How do I know so much about cervical checks? — many people know me as The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. ​ I’ve performed thousands of vaginal exams (and stopped many doctors as well). A lot of women have this issue, and I’m excited to share some great info with you today!

Vaginal checks may be part of your third trimester testing — so grab my free lesson about that right here:

Looking for advice on just how to make them less painful? Click here and jump to just that part (skip the part on why they hurt).

Do Cervical Checks Hurt?

Most people find them uncomfortable, but some people find them downright painful. The way our bodies are made down there (and every person is different, I can testify to that) really changes how we feel them.

Combine that with history of sexual assault or other issues and it can be really bad.

If you haven’t had an exam yet (I have a post here on when they start) you should just plan that you’ll do fine with it (and some of the coping skills in here might help as well). If you go in expecting it to be miserable it likely will be — so go in with a neutral mindset and I think you’ll be glad you did.

But why are they painful?

Can You Refuse a Cervical Exam?

Pro Tip: At ANY point in time you can refuse a vaginal exam (and we’re going to talk about that in this post). However, at some point, you will likely need one. You can certainly lessen the number of them and make sure they are only doing them when necessary.

FYI, you can really refuse pretty much anything at the hospital, but there are consequences.

I have a whole video about them:

I also have a post on my sister site about when cervical exams start.

When you are wondering if you NEED a cervix ask you & your provider these questions:

• Will this change my plan of care (for example if they think you’re in preterm labor and need to stop if it if you are, or if you’re planning on an induction they need to know how to start it)
• Am I curious to know the results? (I’ll never shame you for wanting to know what’s going on with your body)

If it won’t change your plan of care, and you don’t really care as to what the results are you may consider refusing.

We talk about pro tip questions like this a lot in here so you can get in the driver’s seat of your birth!

Why do providers do vaginal exams During Pregnancy?

There are several reasons why providers do internal checks

Pap Smear/STD Testing — It is standard of care to do an internal exam at your first appointment, as well as doing a pap test (checking for cervical cancer) and STD testing. This is done as a speculum exam. Your medical provider will also likely check for any issues with your uterus, ovaries and fallopian tubes with their hands (called a bimanual exam).

Most often they do this smear test to check for cervical irregularities at your first appointment.

As STD’s can affect your baby as you progress in your pregnancy, this is important to be done (and treated if they find one). However, those are just the Q-tips and you can ask you provider to just check for those. Many providers do these as a urine screen as well.

Assess for Preterm Labor — With my last baby, I had an internal exam from 28 weeks on. They said they were checking for any signs of preterm labor. I have heard that in Europe this is the standard of care as your provider will be able to tell if your cervix is shortening (aka, preterm labor).

There is a condition where your cervix just can’t keep closed called cervical insufficiency where they can place a cerclage that basically sews it shut until closer to your due date.

In retrospect, I have ZERO history of preterm labor (nor did my mom) and I wish I would have said no. But, even labor nurses get caught up in the white coat…

Assess for Labor Progress — As you get closer to your due date (often around your 36-38 week appointment) your health care provider might assess how open your cervix is (called cervical dilation). However, these are pretty fruitless. Just because your cervix is closed today, doesn’t mean you won’t go into labor tomorrow.

If you aren’t interested to know what it is, these are easy to refuse at the end of your pregnancy.

If you are in labor for a long time they will likely need to do one to check for labor progress and decide if a cesarean section is necessary. While they do it, they’re also checking baby’s head and baby’s position to possibly rotate you to aid in baby moving down the birth canal.

Beta Strep Testing — Beta Strep is a bacteria that they have found can be harmful if the baby is born through it in the birth canal. So, they test for it around 36 weeks. It is just a Q-tip that is inserted into the opening of your vagina and rectum. It should not be painful and is very quick (some doctors let patients do this themselves).

Stripping Membranes — (also called a membrane sweep) this is a procedure that can be done to bring on labor (although the studies are pretty low for it). This is considered the most painful exam as they use their finger to separate the cervix from the bag of waters and many people find it quite painful (myself included). Read more about stripping membranes << in that article.

Absolutely ALL of these exams should include an informed consent. Providers are bad about saying “now I’m going to check your cervix” but it 100% in your right (and it should be done) to ask why they’re doing and what they’ll do when they are in there.

Assess for Your Stage of Labor — When you present to your provider thinking you are in labor they will need to do an exam to see how far along you are.

For instance, we have women in a LOT of pain who are only one centimeter — and would be much better to go home rather than to stay in the hospital. So, as nurses, we do need to assess where you are at when you first present to the hospital.

Or women who are in preterm labor might need an exam to see what their cervix is doing — if it’s opening they might need bed rest.

Some providers do routine pelvic exams your last week of pregnancy, but you can 100% refuse them (but some pregnant women really like knowing what their cervix is — and both choices are OK).

Assess for Vaginal Bleeding — If you present bleeding, they may want to do an exam to learn more about what is causing it (“bloody show” is not unusual when you are in labor). I have a whole post on bleeding at 20 weeks.

I will say a lot of women find the unknown the most scary — and that can even add to your pain! The Online Prenatal Class for Couples is the easy way to get prepared (just 3 hours my friends)!

Some people find they are in pain even after a vaginal exam << and I explain why in that post.

How do medical professionals perform a vaginal exam?

They can either use their gloved hands (usually two fingers) or they can use a speculum (that’s the duckbill shaped implement they put inside).

The speculum is most often used when they need to visualize your cervix (most often needed for STD exams and a pap smear, although we sometimes use them in pregnancy as well for other reasons — including telling if your water is broken).

During pregnancy, we use a sterile glove in the hospital to be extra cautious about extra bacteria in the vaginal canal.

Most often the doctor uses a small amount of a lubricant (like KY jelly) to make it easier on your tissues. Some tests can’t have a lubricant, they can sometimes use water though.

** Some delivery centers do them every hour (or in some time of regular stages) to make sure a patient is progressing. This isn’t the recommended standard of care (and also not how I routinely practice). If you find that your nurse is doing frequent exams just because it’s policy — that is a time to opt-out of that policy (which is fine).

Pro Tip: A lot of people think you can do your own cervical exam in labor. Reaching your own cervix can be hard when you don’t have a baby, and it’s even harder if you don’t know what you’re looking for. I never tried it as I didn’t want to pull a muscle reaching back there.

BTW if you’re wondering about exams, be SURE you’re doing your kick counts — grab my cheat sheet here:

When not to have a Cervical Exam

There are times that your healthcare providers will NOT do a cervical exam. Most often it is due to a risk of infection once your water is broken. Once your water breaks the bottom line is that your uterus is open to any bacteria in your vagina which can be problematic.

If you bag of waters (or amniotic sac) is intact, there isn’t to much of a medical risk reason to not do an exam.

I actually have a whole post on cervical exams at 36 weeks that explains more about this.

What do they learn from a Pregnancy Internal Exam?

I have a whole post on what the numbers from a vaginal exam in labor mean.

Mostly they are learning the position of the baby (is it head down?), how far your cervix is opened or if it is shortened (called cervical effacement)

Also the position of the baby in relation to your pelvis (or how low the baby is).

I think of your cervix is a thick tight-necked sweater that must stretch over your head.

I will say that vaginal exams have gotten a bad rap on social media in the past. A well-performed exam by an expert provider can actually tell us a lot about your labor progress and any interventions you may need during labor. It’s not just a few numbers, it’s a total picture of your pelvic vault/birth canal for your provider.

We combine all this information into something call the Bishop score that is an easy well to tell each other how ripe your cervix is.

Informed Consent for Vaginal Exams

Your provider will have a reason to perform a vaginal exam, and you should feel free to ask as many questions as you’d like before they do it.

You should also feel comfortable that the exam is necessary (I find that helps me feel better about any discomfort I feel during the exam).

Doctors SHOULD Be asking permission before they do something with your body. The end. It’s up to us to set this expectation with them.

Procedural Tip: Most often your provider will have a “chaperone” who comes in the room when they perform a vaginal exam. Often, if your spouse/partner is in the room, they can forego this (that just protects the doctor if you were to say that something inappropriate happened during the exam).

Related: If you’re thinking about exams, be sure to get that hospital bag packed too:

Why are vaginal exams painful?

I see several places online that say a vaginal exam should not be painful.

And guys — after 20 years in labor rooms (as well as having my own 3 children), I have to say that for most women this just isn’t true (especially with your first baby).

They can be very uncomfortable. They are intrusive, some women find them humiliating (but they shouldn’t). AND, for a lot of women they bring up powerfully bad memories.

I would think this is fairly self-explanatory. Your vagina is a fairly small opening, and while you do use it during intercourse, that has a lot of different feelings and emotions involved vs a check-up.

A lot of people have pain during their first few times with sex, so it isn’t unusual or different for you to have issues with the vaginal exam as well.

You may feel that the doctor is being unfairly rough but most providers are doing it with the utmost respect, but they do have a “job” to do. Sometimes in order to do that “job” it is uncomfortable for you. We do know that prolonging it excessively only makes it worse most often.

Frankly, slowing down the process doesn’t really make it less painful — it just makes it last longer. That’s something to keep in mind.

However, you can 100% stop them at any time if you feel too much pain. Always keep that in mind! It’s just a fine line between being an adult to get the information that you need vs managing your pain with it.

Vaginal infections (including yeast or bacteria) can make exams painful as well. You can always ask your provider if they think you have one of those if you find them intolerable — that could be an issue!

Vaginal Exam Anatomy Lesson:

As a note, women have three “holes” in their bottom/perineum area. There is:

• Urethra: The hole you pee out of.
• Vagina: The hole the baby will come out of.
• Rectum: The hole poop comes out of.

It is not unusual for women to not understand/know those 3 holes before — so I just wanted to clear it up. And yes, I talk about it in here in much more depth.

And I also have a whole post on avoiding pooping at delivery that talks a bit more about how these 3 holes interact at the end.

Something else to keep in mind is that first time moms tend to find the exams more painful than women who have had a baby. So, that’s good news for next time!

I love writing stuff like that down to remember next time. Which is why I made this pregnancy planner for you!

A quick soapbox moment: You don’t see men saying that their prostate exam wasn’t painful? No! They all dread and hate them, so when women say they hate exams we can support them by saying that they can be pretty miserable. No reason to chime in and say you love them!

Reminder: You CAN refuse

At ANY point in time, you can refuse a vaginal exam.

And, I am sad to say that many doctors don’t make this apparent. They just pull back the sheet and say they are going to check you (which is not informed consent).

I have a WHOLE (wonderful) podcast on how to say no in labor — but here are a few times it’s smart to say no to a vaginal exam:

• If you don’t see a reason for it — informed consent should make it clear why they are recommending it.
• You are waiting for your partner to come back to provide support.
• You would prefer they wait an hour.
• They are too painful and you simply don’t want to.

I also have a whole podcast just on refusing vaginal exams.

Keep in mind this can have consequences — and that there are times when you are in labor that you will likely need it done.

However, there are times that I see it done when it isn’t necessary, so I would encourage you to make informed choices with your team. Be sure to weigh the information you could get against the discomfort you might feel.

How to Make Vaginal Exams Less Painful

There are a few things you can do (and we’ll talk more about them below the list):

1. Learn some breathing techniques to help you relax
2. Push your bottom into the table rather than lifting up
3. Wiggle your toes (read on to find out more about that one)

If you love little tips like wiggling your toes to make it easier, there are tons more tips for labor, birth and postpartum in here.

Relax to make vaginal exams less painful

Sure, it seems totally impossible, but the more you tense-up the more painful it will be during your vaginal exam. It just makes the “hole” smaller and that is harder on you.

Try to breathe and try to think about all the positive things about being pregnant including that cute baby (and yes, I go over that type of breathing in one of the bonus videos in this class).

Press down to make vaginal exams less painful

A lot of women lift their hips UP during a vaginal exam (one doctor I followed during nursing school called it the chandelier reflex). This makes it harder and more painful for you.

If you push your hips down, it helps you to relax.

Raise hips to make vaginal exams easier

Sometimes, if you have a tilted cervix (and most people do in early labor) we will ask you to put your hips on your fists (or we will put a bedpan under you) This different position raises your pelvis. BUT you are still able to relax as you are putting weight on your fists, vs tightening your thighs/butt to raise your hips up.

Wiggle your Toes

I had a lot of people comment they wiggle their toes during the exam (I think it makes it easier to relax your pelvic floor).

Find a midwife

I do not recommend lay midwives, I do recommend a CNM (Certified Nurse Midwife)– one that can deliver in the hospital and has a load of training.

However, midwives are often more gentle and explanatory with exams. If you find that your doctor is too rough, consider finding a midwife to work with.

Discuss feelings/issues with your provider to make vaginal exams easier

Women who had forms of sexual abuse often find vaginal exams very painful. Besides the physical pain, it can also bring up emotional pain that they maybe haven’t processed.

Discussing these issues with your provider can be helpful for both of you. Sometimes, by them being specific about what they are doing and why they need to do it, it might help your brain be more at ease with the process.

**Moms of previous stillborns or even miscarriages often have feelings “swept” up during vaginal exams and that can be really hard too.

In all of those cases, we can’t help you unless you let us know — so be sure to talk to us!

Get some support to make vaginal exams less painful

By bringing in your partner, your mom or a good friend, they can help distract you some during a painful time. Some women find a doula very helpful in this case.

I have a podcast episode on what a good doula can do for you:

Some women just feel very awkward with a physician in this experience. I can assure you that it is not awkward for the provider and that it is just their “job” to do that day. Sometimes support can help you in that awkward time.

As you get towards the end of pregnancy, talk with other friends to see if they found it painful. Maybe you’ll realize you’re not alone.

And remember to go in with an open might. Will no one loves exams, many people find them to be very tolerable, and something to get over with (including myself).

What to do if vaginal exams are too painful?

While you can limit the number of vaginal exams (you are free to refuse them at any time) it is important that they occur:

• In the beginning to do a pap smear and std testing.
• In labor, to see how you are progressing (but this is limited, no need to check every hour or so).

Other times, you can talk to your doctor to find out if the procedure is very necessary. Refuse it, if you feel you can live with the consequences of not doing it.

BUT….

You need to remember that your baby’s head is much larger than the speculum or your providers’ fingers.

You are going to need to work on your personal coping skills to get through it.

Even if you plan to get an epidural, you will need to learn how to cope with pain before an epidural.

You will also need a vaginal exam after delivery to make sure that things are healing well. Along with your recommended pap smear.

I can’t recommend taking a prenatal class any more. This one will give you the tools to:

• Decide if you NEED an exam
• How to cope with pain (with it’s natural pain mangement bonus video)
• Know what to expect so things just aren’t as scary!

The good news about vaginal exams

The further along you get in labor, and life — vaginal exams hurt less.

• As your baby progresses down the vaginal canal, it makes it easier for us to reach your cervix, and makes it less painful — your cervix moves forward as labor progresses (remember as they progress into the canal you dilate more too)
• Your baby will stretch those tissues and with subsequent babies it hurts less.
• You learn to cope with the pain better — and contraction pain gets more intense (so the exam feels less painful)

So, that’s good news. It is rare that a second-time mom finds them as painful as they did the first time they had a baby.

Ok, time to get that prenatal class in. There’s SO much about pregnancy and labor that I can help you with if you just take the time to take the class. The meat of it takes just 3 hours, so you can do it! Come join me!

Not sure we’re a good fit check out my free class — It’s your first step towards being your own birth boss.

The post Painful Cervical Checks During Pregnancy: What to do if you’re scared. appeared first on Pulling Curls.

