Down to Birth

#228 | August Q&A: Routine PP Pitocin, Insufficient Glandular Tissue, Boundaries with In-laws, Fundal Massage, Fore-milk, Manual Dilation, Weight Gain in Pregnancy, A Husband with Addiction

August 30, 2023 • Cynthia Overgard & Trisha Ludwig • Season 4 • Episode 228

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It's time for the August Q&A episode with Cynthia & Trisha! We kick off today's episode with the crazy and unsupportive comments most often heard by our listeners. Grab a cup of coffee or tea, and get ready for some laughs. Next, we get into our questions, including:

Is routine Pitocin postpartum necessary?
What can you tell me about insufficient glandular tissue and breastfeeding?
What to do about family members who use sweets as a way to get children's attention?
Is aggressive fundal massage really necessary?
Is too much fore-milk in breastfeeding causing problems for my baby?
and more.

And in the extended version of today's episode found on Apple subscriptions and Patreon we discuss: Experiencing nausea in labor and what can be done about it; manual dilation of the cervix and whether it's effective; how a nuchal hand at birth impacts tearing and whether a cesarean section necessary; and, what is normal weight gain in pregnancy, and what if I have already gained the recommended amount too soon?

Finally, we have our quickie segment in which we answer another ten questions or so, including how period cramps influence labor experiences, heart rate in labor, boy versus girl pregnancies, and more!

Thank you for all your great questions and please keep them coming at 802-438-3696 or 802-GET-DOWN.

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Call us at 802-GET-DOWN

Work with Cynthia:
203-952-7299
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Work with Trisha:
734-649-6294

Please remember we don’t provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Connect with us on Patreon for our exclusive content.
Email Contact@DownToBirthShow.com
Instagram @downtobirthshow
Call us at 802-GET-DOWN

Work with Cynthia:
203-952-7299
HypnoBirthingCT.com

Work with Trisha:
734-649-6294

Please remember we don’t provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Hey ladies, I have a question about weight gain during pregnancy. A quick Google search shows me that it's recommended to gain anywhere from 25 to 35 pounds. However, I am 29 weeks and I have already gained the 35 pounds I was diagnosed with IGT or insufficient glandular tissue after the birth of my first and was wondering if you can talk about any experience you have with this regarding breastfeeding, the evidence is pretty clear that the routine use of Pitocin to prevent postpartum hemorrhage and women at low risk for postpartum hemorrhage is not effective. I feel for doulas because they go into this work ready to be loving and inspired and to have like this beautiful line of work, they're willing to get up in the middle of the night to have no idea when they're going back home. And what happens is they often end up witnessing assault and abuses only to feel guilty after the birth because she couldn't do more to help that mom.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hello, everyone, welcome to the August q&a. We are back on this hot summer day.

And Trisha remember on Instagram when we asked women unsupportive comments people have made to them in their pregnancy. We knew we would get a lot we knew a lot of them would be the same rhetoric we hear right? You will be screaming for an epidural. Don't be a hero. There are lots of those but we got some Oh yeah, we got some particularly unique ones. That I thought it would be fun for us to share and I'm saving my my absolute favorite one for last. Okay, let's pull that up. Shall I begin? Yeah, sure. Okay. First one says in quotations. You say that now because you don't know how bad it actually is. Just wait. ELC nice, loving, very encouraging, very supportive. Okay, this will be to plant the seed. This woman says after she had her home birth, someone said to her, What if something had gone wrong? What if? Oh, why are we having that conversation now? How about like, congratulations on a beautiful birth. Your baby's darling. There are a lot that say what if something goes wrong? Oh, here's a good one. Everyone gets an epidural. Yeah, one woman said one woman was told you would you wouldn't get a feeling without pain relief? Oh my gosh. Okay, that that's said all the time, to people like it, filling a setting a broken bone, having some other form of surgery. All of these things. Our bodies aren't designed to go through those processes. Those are injuries. Those are ailments. Like birth is physiologically normal, and our body is designed to manage and cope with it. Oh, here's one. You don't have a high I would say this. You don't have a high enough painting.

