LONG
PREGNANCIES.
Gloria Lemay
wrote:
I like the so called "post dates"
baby. I am very nervous about thing done to start
labour--makes the birth more easy to stall or turn weird. If
we go back to basics, there are only 2 things that have ever
been proven to result in better outcomes for mothers and
babies:
(1) improving the
nutritional status of the mother and
(2) improving her social
support.
When I read the Cochrane database
it..."suggests" that perinatal morbidity and mortality
"may" rise towards 42 (quotation marks mine) that doesn't
sound like anything I would bet the farm on. Then, we would
need to know if these post dates women are using cocaine,
smoking dope, etc. which is hard to get honest answers about
and "may" be the true cause of problems, instead of the
length of pregnancy. Homebirth midwives often have an
advantage in that they really get to know people's
lifestyles through home visits, who referred, and longer
prenatals so it could be there is a more relaxed approach.
Also, I think if there is no governing, licensing or
malpractise boards breathing down one's neck it's easier to
let Nature take its course.
At about 36 weeks (est.) gestation,
I renew the conversation about the importance of diet. I
acknowledge that the woman is now entering her last month of
pregnancy and there is a tendency to think "I've been so
good all through, now I can coast to the end and get into
the chocolate and snacks because the baby's developed enough
now".
This is not smart. I tell them
that the baby's brain grows the most in this last month and
this is the time that they will vote on what kind of report
card their child brings home in Grade six. I tell them
again to avoid all white sugar, white flour, other refined
foods, keep up their Floridix (iron tonic), vegetables,
proteins, sea salt to taste, exercise, etc. I really engage
them in "beginning the pregnancy newly now". If the father
is there, I engage him in eating better to support her and
also to take her for brisk walks. When a woman has glowing
skin, healthy looking hair, energy and bounce, it's also
less likely that induction looks necessary. I think it's a
good time for the practitioner to introduce some excitement
into the care, as well. Good handouts, a Blessingway
ceremony to look forward to, taking a group to a LLL
meeting--something to make the last month move and inspire
good health for that month and beyond. At each visit from
36 weeks on, I ask "What do we still need to do, say,
prepare in order to be completely prepared for the birth?"
it's amazing what little details will be gnawing at
them.
They know there is no "pressure to
perform" from me if they are in good health. There is a
simple but useful exercise to check for baby well-being
called the Cardiff Fetal Movement test that is non-invasive.
Starting at 9 a.m. the mother counts how many times her
baby makes a distinct movement. She should have l0
movements by 9 p.m. If less than 10 movements are felt in
the 12 hour. period the midwife should be contacted. Most
people feel their l0 movements and can stop counting in the
mid-afternoon. The baby who takes longer than 42 weeks will
suck better, have a more mature liver and heart, and
generally be easier to care for than an early
baby.
Gloria Lemay, Vancouver
BC
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