Listen on Apple Podcasts Here

Big thanks to our sponsor my hospital bag packing list — get it free into your inbox:

Today’s guest is Juli Pyle (she/her) a certified nurse midwife who practices at a community hospital in rural Pennsylvania. Juli was a stay at mom for many years to five children before deciding to return to school to pursue a degree in nursing. She graduated from Colorado Mesa University with a bachelors of science in nursing degree in 2016 and then began her nursing career as a labor and delivery nurse. She quickly discovered that this was her true passion (as she had suspected since having her own children) and quickly gained a reputation for professionalism, compassion and expertise among colleagues and patients. She then returned to Frontier Nursing University to complete a Master’s degree in Nursing with an emphasis in midwifery. In 2020, she graduated and began as a certified nurse-midwife at a small community hospital in central Pennsylvania where she has been since that time. Her focus as a CNM is to provide evidence-based education to all birthing families, give true autonomy and informed consent throughout their time with her and to share love, understanding, empathy and true shared-decision making. When not immersed in the birthing world, she enjoys spending time refinishing furniture, gardening, raising and breeding different types of chickens, hiking and vacationing with her family.

Links for you:

My post on the benefits of using a midwife.

Timestamps:

[00:00:00] Podcast discusses different providers for pregnancy and delivery.

[00:05:28] Licensed midwives provide medical care; some work in birth centers. CPMs are licensed and have credentials. CNMs are similar to CPMs.

[00:08:22] Midwives mostly work in hospitals, not homes.

[00:12:39] Consider midwife for pregnancy provider; clear misconceptions.

Key Points:

• Understanding the different providers who can assist during pregnancy and delivery
• Special guest Juli Pyle, a certified nurse midwife, shares her insights and experiences
• Sponsorship: A free hospital bag checklist created by a nurse with 20 years of experience
• Exploring the four main providers who can deliver a baby, along with the option of a “free birth”
• The potential risks and uncertainties of free birth, and the importance of having a knowledgeable provider present
• Discussing the spectrum of education and certification among midwives, and the lack of regulations in the industry
• The range of fees charged by lay midwives and the value of their traditional knowledge, but the potential lack of medical training
• The role of midwives in birth centers and home births, with a focus on licensed professionals like certified professional midwives (CPMs) and certified nurse midwives (CNMs)
• Addressing stereotypes about midwives and the collaborative nature of their practice, working alongside obstetricians and providing care in hospitals
• Comparing the training and qualifications of midwives to doctors, emphasizing the importance of having options for delivery in a hospital setting.

Producer: Drew Erickson

Keywords:

providers, pregnancy and delivery, Juli Pyle, certified nurse midwife, Pennsylvania, hospital bag checklist, nurse with 20 years of experience, four main providers, free birth, risks and unknowns, knowledgeable provider, training and experience, healthcare providers, qualifications, absence of midwives, spectrum of lending, formal education, certification, regulations, lay midwives, fees, value of knowledge, Ma on a little house on the prairie, historical role of midwives, birth centers, home births, Arizona, board centers, certified professional midwives (CPMs), licensing process, number of babies delivered, certified nurse midwives (CNMs), stereotypes about midwives, hospital setting, collaborative practice, integrated approach, terminology, full title, background in nursing, master’s degree, misconceptions about midwives, certified professional midwives (CPMs), licensing and state laws, administering drugs, tasks performed by midwives, obstetricians, education and training for doctors, residency, specialization

Transcript

Hilary Erickson [00:00:00]:

Hey, guys. Welcome back to the Pulling Curls Podcast. Today, on episode 204, we are talking about the different providers that can help you during your pregnancy and delivery. Let’s untangle it.

Hi. I’m Hilary, a serial overcomplicator. I’m also a nurse, mom to 3, and the curly head behind Pulling Curls and the pregnancy nurse. This podcast aims to help us stop overcomplicating things and remember how much easier it is to keep things simple. Let’s smooth out those smiles with pregnancy and parenting untangled, the Pulling Curls Podcast.

I want to introduce today’s guest. This is her third time on the podcast. She is a certified nurse midwife in Pennsylvania. I wanted to introduce today’s guest, Juli Pyle.

This episode of The Pulling Curls Podcast: pregnancy, and parenting untangled is sponsored by my free hospital bag checklist. It’s the list for you if you don’t want to overpack or underpack, and this is created by a nurse with 20 years of labor and free experience, you can find it in the show notes, or go to the pregnancy nurse and find it under resources, scroll down, and look for free re sources, and you’ll find it right there.

Hey, Juli. Welcome back to the Pulling Curls Podcast.

Hi, Hilary.

So we recorded an episode on what people are thinking during labor, and we thought while we were doing it, we should just talk about the 4 providers that could deliver your baby and just kind of the differences between them because I think a lot of people don’t understand all of them. Now there is 5. You could not have a provider at your birth. It’s called free birth. We absolutely can’t talk about it. That’s always an option, obviously, but I would never recommend anybody choose that on purpose. Right. plenty of people choose it and are calling 911 at the same time freaking out.

Yep. I had to happen last week.

But I I don’t recommend free birth in any shape or form. I cannot tell you how many patients I would have had that would have died the end. There’s way too many unknowns for me to be comfortable with I cannot imagine the husband. Like, my husband would literally die if I was like, why don’t we just have the baby here at home? You and me.

Juli Pyle [00:02:09]:

Oh, yeah. Same with my husband.

Hilary Erickson [00:02:11]:

Okay. So then there’s 4 real providers. So the first one is Lay Midwives. Right? And how would you define those, Juli? Yeah. So

Juli Pyle [00:02:20]:

gosh. Lending by midwife, that incorporates a really large spectrum because these are people who could be a doula, but call themselves a midwife. And they may have had official doula training, but but have decided that they want to call themselves the midwife. It could be somebody who lives in cultures that have trained each other, but ultimately, they don’t have any formal education. Right? Some of them may not even have a high school diploma. Some might have some college, some bachelor’s degree. But, usually, I mean, there there’s nothing saying that they can or can’t be a midwife. And that’s where that distinction gets a little interesting because there’s nothing saying they can’t call themselves a midwife. Right? Right. And so they can offer their services to be at the through the pregnancy and at the birth. And I’ve seen some of these lay midwives charging anywhere from 3 to $5000 per pregnancy and birth. You know? And this is for somebody not trained. Now I do wanna put a disclaimer that I absolutely value all the education and knowledge that comes from generations of people giving themselves are sharing the information with their, you know, with their daughters and their granddaughters, and and they’re helping each other through that. I think that’s an incredible legacy But at the end of the day, there’s not any medical training whatsoever. Right. And it’s basically Ma on a little house on the prairie. Like, she was the one that delivered

Hilary Erickson [00:03:38]:

the doctor would come in and kind of, like, back her up, but he didn’t really do anything. You know? She just knew how people had babies. Right? Yeah. Absolutely. Yep. That’s exactly right. They scared me. I’m not gonna lie to you because it’s so hard to figure out how much training they have or experience even I mean, a lot of them I think lie. because they could have been doula’s at thousands of births, but they’ve never been at midwife. I don’t know. And it’s hard because there’s absolutely no

Juli Pyle [00:04:00]:

real solid regulations on that. Some states are very strict and don’t allow anybody to practice any sort of midwifery without the degrees, but then other states have absolutely no laws against it. And so depending on where you live, you’re gonna see a vast difference of what it might look like where I am currently. There are a lot of lay midwives and a lot of them practicing and doing what they do and making a lot of money, to be honest. Oh, man. I think in Arizona where I am

Hilary Erickson [00:04:26]:

I have heard that home birth is illegal, but I don’t know anything. Like, it’s obviously not something I’ve studied. So yeah. But the weird thing is that all these three that we’re gonna talk about are are all just called midwife. Right?

Juli Pyle [00:04:38]:

Yeah. Exactly. And so, unfortunately, it defaults to the patient or whoever seeking care to say, what are your credentials? What your training, but a lot of them won’t. They’re like, oh, you’re midwife. It’s fine, but that’s not always true. Yeah. So then there’s a second type of midwife called I either a certified well, are they certified? What are they licensed midwife? Some people call them or professional midwife? Yeah. CPM is what they’re mostly known by, which I believe stands for certified professional midwife. Okay. They do have some formal training. A lot of times, I believe it ends up being the equivalent of a bachelor’s degree, but they don’t have a medical degree. Otherwise, no nursing degree or anything, which will differentiate the other type of midwife we’ll talk about. But they do have a board certification process just for that group of people, and a lot of states do actually license them. So they can be technic an actual licensed professional.

Hilary Erickson [00:05:28]:

that is licensed to provide medical care. Yeah. And some states have them employed in birth centers. Most states it it is a home birth, but there are a few states that you’ll find them in board centers as well. We do have them in board centers in Arizona. So the board centers that I’ve looked around here, what it says CPM certified professional midwife. So yeah. they’re licensed. And so, you know, a licensing process at least does show you that they knew enough at the time to take the test and pass it. Correct? Exactly. So they’ve had something something that is giving them the credentials that they currently have. Yeah. Yeah. And then you then you’d wanna go more into, like, how much experience, how many babies have you delivered, like, when how often do you pass off to somebody in, you know, the hospital, that type of thing. Right? Yep. Absolutely. Yeah. And then that brings us to our 3rd type of mid which is the kind that Julia is, which is a — Certified nurse midwife. Yeah. Which is so close to see certified professional c n — CPM. CPM.

Juli Pyle [00:06:25]:

Right. There’s — It’s so close. Yep. So I try and use that full title as much as possible because then that helps people understand, like, certified nurse midwife. Okay. So there’s something with nursing. What is that? You know? And they have something to think about. But so all certified nursing advice first had their bachelor’s degree in nursing and then went on to a master’s degree. in nursing, which is the equivalent of a nurse practitioner degree. It’s the same training. It’s just that ours is specialized

Hilary Erickson [00:06:51]:

in women’s health and pregnancy. Yes. And in Arizona, you actually have to get a PhD. So they — Okay. — considered a doctor. But, no, I would just love to call them doc in front of a doctor and just see them, like, lose their mind, but I’ll we’re just moving on. But they do yeah. For some reason, now like, fairly recently, they now have to get what is basically a doctorate, which is awesome.

Juli Pyle [00:07:13]:

Dumb. It’s dumb. That’s what I meant to say. There there definitely is a a tangent that that in the future, probably, nurse practitioners also will need a doctorate to practice. But at this point, it’s mostly most states are a master’s degree. Yeah. Now can a professional with midwife give you drugs? I believe that’s state dependent. Okay. So there some states that will allow them to have, like, postpartum hemorrhage medications. They can do IVs, maybe do antibiotics for group b strep positive patients, but I believe it’s very dependent on state and the licensing there. Yeah. Yeah. But a certified profession the certified nurse midwife does you can do all the same things at an OB can for the most part as far as drug. Yeah. It that might depend a little bit on state as well, but most states we have prescriptive authority and and can prescribe any medications that a physician can, including antidepressants,

Hilary Erickson [00:08:04]:

anti anxiety meds, birth control, like all those things are up our alley. Yeah. Because you can also see a midwife for your lady bit care for the rest of your life. Right? That’s pretty — — for your well women exams. all your pap smears till you — till you don’t need one anymore. You look your uterus.

Juli Pyle [00:08:22]:

And I it’s important to mention also because, again, when people hear the term midwife, I still when I meet somebody in in the elevator and we’re talking about it, oh, you’re a midwife. So you deliver babies up, home in the barns. And I’m like, no. No. That’s not how this works. You know, 99% of certified nurse midwives practice in a hospital. So it’s shocking to me that so many people think that that old, you know, stereotype of a midwife. But most of us, we’re in hospitals doing things. You know? Yeah. And what I’ve heard a lot is people’s moms freaking out. So, like, I’m the pregnant person. It’s my mom. The grandma of the baby is, like, you can’t go to a midwife because she is thinking Caroline Ingalls. Right? It’s just gonna come to your house. — thinking about about somebody that she’s thinking doesn’t have a real degree or training to take care of that person. You know? Yeah. what are the things you can’t do in the hospital? Like, ours that I’ve practiced with couldn’t do forceps. Do you have any that you’re like, nope. Gotta hand this over or do a doctor. So where I am practicing currently, I have to get extra credentialing if I wanna do any vacuum assisted deliveries or repair a 3rd or 4th degree laceration. obviously, I can’t do a c section or any surgical procedures like a a d and c for a retained placenta, any of those things. I I don’t do that. But I can get you to — — assistant c sections? I do assist in a c section. Yeah. Surgical first assist. Yep. You guys might not know, but you have a surgeon, and then they have, like, a helper surgeon that’s in there. So your midwife can come in the OR, which I always love because then they’ve got that friendly face of the midwife in the OR. It’s just not as crazy as a place. I I think that’s really nice. Yeah. Especially for people that it’s not a plant c section, right, that now we’re transitioning from opening for vaginal delivery to c section. I can still be there. Yeah. Yeah. So that’s not really very many things. All things considered. Right. Yeah. And where where I’m practicing, it’s very collaborative. And so we have all types of patients, a lot of high risk patients, and the way that that we have implemented our practice, like, I am still managing somebody that’s preeclamptic I’m still managing their insulin drip if they’re, you know, extremely diabetic, but I’m also still managing their labor and able to figure out how to get the baby here. And I’m always talking to the OB, you know, letting them know, like, here’s what we’re doing. Does this sound good? Do you wanna change anything? But at the same time, like, they can still have midwifery perspective on on the birth part of it. Yeah. And a lot of times, the doctor who was, like, covering the midwives would just come in and say, hey. Yep. Hey. I’m doctor so and so. If for some reason you need to see me, I’ll come see you. But I hope to not see you. Exactly. Yeah. And I love the way that that works. where where I’m currently at. I I doesn’t work quite as seamlessly in a lot of places, unfortunately. It can be a very much of a a turnover if you risk out of midwifery care because of your blood pressures, you don’t see them anymore at all. Right? And I I like it when it’s a little bit more collaborative, I think the patient gets a little bit better experience overall. And that’s why I like working in the hospital because while I absolutely appreciate and love my nurse midwife colleagues that do these phenomenal home births and water births, and and the women are having exceptional experiences.

Hilary Erickson [00:11:25]:

I still know that there’s people that want to deliver in the hospital that need to have a good midwife. And so it’s important to have all of those options for people. Yeah. And then you could have a doctor. which I think everybody knows what a doctor is. So doctors get a bachelor’s degree. They then go to medical school for 4. It’s 4 years. Right? 3 years? 4 years 4 years. And then they go into residency for 4 years, and then they may do a post residency on something like a I think they call it a fellowship. Right? Yeah. And some of them end up becoming maternal fetal medicine or a paranatologist, which means that then they’re at super high risk OB. There are other options for them, but they do have a lot of school. And then they have that residency where they just like, in residency, they just deliver thousands of babies.

Juli Pyle [00:12:06]:

Thousands of babies. tons of c sections, tons of surgeries, and they get really good at that. They’re experts in the more abnormal or high risk where as a nurse midwife, I can really focus and be really good at normal

Hilary Erickson [00:12:20]:

labor. Yeah. Yeah. I love it. Alright. Thanks for coming on, Juli. I think that helped explain to everybody, like, the different providers that could deliver your baby so that people understand it. And when their mom comes to them, it says, no. You can’t have a midwife. They can come back with No. She’s pretty much the same as a doctor. Just cooler. Yeah.

Juli Pyle [00:12:37]:

That’s more awesome.

Hilary Erickson [00:12:39]:

Thanks, Julie. Thanks, Hilary.

Okay. I hope you guys enjoyed that episode. I cannot more strongly advocate towards considering a midwife for your pregnancy provider. if they’re available in the practice that you go to, ask to see them at your next appointment or just consider them for your next delivery or whatever. I just love certified nurse midwives. I hope that cleared up some misconceptions for you guys or made it more clear because we certainly are not making it clear with our terminology in referencing all those three different people as midwife, as you can there is a huge spectrum of experience and ability and all those kind of different things. So why don’t we get a new word at some point? That would really help untangle things. Don’t you think?

Thanks for joining us on the Pulling Curls Podcast today. If you liked today’s episode, please consider reviewing, sharing, subscribing. It really helps our podcast grow. Thank you.

The post The Best Providers for Your Baby’s Arrival: A Deep Dive with CNM Juli Pyle appeared first on Pulling Curls.

