are somewhat mixed (they’re all linked to in that article).

I have seen some studies say that it only worked if it was your first baby, but I have seen others that show it works with any baby (although probably most important on your first as that’s the first time those tissues will stretch like that).

However, not EVERYONE should do perineal massage. Some people who should NOT be doing it:

• If you have any varicose veins in that area
• Any issues with preterm labor you don’t want to try this until you have your providers approval.
• If you’re not planning on a vagainal delivery, there wouldn’t really be a reason to do this (and you maybe shouldn’t depending on the reasons for the cesarean)

A few things to keep in mind:

You’re massaging the PERINEUM — that’s the outermost part of your vagina, the skin area — not inside your vagina.

Lube is your friend, some people just use water, but this shouldn’t be painful, and you don’t want to irritate the tissues there (it may backfire)

You’re focusing on the bottom of the birth canal area closest to your rectum — that is where tissues have to stretch the most.

I would 100% ask your provider for some tips, and make sure it’s safe to do before you attempt it. Most often they don’t recommend starting until around 36 weeks, but you do want some time to work on it — and it maybe takes a few trys to figure out how to do it.

You can also use a friend (hopefully a partner) to do this for you — as it can be tricky to reach that area).

BTW, while we’re talking about things you should be doing later in pregnancy, did you know that kick counts can save 1/3 stillbirths when done correctly. Learn more here:

Warm Washcloth at Delivery

A lot of studies will call this a warm compress, but it’s really just a washcloth with warm water on it. As a nurse I’d swap them out every few pushes to make sure that it’s staying warm. If the washcloths seemed thin (sort of depends on the laundry day at the hospital) I’d sometimes double up on them to make sure it stays warm.

Studies have shown that a warm compress while pushing can decrease your chances of tearing.

This is mainly for people who are pushing for quite a while. If you only push a couple of times, you’re not going to need this (and that nurses is going to keep an eye on that area to make sure baby doesn’t pop out before your doctor does).

As you push, sometimes your perineum swells.

Honestly, sometimes if it swelled a lot I’d alternate between ice and a warm compress (although this is before I saw the studies on warm compresses).

BUT if you’re pushing much past 15 minutes, I’d ask your nurse if she thinks one might help.

While you’re having discussions like this, studies have also shown that providers keeping their hands out while patients push can decrease tearing. This isn’t talking about checking you every 10 or so minutes to see if baby is descending, possibly ascertaining their position (to possibly move YOU into a more favorable position). This is when they stretch your perineum with their hands while you push.

I have seem some studies saying this is NOT helpful and can increase tears, and possibly just generally increase trauma overall to that area.

If you’re not sure what to do — just say I’d prefer you not press on my tissues as we push, could we maybe try a different position instead? Sometimes nurses are compensating because we’re not sure if you want to try something new.

Honestly, learning to talk with the medical staff can be tricky — and a great birth class not only teaches you how to take care of yourself, but also how to speak up for yourself and make choices for yourself at delivery. That’s why I recommend this one — it’s the best at it!

Nurses often feel a lot of pressure to help you push as effectively as you can. When you tell them what you like or don’t like they can help you push better and change things up. Moving, even changing hand or leg positions every few pushes can help you find what you like the best!

Listen To Your Provider

One of the BIG things your provider will do just before baby is born is make sure that you slow your pushing down to gently ease that perineum over the baby’s head (think of it as slipping a tight shirt over their heads).

This means that if they ask you to slow down on your pushes, or to give tiny ones for a bit — listen to them.

The worst tears I’ve seen are people who deliver alone at home and have no one to help their perineum at the end.

One other things that has been shown to help in some studies is lubrication at the end. Some use KY jelly, some use mineral or olive oil. It doesn’t really seem like one works better than others — just what your provider is best at will likely be the best to help at that tricky stage.

What DOESN’T WORK (but everyone seems to think it does.)

Epidural: I see a LOT of people saying an epidural increases your chance of tears. While women who get an epidural may be more likely to have mal-positioned or larger babies there isn’t evidence that they have increased tears overall when confounding for those factors. Study link here.

Birth Position: I also see that the supine position (laying on your back) is bad to tear — but I really appreciated this study that showed that kneeling/all 4’s was the best and squatting may make it worse. Among all that evidence, how you feel best pushing is the best (but also allowing the provider access at the end like we talked about above).

So, there are 3 of the big things that you can do to prevent tearing at your upcoming delivery. Which ones do you think you’ll try — honestly, as long as your provider is OK with them, all three can be helpful.

I wish providers had more time to talk about things like this at your appointments, but they just don’t.

Getting a birth class in gives you a strong foundation of knowledge, so you can spend your appointment time in important things just for YOU. Most providers think you are getting a class, although most couples can’t find one that fits their needs. That’s why The Online Prenatal Class for Couples is the perfect pairing to give you the information YOU need to feel confident about your upcoming birth!

The post Avoid Tearing at Delivery: 3 things you can do. appeared first on The Pregnancy Nurse®.