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.

I always try to look to nature when I’m thinking about our bodies (some of you might think that’s weird for The Pregnancy Nurse® – but we’re natural people too!). And, one of my favorite places is to be is at the beach. I love to watch (and listen to) waves — and it’s so interesting to me that the tides go in and out like clockwork.

But, how do we know when it’s a problem? When the ocean goes all the way out — aka, a tsunami is coming. It’s something very different than what usually happens.

So, there are times baby is quiet and times when they’re a crazy dancer.

There’s times when you’re tired, and then times when you feel energetic.

There’s times you get a contraction or two, and times when you don’t.

All of that can be really normal — the “waves of pregnancy.”

What’s a problem is when it’s something outside of the norm…. Like suddenly outside the norm? The waves haven’t been creeping up for a while and suddenly you get wet. The waves have been miles and miles away and suddenly you see water coming…. (and we all know that if the tide is WAY out — it’s time to get to higher ground!).

Now, some of these times you go directly to the hospital. Sometimes you call your provider. Sometimes you wait til’ your next prenatal visit. There’s levels…. And when in doubt, call them! That’s what they’re there for and prenatal visits are only if things feel normal. If things change, and you’re worried — call them!

New pains and changes in pregnancy should be mentioned at your regular prenatal visits. I’d keep a list of questions, and changes in your body in your notes out. It will help remind you during that quick visit! I’m talking small things — tiny pains that crop up and start to expand…

Anything that can be brought up, or handled at a regular appointment will save you so much time and energy — so, being sure to use them to their fullest will be a huge benefit to you and your pregnancy!

Rule of Thumb

My main rule of thumb is that if you’re noticing a BIG difference from when you’ve normally been feeling that’s worth a call.

If you’ve had something going on for weeks, and it just keeps going on, might be worth a call but it tends to not be as urgent.

I also have a post on pregnancy pains that are actually warning signs that you might find helpful!

Postpartum Rule of Thumb

Really quick — postpartum isn’t a time to turn-off your radar.

My rule of thumb postpartum is that it should, over time, be getting better. If something starts to feel dramatically worse be it — bleeding, healing, anxiety, sadness or pain levels — call your provider.

I actually have a whole free postpartum class where I walk you through some warning signs during postpartum (honestly, also helpful to watch for during pregnancy).

Remember, there will always be ebbs and flows to our pregnancy, and our healing. It’s those big changes that should remind us to do something.

Let me give you some examples….

Headaches

Headaches were part of each of my pregnancies. Lack of sleep, dehydration, changes in posture, hormones, and probably electrolytes are in flux during pregnancy. If that’s you too, tell me in the comments!

I just had a dull headache most days. It was just there. Like a buddy (not one I liked though).

I found this to be true with a lot of my patients too!

If I’d woken up and suddenly the headache had changed — was significantly worse. I should call.

Now, if you suddenly get the “worst headache of your life” — go directly into labor and delivery. It could be preeclampisa or blood pressure issues that we should take seriously!

Of course, I think every adult should have a blood pressure monitor. They’re not expensive. I think I thought they were pricey — but you can often find them for under $20 (affiliate link). But seriously get one if you don’t have one!

So, if that headache changes dramatically, call your provider, if it’s the worst one of your life. Just head into L&D.

At your next appointment: Ask your provider how quickly you should expect a call back from them. Some offices it’s not til’ the end of the day (and that may not be adequate — so, I’d ask how to ask them a more urgent question). That way you have realistic expectations. I’d also ask how you can get hold of someone when the office is closed. Most have someone on call for urgent questions (just only use those for urgent matters, not regular questions).

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

• Tips To Saying No To Your Provider
• 6 Things Your Provider Does at Prenatal Appointments that Are Important
• The Best Providers for Your Baby’s Arrival
• 5 Things Your Provider Should Get Consent For During Labor
• Picking Your Pregnancy Healthcare Provider

Fetal Movement

As you head into your third trimester (about 27 weeks) you’ll be able to notice a “normal” pattern of movement with your baby.

Why 27 weeks? Prior to that the placenta, baby’s position, and just general size can make baby feel more “muffled” at times. So, size matters. You can still pay attention to baby’s movement prior to that, but it’s just hard to get a handle when things are “decreased” because it’s OFTEN due to the placenta or baby’s position.

One of the best things you can do is do kick counts. I’m a huge fan of them because studies show it can save up to 30% of stillbirths. No clue how to do them? — grab my cheat sheet!

But, beyond that you’re just noticing what’s normal for your kid?

And, as a note — those first few weeks after 27 weeks is really just deciding what’s “normal.”

Your baby takes an hour or two naps, and then has a dance session — that’s their normal.

Your baby never sleeps and dances all day long. That’s their normal.

Your baby is quiet — you don’t feel much at all — that’s their normal.

The crazy thing — all of these can be normal. Because normal is what’s normal for your baby.

Remember how you assess fetal movement can be due to baby’s position, your body (sometimes larger gals have a harder time feeling as much) and even the placenta! Just because you have a “quiet” baby doesn’t mean they’ll be quiet on the outside! Might just be what you’re feeling from them.

Things that are way out of your baby’s normal movement pattern (after 27 weeks) should send you into labor and delivery. I’d skip your provider on this one, just head right in. And yes, that does mean DECREASED movement, but also INCREASED movement as well!

Things feel just a little off, might be worth a call to your provider. But, big changes can mean bigger problems that are best managed at the hospital.

Want to know more about fetal movement? — check out these posts:

• Normal Daily Fetal Movement – Kick Counts
• 30 weeks Pregnant and Baby’s Movements Have Slowed Down
• Increased Baby Movements Before Labor
• Kick Counts Made Simple: FAQs, Expert Tips, and Why It Can Save Babies’ Lives
• When Should You Start Kick Counts?

Swelling

Now, we used to take swelling as a symptom of preeclampsia, but anymore we know that swelling can be a very normal part of pregnancy. Especially for ladies who are on their feet a lot ( solidarity with all the pregnant nurses out there!).

However, if you wake up and you suddenly have swelling — be it in your hands or your legs, or your face (I see a LOT of people who suddenly have swollen noses — often mentioned by a partner). I’d call your provider. Just ask to be seen.

Of course, I’d also take my blood pressure to check that at home. (BECAUSE EVERYONE SHOULD HAVE A BLOOD PRESSURE CUFF). Get one asap if you don’t have one (yes, that’s a partner link but I REALLY think that — it’s just how I can link out).

Again — this isn’t a swollen face for weeks, or swelling after a day at work. All of that has been around, or is normal for you. It’s that brand new symptom that can be disconcerting!

Oh, and if you’re under 20 weeks you should 100% be having the conversation with your provider if aspirin is right for you (that’s another soapbox of mine!).

Bleeding

Now, any bleeding early on in pregnancy should be seen by your provider.

But, some of you just bleed now and then (it’s important to get an idea from your provider what’s OK and what should send you to them or the hospital). And it might be OK (again, be SURE to make sure this is true for you and your pregnancy with your provider).

But, you suddenly have blood in your underwear — you’re seen asap, right? It’s a new symptom. And, if it’s a lot you go straight into L&D.

Of course, to make it super tricky some bleeding can be normal after about 36 weeks — but when has pregnancy ever been cut and dry?

I just want you to think about those rules of thumb.

You know your pregnancy “normal” — for me it was being tired, having a headache, pain between my legs, and mostly enjoying a baby who rarely stopped movement.

But, if I woke up one day and one of those changed a lot — it’s time to be seen.

Two things to remember:

1. Your prenatal appointments are for routine care. When you find something outside of that routine, your provider should be seeing you for that (this is true for both pregnancy and postpartum), or at least a phone conversation with their staff.
2. Big changes for what’s normal for you — that’s when you need to be seen.

Plus, those warning pains. And anything your provider mentions…

Because, for some people even one contraction, or a tiny bit of blood should send them directly into labor and delivery — even though for a lot of you many of those things are fine!

And if you EVER have a concern for you or baby’s safety labor and delivery is open every day, all day all year (even Christmas). I can promise you that we want to see you, we want to see that you and baby are safe than you having a problem that we’re too late to help with!

Understanding how the hospital works and what to expect when you get there is such a smart thing to do. I recommend this. Plus, it’s made to help your partner get prepared too! It’s how smart couples feel confident going into birth.

So, what kinds of questions do you have? I can’t give a cut and dry answer for all of you, because everyone’s so different — but I’d love to try to answer questions in the comments if you have them. Just tell me below!

The post When to Actually Call Your Provider (or go in) vs. When to Wait 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®.

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®.

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®.

While we’re here, if you’re in your 3rd trimester, be sure to grab my checklist just for you:

What does “Natural” Mean to You?

I think we each know what “natural” means for US — but as a provider, it’s really hard to know what it means. I think it’s really important to pinpoint what it might mean for you. Most people think it means one of these:

• No medical pain management
• No induction of labor
• Neither of those things

So, when you’re talking with your provider make sure that you define what it really means for YOU.