McKenzie Caldwell is a registered dietitian nutritionist and owner of the virtual practice Feed Your Zest, where she helps folks heal from perfectionism around food and their bodies so they can live fully nourished through fertility, pregnancy and beyond. She sees clients 1:1 and in her signature group program Fully Nourished Pregnancy, as well as speaking and consulting on the topics of weight inclusive reproductive health. McKenzie lives in Charlotte, North Carolina with her dog Charlie and enjoys hiking, baking, yoga and adult ballet classes.
Website: www.feedyourzest.com
Instagram: @fertility.prenatal.dietitian
TikTok: @fertility.prenatal.rd
Check out her Mini Class: https://www.feedyourzest.com/insulin-resistance-mini-course

Big thanks to our sponsor The Online Prenatal Class for Couples — it has a BRAND NEW bonus video all on prenatal education!

Producer: Drew Erickson

Transcript

[00:00:00.120] – Hilary Erickson

Hey, guys. Welcome back to the Pulling Curls Podcast. Today on Episode 194, we are talking about nutrition during pregnancy. Let’s untangle it.

[00:00:18.990] – Hilary Erickson

Hi, I’m Hilary Erickson, the curly head behind the Pulling Curls Podcast: pregnancy and Parenting Untangled. There’s no right answer for every family, but on this show, we hope to give you some ideas to make life simpler at your house. Life’s tangled just like my hair.

[00:00:39.360] – Hilary Erickson

Today’s guest is a registered dietitian, which, by the way, is different than a food coach or a health coach, just so you guys know. She is the mind behind Feed Your Zest. You can find her on TikTok @mckenzieCaldwellRDN, or on Instagram @fertility.prenatal.dietitian. I want to introduce today’s guest, McKenzie Caldwell.

[00:01:00.880] – Hilary Erickson

Do you feel prepared for your delivery? In just three short hours, you can be prepared for the confident, collaborative delivery you want. You’ll know what to expect and how to talk with your health care team. And there are no boring lessons in this class. I’ll use humor stories from my 20 years in the delivery room to engage both of you. I love how Alyssa told me that she found herself laughing at things that used to sound scary. Most of all, you guys are going to be on the same page from bump to bassinet. Join the online prenatal class for couples today. You can save 15 % with coupon code UNTANGLED. You can find the link in the show notes.

[00:01:36.780] – Hilary Erickson

Hey, McKenzie, welcome to the Pulling Curls Podcast.

[00:01:39.380] – McKenzie Caldwell

Thank you so much for having me.

[00:01:40.770] – McKenzie Caldwell

Yeah, I’m super excited to have you on here. We actually haven’t talked about food. I don’t think ever on this… I mean, we’ve talked about eating, obviously eating is very important.

[00:01:48.470] – McKenzie Caldwell

But as far as prenatal nutrition, just because I’m super picky about who I would have on. I have a lot of diet coaches talk to me and I’m like, If we’re pregnant, I really want a nutritionist. So that’s why McKenzie’s here.

[00:02:00.780] – McKenzie Caldwell

I’m happy to be here. Thank you for being picky. It’s so important that we be picky with where our nutrition information comes from. So I’m glad I made the cut. Yeah.

[00:02:09.520] – Hilary Erickson

Well, I used to work in a diabetic clinic every once in a while. I love the dietitian there. She was so great with the patients. And I think it’s so in gestational diabetes, their dietitians, everything.

[00:02:19.900] – McKenzie Caldwell

Absolutely. And you’d be surprised how many doctors don’t refer to a gestational diabetes dietitian and then just leave their patients hanging. So we’re here. We exist. Please utilize our services.

[00:02:29.430] – Hilary Erickson

Right. Use physical therapists, use dietitians. OB’s are not God, even though they think they are. Okay. So McKenzie came with five tips for prenatal nutrition. So take it away. What’s your first tip?

[00:02:44.490] – McKenzie Caldwell

Yeah. So my first tip, we were talking, hinting at this, talking about diet coaches. My first tip is delete your calorie counting app. That can feel super scary. But what’s really important is that instead of feeling stuck on a restrictive diet in pregnancy, that you’re actually listening to your body.

[00:03:01.840] – McKenzie Caldwell

Your body is really wise and that wisdom really does come through in pregnancy. But listening to your hunger, paying attention to your fullness and using, pairing that with a little bit of evidence based nutrition info on the side really can be plenty to help you gain exactly the amount of weight that your body needs to gain in pregnancy.

[00:03:20.810] – McKenzie Caldwell

We do not need to be worrying too much about calories. It’s not good for your mental health. Postpartum eating disorders are really common. So when we can set you up for not being in that diet mindset during pregnancy, it’s going to help protect your mental wellbeing after pregnancy as well.

[00:03:36.540] – Hilary Erickson

What do you think about the people, though, that just eat macaroni and cheese for every meal? Because sometimes I see stars, especially on their first pregnancy, and they’re just like, I’m just eating whatever I want. And I was like, That’s amazing. But it’s going to be interesting to see how they act after they have their baby. Any thoughts on how you listen to the real voice, not the macaroni and cheese every meal voice?

[00:03:57.260] – McKenzie Caldwell

Right. So what’s funny is that’s what I call the diet rebel voice. So that’s a super protective voice that comes up when maybe you have been dieting for a really long time and it’s very rebellious. It says, I don’t want to do that anymore. Now that I’m pregnant, I have this chance to eat whatever I want. I’m so glad you feel free. But that diet rebel voice isn’t a true self care voice, even though it is protective against dieting and dieting is not going to be helpful for your mental or physical wellbeing at all.

[00:04:24.410] – McKenzie Caldwell

But taking a big deep breath, reminding yourself like, yes, I can eat whatever I want. Technically, I’m an adult, I can eat whatever I want at any point, I can feed myself. And if I value my physical wellbeing, maybe I should have some green beans with my Mac and cheese. Maybe some other protein or something like that to fully nourish your body. But when you’re paying attention to your hunger and fullness, again, you can pair that with some nutrition science to fully take care of your body. And nutrition can be really, really effective in pregnancy. But ultimately, I believe in bodily autonomy.

[00:04:54.920] – McKenzie Caldwell

So if you want to eat Mac and cheese during pregnancy, you’re allowed to do that.

[00:04:58.980] – Hilary Erickson

Yeah, you are 100%. No one’s going to stop you. No one. Unless maybe their agent. I don’t know. Luckily, I don’t have an agent so I can do whatever I want. I love that, though, because it is true that a lot of people live on a diet up until they get pregnant. They go through morning sickness and then they’re like, Well, I need to get all the calories in I want. And then second trimester comes and they’re just like, All the calories.

[00:05:24.780] – McKenzie Caldwell

Absolutely. So if we can get out of the diet before pregnancy, I think that’s awesome. But I meet people where they’re at. So you can get out of that mindset at any point.

[00:05:33.100] – Hilary Erickson

And before we’re a mom, because little guys follow you everywhere. They see everything you do.

[00:05:38.500] – McKenzie Caldwell

That’s why I love working with this population. It’s just like a lot of motivation to work, to take care of yourself, set yourself up for success and work on building a household that is body positive and has a healthy relationship with food, but also takes care of their bodies with nutrition. At the same time.

[00:05:54.620] – Hilary Erickson

That’s awesome. Okay, tip number two.

[00:05:56.460] – McKenzie Caldwell

Yeah, tip number two is to hydrate. So in pregnancy, your fluid volume doubles. Your blood volume is higher. You’ve got amniotic fluid. Your body is starting to produce breast milk. So hydration, hydration, hydration. I recommend 80 to 100 ounces of non alcoholic, noncaffinated fluid per day. If most of that is water, that is ideal.

[00:06:14.900] – McKenzie Caldwell

But technically even a soda does count towards your hydration, especially if you feel like a 7 up or ginger ale is going to settle your stomach when you’re nauseous, it’s totally okay. We just want most of that to be water. And you might need more electrolytes in pregnancy, too, because there’s so much fluid volume, you’re probably going to need a little bit more of those electrolytes like sodium and potassium and magnesium.

[00:06:36.160] – McKenzie Caldwell

So if you’re drinking that much water and you still feel super, super thirsty, maybe grab a Gatorade G2 or a liquid IV or something. Or if you’re really athletic or work out in the yard a lot and are super, super sweaty in the summer, you’ll probably need a little bit of extra electrolytes too. I see a huge difference in my clients who are well hydrated for sure.

[00:06:53.910] – Hilary Erickson

Yeah. Everyone jokes that the labor nurses, everyone’s like, Well, what could I do? We always are like, Well, you could drink more water. That’s how we answered it. Everything. You’re in preterm labor, drink more water. You got a headache, drink more water. You don’t like your doctor, drink more water. Because then you won’t see him as much because you’ll be in the restroom. It’s fine.

[00:07:12.890] – McKenzie Caldwell

Yeah, exactly. It’s our first line. Okay, we got to check that. Everybody is like, nurses, dietitians, PTs, whoever. We got to check that our patients are hydrated. If they are great, but we are going to ask you. So just if you don’t want to hear the question, if you want us to bug you about water, just drink your water, people.

[00:07:32.570] – Hilary Erickson

And check the color of your pee if you have white toilets, because sometimes people have black toilets. I’m like, Well, I don’t know how hydrated you are, but if you have a white toilet, look before you flush, it should just be a super light yellow. I think a lot of people are obsessed with how many ounces it is. But again, if you’re working in the yard, you’re going to need more, all that stuff. So just check the color of your pee. If it’s looking yellowy ambery, if it looks like beer, it’s over. You need a gallon.

[00:08:01.990] – McKenzie Caldwell

Exactly. And I’m the same way. I recommend 64 ounces outside of pregnancy and lactation, 80 to 100 in pregnancy. But I don’t count. I just have these Mason jars. And so if you’re like me and you just drink water and you don’t pay attention and there’s no way you’re going to count it, just look at the color of your pee.

[00:08:18.400] – Hilary Erickson

Yeah. Which is especially when you live in Arizona in the summer because whenever we get somebody’s pee, we’re always like, girl, look at this. Look at this color. Okay? That’s like a jewel you wear around your neck, the color of your pee.

[00:08:32.740] – McKenzie Caldwell

It’s November, because this looks like..

[00:08:35.930] – Hilary Erickson

Exactly. All right. Oh, and I was going to say I got a flu with child number two, and I probably was still working because nurses. But I went in and they checked my urine and they gave me two liters and I cannot tell you how much better I felt when I walked out the door. I know I had said drink more water because I was a labor nurse at the time. And it’s amazing when you are actually hydrated how much better you feel, which it’s crazy town.

[00:09:01.820] – McKenzie Caldwell

Yeah, definitely 100 % super important.

[00:09:05.110] – Hilary Erickson

Yeah, I cannot emphasize my fluids. My second tip talk video was me saying drink more water. And it was like a question flashing up and me going drink more water. My daughter filmed it and makes fun of me all of the time for it. You’re welcome.

[00:09:19.820] – Hilary Erickson

Oh, my God. I love that.

[00:09:21.850] – Hilary Erickson

Okay, tip number three.

[00:09:23.210] – McKenzie Caldwell

Yeah, absolutely. Please take a prenatal vitamin. I was just talking to, and even if you’re not pregnant, if you were trying to conceive, be on a prenatal vitamin, please. I was just talking to a client this morning who has a friend going through IVF that was not recommended to take a prenatal vitamin.

[00:09:35.940] – McKenzie Caldwell

And we were both very confused and just please take one. Anything is better than nothing. Unfortunately, the FDA does not regulate the supplement industry, which on my end is super frustrating. And I think it’s even more confusing and frustrating on the consumer end because you don’t know what to look for.

[00:09:52.330] – McKenzie Caldwell

So what we do need to look for is third party testing. Sometimes a website will just say that they third party test. Sometimes they’ll have a symbol saying that they’re certified by USP or NSF or consumer labs or something. So that’s a really great sign. And those aren’t the only third party labs that do testing for quality and purity and efficacy and safety and all of that stuff. There are other places, but those are great ones to look for. Those symbols are awesome. And if you can swing a little bit of an investment, it is helpful to get a higher quality prenatal vitamin.

[00:10:27.050] – McKenzie Caldwell

For example, Nature Made P renatal USP certified in every drug store, affordable. It’s great. It’s basic, covering all of our super basic nutrients. It’s missing a couple of the vitamins like choline that I think is really important. And then there’s a little bit of debate about… We emailed about this about folic acid versus methylfolate. I’m a fan of methylfolate, but I’m not going to argue with it.

[00:10:47.600] – McKenzie Caldwell

I think it’s way more controversial than it needs to be. And folic acid is not going to kill you, even if Methylfolate might be slightly better utilized by some people. But anyways, that’s there. If you’re taking that, great. If you want to look for a prenatal vitamin that has a little bit more to it, maybe looking for some Choline and some Selenium and things like that, and maybe adding on a DHA supplement if you’re not taking… Excuse me, if you don’t consume seafood, that’s really helpful.

[00:11:16.820] – McKenzie Caldwell

But those can make a really big difference. It’s super important that you’re taking something and then getting your bases covered as far as iron and vitamin D goes is really important for your wellbeing. Usually, baby is going to be fine because biology is nuts.

[00:11:30.970] – McKenzie Caldwell

That way, it will suck all the nutrition out of your body. So I always tell my clients, yes, of course, I care about your growing baby, but you are my client, you are my patient, and I care about your wellbeing. So let’s make sure your iron levels are high enough so that you don’t feel like you’re going to pass out and feel super depressed.

[00:11:45.940] – McKenzie Caldwell

Make sure your vitamin D levels are high so you’re not fatigued and cranky and depressed all the time and things like that. So prenatal vitamin, super important that you’re taking it. Most important that it’s third party tested. If you can invest in a little bit more, amazing, great, awesome, but it’s totally okay if what you can afford is the drugstore version and you feel confident that it is safe to take.

[00:12:09.970] – Hilary Erickson

Especially if you’re on vacation and you forget it, just run to the drugstore and grab whatever. But you had a brand that you recommended that didn’t look too expensive. What brand is it?

[00:12:18.030] – McKenzie Caldwell

Yeah. So Klair Labs with a K is the one that I recommend to a lot of my clients. It’s just one of many. Everybody has different needs. But I like that one because it’s vegan for my vegan or clients who have a dairy allergy or an egg allergy or need to eat kosher or something like that. And it has a pretty wide variety of different nutrients that are covering your bases.

[00:12:39.530] – McKenzie Caldwell

But it’s not like oversupplementing people. There are some really awesome super high quality vitamins out there, but they’re like eight pills a day. And I just don’t think that’s necessary. And I think if we’re working on your actual nutrition with food, we don’t need that much supplementation. And like you said, the price point is pretty okay. It’s pretty comparable. It’s middle of the road. It uses the methylated folate. It uses a form of iron that doesn’t upset people’s stomachs called iron bisclicinate, which I really, really like because some people get super bad stomach update or constipation but still really need that iron. An iron free formula might just not be right for them. So I like that one. There’s, of course, many options in the market.

[00:13:19.240] – McKenzie Caldwell

And of course, everybody’s always changing their formulations, too. So I try my best to stay on top of it. But for my clients, usually that’s my go to recommendation. And if that doesn’t work for them, then I have a whole list of other ones that are my go to as well.

[00:13:32.850] – Hilary Erickson

There are some really high priced prenatal vitamins out there. So talk with your provider if you have questions about it. But a lot of times those are a lot of marketing. There’s a lot of marketing involved in those. They email me, ask me to promote them, and I don’t because I’m like, eat your spinach.

[00:13:48.970] – Hilary Erickson

But it is frustrating that folic acid isn’t regulated. We tell everyone to take it. We should know that there’s how many milligrams in this. So that’s frustrating. Thank you, United States government. Strong work.

[00:14:01.930] – McKenzie Caldwell

I know. It’s like you want to regulate lots of other things that are very important to regulate, but not this. I was thinking something about how the CDC tried to crack down on distilleries that were handing out hand sanitizer during the pandemic.

[00:14:16.910] – McKenzie Caldwell

And then everyone was like, what the hell? For good reason because it’s just freaking hand sanitizer. But why hand sanitizer and not, I don’t know, green coffee that Dr. Ross is selling? I don’t get it.