That was probably that was probably from a family member who would say that to you? And first of all, how can you say this all the time? Someone else's pain tolerance, because maybe because again, they're thinking about injury? Maybe you know, some people get freaked out with a beasting or a paper cut. It's not the same thing.

This one says my lnd nurse my l&d Nurse mother in law. Oh, dear.

Why would you put yourself through that pain is what I don't get. Here's one who heard. Yeah. Good luck with that in a snarky tone. Nice. This one says, What are you trying to prove?

Yeah, don't be a hero. What are you trying to prove at some other? What are you trying to prove? Who would have a natural birth? Who would do that to prove anything? Like it's all ego. There's nothing else driving this. But ego is this implication. You're stupid for not wanting the drugs. Nice. Nice. You'll throw your whole birth plan out the window. As soon as you feel your first contraction. You can't deliver a baby out of hospital. He's measuring quite large.

You can't deliver a baby out of a hospital really high wonder what we did before hospitals.

Regarding my home births, someone said I'm so anxious for you and I'm worried that you're not anxious at all. How about whichever way you go about it? You've got a 40% chance of having a C section. Nice like it's all out of everyone's hands. Oh, wow, how about this one? Once the baby arrived? Oh yeah, that's nothing your baby was small, nice Wow way to demean her. And why would you do that and epidural doesn't even hurt the baby. Interesting. Oh, this is great. Love this one. I'm a nurse burst into our room and yelled at my husband and your wife is in pain. She needs an epidural. Oh, here's a charming one. It's like your bones are all breaking at once. Oh, nice. Wow.

Well, this one is just make sure did not design this process to torture us because Nature needs us to be alive and well to take care of our babies. Just please remember that everyone? This is this one kind of piggybacks off that stupidity. This says I was told that I needed to stay out of the sun to prevent giving my baby cancer. What?

Exactly what Okay, Vitamin D from the sun, by the way reduces like every cancer except certain forms of skin cancer in I think she's talking about when she's pregnant. I know. I think this one says Are you from the 1800s? Okay, yeah, yeah. Okay, I guess so. My baby would be dead if I did it at home like you. Nice. My wife who's a veteran couldn't handle labor and birth without meds. Trust me. You'll want them. You'll want them. Just spare yourself. Here's one. We'll see about that. Who are these people? Who are these unloving, unsupportive, arrogant people? And what gets me is it's no one's business? How like, how do they opine on what someone else is going to do with their life? It's like, it's like someone gets engaged. And you're like, oh, that's what you think. Right? Good luck with that. You're gonna have a one in two chance of divorce. Because everybody's just projecting their own unhealed issues onto other people.

So we can't take these things personally. We have to just let them go in one ear and out the other.

Oh, here's one you won't last five minutes. Unbelievable. From her mother, you better you than me. That's kind of funny. This one says my OB for my first said, you know you're going to tear right? Guess who didn't tear. And here's another you will never have a natural birth because of your pelvis. Wow. Because of your small pelvis. Alright, here at NAMM. A lot of women wrote to us with their stories because they couldn't fit in the little question box. And we got lots of those. This was my favorite one. She wrote, oh my gosh, I've told my mom, the woman. I'm sorry, wait. It says oh my gosh, I told my mom the woman who birthed me that is planning on an unmedicated physiologic birth and she goes, you're gonna want the medicine. It's the worst pain of your life.

And I said, that is your experience, but I've been preparing for this and really trust my body. Her response was that, quote, I want you to record your births. Oh my god. I can't do it. I want you to record your birth so I can watch you scream bloody murder.

Wait, I'm sorry. I can't get this out. Guys. I want you to record your birth so I can watch you scream bloody murder and be in pain. Plus, you almost killed me.