I also think it’s OK to be like “I’d like to avoid those things if possible — but I will manage each step as it comes”. Honestly, I think that is the BEST way to manage labor — so if that’s you, high five!

Prepare Your Cervix

We tend to think a lot of things are out of our control in the birth sphere, but studies have proven that there are a few things you can do to help your cervix soften to prepare it for labor.

I have a whole post on 4 things you can do to prepare your cervix for labor << and you really need to read that post to know what/if it’s right for you — but in case you’re wondering what they even are they are:

• Sex
• Primrose Oil
• Dates
• Pumping

Keep in mind that those things are NOT (I repeat NOT) going to PUT you into labor, but the studies have shown they can prepare your cervix, and make it softer as you head into your due date.

This can possibly make labor easier and less-likely to have a failed induction if you need one.

So often I see people who think a “natural” labor will just happen — but it does require some prep on your side. These aren’t HARD things to do, but they are things I think you should consider.

Use a Midwife

Ok, this doesn’t work for everyone — but using a midwife can really help. If you’re not using a midwife, you might want to consider a doula (although the price of a doula is tough for most families).

Studies have shown that midwives are more likely to have less interventions (those tend to veer away from “medical”) than OBGYN’s.

If you have a low-risk pregnancy, and you’re before 30 weeks you may want to consider looking around to see if there are Certified Nurse Midwife (CNM) options in your local area.

This may mean you have to change hospitals and it may be a bit of rig-a-ma-roll, so this tip might not be for everyone, but I am a huge fan of Certified Nurse Midwives and I think they provide tip quality care, while also having the safety of an OBGYN should you need an increased level of care.

There are a few different types of midwives — you’ll want to research a bit about which one is right for you. I prefer Certified Nurse midwives because they have a standard level of care and can deliver in the hospital. However, pick which care works best for you.

Start Practicing Early

Again, a lot of people think they have a “high pain tolerance” and will just be able to manage the pain at the hospital — and I don’t think this option tends to get you very far.

I recommend start practicing your breathing early on. And yes, I’m talking much of your 3rd trimester. It can have a lot of benefits:

• Deep breathing can help make us more mindful and possibly less worried
• May decrease your blood pressure and stress level
• Gives you a chance to check in with your body
• Gets you practiced for when labor comes.

This isn’t to say that if you’re 35+ weeks, all is lost — start now!

While there is a lot of ways to manage pain — breathing is one of my favorites for labor because it also helps your pelvic floor to relax which allows baby to descend.

If you’re tense, your pelvic floor will also be tense, which won’t do you any favors.

And if you’re thinking — Hilary — I have on idea what these even are. There is a bonus video in here that goes through a ton of natural pain management, including breathing that is SO helpful!

Know About 3rd Trimester Testing

This is the one that trips up a LOT of people.

The reality is that we are getting pregnant older, and possibly less healthy than we have before.

Meaning, we start to have bigger issues as we head later into our third trimester, and for many people that means some third trimester testing.

Usually:

• NST
• BPP or Ultrasound testing
• Preeclampsia labs

Most often, these come back normal.

Sometimes they come back very black and white as to you need to be induced ASAP because there is something serious going on.

And, then there’s the grey zone…. often:

• Baby looks big
• Your blood pressures are high, but labs are sort of borderline
• Baby’s BPP wasn’t great, but also wasn’t often

At that point, you have choices. Often people feel “pressured” into getting an induction. BUT if you’d like to hold off a bit, maybe prepare that cervix a bit more for a few more days you often have that choice.

It’s also REALLY important to know what type of an induction you’re headed in for.

If your cervix is already quite open, and soften you may have a pretty quick one. But, more often your cervix is hard and closed and you are looking at a pretty long medicalized labor.

That isn’t to say that sometimes that medical labor isn’t VERY necessary. Having a baby that is too large for your pelvis, or blood pressures that are too high you might have a seizure aren’t things to mess around with.

But, it’s a choice.

Two thoughts with this one:

1⃣ Understand what your induction will likely look like — I have an induction question checklist that is super helpful for this:

2⃣ Talk with your provider about your priorities, but also how to stay safe. Maybe you can hold off for a bit, get some testing again in a few days and then see where you’re at.

It’s just REALLY important to understand third trimester testing, what the results mean and how they could impact the rest of your pregnancy. Most birth classes skip over this section, but I love that this one really dives into it and gets you prepared for something else people ignore (to their detriment, I think).

Get Prepared

It’s really easy to think that you just need to learn that breathing we talked about earlier to prepare for your birth.

However, there is SO much to get prepared for birth. The thing is, you’re a strong capable woman who is used to taking control of things. That’s very different than how your mom gave birth. She was OK giving control over to her provider >> but women in 2025 don’t want that. They want more from their birth.

Which means you’ve gotta PUT more into your birth — and not just watch some social media videos, or read some articles (even high-quality ones like this one). You really need a class from a professional that walks you through 3rd trimester, labor, birth & postpartum life.

I recommend one that is:

• Taught by a professional (people prefer ones taught by labor nurses because we really know).
• Includes interventions like epidurals, inductions, cesareans and more — because all the preparation in the world can’t always stop stuff from happening, and getting prepared is smart.
• Not too expensive >> class prices have gotten out of control!

I love The Online Prenatal Class for Couples. I know it ticks all the boxes you’ll need to prepare you for your upcoming birth — so you can be a strong, confident, prepared patient. You’ve got this (when you get some help!)

It really is crazy that just putting in a few hours can really pay-off a LOT for birth, and the crazier thing is how few people actually do it.

What type of birth are YOU hoping for, and how are you preparing for it? Tell us in the comments.

I also have this post as a video in case you find that helpful:

And just in case you missed it, grab that third trimester checklist right here:

The post 5 Simple Tips for a “Natural” Labor & Delivery appeared first on The Pregnancy Nurse®.

I should note, these things aren’t “let’s go into labor” tonight type things. The only thing that I’ve really seen that with (that you could do at home) is Castor oil which I don’t recommend as it does have risks. OR medications we give in the hospital like Misoprostol, Pitocin or Cervidil. These are things, that have shown with time can soften your cervix and hopefully make labor (whenever it comes) a bit easier.

These things shouldn’t be done til’ you’ve talked with your provider to make sure they’re safe. Some of these things are NOT good for specific people — so, review your plans with your provider at around your 34 week check-up to make sure you’re all on the same page. In fact, you’ll actively avoid some of these things (like pumping) until you’re closer to 36 weeks.

While you’re there, that’s a GREAT point in time to start talking about your birth plan (and I can help with that too):

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.

One other note: These are only for people planning for a vaginal delivery. If you’re planning on a cesarean there really isn’t a reason to do this, and it may be problematic — for instance, if you have placental issues you definitely do NOT want to try these things!

AND in case you’re a listener/watcher I have a video on the same topic too:

Also, your cervix isn’t the only thing that needs preparation — do this too!

Ok, with all of that out of the way, let’s talk about a few things I’ve found that can help:

“Special Time”

This seems to be birth worker’s favorite thing to say to go into labor. I have a whole post about it with studies linked right here:

Let me boil it down for you:

As you’ll find with all of these, that is very unlikely to “kick” you into labor.

However, if done frequently in that last month (I’m not talking daily here — maybe 2-3 times/week) it may help to soften that cervix. In one of the studies it did show a decrease in gestational age for those who did it vs those who didn’t (although another one showed you were even less likely to go into labor).

More importantly, one of them showed that people were less likely to need a cesarean section who had tried it — meaning, the hope is that it’s softening that cervix, so when labor comes — it’s more ready to let that baby come down!

Who knows if it’s prostaglandin in the sperm, maybe oxytocin released with a nice O or nipple stimulation (we’ll talk more about that coming up)… but I think this may help if done over that last month.

Is it going to be easy or fun? Personally, I haven’t found it to be that way, but maybe I’m in the minority.

You’ll also want to check with your provider to make sure sex is OK with any issues your pregnancy is having. There are things that do require vaginal rest.

Remember that the idea behind a lot of these is to help oxytocin flow — if, at any point, you’re just hating any these — I think you may be blocking your own hormones — and it likely isn’t worth it. Something to consider.

And if you have a big eye roll at just thinking about your partner in that way, I can only recommend getting on the same page with this. I get it, it can feel very heavy to be in charge of growing that baby on your own, but getting them involved can help!

Pumping or Nipple Stimulation

We have LONG known that nipple stimulation promotes oxytocin being released into your blood stream. Will it help push you into labor?

I have a whole article about it here:

As all of these, 15 minutes of pumping isn’t likely to put you into labor, but the studies do show that if done repeatedly over you last few weeks of pregnancy it may well soften your cervix.

This is definitely something you want to talk to your provider about before doing. There is a chance of over-stimulation of your uterus — meaning it contracts too much which can be bad for both you and baby. You’ll want to know the signs of that and anything else to watch for. You’ll definitely at least want to ask when they feel it will be safe for you to try.