[00:14:29.430] – Hilary Erickson

Never know. We will never know. And a quick plug that anyone who could conceive a baby should be on a prenatal vitamin. So even if you’re not trying to have a baby, if you are doing things that could create a baby and aren’t like without your tubes tied, without an IUD, all those things, take a prenatal vitamin.

[00:14:46.570] – McKenzie Caldwell

Or you can also take a B complex that has folic acid or methylofolate or whatever folate in it, or a women’s multivitamin or something like that. If you’re on birth control and you’re confident in your birth control, okay, that’s fine. We get it.

[00:15:00.100] – McKenzie Caldwell

But the rates of unplanned pregnancies in the US are 50%, and so it’s really helpful. We fortify our food supply with folic acid, which is really great, but it’s helpful if you can think about it, that’s just a great extra self care thing. It’ll be good to get a little bit of that extra folic to just protect yourself.

[00:15:21.310] – Hilary Erickson

Yeah. In case you guys are like folic acid, you’ve heard it a million times, but you have no idea why. It means that the tube that connects your spinal column will close all the way. So some babies are born with that open to air, which is called a Neural tube defect. And they have shown probably 80s, 70s. Do we know what year it was? I don’t remember.

[00:15:41.630] – McKenzie Caldwell

We started fortifying our food supply in 1998. It’s actually pretty new. And I think ’92 is when the big recommendation, early 90s. It’s actually not that old, but they started researching it probably in the late ’70s, early 80s thing.

[00:15:58.150] – Hilary Erickson

And just showed that a simple thing could help close that spinal cord.

[00:16:03.310] – McKenzie Caldwell

It’s effective by taking folic acid or folate reduces the rate of Neural tube defect by 70%. It’s extremely effective.

[00:16:11.400] – Hilary Erickson

Note, you can still have a Neural tube defect while taking folic acid. So it doesn’t prevent all of them, but it prevents a good number of them.

[00:16:18.100] – McKenzie Caldwell

Yeah, exactly.

[00:16:19.450] – Hilary Erickson

All right, next tip.

[00:16:21.060] – McKenzie Caldwell

Okay, so tip number 4. If you are nauseous, I know that you’re freaking out. You’re feeling like you can’t eat anything healthy and you really care about your pregnancy. It’s okay. Deep breath, focus on what you can eat versus worrying about what you cannot eat. It is more important to get food in your body, period.

[00:16:37.050] – McKenzie Caldwell

Just get enough calories than it is to hyper focus on what you’re eating and just take a deep breath, even if you need to write down a list, like, what can I eat? What can I tolerate? And go through that. Getting something on your stomach first thing in the morning can be really helpful. Some people will keep like peanut butter crackers or some salty nuts or something on their bedside table and just eat a handful before they get out of bed in the morning. That can be really great.

[00:17:03.070] – McKenzie Caldwell

But eating your three meals, a couple of snacks at regular intervals throughout the day can be really helpful to keep that nausea at bay. Sometimes in pregnancy and sometimes even when people are just anxious or different times of their life, hunger actually shows up as nausea, which feels super counterintuitive.

[00:17:19.610] – McKenzie Caldwell

But getting something on your stomach can really help settle it a little bit. So eating consistently throughout the day. Usually what I see people missing out on when they’re really nauseous is fiber and protein. So don’t be afraid to just use fruit as your fiber. That’s totally okay. In fact, that might even be really helpful.

[00:17:36.850] – McKenzie Caldwell

Bananas are a good source of vitamin B6, which can sometimes help with nausea. And those tart flavors can often settle people’s stomachs as well. And then you’re going to get some fiber and some micronutrients and antioxidants in with that fruit as well.

[00:17:51.180] – McKenzie Caldwell

And then you can try some non meat proteins. A lot of people have meat aversions when they’re nauseous. And so proteins like cheese and peanut butter can also help a ton if you’re really struggling. So breathe. Ginger tea is also really great if you’re nauseous. But again, just try and ground down, focus on what you can eat and don’t worry too much about what you can’t.

[00:18:13.290] – Hilary Erickson

And talk to your doctor. And if they’re saying some nonsense like, well, we’ve done all that we can, unless you have an IV in your arm at the time that they’re saying that, they haven’t done all that they can. And you should say, I’m interested in other things to increase my quality of life right now. Thank you. Because some doctors are real hesitant.

[00:18:30.730] – McKenzie Caldwell

Yes, Unisom exists. I have had some clients on Zofran, and I know that some doctors are hesitant to prescribe Zofran in pregnancy, but I know that it’s a thing and it’s totally okay to ask for those medications. Absolutely. Also, I saw Do you follow paging Dr. Fran?

[00:18:47.710] – Hilary Erickson

She’s been on the podcast. We love Paging Dr Fran. Oh, my God.

[00:18:50.490] – McKenzie Caldwell

She’s awesome. But she posted a TikTok about Zofran in pregnancy, and she also recommends Neurax alongside it because it does cause constipation. So just remember that, too, if you’re listening to this and you’re like, Okay, now I’m not nauseous, but now I’m constipated. Get the Miralax.

[00:19:05.040] – Hilary Erickson

There’s no winning, guys. There’s no winning to it.

[00:19:08.510] – McKenzie Caldwell

No, we apologize.

[00:19:11.430] – Hilary Erickson

All right, last tip.

[00:19:13.440] – McKenzie Caldwell

Last tip. So I mentioned DHA a little bit earlier, but DHA is such an awesome nutrient. So it is a omega 3 fat that is super helpful in fetal brain development. And it actually is shown to help with adult mental health as well. So our brains have a lot of fat in them. And so when we can add in more of those anti-inflammatory omega 3 fats like DHA, it’s super helpful.

[00:19:39.070] – McKenzie Caldwell

So the main source of DHA in our eating patterns is seafood. So if you can eat seafood two to three times a week. And in pregnancy, we won’t want to be focusing on that low mercury seafood. That’s really amazing. And it’s a great way to get enough DHA into your system.

[00:19:52.960] – McKenzie Caldwell

But if you’re like, heck, no, I hate seafood, or it’s given me the ick right now, I can’t get it down, or it’s too expensive, I get it. Absolutely get it. You can take a fish oil supplement. Some prenatals will have that wrapped in there. But if you want to look for 250 to 300 milligrams of DHA, great. If you’re vegan, you will need a DHA supplement. They make vegan ones and it’s coming from algae.

[00:20:19.270] – McKenzie Caldwell

There’s a bioengineered algae that they figured out how to make it produce DHA, which is super cool as well.

[00:20:25.710] – Hilary Erickson

Wow.

[00:20:26.220] – McKenzie Caldwell

So that’s a really amazing nutrient that’s super cool. And if you can get in some more seafood, great. If not, DHA supplements exist.

[00:20:33.670] – Hilary Erickson

Yeah. And we actually have evidence based mommy coming on, I think it’s going up next season, but she recommends that the cheaper the fish, like canned tuna, you’re less likely to have mercury in it because she does all the…

[00:20:45.290] – Hilary Erickson

She said the like, if you got a big tuna stake, you’re more likely to have mercury in it because it’s a larger fish versus they get the tiny tuna to can it. And so you’re less likely to have mercury in it. I have no idea. Yeah. So if you are craving a tuna salad, get in there.

[00:20:58.050] – McKenzie Caldwell

I am going to use that for my clients. Absolutely. Yeah. One, so the light albacore tuna that’s in a can tends to be like a medium mercury fish. So one can a week is generally fine. And then there’s some companies like safe catch that actually test all of their tuna to see the mercury levels if you feel freaked out by it. But that’s great. I had no idea that they would… That makes sense, though, that they would use the smaller tuna for the cans. And it’s a great hack. I love that.

[00:21:23.840] – Hilary Erickson

She just said the smaller the fish, the better. So I was like, I don’t want to think that it was alive as a fish at any point, but I do like tuna salad. I don’t find a lot of pregnant women, though, in case you’re out there being like, No, smell. No, that’s not unusual. People are not like downing fish like crazy, which maybe we’re made to not love fish because of the Mercury issue. I don’t know.

[00:21:48.810] – McKenzie Caldwell

Yeah. There’s only a couple of fish that are super high in Mercury. It’s like tile fish, which I’ve only seen once on the menu in Charleston. And I was like, I don’t want a bottom eater from the Charleston Bay.

[00:21:58.440] – McKenzie Caldwell

Anyways, even if I’m not pregnant. Shark and swordfish, orange roughy, aji tuna, and big eye tuna are our big ones. And most people aren’t eating those anyways. It’s all of the other seafood. So you get seafood great, but if you can’t, it’s okay.

[00:22:16.700] – Hilary Erickson

And there are supplements there everywhere. You can find DHA pretty easily. Yes.

[00:22:21.660] – McKenzie Caldwell

Costco has a really great Kirkland fish oil deal. I just posted on my TikTok, all the Kirkland supplements that I thought were good, but they do a really good job with checking quality for Kirkland supplements. And their fish oil was a great price.

[00:22:35.470] – Hilary Erickson

That’s what is purchased at the Erickson household because I still take DHA. I probably don’t take it every day, probably three or four times a week. Sure, that’s fine. All right, so many good tips. Where can people find you to get more information?

[00:22:48.570] – Hilary Erickson

Because, guys, I think it’s so interesting that we get patients who come in that I’m like… They’re like, I haven’t felt the baby move. And I’m like, oh, man, bummer, because, of course, decreased fetal movement. All the labor nurses are like hearts in our stomach. Baby’s on the monitor. And then I’m like, when did you last eat? And they’re like, oh, like last night at eight. And it’s like noon. And I’m like, Come on, guys. You got to feed yourself.

[00:23:09.650] – Hilary Erickson

And I just think it’s something. That people ignore because you’re young and vibrant and you haven’t really ever thought about your diet up until now. So I think it’s really important to follow a dietitian, possibly get some help thinking about nutrients, especially once you start to breastfeed because you have a parasite in you. That’s just the bad news. They will take all the things.

[00:23:27.510] – McKenzie Caldwell

That they want. It’s a little alien. It’s a little alien. We love our little aliens. Most of the time. Most of the time. But they are taking a lot. So that means you just need a little bit more and that’s okay. Yeah.

[00:23:39.560] – Hilary Erickson

So where can people find you to increase their nutrition education? Yeah.

[00:23:43.500] – McKenzie Caldwell

So I am on Instagram as @ fertility.prenatal.dietitian. And on TikTok, fertility prenatal dietitian was too long. So I have to go by name of my name on TikTok. So it’s @mckenziecaldwellrdn. And then my website is feedingyourzest.com. And I have a group program in addition to offering one on one coaching as well.

[00:24:04.280] – Hilary Erickson

Yeah, because this is a good time to really get your diet in order before the little people come and you’re trying to feed them, too. It’s such a good time.

[00:24:10.700] – McKenzie Caldwell

If you can give yourself three months to work on your nutrition. That’s a really amazing amount of time to give yourself time for behavior change. And it takes an egg three months to fully develop before you ovulate, too. So it’s a great time to use nutrition to impact fertility and pregnancy outcomes as well.

[00:24:26.300] – Hilary Erickson

Awesome. All right, thanks for coming on, McKenzie.

[00:24:27.980] – McKenzie Caldwell

Thanks for having me. Have a great day.

[00:24:30.020] – Hilary Erickson

Okay, I hope you guys enjoyed that episode. Just like with the rest of life, I feel like we ignore a lot of our food requirements, and I loved having McKenzie on. I want you guys to know that she does do one on one coaching. She also has a signature class that you can take to learn more about fertility nutrition as well as pregnancy, breastfeeding, nutrition, and stuff like that, because now is the time to fix it because it is only going to get worse the older you get your eating habits and things like that. I loved having her on. Thank you for coming, McKenzie.

[00:24:58.390] – Hilary Erickson

Stay tuned because next week we are talking about the hardest parts of parenting for me, like right now. And then I’m having my friend come on who is a neonatal nurse practitioner to talk to us about what happens in the hospital if something were to go wrong with the baby. So stay tuned.

[00:25:12.800] – Hilary Erickson

Thanks so much for joining us on today’s episode. The Pulling Curls Podcast grows when you share us on social media or leave a review. If you do, please tag us so that we can share and send you a virtual hug, which, frankly, is my favorite kind of hugging. Until next time, we hope you have a tangle free day.

The post Prenatal Nutrition with McKenzie Caldwell, RDN from Feed Your Zest – Episode 194 appeared first on Pulling Curls.

As a labor and delivery nurse, I get asked by expectant moms how far apart are my kids. I often get wide eyes — they’re awfully far apart (although certainly not as far apart as some). For your info, my kids are 5, 11 and 14 — at this moment in time. I have 9 year age gap between the first and the last, with only one in between them.

And that’s how God wanted it.

God made it easy for us. We started trying fairly soon after each child, but it took a while to get pregnant each time. About 9 months to get pregnant with our second child, and about 3.5 years for little sister. That is a post for another day. I also have a post about not getting pregnant when everyone else is (as I know just how it feels when it takes a long time to get pregnant with your next child), and another one on why I think we didn’t get pregnant (and it’s not the reasons you’re guessing)

BTW, if you’re in an infertility battle — you might like the story of my pregnancy.

If you’re looking for the studies, check out the article that goes through the research of The Pregnancy Nurse®.

I also talk about this topic on Episode 003 of my podcast, Pregnancy & Parenting Untangled:

Today’s post is the pro’s and cons of large age gap kids. Again, I had no say in the issue — I, in fact, wanted them much closer together to be “done”. I always wonder what life would have been like if my kids were closer together, I observe that in other families and here’s what I’ve found:

Other posts that might interest you:
When am I going to go into labor quiz?
Plus Size Clothing Subscription Reviews
Budgeting for a Family of Five

How Far Apart Should Kids Be?

Pro’s For Far-Spaced Children:

1. Lots of individual attention for each one. A lot of people wonder how my kids were all reading so early (each read before they were 3). The reality of the situation, I was at home and had time on my kids to spend a LOT of one-on-one time with each one! I consider myself very lucky to have had that time. So much time to love and cuddle. I especially took that time with Princess P (although, I am not sad to send her to Kindergarten now).

2. The older children are great helpers. We have 2 older kids that can babysit now. Just today we took our first child one out for some quality time with both myself and my husband. The middle one could watch the younger sibling and it was just a dream. SUPER handy! Think, Duggars (haha, I actually wrote this before “that” was all an issue)!

3.  Less fighting. While my older 2 fight an AWFUL lot, and we can’t pretend that the littlest doesn’t get in the fray every now and then, I bet there’s less fighting because they’re all in their own age group. Rarely do 2 want the same toy at the same time (unless that toy is the TV or the computer, which can’t be helped).

4. More space to grow, less comparison. Next year I will enter kids being at different schools the rest of their school careers. It’s hard, but at the same point — no one has a teacher, right after another one had a teacher.

5. A little more time to adjust. Instead of throwing more on your pile in a short time, you’re throwing it over a few years. I sometimes wonder if I wasn’t cut out to have 3 close together. Having a baby really rocks my world, especially the third. Turns out God knows what he’s doing after all!

6. Great for your uterus. I have to say that if you get pregnant TOO close together, you might have higher risk to have preterm labor — as your uterus never had time to recover (and a year apart is plenty for a mother’s body).

BTW, if you’re struggling getting through daily activites (no matter how many close/far kids you have) I have found a course that makes all those problems a thing of the past!

Simplifying family life takes some thought and action. If you join for JUST a month and add the discount code PC10 the price is less than a lunch out (and much more worthwhile).

What is the best spacing, medically, for children?

I haven’t heard doctors give hard and fast rules for a perfect age gap.

If you’ve had complications or health risks such as:

• Preterm labor
• Bleeding (especially hemorrhage at birth)
• Severe postpartum depression
• Cesarean section (especially if there were complications)
• Uterine issues

They may want you to wait longer for your next baby so you don’t up your risk of pregnancy complications. I would probably check with them at your 6 week check-up to make sure you’re “good to go” if you’re wanting to have your next pregnancy soon.