Another woman wrote and quote and the woman wrote to us, like what? Wow. Okay. Thank you. Thank you for that. Isn't that unbelievable? I laughed until I had tears going down my face yesterday. And I I just couldn't believe it. I thought it was hilarious. It's, I mean, it's horrible. But it's so off the deep end. And plus you almost killed me. What was that necessary?

None of it was necessary. Please. I want you to record your birth so I can watch you scream. Watch you rise in pain. I can watch you scream bloody murder and be in pain. What kind of mother? Um, I just, they must have a rather humorous relationship. I hope

they would have to. All right. Wow. Okay. Shall we get into questions? Let's begin. That's Oh, that was that was really invigorating.

Hi, my name is Sarah from South Dakota. I'm currently pregnant with my first baby. And I really appreciate your podcast. I've been listening to it and just thank you for everything you guys do. My question is about Pitocin after delivery to prevent postpartum hemorrhage. Nurse Practitioner mentioned that that is something that they do. She kind of said it in a kind of quick offhand way. And I just kind of took me by surprise because I've never heard of that before. So

yeah, I was just wondering what your thoughts are on that. And thanks so much for your time.

Yes,

He just wants to know our thoughts on routine use of Pitocin, postpartum to prevent hemorrhage, which is little perfect timing because we did an entire Pitocin hour long webinar or live stream event on Patreon. And this came up very much we talked about the use of Pitocin. Before labor for induction, during labor for augmentation, and postpartum for hemorrhage. What do you want to say? The evidence is pretty clear that the routine use of Pitocin to prevent postpartum hemorrhage and women at low risk for postpartum hemorrhage is not effective. It's not helpful. So it shouldn't be done yet it is. Yeah.

So it may be used appropriately. If a woman is having a postpartum hemorrhage, yes, or possibly if she has high risk for postpartum hemorrhage, it may be prophylactically used, but routine use and low risk women is not reducing postpartum hemorrhage risk is not reducing the incidence of postpartum hemorrhage. Okay.

Next, Hey, ladies, I love your podcast, I've been listening my entire pregnancy with my second I was diagnosed with IGT are insufficient glandular tissue after the birth of my first and was wondering if you can talk about any experience you have with this regarding breastfeeding, much of what is addressed with breastfeeding often ignores this issue, which seems to be no matter how much demand supplied doesn't increase due to the physical nature of the breast. I guess I'm wondering, is each pregnancy different? Are there specific steps to take to increase success with breastfeeding early on, I tried basically everything to increase my supply the first time around, and it was eventually preventing me from enjoying my baby. I gave up breastfeeding at eight weeks, due to the stress of triple feeding frustrating, frustrating feeds and feeling inadequate for my baby. I do wonder if there was more I could have done proactively prior to birth and immediately following as I was just feeding every two hours, unaware supply was an issue. And just in the dark in general, the first several days, which I know are crucial for supply. I want to go into this postpartum with realistic expectations and appreciate any and all advice or expertise you have. Thanks so much.

So there are so many factors that go into low milk supply. But insufficient glandular tissue or IGT should not be the thing that we immediately jump to that is a real thing, but it is not very common.

So what it means basically is that the breast never fully developed. And there's, there isn't enough glandular tissue in the breast to produce milk rapidly enough to have a full milk supply. So those women who truly have cases of IGT it's usually something that is diagnosed or should be picked up on by your midwife or OB GYN in a prenatal exam and a breast exam. There are some clinical features and anatomical identifiers in breasts that have insufficient glandular tissue, they look different than a normal breasts and those woman those women also don't generally experience the same breast changes in pregnancy. But that shouldn't be the first thing that we jumped to, like I said, there are so many factors that go into low milk supply. And she said right at the end of the question there that she wasn't really paying that much careful attention in the first few days. And the first 24 hours has so much influence on what happens when your milk comes in, not in third or fourth day. And what happens on the third or fourth day has so much influence on where you land at two weeks. And if you don't get off to the right start, it is like playing catch up all the time. Now, if it is really IGT you still can breastfeed and I wouldn't ever tell a woman to not plan to breastfeed, there is an herb called goat's Rue that can be helpful in helping the tissue that is there develop more. So I would use I would use go through in those cases and then we would have you know, an aggressive plan of trying to help her build her milk supply to whatever amount we could get it to.