A note on colostrum collection: I know this is all the rage right now, and I don’t think that having a few syringes of it is a bad idea, but I’m seeing people with TONS of syringes of it and I just think that might be a waste of supplies and effort. If you just want to pump and be done, that’s fine too. don’t feel like you have to collect anything that comes out (and for most people, not much will come out). It saves you in wash time too.

I have a whole post on leaking and what that means in case you’re interested in more info on it.

While I am 100% a fan of getting that pump set up and figuring out how it works — you can also just use your hands to do this. It doesn’t have to be a pump, I just think most people prefer that… Read that full article if you want more info on it.

Want to know more about “old wives tales”: about going into labor? — check out these posts:

• When Should I Start Drinking Raspberry Leaf Tea?
• Can Curb Walking Induce Labor?
• Can You Push Yourself Into Labor?
• Can a Hot Bath Induce Labor at 39 Weeks?
• Why Does Eggplant Induce Labor?

Evening Primrose Oil

This is a supplement that you can put into your body (studies seem to show a vaginal application works best) and may have some good effects. I have a whole post that goes into the studies:

This, again, is one of those to check with your provider about where to put it, what ones are best (I have NO idea on that) and what dosage would be right. ALSO, there are specific issues that make primrose oil contraindicated, including people with clotting issues or mental health issues. So, be SURE to talk with them.

In that post above I link to some studies that do show babies were born sooner by those who took this supplement over their last few weeks of pregnancy vs those who did not.

Which was honestly, VERY promising for me to read.

It also showed a decrease in cesareans — hopefully just getting your body ready, so when labor does come it’s ready!

But, if your provider recommends vaginal insertion and it’s just too hard or too annoying, you may want to skip it. Again — if you find yourself HATING any of these, you may be blocking your own oxytocin. A good life lesson for all of us!

For any friends who are in their third trimester, don’t miss my checklist pack here:

Ok, last one that’s for your cervix (I have a few other things to get the rest of you ready too, so be sure to read the full article)….

Dates

And no, I’m not talking dinner and a movie, although those are great too — especially when you include this!

I’m talking about the dried fruit variety. I have a full article with the studies linked here:

Studies have shown that those who eat 6 days/day starting about 36 weeks have a higher cervical dilation upon admission than those who didn’t. That’s really boiling it down — more info in that full post.

To me means that it’s softening that cervix. Those people also were less-likely to need induction agents, and had a shorter first phase of labor.

The idea is that something in the dates promotes prostaglandins. I think it’s been used in areas where dates are prolific for hundreds of years by midwives — pretty cool!

This one doesn’t have a lot of cons other than:

• If you’re diabetic you’ll need to watch the sugars with them, this might not be for you (check with your nutrition counselor)
• Some people find them gross… although I’ve seen some people blending them into smoothies or filling them with peanut butter.

They’re also dried fruit that may help with constipation. Which may mean less likely to poop at delivery (and frankly, keep them going afterwards to help with that first poop too!).

What Else Can I Do?

Yeah, a couple other things:

Get Prepared

Did you know that people who took a birth class were less likely to need to be induced? I mean, that’s pretty great and it also doesn’t involve putting anything into your baby exit area.

The reality is that your own concerns about giving birth may be stopping that oxytocin from flowing.

I recommend this class. Studies have shown that people feel 60% less nervous about birth and over 70% more prepared to give birth after taking the class, which is pretty great!

But, let me stop some of your concerns about it right now:

I don’t have time: I get it, some birth classes are like a marathon where they throw information at you. This class isn’t that. It can be done in under 3 hours (less if you speed up the videos, my favorite) and it’s in less than 20-minute “birth bites” so you can get prepared fast. I get it, you’re busy — it’s just waiting for you 24/7.

I think I’ll take a hospital class: Our moms mostly took this type of class, but studies are showing these classes often fall short of what you really need. I hear far too many people saying their class just prepared them for labor stages and breathing, but didn’t prepare them for anything else happening, and I don’t want that for you. You need a high-quality class with great review, and hospital classes are hard to vet. I’m not saying they can’t be great, they can — but they’re just trickier.

It’s too expensive: I don’t know how we got to a place where birth classes at $400-$700 were the norm? Especially online ones. The one I recommend starts at under $100 and even has payments so you can spread it out. I’m a huge fan of that. Birth classes don’t need to be expensive.

In fact, in an effort to make this even LESS of an issue — I got coupon code PREGNURSE that will save you 10% on the class right now!

What if I hate it? Man, oh man — I get this one. First off, that class has a money-back guarantee. If you get in and just hate it or find that it’s not preparing you, she will refund your money. Good news on that front.

Also, if you’re worried — you can sign-up for a little mini class with her here to find-out if you’re a good fit:

Good news! You don’t even have to talk with your provider about this one. Birth classes are perfect for all pregnant couples and I think you’ll feel SO much better being prepared for your upcoming birth!

Stripping Membranes

Stripping membranes is tricky. The studies show it may work… ultimately I think that if you were going to go into labor already in the next couple of days it may “bump” you into labor. I have a whole article with studies right here:

However, if you already think that a vaginal exam is painful — this may not be the best option for you. It’s mostly a more-prolonged and painful vaginal exam. And yes, I tried it with all 3 of my kids. Worked well on one of the kids. Not a great batting average but I was grateful when it did work.

Ok….

What About Preparing My Body?

I think this is so smart, and while this isn’t what this article is on — let me give you a few things:

Prenatal Yoga/Exercise that Involves Deep Squats

We live in a society where we’re sitting far too much of the time to then try to send a baby through our hips.

I don’t know that there are studies, but I do know that people who exercise are less likely to have birth trauma.

Also, for a long time they’ve encouraged women to get into deep squat position and learn to relax their pelvic floor.

I just think it’s a good thing to do. Unless you’re in that position frequently, it can help those ligaments get their head on straight.

I had one of my favorite trainers on youtube on my podcast a few weeks ago to talk about pregnancy exercise:

Perineal Massage

This is one you again need to start early, but most of the studies do show a decreased chance of larger tears at delivery if you do some perineal massage. I (of course) have a whole article on it that explains it more:

Again, you’ll want to talk with your doctor about if it’s right for you. There are people who should NOT be doing it (any varicose veins in that area is one specific reason not to). Plus, they can show you how to do it safely and what to watch for.

But, if I was pregnant again, I would try this — even after having previous babies….

This one’s not going to put you into labor, it may just make birth a bit easier, and hopefully recovery a LOT easier (which was an area I wish I’d had more help with).

So, those are a few things that I would be doing in those last few weeks (with the approval of my provider) to get my body ready to have birth.

Honestly, it’s so easy to put-off the fact that this baby is coming OUT of your body at some point. To try not to think about it.

I think it’s so smart to prepare your mind, and your body with things like this.

And here’s where I share this secret. I’m actually the one who teaches that birth class.

I used to teach classes for my hospital, but found for a variety of reasons they just weren’t really preparing parents. The rigid timeframes were too much, and I was guided to only speak on specific subjects from my hospital.

I want you to not just be a great patient, but also to be great at making choices on your own — and that can be hard in the hospital class setting.

This pregnancy class was created for couples who…

• Want an all-in-one class for pregnancy, birth, breastfeeding and life after birth.
• Need flexibility to fit busy schedules (it’s available on-demand 24/7)
• Are looking to not only get prepared, but have a more solid relationship to bring baby home to
• Want evidence-based education from an experienced labor and delivery nurse
• Feel anxious about their upcoming birth, and wish they didn’t.

If that sounds good, you can check it out here! And, remember coupon code PREGNURSE will save you 10% — so you can get started right away!

Ok, did I miss anything? Tell me in the comments if there is something you’re trying to help your body prepare for labor. I’m always looking to research new ideas to share with you guys — so I appreciate it when you guys let me know!

The post 4 Things You Can Do to Prepare Your Cervix for Labor 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.

Note: Every family is different. I very much understand that a lot of people are “under the gun” if declining fertility and increase health risks to mom the longer you wait to get pregnant again. I am only here to present what the studies say, to give you a baseline idea as you discuss your next pregnancy with your provider. That all has to be balanced, and is best done with your own, individual provider. However, looking at the studies is smart to do on your own, so you’re not coming in blind.

Every family is different, no choice looks the same — so remember that as you read this article.

I have a whole article on my parenting site based entirely on emotion and what I’ve seen in other families you might also find helpful.

I also want to say that not everyone gets to “choose” their baby spacing. I wanted all of my kids much closer together, but infertility made that not happen. That isn’t what this article is about — it’s more about when you should start to “try again” — and then mother nature does her thing.

We’re also basing this entirely on health outcomes, not any effects (like mental or emotional) for babies/siblings as they age (although if you’re interested in this, I thought this article was helpful — it showed poor outcomes for both very short intervals and very long ones as well).

And, if you’re a pregnant friend — grab my 3rd trimester checklist that comes with SO many awesome resources:

Optimal Spacing for Healthy Babies

Here is a few basic findings:

This one showed that 18-23 months provides the “ideal conditions” for a healthy pregnancy. Babies conceived within six months of delivery had a 40% higher chance of being premature or undersized compared to those who waited 18-23 months. It ALSO showed that people who waited 10 years+ were twice as likely to have a small for gestational age baby (SGA), and were 50% more likely to give birth prematurely.