If you’re thinking about activities that could keep older kids busy while you’re handling younger kids (or, frankly also great for younger kids) — check out the Kiwi Crate. They have lines from infant through, elementary ages, and up to Teens/Adults that my kids have enjoyed at every stage!

Pro’s for Close Kids:

1. Easier to room in. At one point we had all 3 in one room. That’s hard when you’re 10 and your new baby sister is one waking up all night. If they had all been closer to the baby stage that would be easier (at least for a while).

2. Get it “done” — we are stretched out between 3 schools and I will be on an elementary PTA for the rest of my life, but I deal with it. Is it awesome? No, but it’s fine. I make the best of it.

3. Easier to do activities. A lot of kids who are close in age like similar activities. It’s hard to please everyone with an activity around here. We try, half-heartedly. Family Home Evening tends to usually focus on one age range to make it meaningful for someone. Luckily, we all like to be silly — so throwing it young, usually gives everyone some enjoyment. I’ve considered homeschooling a few times, but I really think it would be impossible with 3 kids on VERY different levels. I do have a post about how we do Disneyland with very different ages!

4. Good friends. While my kids have moments they get along. They wouldn’t really be “best friends” because they’re so far apart. That makes me sad. But, I know that as they get older the time between them will fade. When they’re adults they’ll have each other!

5. You’re younger when it’s done. I dream about being a cool grandma who still has tons of energy to play with the chicklets and then send them back crying to their parents. Luckily, I started pretty young (24, to be exact) so this is still likely. Good news is, I am extra cool and hip now — so I’m ahead of the game!

Related Post: Why Can’t I Get Pregnant Again

How to Space Children

Frankly, that’s between you and your partner (and mother nature/God). And quite likely, your physician. Once you decide on your ideal age gap, it’s a good idea to decide how you want to handle the baby spacing.

Ways to space babies:

• Celibacy
• Medical birth control — things like the pill, IUD, etc.
• Physical birth control — the “pull out method”natural family planning, etc. — in my experience as an L&D nurse these are less effective.

How Far Apart should kids be?

The reality is that you need to pick what’s right for YOU.

Are you READY to have another one, before you jump back into the game? 

It’s never ours to judge how others space their kids. We have no idea what other families are dealing with. SO many things come into play with little kidlets.

Each one is a blessing, no matter where on our path they come. This is just some things I’ve noticed as I’ve pondered our own spacing. I do — as I mentioned at the time, entirely believe this is in God’s hands.

Having multiple children is wonderful. I couldn’t imagine life without them. 

… I mean, I try — but I don’t succeed.

Multiple kids brings lots of changes around the house that I know this course will help you cope and thrive in! It’s even guaranteed!

The post How far apart should I have my Babies?: Baby spacing appeared first on Pulling Curls.

Pregnant women taking marijuana can have serious consequences (also during breastfeeding as well). Today we’re going to talk about the consequences of marijuana use in pregnancy.

How do I all all of this? Hi, I’m Hilary — many people know me as The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. ​ Please note that this post is written from my own experience in working in two states and also interviews with other nurses around the country. This seems to be the standard of care for women in both states where it is “legal” and not legal, however guidance is constantly changing.

I know a lot of you don’t like this information (hence, comments are off since someone mentioned they would like my house to catch on fire and my family die in it). I really am just here to tell you what will happen and remind you that honesty is TRULY the best policy.

Don’t miss my post on my sister site about wine during pregnancy (and I dive deep into the studies in that one since there are so many).

But, if you’re really looking to get prepared for what happens at birth — come join me in The Online Prenatal Class for Couples where we get you prepared for all of it in just a few hours!

Will they take my baby away if I test positive for drugs?

Positive drug use often leads to a social services referal, which often leads to a call to CPS (child protective services). From there, it’s up to them (but most often doesn’t end up in anything more than possibly a visit and a record of it).

BUT it’s complicated, so let’s talk about it….

It’s important for you to undertand that in my state (and most states) it does require a CPS call by us to notify them — most often done by a social worker (however, if the social worker wasn’t available I have made the call before as the RN).  Drug use during pregnancy is considered a form of abuse and we are required to report all forms of abuse to CPS.

CPS may or may not visit you, but they will have a record of it in their system.  If you have questions about the requirements in your state, I would recommend you to ask your doctor.

During your prenatal check-ups they will likely ask about your drug useage, and it may be routine for them to do a drug test on you. In some states this requires consent, and in others it does not.

BTW, if you’re doing marijuana and might be pregnant it is important to take a pregnancy test so you can STOP as soon as you are (I also have a little online pregnancy test — which isn’t as accurate, but good if you’re just wondering). The vast majority of women do stop taking marijuana as soon as they find out they are pregnant.

Of course, marijuana isn’t the only type of drug that we are testing for in these screen. A positive drug test can come from many types of drugs. Many on the drug screen are taken more seriously by a social worker than marijuana — and at times you could have issues with child endangerment from law enforcement.

Prenatal drug exposure is taken really seriously (as it should be) by child welfare.

Please note that if the health care provider does NOT notify CPS (or social services) we can lose our license, and it would be illegal as we are mandatory reporters.

If you test positive for prescription drugs that you have a prescription for, they may also discuss your opioid use and the safety of your family. This isn’t just about marijuana — it is definitely about the safety of children overall.

Please note that any actions taken on the baby’s plan for where it will live after it leaves the hospital is not up to health care workers. We are required to report things, and then it is in the hands of child protective services.

I love that you’re planning for all of this — and that is a HUGE step. If you’re a planner, check out my pregnancy planner full of places for memories, managing it all and your medical info you’ll need!

Marijuana during Pregnancy

It is my firmest desire that babies are given the most benign environment to grow in during pregnancy.  That means limiting coffee, alcohol, drugs (especially those unstudied), etc — except when the benefits far outweigh the risks, and can’t be gotten in other ways.

That is what this article is about.  If you strongly believe Marijuana is great during pregnancy, you and I will just have to disagree.

Smoking Marijuana While Pregnant

Marijuana is becoming legal in more and more states both for recreational and medicinal uses.  Whatever side of the argument you stand on for that — the reality is that when you’re pregnant things are very different.

Is it illegal to smoke weed while pregnant?

It is illegal to take marijuana during pregnancy.  It is still a federally controlled substance.

While, in some states where marijuana is legal, there is a bit of grey area — they really encourage moms NOT to take marijuana during pregnancy, just as we encourage them not to drink or take other controlled substances.

Taking marijuana during your pregnancy is a bad idea and is illegal — in some states. 

ACOG (American College of Obstetricians & Gynecologists ) has said that because there is very limited research, they recommend against marijuana use during pregnancy. This statement is also echo’d by The American Academy of Pediatrics.

It is illegal for a doctor to give you a marijuana prescription while you are pregnant.

Consequences for your baby for smoking marijuana during your pregnancy

**Honestly, there aren’t a lot of studies that have tracked babies of moms who smoked marijuana (because it’s illegal, and moms are unwilling to come forward for such a study.

There doesn’t seem to be anything specific like birth defects that they notice at birth. Which is good.

However, there are studies showing that marijuana use during your pregnancy can cause:

• low birth weight
• premature birth
• small head circumference
• decreased length
• stillbirth

If you’re interested in this, the CDC has a whole page on marijuana use during pregnancy.

Some drugs can cause a placental abruption due to the changes in blood flow in your body with these types of drugs.

There is a new study about marijuana use in pregnancy increasing kid’s anxiety and hyperactivity, showing there is a correlation between it and behavioral problems.

Studies are still being done, and the research on this topic is PRETTY poor, but most things show those consequences above are possibilities.

After birth, babies exposed to marijuana in utero have changes in brain development — things like changed responses to visual stimuli, higher-pitched cry or trembling.  While it doesn’t appear that babies go through withdrawal, the longer term studies are noting things like change in school performance, memory, impulse control or attention spans.

You can learn more about these consequences in this article  from the NIH.  I’ve read a few studies and it seems that there just aren’t many out there.  While the results are fairly inconclusive (and many studies seem to contradict each other) the majority point to possible brain issues as the child develops.

There is a recent study out of Australia that continues to link it to lower birth weight and complications.

Smoking weed while pregnant — cps involvement

Depending on your state, your provider can sometimes take a urine drug screen with or without your consent.

In my state, we do need a consent to test YOUR urine but we do not need one to test your baby. So, if you refuse, we just test the baby’s — and it also looks extremely suspicious.

Remember that honesty is always the best policy and CPS will note that if they are required to come.

The results of that urine drug screen (which always includes a screening for marijuana) will be noted in your chart. BTW, you can also test at home.

If you test positive for marijuana during your prenatal care, the hospital will likely ask to test you at delivery. They will also make a call to social work, and they will follow CPS guidelines for their area.

**If you plan to refuse the drug screen, we will screen your baby (that does not require consent).  We will also call social work about your refusal and that refusal will be noted.**

From that point, it is out of our hands.  It is in CPS’s hands at that point.

Nurses may also take your baby’s first stools to test it for marijuana to see how far into your pregnancy you took the drug (which may be a relief for those who mistakenly took it early in their pregnancy, before they knew — those stools will back you up). This is called a meconium screen.

If you are currently pregnant and using marijuana you need to stop.  If you are taking it for a “medical condition” you need to talk to your doctors about alternative methods that could be safer.

**If you disagree with this article I strongly encourage you to talk with your doctor about your drug use and what to expect after delivery. **

As a note, often marijuana use during pregnancy can also show as other substance use disorders, or use of other illicit drugs — so that will be considered by child protective services as well. Substance abuse while caring for children (or growing them in your womb) is certainly a cause for concern. They may talk about drug treatment programs with you.

Nurses will also keep an eye on baby using the Neonatal Abstinence syndrome scoring to make sure baby isn’t having any withdrawls from illegal substances.

Baby Testing Positive for THC at Birth

So, in summary, if a mom or a newborn tests positive for THC at birth they will send a social work consult, which will then go to CPS and they may follow-up with you. Most often, nothing at the hospital happens — although the nurses may watch baby closer for any withdrawal symptoms (although most often there aren’t visible signs from withdrawal from cannabis).

In some states they also can’t assist you with breastfeeding if you test positive for THC (we’ll talk more about breastfeeding in a bit).

Can they take your baby away for smoking pot while pregnant?

If it is illegal in your state — I do believe that they can take your baby away (but only with other issues of neglect or a lack of safety).  That does not mean that they WILL take your baby away.  Family court’s goal is to always keep families together if at all possible.

Will they take my baby if I test positive at birth?

Likely, no.  However, it will trigger a CPS visit to you, and possibly one to your home.  If they find other mitigating circumstances, that could become a real possibility.  It could also be a possibility for any other children you have in your care as well.

They may also commit to some random drug tests to make sure you are a safe parent.

Cleaning system while pregnant third trimester

While it varies, you can test positive for around 3 weeks after you’ve smoked.  There is a good article here that talks about how long marijuana stays in your system.

There really isn’t anything you can do to clean your system out in that time frame.

I have really heard it all before:

• “I haven’t smoked for MONTHS”
• “I was just in a room where other people were smoking”
• “I never smoked”

A positive, is a positive, is a positive. If you believe there is a false positive, you can ask that they take bloodwork. I have seen false-positive results in a pregnant mother, but they are extremely rare.

And once we have a positive — we can test your baby’s stools to see when during your pregnancy you smoked.

If you believe it is a false positive, ask for a blood test to be taken (which is more sensitive).

What happens if I fail a drug test while pregnant?

Your health care providers will likely council you on it and will note it in your prenatal care record. Most providers do a drug test on the first prenatal visit as part of universal screening for many things (like chlamydia, ghonorrhea, anemia etc). They may or may not need your consent to specifically do a drug screen.

The most important thing is to always be honest with your doctor, so that he/she can give you the care you need.  If/when CPS visits you, honesty will be super important for them!

Honestly, what that provider does with the info really varies, but most often they will at least council you to stop.

I think we all understand that new mothers really are trying to do their best for their baby. They want families to stay together.

Using a planner can help you keep track of any information you need to stay honest and on top of things.

Alternatives to Use of Marijuana during pregnancy

A lot of women take Marijuana during their pregnancy because of morning sickness, or other medical conditions.

I’d encourage you to talk to your healthcare provider about other options. A lot of people take this with this (but talk to your doctor first). I have a whole post on Unisom use during pregnancy on my sister site.

Check with your provider, and be specific with your symptoms, to see what they think will be right for YOU.

Marijuana and Breastfeeding

The compounds in Marijuana are found in higher concentrations in breast milk than they are in the user’s bloodstream.  It can have similar consequences for your baby as noted above, and also noted in the study above.

In Arizona, we are unable to help you breastfeed if you have had a positive screen during pregnancy. It was not like that in California, but it is something to keep in mind.

FYI, my friend Katie has a great Breastfeeding & Alcohol Calculator — in case you’re looking to drink and breastfeed.

Marijuana in Pregnancy Faq’s

My baby is smarter than other kids because I took marijuana.

While not a question, I do get this a lot in the comments. Again — as I said above, the studies are pretty poor, but most do point to some delays as kids get older.

Will my baby have withdrawl symptoms from marijuana

No, they will not. There has been some noted irritability in babies of moms with substantial marijuana use, but nothing tangible.

What if I test positive for other drugs?

Again, we will call CPS. That’s all the hospital does, but CPS makes calls like that, not us. Other drugs are certainly more problematic for both you and the baby.

Will my baby have withdrawls from other medication

Yes, we have moms who take both prescription and elicit drugs during their pregnancy and their baby will have withdrawals. It was on the most painful things to watch as we wean that baby from the medication. So sad.

Where do you get off telling me what to do?

I don’t. I am just explaining what will happen. I am also sharing that as a labor nurse who has seen THOUSANDS of babies, the less we can do to affect their environment, the better.

A note on comments:  I turned them off. People just couldn’t be civil.

And, like I said your best starting point to get prepared is The Online Prenatal Class for Couples. It GUARANTEES you’ll be more prepared for birth — and studies show you’re going to be happier about the whole process too.

Or, if you’re not quite ready for the full class, check out my free prenatal class — It’s your first step towards being your own birth boss.

The post Marijuana Use During Pregnancy: Cannabis, THC and the newborn drug screen — what happens? appeared first on Pulling Curls.

You’re not pregnant.

I would take a big sigh and think that at least I can take an ibuprofen if I have a headache for the next couple of weeks after not getting pregnant.  There are always bright sides.

We tried for child #3 for for over 3 years.  Mr Middle was just a few months old when I decided we should have a third and I wanted to be “done.”  I actually blogged about this in my post no bambino.

But there was certainly another plan for us.

And I knew my friends found it awkward.  I had friends that had TWO babies in the time that I had none.

But I never became someone with “fertility issues” — I just wondered what God’s plan was for me.

I found joy in my friend’s babies.

I loved that they were pregnant and was so excited for them.  I never wanted them to feel badly to tell me that they were pregnant.

When they had babies that were driving me insane and screamed to me about how horrible it was to have a newborn or how horrible it was to be pregnant.  I sympathized.  Pregnancy is surely a 2 edged sword that can have painful results when you’re pregnant or NOT pregnant.  It is so weird like that and we all need to show love to each other regardless of our situation — soapbox moment done.

I think it’s really important to not let the infertility define you.  Who knows why it’s happening today, but you could just as easily be pregnant next month and you don’t want pregnancy to define you either.

Check out Jon and Morgan’s podcast episode about what they did for their infertility:

I finally had to give up the try for a girl.  I finally had to be ready for whatever God had in store for me.  I just happened to be lucky enough to get Princess P.

I mostly just didn’t love the limbo.  I really wondered if 3 kids was more than I could do.  I was certainly overwhelmed with 2 kids and I know God doesn’t give us more than we can handle.  I also knew I had a career and wondered if that was more of the path I was going to take.

I have spent a lot of time in limbo land.  It’s not my favorite, but I’ve found the other end so many times, knowing God did have a plan for me.