How do you spell that word? IGT. No, no, the going through. Goats route. Goats ru goats, like a goat with a apostrophe S. are you E? Goats RU. Ru is like sadness, isn't it?

Oh, it's also a shrub shrub. Okay. Goats Rue to rue the loss of opportunities for goats.

Very sad stock of goats are a little woeful.

All right, it comes from the shrub. And I didn't know that shrub existed. So now I know.

Hello, ladies. I don't understand why

Do people, generally grand parents, children and babies feel it's so necessary to give treats? And like garbage treats to kids all the time?

Why? Why can't my family give out, you know, crayons, or stickers or time? To me, I feel like just spending time with grandkids and family members are way more important than my in laws. This, this guy that I have, he's their eighth grandchild, I seem to be the only one that cares about what goes into his mouth. Yeah, so that's a big one. Thanks for listening.

Junk food from the grandparents, this is so common, this comes up in my postpartum group a lot. Yeah, it's just like the norm, it comes up in all forms that comes up with junk food, it comes up with, you know, the really cheap gifts, like the the junky things that entertain them for three minutes and never get in life. And they're made of plastic and they clutter the house and you feel guilty getting rid of them. And, and then I even have a mom in my group who's been very sensitive to the books that her mother in law has been giving her baby. And they're, they're lovely, beautiful books, but they have some concepts in there that really upsets the mother, like a kid being mean to another kid, or jealous of another kid. And this client of mine is like my child is one and a half, she doesn't have a concept. So she's furious about it. I try. Alright, the food thing I definitely understand I understand all of it, I would be upset about all three of those things personally. I also think that it's not hard for me to imagine being that grandparent and trying to make your daughter in law happy, I would imagine. And really just wanting your grandchildren to love You and to miss you when they don't see you and having a worry that they're going to forget about you when you're not visiting. And just feeling like you would do anything to have these kids love you and feel connected to you. I think letting them build that relationship is precious. So you just have to tell them like can you please bring fruit instead? Can you please, I remember when my son was like three saying, You know what? We don't want any more toys in the house, can you like bring him to a little local theater, they have little kids plays and stuff. And such can you do activities with him, bring him to a local museum or something, spend the day with him. So you just have to get creative, you have to be willing to ask, but keep in mind that that grandparent is sensitive. They don't want you to not like them, they don't want the child to not bond with them. Just understand that's where they're coming from, I don't think they mean to disrespect you. If they do mean to disrespect you then you need to have a much firmer conversation with them if they're doing this out of passive aggression. Hopefully that's not the case. Most likely not. But you know, junk food is just it's the easy thing. It's the thing that you know, the kid is never going to be disappointed about, they're always going to be thrilled about it. So it's it's a easy little ticket to win a little extra affection. But there are better ways. Like she said, you know, spending time is the most valuable bad is ultimately what's going to build the deepest lasting bond. The junk food is just the quick fix. Totally. Yeah, you want to see their face light up. But truly, if you just sit on the couch and talk to them or read to them, that's really where the bond is. Good luck with that one. It's very, very stressful. And I'm sure it builds a ton of resentment. And you're not alone. This is happening in most households.

So the next question is not going to come through on audio because the mother left us a message and asked for anonymity even as far as her voice. She asked us to read her question, but I don't think there's any need.

We just listened to it. She's in a lot of distress, no doubt. She said that she and her husband both used to drink a lot. And she gave it up and her husband still drinks and she said smokes a lot of marijuana. She's struggling. She said they fight about it all the time. She said it's a nightly practice for him. She's pregnant with her second child, she has a four year old and pregnant with the second child. And she said she wanted to know what she can do. And she wanted to know if we think she's being inflexible to serious situation. It's easy for people to say it's just a trick. It's just that I think it's a very serious issue, personally. Well, I think the thing is that, you know, she she described them both as kind of having a party lifestyle before they got together young. They a little bit of a party lifestyle. She went through this transformation and becoming a mother and taking care of her children and giving up that party lifestyle giving up alcohol and her husband has continued on the same path. Although he has maybe reined it in a little bit. He's still kind of in that place. And I think, I think when people eliminate those things from there.