Pro tip: It’s important to look at if studies are talking from birth to conception, or birth to DELIVERY. Many doctors say to wait 2 years to have a baby, but they mean to aim the next delivery to 2 years after your last one — meaning you could conceive about 15 months after delivery.

ACOG (the American College of Obstetrics and Gynecology — the governing board of OB in the US) recommends waiting at least 6 months to conceive. They recommend that patient be counseled on the risks and benefits of waiting 18 months or more to get pregnant again. They have a few studies they site and ultimately say:

• Intervals of less than 18 months after a cesarean have shown an increase in uterine rupture
• Intervals of greater than 5 years can have adverse outcomes

This study tested these theories based on mom’s age at conception. However, they didn’t really find big differences based on the mom’s age (they do show some differences but ultimately concluded the risks were similar regardless of your age). Risk of preterm delivery for those who had less than a 6 month birth to conception date was increased across the board (although a bit less in those over 35).

They took their results to conclude that those who are looking to have their babies closer together, and are older may be safer to do so than those who are younger. Although, they don’t particularly have an explanation for why. You can read more about their explanations in this article.

This study showed an increase risk of stillbirth with intervals less than 6 months. Although they said there may be a variety of factors in play with that, and the increased risk was small.

This one showed that if you’ve had a previous preterm birth it is recommended to wait at least 9 months to decrease your risk next time.

Want to know more about having more babies — check out these posts:

• Reason You’ll Want a Birth Class on Your Second+ Baby
• The Fear of Miscarriage or Loss
• 5 Things That Are Different on Your Second+ Baby
• Second Baby Checklist: Preparing for the NEXT baby.
• How to Fit In A Birth Class

Application of these Studies:

Now we get to sort of guess as to why these might be true — and apply them to you and your needs. Here’s a few things to think about:

Did you have a cesarean?

If you previously had a cesarean, it does stand to reason that increasing your time of healing between pregnancies allows for a healthier baby and not having your uterus rupture (a big complication of post-cesarean pregnancies). This study showed that less than 6 months had the greatest chance of uterine rupture (and frankly — it was a lot higher, so that’s really something to consider).

In the case of a previous cesarean birth — I think most providers recommend at least 18 months between conception to conception, and they prefer closer to 24 months. If you’re wanting to VBAC, this especially makes sense.

Want to know more about cesarean births — check out these posts:

• C-Section Recovery: Tips You’ll Need
• Considering a VBAC: What to do
• What to Wear For a Cesarean Section
• How to Prepare for Your C-Section (Cesarean Section)
• C-Section Scar Pain During Early Pregnancy

Are you on a “ticking clock” for fertility?

If you feel like you need to have those babies faster for everyone’s health, that study showed that maybe you were safer if you’re over 35.

Personally, I likely guess that’s due to a higher socioeconomic level for people having babies later in life. They tend to have better insurance, better access to prenatal care and eating the right foods for the best health. However, we can’t be sure.

I will say that I don’t see a lot of studies looking more at a 1-year interval. Most seemed to focus on comparing 6 months to 18 months, but maybe a year is enough. A good question for your provider (as they can base it off you and your specific medical needs).

Why might longer intervals be safer?

So, why might waiting be better for you and baby?

Nutritional Depletion: That baby will take from you whatever it needs, so if you don’t have as much time to “shore up your reserves” — to eat a great diet and replenish what has been taken it might be harder for the second baby. They won’t have as much to work with.

Grab my safe eating guide to make sure you’re eating the right foods:

Damage to your Reproductive System: Your uterus grows and shrinks a lot during pregnancy & postpartum, so allowing your whole system to heal for a bit does seem smart.

Postpartum Stress: If you’ve already had a baby I am here to tell you it’s stressful to add a baby to your family. That stress takes a toll on your body, so you should plan on being kind to it.

Some other sources say that it allows you to bond better with your baby as well (although I don’t see any studies on that).

However, you have to remember that people who conceive less than 6 months after their last baby are often doing so un-planned. That means they have less prenatal care early on compared to those who wait. Most often I see these as “oops” babies — often conceived before mom even gets her period back and isn’t paying attention to that issue.

That’s clearly different than those who plan to have babies very close together and will hopefully get the same prenatal care as they did the first time.

I gotta say a lot of second+ time moms are carrying around a lot of birth trauma. Which isn’t doing anyone any good.

I definitely had that on my second baby — I was so worried about things going wrong again and me having a horrible recovery — until I found this.

It prepares you for the rest of your pregnancy, labor, birth, and postpartum (thank GOODNESS for the postpartum section). It really will get you prepared.

Effects on Mom?

I will say that I felt there was a gap in coverage on effects to mom’s health in baby’s spacing. Are there increases in postpartum complications when babies are closer together?

We spend so much time focusing on outcomes for the baby — I wish we did more about effects on mom.

This one showed some issues like “maternal nutritional depletion, folate depletion, cervical insufficiency, vertical transmission of infections, suboptimal lactation related to breastfeeding-pregnancy overlap, sibling competition, transmission of infectious diseases among siblings, incomplete healing of uterine scar from previous cesarean delivery, and abnormal remodeling of endometrial blood vessels.”

I did see some stuff on folate levels really taking a while to ramp back up after delivery — and I think that’s something we should consider (but effects baby more than mom, most likely).

Does this apply to Miscarriage?

I often get asked if this same thing applies to miscarriages, and doesn’t seem to.

This study showed conception of less than six months between miscarriage and conception had the best reproductive outcome and the lowest complication rates.

This one showed there really wasn’t a difference based on how long between (including abortions as well).

This one showed waiting less than 3 month showed the lowest risk for subsequent miscarriages.

All of them showing that you did NOT need to wait between miscarriages to try to conceive again.

It makes sense, if it’s an early loss (so these would be prior to 20 weeks) your uterus and body hasn’t had all the effects on it as carrying a baby to full term.

However, if you’ve had a loss after 20 weeks you may consider waiting like we had talked about above. Definitely a discussion to have with your provider based on your past obstetrical history.

Also, if you’re having frequent losses you definitely want to get with your provider to see if you can find an issue for it, at least check basic labs to make sure all are normal.

Conclusion:

After reading all of these studies it really makes sense to wait at least 6 months to get pregnant again. As someone who’s had children I really think it takes time for your body, and your mind (and your pocketbook) to heal after having a baby.

It was interesting that longer intervals showed larger issues — that may be due to maternal age, it’s hard to say.

Ultimately, you have to decide what’s best for you — and then do as much as you can to promote a healthy pregnancy depending on when you do get pregnant. Including:

• Getting good prenatal care (so hard to get appointments in with a small baby in tow as well — I get that!)
• Eating as well as possible, and making sure to take prenatal vitamins (and possibly even more — like choline or higher levels of folate if you discuss it with your provider or nutritionist)
• Taking appropriate self-care measures including stress relief and working out to make sure your body is as healthy as you can make it.
• Watching for signs of preterm labor, at a recent conference they talked a lot about cervical length and this may be something you want to discuss with your provider. Preterm labor is one of your biggest risks, so it’s important to know the signs.

Many of you may be thinking SIX MONTHS — NO WAY! I think it’s also valid to wait until you feel ready. No shame in that either. Increasing your family size isn’t something that should be taken lightly, so I’m glad you are considering both you and your baby’s health in regards to this issue.

AND if you’re pregnant right now, I would like to make sure that you’re taking a birth class. Even if it is your second babies studies have shown huge benefits to taking a high quality class including:

• Decreased c-section rates
• Decreased induction rates
• Decreased assisted delivery rates (like forceps or vacuums
• Increased birth satisfaction due to your preparation.

I recommend this one.

Sources:

Gottlieb S. Research shows optimal spacing for healthy babies. BMJ. 1999 Mar 6;318(7184):624A. doi: 10.1136/bmj.318.7184.624a. PMID: 10066193; PMCID: PMC1115082.

ACOG Recommendations: https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2019/01/interpregnancy-care#:~:text=.org%2Fbreastfeeding%20.-,Interpregnancy%20Interval,pregnancy%20sooner%20than%2018%20months.

Schummers L, Hutcheon JA, Hernandez-Diaz S, Williams PL, Hacker MR, VanderWeele TJ, Norman WV. Association of Short Interpregnancy Interval With Pregnancy Outcomes According to Maternal Age. JAMA Intern Med. 2018 Dec 1;178(12):1661-1670. doi: 10.1001/jamainternmed.2018.4696. PMID: 30383085; PMCID: PMC6583597.

Stamilio DM, DeFranco E, Paré E, Odibo AO, Peipert JF, Allsworth JE, Stevens E, Macones GA. Short interpregnancy interval: risk of uterine rupture and complications of vaginal birth after cesarean delivery. Obstet Gynecol. 2007 Nov;110(5):1075-82. doi: 10.1097/01.AOG.0000286759.49895.46. PMID: 17978122.