Related Post Why I couldn’t get pregnant with my third child

For instance:

I had a horrible pregnancy with Princess P.  I had 3 kidney stone bouts, my pelvis split and I had glucose intolerance diagnosed in week 9, so I followed the diabetic diet for 31 weeks.  OH, and I was 12 days overdue.

I think if I had gotten pregnant right away it would have been too tough with a tiny Mr Middle.  God really was looking out for me by making me really WANT the torture that awaited me.

I also met new friends when I moved to AZ that I might not have if she was older and in school by the time we got there.
I know God has a plan for us.

You might wonder how I finally got my baby.  I never did go on fertility, but I do think a few things helped:

I did a basal body temp for a few months and found out that I ovulate really late in my cycle.  I was “aiming” way too early (which would’ve been the normal cycle). You could also use ovulation kits (but basal body temp just uses a thermometer).

I worked PM shift (3-11pm) when we lived in CA which removed a lot of “prime” baby making time.  We did “attempt” from day 10 to day 30 every other day for a few months.  It wasn’t fun.  Feel free to check out this guest post from Marissa on keeping the relationship solid while ttc (trying to conceive)

I lost some weight.  Probably about 25 pounds.  Honestly, I do think that weight is a huge issue for a lot of infertility.  That’s probably a post for another day, but I will say that’s a huge issue.  If you’re not getting pregnant you might want to look at your weight and how you might work on either gaining or losing.

My friend Katie has a great post on “Why am I not getting pregnant” — that you might like too!

Just one more message of trying to love each other. You have no idea who’s suffering from infertility, and you have no idea if someone is really happy about the pregnancy that they have inside them.  Having babies is tough.  It’s something that we as women share and I wish we could share more love about it than hate.

** A few people in the comments  have decided to say that just because I already had children, I didn’t “suffer from infertility” — but I beg to differ.  On this point we will agree to disagree.  Yes, we each have a different story, but I find it unfair that you told me that it wasn’t painful for me.  I, personally, believe that these points can be true for anyone suffering from infertility be it on their first or their 10th. **

You might also be interested in these posts:

• Why can’t I get pregnant?
• Find your dates to get pregnant
• Keeping the sexy while trying to conceive

I love familes, I’m grateful for each family that chooses to have a child.  They are lucky to have loving parents.

The post Not Getting Pregnant, When Everyone Else Is appeared first on Pulling Curls.

First off, hello! I’m Hilary — many people know me as The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. ​ I’ve seen THOUSANDS of pregnant women and I know how many thoughts are going through your head. Let’s untangle a few of them, but first I’d love it if you let me walk by you during this pregnancy:

1.  Dollar Store Pregnancy Tests to find out if you’re pregnant

They’re legit, people.  They just have less packaging, less advertising and less plastic.  It’s not like your doctor’s office needs an EPT to tell if you’re pregnant each time.  I buy them in bulk, just so when I’m having a procedure or I’m taking medicine I can KNOW.  Do it. Or, check these out from Amazon!

BTW if you’re reading this without a positive pregnancy test — the first thing you want to do is to go buy a test and take it (don’t email me, I have no information on if you’re pregnant or not).

I know a lot of people worry their pregnancy test wasn’t right — but there are VERY few false positives (but some people do lose the baby in early pregnancy and that’s different).

False negatives do happen for a variety of reasons

• Taking it before a missed period (too early)
• Not doing the test right
• Expired tests

Also, the time of the day can matter (your first pee of the morning is best). If you have irregular periods, wait at least 30-40 days from your last period, or about 2 weeks from when you think you conceived.

If you get a negative result, and don’t get your period for a few more days (and it’s passed the time you would have missed your period) take another one, or call your provider.

I also have a “super accurate” online pregnancy test. I also have a really cool pregnancy calendar that gives you a lot of dates to look forward to (including your due date, when your first trimester ends, and more).

FYI, a home pregnancy test is just about as accurate as a blood test — although a blood test can show if your levels are rising and falling, talk with your provider if you have questions. However if you get a positive result on a pregnancy test, you are most likely pregnant and you should call your provider (there are some rare medical conditions that can also cause a positive pregnancy test, but all of that would require you to see a provider for help).

Ok, now you KNOW you are pregnant, what are the next steps?

Well, first grab this pregnancy planner. You’ll feel so much relief with something reminding you what needs to be done, so you don’t miss a thing!

2.  Find a health care provider when you’re first pregnant

Perhaps you had an OB before you got pregnant, but a lot of people just see family practice doctors for physicals outside of pregnancy.  I have a whole post on finding a doctor but let me boil it down to the best way:

• Find someone close to your home or your work (this is a good idea because you see them FREQUENTLY near the end).
• Figure out what hospital you want to deliver at and find a doctor that matches it.
• Find one you agree with — and this post has lots of hints to help you figure that out!

Most doctors want to see you for your first appointment between 6-10 weeks. However if you have certain medical conditions (like high blood pressure) they may want your first prenatal appointment earlier, so find a doctor ASAP.

At your first appointment for pregnancy care they will do a thorough medical history, and will likely do some blood work and urine tests. They will also ask a lot of questions about your insurance (to make sure they get paid). If you don’t have insurance, they can possibly help you get on medicaid.

I also did a podcast on choosing your provider.

3.  Find a hospital when you’re first pregnant

Again, 2 and 3 are kind of inter-related.  I worked at a free-standing birth center.  This offers the ability to not be in a “hospital” environment, but having a full hospital at your disposal (because I am a nurse that works for the hospital).  I think it’s really nice not to have share elevators with people who have who-knows-what.

I’d see what’s around you and get recommendations from friends about local hospitals.  Keep in mind that doctors only get “privileges” at one or two hospitals.  They can’t just go to any hospital and deliver a baby.  It’s just not how it works.  One word: paperwork.  Lots and lots of paperwork.  Hence, they can usually only keep up with a few. Also, it would require them to drive and possibly be at several hospitals and that can take time away from other patients, so it can be a hard call.

That’s just one of the ways why a hospital is not a hotel (pregnant women need to read that article).

4.  Call your insurance in early pregnancy

Check out co-pays and how much your hospital stay is likely to cost.  Also, you may need to pre-approve your hospital stay, they can give you the skinny!

5.  Find a prenatal vitamin and take it when you’re first pregnant

Hopefully, you were taking prenatal vitamins before you conceived, as folic acid is most important before you’d really even know you’re pregnant.  They can help prevent birth defects. Any questions about what you should take, ask your healthcare provider.

Prenatal vitamins are a cornerstone of a healthy pregnancy. You should take them all of the weeks of pregnancy. It’s a really important thing.

Keep up with a healthy diet too, just because you’re taking vitamins isn’t a reason to slack on “eating the rainbow”. A balanced diet will help you feel better too.

You’ll also want to stop things like illicit or addictive drug use, birth control pills (if you were on it), and most alcohol or coffee consumption. Ask your doctor what levels they think are OK. And yes, marijuana use during pregnancy has been tied with low birth weight in babies (and possibly issues later on).

6.  You can continue to work out in early pregnancy

If you feel up to it, you can continue to keep up the same activity as you did before you got pregnant.  There are more restrictions on what type of workouts you can do as you progress in your pregnancy.  Check with your doctor, but there’s no reason to feel like a fragile flower.

Many women find low impact exercises extra helpful during pregnancy.

7.  Being tired is normal in early pregnancy

I remember with my last baby, if I wasn’t pregnant I would have been sure I had cancer.  I wanted to lay in my bed ALL. DAY. LONG.  When I wasn’t caressing my pillow I was wishing I was.  Constant droopy lids.  SO. TIRED.  When you think of all the iron it takes to build a placenta and a baby, you’ll know why!  Having a hard time sleeping — this post shows you some ways to sleep during pregnancy.

Looking for more info on very early pregnancy symptoms << that blog has some awesome info!

Also, if you haven’t told your husband/partner yet — my friend Camille has some cute ideas on how to tell your husband you’re pregnant.

It’s NOT too early to think about fitting in a prenatal class? Check out my online, non-nonsense prenatal class for couples available now with 3 price points to fit your wallet! — even a free version to try out now!

If you’re interested in getting prepared, but not sure you’re ready for a prenatal class, try my Free Beginning Prenatal Class:

Do NOT miss my new post about what you REALLY need for that new baby!

The post What to Do When Pregnant for the First Time appeared first on Pulling Curls.

Being stressed out at delivery has complications you may not be considering right now. Let’s talk about pain management options that allow you to be in control during your delivery.

This episode was inspired by my post on stress at delivery.

Big thanks to our sponsor The Online Prenatal Class for Couples — if you’re looking to stay in control and decrease your stress at delivery, TAKE a prenatal class. Understanding the steps along the way, and what’s a normal bump in the road will TOTALLY help you out!

The reviews are amazing >> check them out here!

How Stress at Delivery Can Affect Your Baby

In this episode

The benefits and concerns of stress during pregnancy & delivery

Stress can:

• Increase your blood pressure
• Increase your use of “vices”

Info on marijuana in pregnancy

Understanding your pain management options

My Hypnobabies bundle.

Online Prenatal Class for Couples Reviews.

Other things that might interest you

When to take a childbirth class

Nervous About Delivery

10 Things to do before Coming to the Hospital

Producer: Drew Erickson

Check out my other pregnancy podcasts:

Check out all my podcasts:

Transcript

[00:00:00.205] – Hilary Erickson

Hey, guys, welcome back to the Pulling Curls Podcast. Today on Episode 85, we’re talking about stress and it’s something that I really didn’t notice until… I don’t know, 15 years into my nursing career? Just how stress really affects the baby at delivery. So let’s untangle it.

[00:00:23.825] – Hilary Erickson

Welcome to the Pulling Curls Podcast, I’m Hilary, your curly headed host on the podcast, where we untangle everything from pregnancy, parenting and home routines. I want you to know that there are no right answers for every family. And I find that simplifying my priorities is almost always the answer. It’s tangled, just like my hair.

[00:00:48.415] – Hilary Erickson

OK, guys, before we get started, make sure you’re subscribed and while you’re subscribing, don’t forget to leave a review! It really helps other people find us and I really appreciate it.

[00:00:58.195] – Hilary Erickson

OK, so I remember the delivery I was in. The patient was just losing her mind, which is 100 percent fine, totally prepared for this. And honestly, because I had worked at a hospital that did not have a lot of epidurals initially, I was very used to this type of delivery, but just screaming… Very out of control. You know, I was doing my best to keep her under control, but there’s only so much you can do. Didn’t have a lot of family support, all that kind of jazz.

[00:01:21.445] – Hilary Erickson

So, baby comes out and it’s just like unamused. Does not want to breathe, does not want to do anything. It was just like how I would feel after I had run a marathon. I would lay down on the grass and wish that God would take me home. Right? Like, you know, I could just tell that this baby was just pooped out. And I realized that it had gotten all those same hormones from mom. But at the same point, it’s just this little tiny person who has not dealt with that type of stress before.

[00:01:47.845] – Hilary Erickson

So let’s talk a little bit about stress and how it can affect you both during pregnancy. And also then we’ll circle back to at delivery.

[00:01:57.995] – Hilary Erickson

Do you feel prepared for your delivery? In just three short hours, you can be prepared for the competent collaborative delivery you want, you’ll know what to expect and how to talk with your health care team. And there are no boring lessons in this class. I’ll use humor, stories from my 20 years in the delivery room to engage both of you. I love how Alissa told me that she found herself laughing at things that used to sound scary. Most of all, you guys are going to be on the same page from Bump to Bassinette.

[00:02:22.805] – Hilary Erickson

Join the online prenatal class for couples today. You can save 15 percent with coupon code UNTANGLED. You can find the link in the show notes. So some stress during pregnancy is really important, your baby needs to experience those types of hormones while it’s in the womb because it will have those types of hormones when it comes out. So small periods of stress, though, you know, you have a stressful bill that you need to take care of. Or there’s stressful moments at work.

[00:02:50.125] – Hilary Erickson

I actually I kind of enjoy some stressful moments at work just because it keeps me on my toes and stuff like that. So those types of things are great for when you have a baby inside of you. OK, so short term stress, small stressors are great. They’re good for you, they’re good for the baby. Everyone has them. There’s no way to avoid them in general. The problem is the longer term stress, if you’re in a relationship that is sucking the life out of you or in a domestic violence relationship.

[00:03:13.555] – Hilary Erickson

Side note, if you are pregnant and in a domestic violence relationship, reach out. There are a lot of people willing to help you get out of that relationship so that you and baby are in a safe place. But a super stressful long term work environment. That’s not so great. So we’re thinking longer term stressful. And I honestly… Covid could kind of go into those depending on how you’re handling covid all of the things that came with it. It could be a long term stressor.

[00:03:37.615] – Hilary Erickson

Now, as I said, a lot of it is how you’re handling it. So a lot of people have very stressful lives, but they deal with it very well. Inside, they’re doing fine. They’re able to sleep. They’re able to do their, what we call activities of daily living without much interference by the stressful things. So that’s something to keep in mind, because a lot of times people will be like, oh, that’s so stressful, when in reality you’re like, oh, I love it.

[00:03:57.475] – Hilary Erickson

I thrive off of that kind of stuff. And if that’s the case that you’re sleeping and you’re able to do all those things in a stressful environment, then that is fine because stress can cause things like decreased sleep, and that’s not great for the baby, if you’re not sleepy because of the stressful thing. Changes in eating habits. You know, either you’re eating more, not great for the baby, or you’re eating less because you’re stressed out. Also not great for the baby.

[00:04:15.355] – Hilary Erickson

If the stress is causing things like this, then you got to think, oh, this is handling the bigger picture in this point. It can increase your blood pressure. Obviously, we know that people who lead a very stressful life can have higher blood pressure. You know, if I’m running from a bear and I had a blood pressure cuff on which, gosh, I hope I don’t run away from a bear with a blood pressure cuff on, it would be very high because I’m stressed out and blood is coursing through your body and your body is made to increase your blood pressure at that time so that you can make decisions and actions that will keep you alive from said bear.

[00:04:43.585] – Hilary Erickson

Now, I’m just envisioning myself running away from a bear with a blood pressure cuff on. So there you go. Another thing I was looking when I was kind of researching this topic is a lot of times people turn to their vices when they are in serious, stressful times. So that could be smoking, it could be drinking, it could be marijuana’s so legal anymore, it could be those types of things. So I know if you’re thinking about taking marijuana or considering it, I do have a post on what usually happens in the hospital.

[00:05:07.735] – Hilary Erickson

If you were to take marijuana so you could check that, I’ll put the link in the show notes. So by turning to these vices, obviously these are not super healthy things, like if your vice is going on walks and breathing, then that is an OK device. But if your vice is smoking, especially during pregnancy, we would like you to limit that. So that’s something to think about. So when you have these long term stressors, studies show that it increases your chances of having a premature baby, which means they’re born before thirty seven weeks or having a low birth weight baby, which means that they weigh less than five pounds, eight ounces.

[00:05:35.365] – Hilary Erickson

So, and, you got to think that all of that is happening because there’s probably less blood flow or less adequate blood flow to the baby during the pregnancy because you’re trying to run all of these other different things, increasing your blood pressure, those kind of things. And then if you’re eating wrong or all those other things, you can just have more complications. So that’s just something to consider. Now, they are always like, oh, it can cause PIH. Now it can increase your blood pressure, and, which can increase your incidence of PIH, pre-eclampsia.

[00:05:58.495] – Hilary Erickson

But in general, stress isn’t going to cause because PIH it’s something that’s growing along with a baby from the very beginning, so that’s something to consider. Now, if your blood pressure is high, that’s definitely something to talk with your doctor about. But it may not be PIH. Sometimes just high blood pressure, which is different than pre-eclampsia. So some to talk with your provider about. OK, so back to stress at delivery because delivery is obviously a very stressful time.