If and they really get sober from whatever addiction it is that they have drugs, alcohol,

whatever else people get addicted to. And then you see, the person you love, still addicted, and still, how it influences their life. Your perspective is just so clean and clear. And what they're doing just looks so massively wrong. And it really, it really does divide people, because he's living in a completely different place than she is.

Yeah, I mean, there are many problems with addiction. But one of them, that's the most apparent is that when someone has an addiction, even if it's not a chemical addiction, but any kind of addiction or daily practice like that, that they're prioritizing. It's like being in any kind of three way relationship, you're with a partner who has to manage their habit. And she is clearly in a lot of pain, she could barely speak in a normal voice leaving the message. My thoughts are that she should find a therapist who specializes in addiction.

Even something like like an Al Anon group like those that you know, AAA and Al Anon, those are incredible organizations that really help people. And I think if she went to something like an Al Anon meeting, and she were surrounded by people who are going through exactly the thing that she's going through, you're seeing that new perspective, and her feelings would be so validated, and she would be able to come back to the relationship with so much more conviction in her in her in her truth, which is like, I don't want this lifestyle. I don't like it. I'm not living that lifestyle. It's, it's not good for me. It's not good for the kids. It's she knows it's not good for him. Of course, he can't see that. Right? Because he's in it. But But that will give her the strength and the clarity, to have those conversations and help her to realize that she's not being what did she describe herself as over?

inflexible, inflexible? Yeah, and I, if he's using language like that, then he's really pretty far into it. You know, at the most basic level, they're completely out of rapport with each other. They're out of rapport. They're not living the same life and not living the same lifestyle. So in the best case scenario, all addictions aside, habits aside, money aside, they're not able to live the same lifestyle share the same lifestyle, they're out of rapport. She's probably thinking about it morning, noon, and night. So hopefully, she will continue on and get Sitecom some kind of support, it probably is going to come down to him either completely giving it up, she made something some comment about like a happy medium. There is not a happy medium with things like this. There just isn't this is not a casual drinker we're talking about, I think it's going to come down to him either giving it all up or probably being at risk of losing his wife and kids.

Because what else can happen? Or his wife becomes depressed? I mean, people can people, it's so easy with alcohol to just sort of brush it off and say everybody drinks, like everybody drinks most people drink, right? But if if you're the person who's not drinking, and you're looking at the person who is drinking and you're saying this is not working for me, then you have to do something.

Hi, I am a birth doula. And I recently witness and an OB, applying very forceful, fundal pressure with a client of mine who was in her pushing stage of labor. Basically, they were trying to get baby lower. Not only was the doctor pushing down on her uterus with what really felt like excessive force, but she he was also encouraging her partner to apply a strong amount of pressure onto her stomach onto her uterus pressing down as she was pushing. And I have to say it felt very wrong to be witnessing and I can tell it was obviously very painful for her. The nurse had spoken up at one point and said to the partner, please don't press down on her stomach and the doctor had kind of cut her off and, you know, encouraged him to keep doing it. And I just wondered like fundal pressure in labor. Is this a thing? Like, are they still doing this? Is this been debunked? That was a first for me. Well, it felt wrong because it is wrong. Yeah.