Love ER, Bhattacharya S, Smith NC, Bhattacharya S. Effect of interpregnancy interval on outcomes of pregnancy after miscarriage: retrospective analysis of hospital episode statistics in Scotland. BMJ. 2010 Aug 5;341:c3967. doi: 10.1136/bmj.c3967. PMID: 20688842; PMCID: PMC2917004.

Tessema GA, Håberg SE, Pereira G, Magnus MC. The role of intervening pregnancy loss in the association between interpregnancy interval and adverse pregnancy outcomes. BJOG. 2022 Oct;129(11):1853-1861. doi: 10.1111/1471-0528.17223. Epub 2022 Jun 1. PMID: 35596254; PMCID: PMC9541236.

Sundermann AC, Hartmann KE, Jones SH, Torstenson ES, Velez Edwards DR. Interpregnancy Interval After Pregnancy Loss and Risk of Repeat Miscarriage. Obstet Gynecol. 2017 Dec;130(6):1312-1318. doi: 10.1097/AOG.0000000000002318. PMID: 29112656; PMCID: PMC5709156.

Conde-Agudelo A, Rosas-Bermudez A, Castaño F, Norton MH. Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms. Stud Fam Plann. 2012 Jun;43(2):93-114. doi: 10.1111/j.1728-4465.2012.00308.x. PMID: 23175949.

Wendt A, Gibbs CM, Peters S, Hogue CJ. Impact of increasing inter-pregnancy interval on maternal and infant health. Paediatr Perinat Epidemiol. 2012 Jul;26 Suppl 1(0 1):239-58. doi: 10.1111/j.1365-3016.2012.01285.x. PMID: 22742614; PMCID: PMC4562277.

Birth spacing and risk of adverse pregnancy and birth outcomes: A systematic review and dose–response meta-analysis Wanze Ni, Xuping Gao, Xin Su, Jun Cai, Shiwen Zhang, Lu Zheng, Jiazi Liu, Yonghui Feng, Shiyun Chen, Junrong Ma, Wenting Cao, Fangfang Zeng

The post Safest Age Gap Between Kids: For Health of Mom & Baby appeared first on The Pregnancy Nurse®.

While you’re here, grab my third trimester checklist — it gives you a few checklists I think you’ll find super handy:

I LOVE a to-do list or pregnancy goals, so I hope you guys find this helpful:

Schedule-Out Prenatal Appointments

Get those prenatal visits scheduled out. When you’re planning in advance you can get the time that works best for you (or perhaps a time when the doctor is most on schedule — I found that right after lunch or first thing in the morning was a good spot).

You HAVE to make prenatal appointments a priority. I know, I know that a lot of prenatal appointments feel like a 100% waste of time for much of pregnancy, but they’re going to be quite frequent now — because things can change day to day in pregnancy.

Keep Doing Kick Counts

You should’ve started kick counts as you entered your 3rd trimester.

Did you know that they have been proven to save 1/4 stillbirths when done correctly?

Unfortunately, a lot of providers don’t really explain them right (it is NOT 10 movements in 2 hours) — grab my cheat sheet here:

Pro Tip: I understand that kick counts can also seem like a waste of time when I was already so harried and busy — but I found that doing them after dinner got me out of cleaning up dinner AND I did something healthy for me and my baby.

Prepare for GBS Testing

At your next appointment your provider is likely going to order GBS testing. It’s just one of those pregnancy tips that’s nice to know in advance (because you’re going to have to take your pants off for it).

Don’t know what it is — I have a whole post on GBS testing that goes into it more.

Also, if you’re not in the US check with your provider to see if it’s something they DO offer.

Pro Tip: GBS stands for Group Beta Strep — it is NOT an STD but it is bacteria that a lot of us just have on our bodies that they have found can be problematic for babies to encounter in the birth canal.

Finish (or Take) a Birth Class

By now I’m hoping you’re finishing-up your birth class — but some of you may have laughed when you read that. Some of you may even think it’s too late to get a class in.

I remember on my first it felt like Hunger Games trying to get into a class at the hospital and if you didn’t call at the exact right time you were out of luck. The other sad news is that my class I took there was actually horrible. They didn’t teach me anything other than being a good patient — but that wasn’t that helpful for me.

I then found this class that can easily STILL be done at 35 weeks of pregnancy (honestly, even just a few days before delivery is still manageable).

It only takes 3 hours of time, can be done from your couch or bed, and I love that it’s cut up into small 20-minute “bites” so you’re not overwhelmed as you’re trying to process this big thing in your life.

Honestly, it’s nice to have something finally to be just for YOU — rather than struggling to get a class, find the classroom, stay awake…. that’s why I think this is a game changer!

Learn about 3rd Trimester Testing

Now is the time to be aware that your provider may order extra testing, for a variety of reasons. Those tests include:

• NST (non-stress-test) to see how baby is handling life in the womb
• BPP (biophysical profile) to see how baby is growing/how much fluid you have and how baby is developing.
• Preeclampsia Labs – it’s easily caught via lab work that isn’t pricey or hard to get.

Fun fact: The first lesson in here talks about 3rd trimester testing, what it’s for, how to understand how the results can affect your pregnancy moving forward. This can make a HUGE difference in your labor to understand.

Learn About Problem Signs

There are some pretty specific problem signs that you’re going to want to keep an eye out for.

Honestly, at this point in pregnancy everything seems like a problem sign — including the fact that putting your own shoes on is a pretty big trial — but there are some really specific ones we want you to watch for — so make sure to have that talk with your provider. You’ll also want to find out when to head to the hospital for labor too!

I just had a friend who had a great pregnancy until she started having itchy palms and found out she had cholestasis.

I have another friend with a great pregnancy until suddenly her blood pressure spiked. In both of those cases they decided an induction was in their best interest — which was completely unexpected!

They were so glad they took this class to really be prepared for how to find out what they were testing for, and how to make the choice to be induced (because it is always your choice!).

I think when we think about birth classes we always think about breathing — but there is a lot more to think about in a birth class. This one includes testing, labor signs interventions, PLUS breathing!

Preterm Labor Signs

You’re right at a spot (or, if you’re a few weeks before this — I’m especially talking to you) that we still really don’t want baby to come for a couple more weeks.

Learning the signs of preterm labor can help you get into the hospital fast so they can stop it (with medications).

Grab my labor signs checklist here:

Get Hospital Supplies

Now is the time to grab anything you want at the hospital.

Now, the hospital will provide you with what you need should you come in with nothing — we do that all the time. BUT, I will say that our toiletries suck.

If you can avoid using them, I say do so. They are gross.

I recommend everyone bring:

• Something for chapped lips (Vaseline, etc.)
• Toothbrush / toothpaste
• Lotion (the hospital is VERY drying to lips & skin)
• A hair tie
• If you think you’ll want to wash your hair I’d bring those products too.
• Any other toiletries you think you’ll want (some women do make up, some do not — either ways is fine!)

Then, you’ll obviously need to bring whatever else you need.

The hospital will provide linens/towels — so you don’t have to worry about that.

Here are a few more posts that might help you know more of what you’ll want at the hospital:

• What to Wear For a Cesarean Section
• Do You Wear a Bra During Labor?
• Your Guide on What to Wear in Labor & Delivery and Your Hospital Stay
• The Best Postpartum Pajamas

Pack Hospital Bag

First off — I have a hospital bag packing list right here if you want just that (it’s also a bonus in that third trimester checklist I linked at the top though):

I am a big fan of not OVER-packing for the hospital, mostly because it gives you less to put away when you get home (and less to sort through for what you REALLY need). I do recommend 4 different bags though:

• A Labor Bag
• After the baby bag
• What to pack in the diaper bag for the hospital for the new baby
• What to pack in hospital bag for dad
• Bonus for those with a scheduled c-section

But I do recommend that your partner know where these three items are (so they can easily get them when you need them, vs you giving them the death stare when they can’t find them):

1. Chapstick/Vaseline – something for dry lips.
2. Hair Tie (unless you have a pixie cut — if your hair can get in your face you’ll want something to keep it out of it, especially during pushing)
3. Phone charger or external battery

If it was me, I’d have those three things in a special pocket in the bag that I would show them where they are in advance.

Honestly, at 35 weeks I never had my bag packed — I felt like it was bad ju-ju since I figured I’d go late (I was right). However, I think it’s smart to have the necessities in a small case and then you can add to it as you get closer to your due date.

I have a whole post on when to pack your hospital bag.

Get Postpartum Supplies

In addition to labor supplies, you’ll also want to grab your postpartum stuff. This means pads, tucks, Ibuprofen. I have a whole list here (that’s also included in that third trimester checklist I linked to at the top):

Figure Out Your Birth & Postpartum Plan

Now is the time to start solidifying your birth plan. Mostly you’re thinking about what you’d like in a perfect world (I never recommend getting your heart set on something specific). I have a whole birth plan series I can send you right here:

I actually also recommend making a postpartum plan as well. This is going to go over where you plan for baby to sleep, how you’ll feed them, who will get up at night, who can help — and more. Just like a wedding we spend far too much time planning for the “big day” (aka, labor) and not enough time thinking about what life will be as a married couple (or after you have a baby in this case):

Remember that class I shared up above? I absolutely LOVE the couples questions, because it helps you start making that postpartum plan from the beginning. I love how it sparks conversations that you really need to have (but may not even know you need to have). Huge fan of them!