[00:06:18.985] – Hilary Erickson

It is basically your body running away from a bear with a blood pressure cuff on. Now, the picture is much more vivid because I’ve obviously seen that. So you’ve got to think if baby and you if you are going through these super stressful times and you’re not in control, you’re feeling like you’re running away from that bear. Instead of feeling like I can do this, I can handle this, baby’s feeling that, too. And then they come out and they’re just super tired.

[00:06:38.635] – Hilary Erickson

So how do we prevent you from feeling so very out of control, running away from a bear, during your delivery? I just came up with a few things that you guys can do to really try and keep that type of stress, right before baby is born, at bay. Obviously, I would recommend taking a pain management class. So some people feel this type of stress, even with an epidural in because they’re expecting that epidural to work one hundred percent and they’re still feeling some pain and they might be feeling some anxiety over what’s coming.

[00:07:03.325] – Hilary Erickson

So understanding what the pain management options are going to do for you can be really helpful. I recommend understanding that. And of course, I go over all of that a lot in my prenatal class. But you can also take something more like hypno babies where you’re kind of putting yourself in a self hypnosis that you can handle the pain better. And honestly, man, if hypno babies had been more available and online because I didn’t really have time to go to classes in the Bay Area back in the day, but if it had been more available, I really would have done it.

[00:07:29.935] – Hilary Erickson

And I think it would have been helpful with the old teenagers right about now, so I’m a big fan of hypno babies, in fact, I’m such a fan of it, I give my class 50 percent off if you take hypno babies, I’ll put all the links to all that in the show notes. At least that’s what I do currently at this time. So check out the link in the show notes. This is episode 85, Stress at Delivery.

[00:07:48.865] – Hilary Erickson

The other thing I think is important is to have a frank discussion about this with your partner or whoever is coming into the birthroom with you. So just say if they feel like you’re getting out of control because a lot of women are like, do not offer me the epidural, do not talk about the epidural. And I think that that’s unfair to you because, you know, if you don’t know what your labor is going to be like and by not even offering or discussing the epidural at all with your partner or your birth team, that’s doing you a disservice because there may come a point in time where you really need it.

[00:08:18.235] – Hilary Erickson

And I think that that is true of every mom I know. I see moms on Tik-Tok who are like I did it so natural because I did X, Y, Z. And I think, but your baby came out in a mere number of hours. If you’re going in, you have to have an early induction because of of things that are going on with your body. You’re fighting an uphill battle and you’re going to be more tired than that.

[00:08:36.235] – Hilary Erickson

And yeah, so I just think it’s something to talk about with your partner in advance. I don’t want an epidural. I would like to not talk about the epidural. But if you’re noticing that I seem out of control, let’s have like a safeword or something where you say, you know, honey, I think it’s something that you should consider. Because we don’t want the baby to have this type of stress on them before it comes out, because again, it’s a lot easier to feel like you’re running away from a bear in labor if you, first off have no idea what’s going on, which is why you should take a prenatal class.

[00:09:02.155] – Hilary Erickson

But also you haven’t had any sleep. You’re super uncomfortable. Nothing’s making it better. And it’s just going on and on and on. That’s why I think it’s good to have a supportive partner who understands that you don’t want to be out of control. If you’re feeling in control and all that type of things, at least they can bring it up, be like, hey, babe, how are you feeling right now? Are you feeling in control?

[00:09:20.635] – Hilary Erickson

Do you feel like this is something you can keep handling, and have that type of discussion. And again, whatever pain management option you choose and labor is just a pain management option that you choose in labor. There are no prizes. There’s no victory for getting an epidural or not getting an epidural. It’s just making it through that point in time, because I promise that getting an epidural or not getting an epidural is not the worst parenting choice you’re ever going to make.

[00:09:43.445] – Hilary Erickson

I… Not by a long shot. There are a lot of other things you’ll do as a parent. You’ll be like, oh, it probably wasn’t a great choice, but you don’t know this in advance and you’re trying to keep your baby perfect. So just some ideas about stress at delivery. I think a lot of people feel like that as long as they can just make it to get that baby out, that they’ve done a great job by not getting an epidural when in reality, if they’re just too out of control, maybe that’s not doing their baby a huge service when it comes out.

[00:10:06.625] – Hilary Erickson

Anyway, just some thoughts. I would 100 percent recommend getting a prenatal class, though, because I always say, like, it’s like riding a roller coaster in the dark if you have no idea what’s coming up. I mean, I love Space Mountain as much as the next person, but I wouldn’t want to do it if I didn’t know that I was going to get back there safely. And you have fears and stuff like that during labor. So I always recommend just kind of having an idea of what’s coming up.

[00:10:26.995] – Hilary Erickson

And that’s what a prenatal class totally does. It gives you just an idea of what to expect as you go in. People love my class. I’ll put a link to all of the reviews. I think I have hundreds of reviews at this time of people. You’ll see a few four star reviews, but most people give it five. They’re coming directly from the people and I love them. They’re like one of my favorite things when they land in my inbox.

[00:10:44.305] – Hilary Erickson

But people love my class because it really just prepares them in a quick, fun, informative nature. And I think it’s going to prepare you to have less stress at delivery.

[00:10:51.415] – Hilary Erickson

Thanks so much for joining us today. I hope we helped smooth out a few of the snarls in your life. We drop an episode every Monday and we always appreciate it when you guys share and review. Until next time, we hope you have a tangle free day.

The post How Stress at Delivery Can Affect Your Baby – Episode 085 appeared first on Pulling Curls.

Knowing what is happening during your prenatal care is so important. So often patients let their doctor control that information, so knowing what you need to know about yourself puts the power back in your seat.

Big thanks to our sponsor The Online Prenatal Class for Couples — I’ll engage you as I lead you towards your confident delivery where you can be an expert in your own care!

Things to know about your prenatal care

In this episode:

Things to know about your prenatal labs:

• Your blood type
• If you got RhoGAM
• Beta strep results (GBS status)
• Average blood pressure in the office lately
• Medications & dosages

Things to know about your health history

• Major family health history
• Immunization record
• Past problems with general anesthesia in your family

I recommend putting these things in your Google Keep or Evernote file.

Other things that might interest you:

Picking Your Provider Podcast Episode

Smoking marijuana during pregnancy

Waiting on Delivery Day Podcast Episode

Producer: Drew Erickson

Check out my other pregnancy podcasts:

Check out all my podcasts:

Transcript

[00:00:00.265] – Hilary Erickson

Hey, guys, welcome back to the Pulling Curls Podcast. Today on Episode 82, we’re talking about what you should know about you. I mean, you should be the expert in you, right? Let’s untangle it.

[00:00:21.115] – Hilary Erickson

Welcome to the Pulling Curls Podcast, I’m Hilary, your curly headed host on the podcast where we untangle everything from pregnancy, parenting and home routines. I want you to know that there are no right answers for every family. And I find that simplifying my priorities is almost always the answer. It’s tangled, just like my hair.

[00:00:46.105] – Hilary Erickson

OK guys, before we get started, I’d love it if you’d leave a review. No, seriously, I would. If you’re on Apple podcast right now, I really don’t see any reason why you can just click and leave some words. Some positive words would be nice. And like five stars, please leave a review. OK, so when I worked in California, we had a physician there who sent all of his patients in with this card that had all of their important information.

[00:01:09.355] – Hilary Erickson

It was just like a little almost like a gift note. And he had him print it up and it just said, like the basic labs that they had. And that way, no matter where they were, they could go to any hospital and have that basic information with them. And I always thought that that was so smart and giving to his patients. And the other thing was that those women knew what was on that card because they looked at it.

[00:01:28.645] – Hilary Erickson

And so often we have women coming in that I’m like, do you know your baby’s strep status? And they’re like, no. You know, when we do stuff like that, we are giving a lot of our power to our provider. So today, I want to talk about some of the things you should know about yourself, especially with prenatal care. But we’re also going to talk about a few other things so that when you go to the hospital, you know, you should go to the hospital where your doctor has privileges, but sometimes you can.

[00:01:50.425] – Hilary Erickson

Sometimes you’re on vacation and your water breaks up. And my friend Jamie, she was in Hawaii, but you would have that information with you no matter where you were. So I know you really go to the hospital where your provider has privileges. That’s really the best thing to do. A lot of people are just like, oh, I can deliver wherever, but go to the place where your doctor has privileges or your midwife or whoever.

[00:02:10.935] – Hilary Erickson

Do you feel prepared for your delivery in just three short hours? You can be prepared for the competent collaborative delivery you want, you’ll know what to expect and how to talk with your health care team. And there are no boring lessons in this class. I’ll use humor, stories from my 20 years in the delivery room to engage both of you. I love how Alyssa told me that she found herself laughing at things that used to sound scary. Most of all, you guys are going to be on the same page from Bump to Bassinette.

[00:02:35.745] – Hilary Erickson

Join the online prenatal class for couples. Today, you can save 15 percent with coupon code untangled. You can find the link in the show notes. OK, one of the first things you should know about yourself and everyone should know about this, about themselves, you know, no matter if you’re having a baby or what is your blood type, if you don’t know it and you’re going to and you’re not pregnant or whatever, ask your provider just to order.

[00:02:57.155] – Hilary Erickson

It is a super quick, simple test. Just so you know, I noticed during covid when we were hearing that, oh, people people with the blood type were less susceptible. A lot of people were like, I have no idea what my blood type is. We most often blood type the babies in the hospital. So you should know your kids and just know your blood type. I think it’s just handy also when you come into the hospital, it’s just nice to know, especially if you’re positive or negative, because then of course we have Rogan.

[00:03:21.545] – Hilary Erickson

That’s something else you should know. Rogan is a shot that they give you if you and your baby daddy, your blood types don’t match antibody wise. So my husband’s a positive i’m o negative. I have to get rogallo. So usually if your partner is positive and you’re negative, you have to get Rogow. It is so that on your next baby, your body doesn’t decide that your baby’s an intruder and try and kill us. So that sounds pretty important, right?

[00:03:44.625] – Hilary Erickson

Anyway, if you’ve gotten real game, you know what I’m talking about. If you don’t know your partner’s blood type and that happens very frequently, they will probably just give it to you if your blood type is negative. And then when the baby is born, they’ll check the baby’s blood type. And if it’s positive, then they again will give you the real game shot. It is a shot. It is in your bum. So, yeah, very important, though, even if you’re not planning on other children, I would 100 percent still recommend getting the program shot.

[00:04:06.155] – Hilary Erickson

You just never know what future holds. Second thing we’ve already kind of talked about well, kind of third thing after a game is your status. So beta strep. I should do a whole podcast on beta coming up, coming soon. It’s something that they swab in your who and your your poop hole, your rectum for this bacteria that’s normally found in women’s vaginas. A lot of people think it’s an STD anyway. They found that it can be problematic in babies that have been in the Nichue.

[00:04:30.305] – Hilary Erickson

They just don’t have as good of outcomes. If the moms tested positive for this normally occurring bacteria, no idea how they decided to check for that. But they did. And if you are positive, then they just give you antibiotics in labor. But if you are done at thirty six weeks, so if you’re not thirty six weeks yet, you wouldn’t know what your GBS status is. But if you are thirty six weeks and it’s gotten back, ask your doctor, because it’s important for you to know that’s something that you would definitely want to know if you were coming in and you ended up at a hospital that wasn’t your hospital.

[00:04:57.485] – Hilary Erickson

That happened to me. Once I went, I got in a car crash and so I was taken to the closest hospital. But know your GBS status, because it just makes it so much easier if we know that you’re positive or your negative. If you’re in labor, we can quickly start antibiotics, stuff like that. So gbs status, that’s something else you should know. And if it’s taken, definitely follow up. Put a note in your phone to follow up with that at your next appointment.

[00:05:17.405] – Hilary Erickson

So if it’s taken at thirty six weeks, you probably have another appointment the next week. Later it should be back by then. It doesn’t come back like right away. And it’s not something that they would call you for at home. It’s just something that they note on your record. But definitely follow up with that. And hopefully if you have a good provider, they’re following up with you on these kind of things anyway, especially bad. Ostrer, I would say probably half my patients know it was positive or negative.

[00:05:37.265] – Hilary Erickson

And a lot of them, I think, just don’t know because it was negative and their doctor doesn’t bring it up. Most of them know if they’re positive, but some don’t. OK, another thing you should know is your blood pressure in the office. Like what your average blood pressure has been in…. In the weeks. Coming up to this, just ask. I am always so frustrated when the text doesn’t tell me at all what the blood pressure is or the temperature like.

[00:05:56.165] – Hilary Erickson

I don’t know. I always I mean, I don’t tell you every thirty minutes as I’m taking your blood pressure in the hospital, but I tell people frequently, oh, it’s normal, it’s good, or it’s a little high. A lot of times when you come in to labor and delivery, your first blood pressure is going to be high because you’ve huffed in off the street and you know you’re tired. My blood pressure in the office was always high initially because usually I was dragging another kid in with me and I was tired and it was stairs and, you know, all the things.

[00:06:17.825] – Hilary Erickson

So but you should know what your blood pressure normally runs. That’s an important thing for all of us to know. So just ask them when they take your blood pressure, OK? The other thing is the medications that you’re taking and the dosages now, it’s probably not something that you’re going to have on the top of your head, but it would be something that’s important to have in your phone. If you’re on thyroid medication, if you’re on like metformin or Glucophage or whatever, just have it in your phone.

[00:06:38.465] – Hilary Erickson

And if you’re not pregnant, you’re listening to this. This is something everybody should know. I take a Zyrtec every day. There you go. This is my only medication and sometimes I don’t take it, but it’s what I take every day. So everyone should really know the medications that they’re on and the dosages. I would just keep Google keep note on your phone so that you can quickly bring it up, you know, when you’re in a situation like that, because it’s so frustrating when you ask them and I don’t mind when you go grab your phone and look it up or you have the bottle in your purse, a lot of people have that.

[00:07:02.855] – Hilary Erickson

But it’s like, oh, man, I don’t know. I don’t it’s like a pink pill and but I don’t know, you know, I’m like, come on, let’s take a little little care of ourselves. That’s not up to me to know your medication. So, yeah. There you go, rant. OK, here’s just a few other things to have in mind, because a lot of times when you go in to have a baby, that’s your first, like, medical thing that you’ve done without parents.

[00:07:22.175] – Hilary Erickson

Some people it’s not some people have gotten had surgeries and all these kind of things without their parents. But a lot of people I see coming in who kind of have a glassy eyed look and are like, I should ask my mom that, and I know that feeling. I knew that like my grandma had cancer, but I wasn’t really sure what kind that kind of thing. Nurse here just, you know, sometimes some families just aren’t real open about that kind of stuff.

[00:07:40.145] – Hilary Erickson

So you’re going to want to know your major family history. Cancer. Diabetes. Those kind of big things, big problems in your family, high blood pressure, possibly, you’re going to want to know those types of things, cancer, especially like when I went in to do my mammogram, I had to fill out like everyone I knew was like cancer history. I mean, they were going back with, like, uncles. And I was like, I don’t know what’s up with my uncles or aunts or anyway.

[00:08:03.075] – Hilary Erickson

But I think it’s just a good thing to talk with your parents about in general. And in fact, sometimes some of that stuff, especially way back, was hid it from us so we wouldn’t know. So it’s a good thing to have a conversation with with your parents. You’re going to want to know your vaccine history. That’s probably because TDAP has become in vogue lately. That’s probably something that your provider is going to talk to you about in the office.

[00:08:22.665] – Hilary Erickson

It’s really important that we try and have a cocoon of safety for the baby. So we encourage parents, mom and dad, to get the tdap during pregnancy so that because pertussis has become more frequent, we have a cocoon of safety where mom and dad are not getting pertussis. So that protects the baby a little bit more because the baby can’t get the pertussis immunisation for a few months. So if baby were to get pertussis, it is really bad.

[00:08:44.025] – Hilary Erickson

So that’s why we recommend having the tdap. But that’s something that you’re going to want to know. And if your mom still has your shop records, get them right. Just get them. I have mine somewhere. I don’t know how helpful they are. And honestly, some of them like the MMR, we actually do titers on you, which means we take your blood and we see if you have antibodies for it while you’re pregnant. Because if you were to get I think it’s Rossella during pregnancy, it’s really problematic.