Choose a Pediatrician

This is one a lot of people are sort of surprised they need a baby doctor (your OBGYN will not be seeing the baby — they honestly don’t do babies at all).

You’ll want to look for a pediatrician for your baby. I recommend:

• Asking friends who live close to you who they recommend
• Check your insurance to see who they cover
• Find someone close — you go to the pediatrician often!

This is one of those little things a lot of people miss, so I’m glad you’re here in this post with me.

Once you pick them, note their name, their practice name, phone number and maybe address so you can tell the hospital when you’re admitted.

Pro Tip: Pediatricians used to come to the hospital to see babies they’d follow later on, but anymore most newborns are followed in the hospital by a hospitalist (a doctor who just does rounds at the hospital) and then you take them to your own pediatrician once you’re home — so you don’t have to worry as much if your pediatrician comes to your hospital (although it would be awesome if they did).

Take a Breastfeeding Class

I think a breastfeeding class (a very basic one) can be REALLY helpful.

For the majority of people breastfeeding doesn’t come naturally, which is a shame since it’s all very natural. I will say that it did NOT come naturally for me, and I’d helped moms breastfeed.

Taking a class that:

• Teaches you what to do in the first few days as far as getting baby to feed
• Cues baby will have for when they’re hungry
• What a good latch looks/sounds like (or doesn’t sound like)
• Problem signs that it is not working and you need help.

You don’t need a giant class that troubleshoots a ton or talks about pumping — just some basics. Don’t get overwhelmed.

The good news? That class actually has a breastfeeding class written by an IBCLC bundled in. Plus, she also does postpartum consults and so you’re tied into someone who can help you even when you go home!

If you’re JUST in the market for a breastfeeding class, you can find them at The Breastfeeding Mama.

Figure Out Missing Baby Needs

Ok, this is pretty far down the list — mainly because this is the thing that most people focus on.

I think it’s smart to make a final list of what you have LEFT to purchase at this point.

I have a whole post on baby necessities that you might find helpful.

Want to know more baby info — check out these posts:

• Best Baby Names 2025
• 3 Medications for Baby to Have On Hand
• Help! My Baby Won’t Sleep — my epiphany!
• What to DO With Your Baby?
• 5 Things That Are Different on Your Second+ Baby

Get Your Cervix Ready

These might not be for everyone, and I 100% recommend talking with your provider before starting them (especially primrose oil) — but they have been shown to possibly make labor easier if you start around now.

I see FAR too many people require an early induction (first, understand your testing, to understand if it’s really required) and then end up with C-section because their cervix just wasn’t even close prepared for labor. I just think we can do a few things to maybe prep it after reading the studies.

I have a whole post on how to prepare your cervix before labor. It includes links to my posts about dates and my post on primrose oil (both include the studies).

Learn The Postpartum Warning Signs

I think that in the last month of pregnancy it is an AWESOME time to go over the postpartum warning signs.

Once baby is born you may be CONSUMED by all there is to learn and know about your new baby as you get to know them — so being prepared on what to watch for YOU (including your support people) is so smart.

I actually have a whole class that is included in here where I run through them with you giving examples and what exactly I’ve seen in my experience.

BUT if that feels like too much, I also have a quick (and free) presentation here.

Both of those include a printable you can put on your fridge with the signs that either should send you directly to the hospital or to call your provider — it’s super clear and concise, I love it!

Don’t Forget Self Care

Alright, I worry that this post may have made it worse — but I am also here to say that taking care of yourself is VERY important in all of this.

Think of who can help you, get your partner involved. Make sure that you’re taking care of yourself!

I have a whole post on self care during pregnancy (and postpartum) — as it sometimes looks a bit different than it did before.

I worry this list feels very overwhelming.

Honestly, that’s how preparation is — sometimes it might require a LOT of work, but if someone just bundles it all together — helps you understand third trimester testing, preparing your cervix, preterm labor signs and more — that’s the beauty of a good birth class.

You know the crazy thing about online courses’ — is that their information can often be found on the internet. Which is handy, right? BUT, what you’re actually paying for is having it all in one place, where you’re not getting repeated info but also it’s all from one quality source so you know it’s all correct.

That’s why I recommend The Online Prenatal Class for Couples. You won’t regret it! In fact, I’m so passionate about you getting it done — if you start right now, use coupon code 35WEEKS to save 10%!

So, did I miss anything? Tell me in the comments! I hope you found this post helpful!

The post 35 Weeks Pregnant Checklist appeared first on The Pregnancy Nurse®.

I have a friend who, when she took her birth class, was asked to write down all the things they hoped for their birth. She then told them to rip them up and save just one of them. For her, it was skin to skin time after baby was born and she did get that, and felt good about how things happened, even though much of it didn’t go to plan (including an unplanned cesarean).

Birth plans are often full of lots of hopes and dreams, which I love. We should have lots of hopes and dreams for this little one. We gotta shoot high as we raise these new little humans. However, it also helps to have over-arching priorities that we are clear on that matter the most.

It might be fun to do a post on Pulling Curls about parenting priorities (like keeping baby safe), but for today we’re going to talk about pregnancy priorities.

So, the first question:

What’s your top priority?

Most often you’ll hear that the top priority is a healthy mom and a healthy baby.

This isn’t always true, that may truly not be your top priority, and that’s fine too — I’m just speaking to my experience with thousands of patients.

I also get a lot of flack online that this is the “bare minimum” — but in reality that is sometimes what you achieve as a parent. I have many bare minimum days as a mom….

You put your baby in a safe sleep space but they cry more than you wish, you’re sleeping less than you need and you feel fairly miserable some of the time.

But, I think it’s smart to put this down as your #1 priority. To remember that really is what’s most important, even if you hope for a lot more.

So often I see people online saying how upset they are that baby had to go to the NICU and they weren’t able to hold them for 4 hours because of all the testing and needs the baby had by the NICU team.

And I’m not saying that isn’t INCREDIBLY hard, but when you remember that top priority is that baby is healthy you realize that the other priorities just aren’t as important.

Now, if you believe baby was in the nursery but didn’t need to be that’s a whole other bag of chips — learning to communicate with your healthcare team should be a priority during pregnancy and learning to that can help in numerous situations. I recommend this class where a pro teaches you to do just that.

So – yes I want you pull-out a piece of paper, or your notes app and I want you to start a list of birth priorities. Put your #1. It may not be that one, but I want you to put down what is TRULY most important to you.

Some people think they can detach “healthy mom & healthy baby” putting baby healthy is #1 but I will remind you that wrapping baby in a very sick mom isn’t a good idea. We don’t choose one over the other at the hospital, so you can put that notion out of your head.

I want to also say that everyone’s idea of “healthy mom & healthy baby” looks different. To me that is delivery in a hospital where they can accommodate any emergency.

For some other people it looks like a home birth with a great midwife (I love home birth stories, but I have to admit that my history makes me very nervous about them).

For some people that looks like free birthing.

I honestly think that all of these people still have that priority, and for some reason they believe that delivering without assistance is the safest way. As a note, I take responsibility for that as a women’s healthcare provider — we have to do better to accommodate people’s wishes.

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

• What a Birth Plan Can ACTUALLY Do For Your Birth?
• What do People Wish They Had Known About Before Birth?
• Advocating For Yourself in Labor
• 5 Things You CAN Control in Labor (mostly)
• Planning for Bump to Bassinet: Must-Have Resources for Expecting Parents

Other Birth “Values”

After that big one, our birth “values” differ a lot. I want to share 3 themes that I’ve seen in birth “values”, and maybe you’ll identify with some of these.

I want you to think of these are over-arching things that sort of guide your birth. Like, if you’re a democrat you often vote that way on the ticket (even though that’s a pretty bad metaphor this time of year).

Personally, I’m an independent so I very much pick and choose what’s important to me down the ballot and in birth — but I think it helps to know what other people are thinking in labor.

It’s also OK if you don’t know, and you honestly don’t have a clue what you want. If that’s you (and honestly, even if that’s not you) I recommend taking a birth class to get more clear on what’s going to happen at your hospital delivery. I recommend this one. It’s taught by an expert RN and doesn’t take over your life which I think is important.

Mother Nature Knows Best

Many people have as a core belief that when we do as little messing with mother nature, the better things turn out.

It may surprise you that I am one of these people. I’m not a fan of induction and I look for extremely conservative providers who don’t look to do more than is absolutely necessary.

Things that might be important to you:

• No inductions
• No breaking your water until later into labor
• Staying at home until you’re well into active labor
• Allowing movement in the delivery room
• No/less pharmacological pain management options
• Pushing as you’d prefer rather than regimented pushing (I have a whole post on how to push here you might find helpful).
• Avoiding a cesarean section as much as possible

You may also consider refusing medications, or a circumcision or a bath for the baby.

For every family how this looks is different. But, maybe you feel like mother nature knows best. That can be one of your values and then your priorities fall in line behind that.

No Epidural

Some people really don’t want an epidural. They go-in hoping for this and make all efforts to avoid it.

That can look like:

• Avoiding induction (because it lengthens labor and makes it more likely you’ll want an epidural)
• Staying at home as long as you can so you’re not “tied down” at the hospital as long.
• Using movement to your advantage during labor
• Possibly intermittent auscultation to allow for that movement.
• Asking your providers not to talk about it and you’ll bring it up if you want it.

For me, I was actually a “mother nature knows best” but I got an epidural. I was tired, and I knew I was already very anxious about the whole process if we added the pain it would be very difficult for me to remain calm and enjoy my new baby.

You can make a combo of any of these values…. Just like any good pizza chain.

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

• Epidurals During Pregnancy & Labor
• How Many CM Do You Need to Be to Get An Epidural?
• Weird Side Effects from The Epidural That No One Talks About
• What to Do If You Can’t Decide if You Want an Epidural or Not?
• Is a “Walking Epidural” A Real Thing?

My Doctor Knows Best

Maybe you’re up for whatever your doctor recommends. I love that you trust them like this!

Hopefully, you’ve picked a provider that aligns with you (I always picked a very treatment-conservative provider who was willing to speak-up if they saw a big need). You trust them, and you really think they’re trained to do the right thing.

Honestly, we don’t like to think of it, but your provider (whether you like them or not) could very well hold your life in their hands. It’s rare, but it can happen — so you at least want a provider that you think will make the good choices if the chips are down.

But, there’s a lot of people who just want to hear their doctor’s recommendation and go with it.

I love that trust. However, sometimes they give you options that are equally fine — at which point those other priorities come in.

Ok, now that we’ve gotten the values out of the way — what are your next priorities? I want to share 10 that I’ve seen people be very fond of that might help you think of your own.

Again, this isn’t cut and dry but it helps you know what’s important to you. It helps you think about birth and get started making choices for yourself, which I think is SO important.

Quick note: I really do think that one of your most important things to make a choice on is what birth class you’re going to take. Personally, I took a hospital class that just sucked and while it checked off “take a class” it didn’t prepare me at all. I recommend this class — it’s so much better than I did for myself!

Birth Priorities

Again — these are going to be different for everyone. You may think some of them seem crazy, but remember everyone has had different traumas and background in their lives. Hospitals are meant to accommodate them all (I hope).

I would also encourage you to share these birth priorities with your healthcare team. When we know what’s important to you, we can make them important to us too! Share them early and often!

This is actually something I recommend with all “birth plans” and while this one has more specifics than what we’re talking about in here thousands of couples have found this birth plan series helpful:

Avoid the Hospital

Some people want to avoid the hospital as much as possible. This may be:

• Delivering at home
• Delaying going to the hospital
• Leaving early after baby is born

They may have had a loved one die in a hospital, or previous poor experiences with the hospital and it really makes them uncomfortable.

All of this is fair and valid. I hate hospitals, I get this.

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

• My #1 Tip for Hospital Birth
• What To Do If Your Labor Goes Long?
• How a Birth Class Changes Pregnancy, Labor, Birth & Life With Baby
• The MOST Traumatic things in Labor & Delivery
• Considering a VBAC: What to do

No Needles

Maybe you just hate needles, so you’d like to avoid them at all costs.

This may mean less/no labs, no IV and no shots or epidural.

This is one I would definitely bring up with your provider early on. The unfortunate news is that if you want the “healthy mom & healthy baby” you are likely going to need to confront this fear a few times during your pregnancy.

There are very important labs during pregnancy, including the glucose test. I am also a huge fan of at least having a saline lock at birth “just in case”.

So, again — talk with your provider on this, and maybe consider some therapy to get a toolbox of tools to manage this fear.

I actually went to therapy for my fear of flying (I had an uncle that died in a plane crash that triggered it in my 20’s) and it really helped. She gave me some audio snippets to listen to on a few flights and slowly I stopped needing them or being bothered by turbulence much. I am really glad I did it.

No Induction

Some people want to avoid an induction at most costs. Of course, everyone is balancing everyone’s health but I really tried to avoid induction myself.

The reality of L&D is that most cases are not cut and dry. We may slightly recommend one option over something else, but the choice is ALWAYS yours.

I can 100% promise your provider is NOT going to show-up at your home and drag you to the hospital. If you choose to refuse the induction they’ve scheduled please do call the hospital to let them know you’re not going to be there as a courtesy for their workplace.

I actually did a whole podcast episode on choosing if an induction is right for you.

If you’d really like to avoid an induction, let your provider know that and then have a frank discussion on the risks you’re facing and then make the best choice for yourself on that day.

The good news is there’s often time to change your mind.

Oh, and keep doing those kick counts (don’t know what I’m talking about — grab my cheat sheet here):

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

• 5 Things NOT to do Before Your Induction
• Pitocin to Induce Labor
• Inducing Labor at 39 Weeks: Pros and Cons
• What Happens if Your Induction Doesn’t Work?
• 5 Reasons to NOT Get Induced

Employ Natural Pain Management

Some people really want to avoid the epidural, and some also want to avoid IV pain meds or nitrous (or anything else the hospital offers).

I have a whole post that addresses this more called How to have a “natural” hospital birth (also talks about avoiding induction).

That post gives tips on how to make that happen for you.

I think it’s pretty important to think how important this actually is for you.

My experience is that a lot of people hope to not need the epidural, but then end up getting it in the hospital, which is fine.

You have no idea how painful labor will be — so when it comes, the majority think — “no thanks” and ask for an epidural.

However, if it IS really important to you I think taking a natural pain management class is a must. This one has it included.

You’ll want to have multiple tools in your “toolbelt” to manage the pain when it gets tricky. You’ll also want to know about the labor stages so you can have an idea what to expect of your body as you progress.

All About Birth Environment

Some people really want the birth room to be a specific way.

The great news is that hospitals are much more accommodating to this than they used to be.

Just be aware the hospital can refuse specific things. Here are a few things I’ve seen online that the hospital may say no to:

• Bringing labor tubs into the hospital (I honestly can’t imagine a hospital OK-ing this, unless it can be inside their own tubs).
• Fairy lights in the room (could be a fire hazard)
• Temperature (we have rules about how warm/cold a room can be for safety reasons)

I have a whole post on things you can’t refuse at the hospital that goes into some of the rules you may not have thought about.

BUT I think including these on your birth plan is super cool. Maybe just sum it up in specific words like quiet, dark, or what type of sounds you’d like playing (or music).

I was always happy to accommodate these (as long as it’s safe — you will likely have some light in your room so no one — especially your nurse — doesn’t trip). And it also made me super happy to know this rather than turning lights on and off trying to assess how they liked things.

Along these lines you may also have something you want to wear during labor. Asking questions about what you can/can’t have at your birth is an awesome thing to do at your hospital tour.

Skin to Skin

Most often baby is brought to your chest. At that point I most often encourage you to just love your baby, look them over and meet who you’ll spend the rest of your life worrying about.

This gets trickier in the OR (if you have a cesarean birth), but telling us it’s a priority helps us work around things.

Here is my reminder that sometimes things that WERE a priority don’t end-up being one at the time. Sometimes skin to skin sounds magical until you’re having a panic attack that you’re in major surgery. Everyone is different, and allow yourself to change your mind by what you want in the moment.

Prioritize Breastfeeding

Some people want to breastfeed right away, and want to prioritize it over sleep, or their own healing in some cases.

With my first breastfeeding didn’t work. I worried it was something I did wrong on my first, so I prioritized early latching and trying as much as we could to make breastfeeding work. Fun fact, it ultimately did not work — but in my head I wanted to give it as hard a shot as I could.

I think it’s super important for a couple to talk about how “married” they are to breastfeeding before baby is there. Partners will often be surprised that one is much more for it than another and it’s good if they get on the same page by discussing why it’s important to each person.

We actually review this in the couples questions in here so you’re not caught by surprise.

Involve Partner

Some people really want their partner involved, and some partners really want to be involved.

We love that at the hospital, but we’re often reticent to really involve them because a lot of partners do NOT want to be involved in birth.

So, telling us your partner is really wanting to help is awesome. They can do things like help change your position, change pads underneath you, help position the monitor. Honestly, there is a ton they can do if they just ask and step up to the plate!

Here’s some of my best partner tips you might find helpful:

Limit Exams

A lot of people want to limit exams. Somehow the internet has made people think you can easily refuse all exams, although that’s pretty rare.

BUT, we can definitely limit them. Especially in cases like:

• Re-checking just to see how things are going
• Double-checks by a nurse in training
• Doctor is coming in soon, let them just do it

Letting us know it’s a priority is a win for all of us. It also sometimes allows us to think ahead a bit more and really tailor it all to your needs.

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

• What do the Cervical Exam Numbers Mean?
• Can You Refuse Cervical Exams with Nurse Chantel
• What Does the -2 Mean When They Do a Cervical Check?
• Painful Cervical Checks During Pregnancy: What to do if you’re scared
• Pain After Your Cervical Check: What’s it mean?