[00:09:05.475] – Hilary Erickson

And so we would encourage you to get the MMR after you have your baby. If the titers or the things in your blood showing that you have antibodies. covid is helping all of us learn a little bit more about all this. Right. Anyway, if your antibodies aren’t there, we’ll just encourage you to get it, because we definitely don’t want you to have the ROSIO low while you’re pregnant. It can be really problematic for the baby. OK, vaccine history, OK, any surgeries that you’ve had and any issues that you’ve had with anesthesia.

[00:09:26.865] – Hilary Erickson

So this is talking about you right now. Some of you might have gotten ear tubes or tonsils when you were little. So definitely just talk with your parents about how that went. If there were any problems with you and anesthesia or pain pills after that. It’s just things that maybe your parents know that have never really passed on to you because they really haven’t had a reason. But check with them while you’re pregnant so you can know those kind of things.

[00:09:44.655] – Hilary Erickson

And then finally, one of the big questions that we ask is if anyone in your family, mom, dad, aunts, uncles, brothers, sisters, grandparents have ever had a big problem with general anesthesia. There’s a thing called malignant hypothermia, which is something that you have in your DNA that doesn’t react well with medications that we normally give for anesthesia can be extremely problematic and it is run through families. So if you and someone in your closest mom, dad, brother, sister and uncle network of family have had that, that’s something that we’re going to want to know ahead of time because I think they switch what anesthesia they give you.

[00:10:15.975] – Hilary Erickson

It’s just something great for us to know ahead of time. So there you go. Those are the things that I think it’s super helpful to know during pregnancy. Again, keeping an app on your phone, Google Keep is awesome for stuff like this because it travels with you. It will be on your laptop. It will be on your phone. It will be on your next phone, most likely if you install Google Keep or Evernote or something like that.

[00:10:34.365] – Hilary Erickson

Just handy to have that going along with you. So I think a lot of people are like, well, I want to have a say in my care, but then they don’t know stuff like this. And by being on top of your things, it just helps the medical staff know that you want to be involved in your care rather than just like just do whatever to me. So I think it helps you have a more confident birth when you know stuff like this.

[00:10:52.935] – Hilary Erickson

So that’s why I wanted to come up with this podcast today. These are simple things, good things to know in advance. If you are not currently pregnant and are considering it, ask your mom about this family history stuff, because I think it’s really important as you go be adopting around the world and honestly know that I’m thinking about it.

[00:11:08.475] – Hilary Erickson

I don’t know that my twenty year old knows a lot of this kind of stuff. So that’s something that I should have a conversation with him about. So if you’re a mom and your kids are teenage age, talk to them about this kind of stuff, too.

[00:11:18.045] – Hilary Erickson

Thanks so much for joining us today. I hope we help smooth out a few of the snarls in your life. We drop an episode every Monday and we always appreciate it when you guys share and review until next time. We hope you have a tangle free day.

The post Things to Know About Your Prenatal Care & Health History – Episode 082 appeared first on Pulling Curls.

What should you consider when picking an OB or midwife for your pregnancy. What are all the factors that might be problematic as you head towards your delivery?

Picking Your OB:

This episode was inspired by: Picking a Provider

Big thanks to our sponsor The Online Prenatal Class for Couples. This class starts in the third trimester and has ton of information to get you prepared for your delivery. Be sure to use the code mentioned in the episode!

Items Mentioned about picking an OB:

Find a doctor that matches you

My free birth plan printable

Questions to ask / things to consider

• Your Insurance
• What hospital you hope to deliver at
• Who will deliver you (who’s on for them at night)
• Who will answer your phone call after office hours
• Who will answer or deliver you on weekends?
• Who will see them in the office (and what are their credentials)
• Discuss any high risk issues you have
• Any special concerns you have about delivery (IV’s, home delivery and more)
• How easy it is to get appointments, and how likely they are to get delayed/moved
• Office staff customer service

Saying no in labor episode

What to ask your doctor at your first appointment

When you likely are “stuck” with a particular provider

Other things about picking a pregnancy provider that might interest you:

5 Tips for a C-section

What to consider before a VBAC.

Producer: Drew Erickson

Check out my other pregnancy podcasts:

Check out all my podcasts:

Hilary Erickson 0:00
Hey guys, welcome back to the pulling curls podcast! today on episode 58. We are going to talk about picking your provider for your pregnancy. We’re going to talk about what are some questions you can ask when are you locked in to that doctor? And also probably some things you haven’t thought about that we only think about because we’re nurses and we see all the things so let’s untangle it.

Welcome to the polling curls podcast. I’m Hilary, your curly headed host on the podcast where we untangle everything from pregnancy, parenting and home routines. I want you to know that there are no right answers for every family and I find that simplifying my priorities is almost always the answer. It’s tangled just like my hair.

Okay, guys, before we get started, I wanted to remind you that I have a free birth plan that you guys can download. You can check it out. In the shownotes, and it might give you a few ideas to talk to your ob about at your next visit, so totally free. Check it out in the show notes.

This episode of The pulling curls podcast is sponsored by the online prenatal class for couples. It simplifies understanding labor so you can have a more relaxed pregnancy and birth taught by a highly experienced labor and delivery nurse and can be done wherever you are whenever you want. No more arranging busy schedules to fit in a prenatal class. Save 15% with a coupon code untangled You can find out more at pulling curls calm and the menu under courses or in this episode show notes.

Okay, guys, picking an OB is hard, right? I have so many friends who find that they thought it would be easy and then it’s more difficult than they thought. And I actually have a friend who’s about 32 weeks right now who’s really not happy with her practice, but she’s kind of changed at this point. So she has some other limiting factors. So and we all do so the number one is to check your insurance now insurances have just gotten real crazy.

I know that The insurance that they provide at work, which I’m not actually on very confusing, it only allows for a few physicians and most of our OBS are actually not on our insurance at the hospital. So all these nurses who’ve been to these OBS for so long can’t go to them anymore. So check your insurance, you’re gonna want to start with that list because you can end up paying thousands and thousands more for just a doctor that you somewhat prefer more and honestly guys, I do not think that that is worth it. So check your insurance.

And then I would definitely ask around ask on Facebook who people have gone to the problem is, is you’re probably early in pregnancy. So you don’t want to make like a big announcement. But if you’re considering pregnancy, I think it’s great to make an announcement on Facebook before you’re even pregnant. That way you can kind of have somebody picked out ahead of time.

Second thing is you’ll want to consider what hospital you plan to deliver at and then you’ll want to find out if your doctor that you’re looking at delivers at that hospital. This is mostly in like larger metro areas like I live in the Phoenix area and our physicians usually have privileges at one to two hospitals and so if you’re planning on delivering at a certain time Do you want to make sure that the doctors have privileges there?

So privileges are just like their rights to practice at a hospital and each hospital makes doctors go through a lengthy process in order to practice at the hospital. It’s kind of weird, but it’s not just like a restaurant where you can show up an order whatever you want from whatever doctor you want, the doctor has to have privileges at that hospital. So something to keep in mind if you have a particular hospital that you want to deliver. Most people pick their doctor and then just go to the one of the hospitals that they deliver.

As a side note, just because your doctor doesn’t have privileges like at a hospital that you’re preferring doesn’t mean that they’re a bad doctor. It really is a lengthy process. Plus, they then have to do rounds at all of those different hospitals. So most doctors, the limit I’ve really seen is three and that is really stretching them thin. So just something to keep in mind. Okay, so once we have those two narrowed down, you’re gonna want to ask kind of some more technical questions.

So who answers the phone when they’re not in the office? Do they have an answering service? Do they answer calls? 24 hours a day, most OBS have some dogs slash nurse and usually the nurse is the gateway to the doctor that you can talk to 24 hours a day. That doesn’t mean that they’re going to call you right back but you should be able to get in touch with one of them you know any time of day because obviously you’re pregnant 24 hours a day if you have a problem, you should really be able to get in touch with you.

Also you’ll want to know if there’s like 40 doctors in the group that answer those phone calls because if it’s some faceless name, then service just might not be what you’re hoping for. And then the same thing is who takes their calls on the weekends. You can’t expect your ob to be on every weekend. That’s just not how healthcare is happening anymore.

I know back in the day these OBS were on 24 seven 365 days a year maybe they take a week off for vacation but OBS just aren’t practicing like that and think about your own life would you really want to be on would you want your husband on 24 hours a day seven days a week or your wife You know what I’m saying? So they really just are not on like they used to be but how often are they taking weekend call?

How often are on a phone call at night? How big of a practice are they splitting things with now even if your doctor is alone in their practice, they most likely They split their call time with different practices, we do have one or two do most of their own deliveries, which is awesome. But most practices I’m seeing really go to a different model. That all being said, You will be surprised at how little you actually see your doctor while you’re in the hospital.

You mostly see nurses like me, we call them at the very end, sometimes they’ll come and break your water but really you don’t see your ob that much in the hospital. So if you love their office staff and you love the care that you’re getting at each prenatal appointment, and probably what care you’ll get after the baby then that is probably more important than if they’ll deliver your baby at the hospital. FYI, one other thing is sometimes you’d see the OB at your first appointment and then after that you’re going to see either a nurse practitioner or physician’s assistant. Now I have some bias against physician’s assistants in labor and delivery.

They are not actually allowed to deliver babies most of them have never delivered a baby they’ve never been in labor and delivery. So they really sometimes when they call me I’m like I just shake my head. They just don’t know all that much about delivering babies so nurse practitioners generally do because all nurses have a labor and delivery rotation.

During nursing school so nurse practitioners cannot deliver a baby physician’s assistants cannot deliver baby as far as I know maybe there’s some states that they can but certified nurse midwives can deliver a baby in the hospital doctors OBS can deliver babies in the hospital as well. Oh and family practice can deliver babies in the hospital as well but just ask them how often you’re going to see an OB how often you’ll see a PA or an NP and honestly, there’s great ones of pas and NPS as well.

Just you know, if you’re constantly seeing a new face every time you go into the office, that can be frustrating for a lot of people something to keep in mind. Okay, if you have any high risk issues if you’ve had any problems with previous pregnancies including VBAC, you’re going to want to bring that up very early in your office visits, see how they’re going to do it. Some practices still really don’t be back. Most people even though a cog really recommends it.

That is their choice. Just like you can make choices they can make choices. So you want to find those things out early on in pregnancy don’t so definitely ask the questions that you have. If you have any like endometriosis, or fibroids or stuff like that, bring that up early on so you can see how they’ll deal with it and also just how they educate you and if you feel comfortable with how they’re doing that you guys might want to check out my episode called saying no, it’s with my friend Mandy, we talk all about how to say no and labor and how doctors should be talking with you. And they should be talking you in a very educating mode during all of your pregnancy.

So something to keep in mind. Also, if you have any other special concerns, like you definitely do not want an IV, you 100% want to be back. If you’re planning to use a doula or go natural, or if you’re planning a home birth, and you’re just seeing them on the download. You want to be honest with them throughout your pregnancy, you want to be honest with what you’re hoping to expect at delivery so that neither of you is caught off guard. I know I have a lot of patients who come in and they’re like, they want to refuse the IV and I’m like, that’s great. Have you talked with your doctor about this? And they’re like, no, why would I do that?

and I’m like, well, because they’re the one that ordered it, I don’t order anything and then the OB gets very frustrated that they haven’t talked about it the whole time and the patient wants to be induced but they don’t want an IV it’s all just you know, you just want to be educated but you also really need to give the doctor the facts from your site as well. Okay, so when you have your first appointment, I was asking the OBS at work if they do like interview appointments and…

They all were kind of like no they really just don’t have time because those would be considered unpaid appointments so they really just don’t have time to spend like a half an hour with you totally dressed at that appointment the your first appointment should be that type of interview now I have been to some ob offices where the first appointment is really just weighing you getting your urine doing a blood draw checking out your insurance, you don’t even see the OB so that is frustrating I’m sure because then you can’t really make those choices but those labs are going to be done with any physician you know, at any practice and you can always take those to your next practice with you I would go ahead and make an appointment at whatever physician seems to be the best give that a try.

You know, take those first few appointments honestly, up till at least 25 weeks you have a vast ability to be able to change your provider once you hit 25 weeks and especially as you head into 30 weeks other providers are going to be very hesitant to take you they are taking on the risk of your pregnancy and if you did or did not get good prenatal care before that. Now that being said if you were like moving and your ob you know if you have a reason of why you Have to go to a new ob they’re much more open to that versus someone who just wants to change at 30 weeks.

I don’t know if that’s because they’re concerned, they’re not going to get paid as well. I don’t know what it is. But that’s something to keep in mind that really once you hit 30 weeks, you’re kind of locked into that ob unless you have extenuating circumstances like moving, etc. Now, while you are at those appointments, ask them lots of questions you can ask them their frequency of C sections, I asked the doctors if they knew what their c section frequency is, and they were like, I don’t know, which is interesting because our hospital does know I’ve seen the statistics of who does the most c sections and they I’ve also seen their PCI dummy rates so those are not 100% accurate because sometimes they’re not charted right because it’s just taken from our charting but they didn’t know their actual rates.

However, when you’re discussing stuff like this, you’re wanting to make sure that they’re not like condescending and rude while you’re asking those types of things. They might say I don’t know the actual rate but I’m really hesitant to do an A PCR to me unless I find that the baby’s life is in danger. I probably only do XYZ number of PCR dummies a year you know, I only do five And that will give you an idea that

yes, and in fact a PC armies are sometimes necessary and important. So you want a doctor that skilled enough to do them in the right cases, not just oh, I never do a PC enemies, that would be a danger sign because sometimes they really aren’t necessary. I never do see sections also a danger sign because they are necessary sometimes. So if you mostly want to look at their teaching attitude as you’re talking about questions like this, so those are my suggestions.

Other things you want to consider is how easy it is to get an appointment. You know how frequently your appointments are pushed back, stuff like that. Now if you have an OB that’s just kind of delivering on their own, you’re going to be aware that their appointments get pushed back somewhat frequently, depending on how their office is scheduled because they will randomly get called in for delivery during the day of course your appointment is going to get moved around.

If you’re at a larger practice where you see more providers, especially nurse practitioners and physician’s assistants who are not going out to deliver frequently then your your appointments are going to be more on time and that might be important to you if you’re busy and you’ve got work and stuff like that and having appointments moved around can be really problematic, you’re probably gonna want to look at a practice that that physician is just in the office that day even with doctors, sometimes they’re just in the office or they’re just on call but some providers are doing both, you know, on their own.

So that’s just something to think about. Every person is going to have to decide what’s important for them. You know, if you’re a stay at home mom and it’s easy for you to move appointments around then that wouldn’t be as big of a concern as well. One other thing to think about is how nice the office staff is.

I know a lot of people just dread their appointments and if you’re feeling that way because the office staff is rude and condescending, first I will talk with your physician about it if you feel like they are just out of touch you know the office app is just super rude I would definitely talk with a doctor about it but also if you hate it, then stop going to them pick a different one just be keep in mind you are not locked into a doctor once you pick them.

However, there may be some insurance things that you have to deal with. You might have to pay for that first appointment separately. If you switched positions, you could definitely call your insurance to find out how that works. But don’t feel like if you don’t like your doctor that you just have to stick it out with them because you’re going to end up you know, possibly delivery with That person making life or death decisions for you and you really want to be able to trust them. So those are my tips for picking an OB.

If you guys have other tips for picking an OB or things that did or did not work for you, I would love to hear it in the comments in the show notes. Be sure and check it out. This is Episode 58.

You can find it pullingcurls.com\podcasts and I would love to hear what you guys think so definitely pick a provider that aligns with you, you really can make a difference. Thanks so much for joining us today. I hope we help smooth out a few of the snarls in your life. We dropped an episode every Monday and we always appreciate it when you guys share and review. Until next time, we hope you have a tangle free day!

The post Picking Your Pregnancy Healthcare Provider — PCP 058 appeared first on Pulling Curls.