Free Flow.

Maybe you’re looking to just let labor come as it wants to.

You’re educated about what can happen, and ready to make choices as it comes — but you’re ready to let it be what it’s going to be.

Honestly, these are my favorites (for the most part, I spend a lot of time asking these types of people what they want).

Was I this? Absolutely not (although I am working on being more like this in general — I think my life would run more smoothly).

But I really think these people end-up with the best outcomes.

This isn’t to say you just let “whatever” happen to you in labor. You’re engaged, you’re making choices but you’re aware you have no control in this situation — and that’s OK with you.

Now, I just wanted to give you some examples of birth priorities. I really think you can only pick a few of these and really work towards it, if that’s what you want to do. Or, be free-flow. It’s just not in my personality.

But, the MOST important priority needs to be getting educated on what to expect.

It’s easy to think that it will be so easy to manage the pain because you rarely take tylenol, only to be blindsided by what labor actually looks like.

It can be easy to think you don’t need help or a support system postpartum, only to be blindsided by how much it is taking out of both of you, and you could really use assistance….

When I took my birth class in my delivery hospital (pre-working L&D) I was blindsided by SO many things because the class just wasn’t good. I don’t want that for you. I want a high quality class that can really help you both get prepared!

The Online Prenatal Class for Couples was created to:

• Be fast and efficient so you’re not spending your life in this class
• Make you a team rather than your partner being just a cheerleader
• Get prepared with an expert and a mom to three who really knows what you need to know.

Come get prepared with me right here.

Want to do a vibe check before diving into the whole thing with me? — check out my free labor pro tips. It’s your first step toward getting in the driver’s seat of your birth.

The post YOUR Birth Priorities: How to make them clear appeared first on The Pregnancy Nurse®.

Grab my best 3rd trimester checklists here:

As you step into the final stretch of pregnancy, having a 3rd Trimester Checklist becomes your map to preparing for your little one’s arrival. From organizing a detailed Baby Preparation Checklist to covering all the must-dos on your Third Trimester To Do list, it’s time to dive into everything you need for the last weeks of pregnancy. This Pregnancy List includes tips on Nesting, Pregnancy essentials, important 3rd Trimester Food choices for staying strong and healthy, and all the “to-dos” Before Baby Arrives. With this comprehensive checklist, you’ll feel prepared and confident in those last precious weeks before meeting your baby!

I also have a video on this subject:

I really want to boil it into 4 parts that will SIMPLIFY it into something you feel like you CAN do.

Get Your Body Prepared

This one has 3 tasks:

• Keep that Body Moving
• Make Prenatal Appointments a Priority (schedule them NOW)
• Eat the right foods

We’ll dive into those each a bit deeper:

Keep that Body Moving

I recently saw a tiktok where a mom said it felt like someone was pouring in a bag of sand into her every day — she just felt heavier, and less mobile every moment of that last trimester. I get that feeling.

So, will you be running a marthon? no.

But, can you still get out on some walks, and make stretching and mobility part of your day? Likely so.

Of course, ask your provider if you’re good to work out, move — and see if they have anything/anyone they recommend.

Bonus points if you’re able to get a PT appointment just to talk about your body — what you should and should not be doing and any tips they have for any issues you’re having.

I am a HUGE fan of really getting that pelvis into movements like a squat to help keep those ligaments open. You can use your couch or a small stool to help you. It really can make a big difference when you’re pushing out that baby.

More and more I think our time sitting in an office chair is ultimately not paying off for our birthing hips.

Make Prenatal Appointments a Priority (schedule them NOW)

If your office offers to schedule your last few appointments, take them up on it. Become chummy with the front desk lady to see when the best time for appointments are and when you’ll wait the least.

Make these appointments a priority.

Prior to now your appointments have probably been pretty routine, and may have even seemed dumb. But, now you’ll want to:

• Review your birth plan with your provider
• Find out when you should be going to L&D
• Have the basics covered so you can dive deeper into YOU and any issues YOU are having.

There’s also a chance they’ll send you in for some testing and you’ll need to make some pretty big choices based on those results. We talk all about third trimester testing in here. If you don’t know what it’s testing, you can’t understand how the results impact you/baby, or how to make choices based on those results — so understanding them is SUPER important.

Eat the right foods

We gotta fuel that body!

The thing is, sometimes (meaning, a lot of the time) you just put yourself last.

You wake up at the last minute and drag yourself to work, and ignore a decent breakfast, because sleep just seemed more important.

Eating foods that hit both protein and carbs (and hopefully fats too) at every meal will keep you feeling better.

Don’t get up and just eat the brownie before work. Even if you don’t have gestational diabetes, your blood sugar is still much more high/low than it used to be — so take care of it by balancing out with some protein.

Oh, and remember that baby is sucking your fluids dry at this point, and water has to be a priority too (and also the toilet, sadly — dang tiny bladder).

I think food is so important (and so easily forgotten) I have a whole bonus video on prenatal nutrition in here that is so helpful for snack and meal ideas both during pregnancy, labor & postpartum life.

Get Your Mind Prepared

This one is all about the preparation you’re going to need as you’ll face one of the biggest things in your life — labor.

You’ll want to be prepared for:

• The rest of pregnancy
• Laboring at home
• Birth
• Postpartum

You may be thinking — oh crap — I just thought I needed to learn some breathing techniques, but I’m here to say that the birth class you have in your mind (or have seen on TV) is likely not the one you need.

Cut to the chase: I recommend this one.

You need to know about that third trimester testing, and how to make choices based off of it (I haven’t seen many classes that cover that — but this one does).

You need to know what to do when you’re laboring at home to make things go faster and be prepared to head to the hospital (but not too soon).

You need to know what happens at birth, including common interventions, so you’re not caught off-guard. That’s really when birth trauma gets tangled into your brain — so, knowing those things in advance can really help.

Likely, you haven’t taken much time to think about your actual life postpartum. Sure, I have a postpartum plan that can help, and a postpartum checklist for the things you’ll want handy:

(Both of those are included with my 3rd trimester bundle of checklists):

But do you know what to expect, what to watch for, or how to manage life with a new baby?

Some might say to make a birth plan, or talk with your provider but I personally think those just aren’t enough. I think you’re smart, and you want to do it the RIGHT way.

Frankly, all of these areas can feel overwhelming and each area has a LOT of pitfalls along each way — which is why I created the birth class I wish I had with my first baby (over 24 years ago). It goes through every single one of those areas (with an expert you can trust).

Make preparing your mind easy by just jumping into it (it’s cheaper than you think):

You can even watch it on your own timeline while you’re working on home projects….

Because the next section is….

Get Your Home Prepared

This one gets a bit tricker because we each have different levels of preparedness.

Some may just have a stack of onsies, diapers and a place for baby to sleep and call that good.

I think most people tend to over-prepare in this area…. which is why I wrote a post on those baby NECESSITIES (and then you can go overboard on whatever area is important to you past that).

This tends to be the area that gets the most focus in the third trimester, but I’m here to say that baby’s needs in those first few weeks are very small. Onsies, diapers, a blanket, a place to sleep… and a carseat. Other than that it’s a lot of time and effort…. so be kind to YOURSELF.

Again, I have the baby necessities list included in that third trimester bundle:

The two things I recommend to have done by about 35 weeks:

• Have the space for baby to sleep set-up (it’s fine to not use a crib, but you need a safe sleep environment — learn more about that here).
• Have the car seat installed in your car and know how to use it (use a towel or stuffed animal in place of a baby).

I will give you one tip — if there’s anything you’d like fixed about your house, if you can do it now you’ll be glad for it. I remember thinking we’d get blinds fixed after baby was born. Newsflash, we did not. I’m not sure we ever did before we moved. Doing things becomes harder after baby is born. For the most part.

Get your Heart Prepared

I just don’t think we give ourselves enough time to get ready for the big change that is about to happen. Especially as the mother — your body will have all sorts of changes, but so will your life.

I joke that I kind of thought my baby would be like a new purse I was just hauling places. I was wrong. So, very wrong.

Have you taken some time to think about how life is going to be different after baby is born?

How you’ll want to preserve yourself, relationships & activities you want to prioritize.

What type of backup you can reach for if things start to spiral downhill?

I am a doer, I get it. I think that we can “do” ourselves out of most problems. However, sometimes we just have to realize that we only control so much, and we are ready to accept life as it comes.

The Online Prenatal Class for Couples actually has a lot of couples questions that will guide you through thoughts like this. Since I’m not just a labor nurse with 20 years of experience, but also a mom to three and friend to thousands of people who’ve had a baby — I know what things often catch couples off-guard and I can help you prepare in advance.

And I can also remind you that preparation can only do so much, and often teamwork and a sense of humor can carry you through the rest of the way.

I hope you found this article helpful — be sure to grab those checklists and I wish you the VERY best in your upcoming birth!

The post Your Third Trimester Checklist appeared first on The Pregnancy Nurse®.