It's risky. I feel for doulas because they go into this work ready to be loving and inspired and to have like this beautiful line of work. They're willing to get up in the middle of the night to have no idea when they're going back home. And what happens is they often end up witnessing assault and abuses and they're really powerless. A lot of times women hire a doula because they're in their mind hiring a birth advocate. But legally, the doula really can't speak for you. They don't have your power of attorney. So they're often just witness to things that shouldn't be happening. And I just think it's um

You know, it's it's such an unfortunate thing for doula to experience when she went into this with her heart in the right place, only to feel guilty after the birth because she couldn't do more to help that mom. It's terrible situation. Yeah, anything forceful? I wonder how the mother was responding? Did she mentioned that in the question? Yes. She said the mother was uncomfortable and the husband didn't like it. The mother was physically uncomfortable. The husband knew something was wrong. Even he felt powerless. Think about it. Think about what that perceived authority figure does to all these people in the room who had power, the husband, the wife, and other professional now, I mean, what what is that's very old school. It's like, Why? Why are we doing that to her and her baby?

What is that really helping? The baby has to find its way. It's like, it has to make those little subtle manipulations of movement as it winds through the pelvis. And if you're pushing down, how can it do that? Just get her up, right? She's get her off her back. You won't have to worry about that.

Am I right? Yeah, you're right. You'd think it wouldn't have to be said. Right.

Hi, I'm a Patreon member. And I have a question about breastfeeding. So my little guy is about nine weeks old. And two weeks ago, I realized that I had a really strong, fast letdown. And that was part of the reason he was struggling to feed a little bit. He was kind of gigging at the breast or pulling off or doing really short feed, because he was just getting too much milk too fast. So a couple of weeks ago, I started pumping off for a few minutes before I fed him just so that that left on wasn't so fast, and that has helped significantly with our feeds. However, my pediatrician told me that because the for milk is higher and carbohydrate, and lower in fat and protein, if I'm using only that pumped milk for bottle feeds, once a day, that that could be part of the reason that sometimes he doesn't take the bottle well, but he can be like, fussy and make after taking a bottle because of the high carbohydrate of that for milk. So I'm just curious if that's true, like, is that true? And is that and if I'm, you know, wanting to pump milk to, you know, use for bottles, and I go back to work here in a month or two?

Does it? Should I use that for milk that I pumped up because I actually have quite a bit of a supply in my freezer from that? Or do I need to be doing like a full time session. So I'm getting the full, you know, for milk and high milk both in order to use that for the bottle. Thank you.

So here we have another example of a pediatrician giving breastfeeding advice, which actually is somewhat true, but not the whole picture. Again, it's like a segment of the story. Yes, if you're giving your body your baby straight for milk, that for milk or though the watery milk is higher in breast milk sugars, and therefore, sometimes babies will be gassy if they have more for milk and not enough fat because they can actually run out of the enzyme to break down all the lactose sugars. And then they can't digest as well. So we are, you know, our babies are meant to get the full spectrum of milk at each feeding. We really can overthink this though, and I really try to encourage moms to not overthink this. But the bigger problem here is that she's pumping off the four milk. So if she continues to pump off the four milk between every time before every time she feeds, she's going to continue to create this problem of over producing for milk, what needs to happen is that we have to get the the milk supply imbalance with the baby's needs, so that she's not over producing that form out. So she started pumping the form out because her baby was struggling to cope with flow, because maybe she has a strong letdown, or maybe she was over producing, but she's kind of just contributing to the problem by pumping up the form milk. So in the short term, it solves the problem for that particular feed. But in the long term, it's just perpetuating the problem. And what she really needs to do is slow down her milk production so that her baby can just feed at the breast and get through kind of a full normal feeding without having to pump off for milk.

There's been a lot of conflicting information about for milk in the past 10 or 15 years hasn't there? Yes, because there's way too much focus on it being separate. Separate milk like for milk, then middle milk, then high milk, there's fat in all parts of milk there's fat in the for milk, so we're just we're breaking it down. It's not it doesn't really work like that. But the fuller the breast is yes, the more watery for milk comes out first, but I mean that is true. You can see that.

You can see that when you pump you can see that when you feed. But that does not mean that there's not fat in all parts of the milk. When I was a breastfeeding mother I remember reading the first moments of breastfeeding is to hydrate your baby and then the remaining is to feed the baby

Right. That's what I imagine if we went four or five hours without eating in a baby going two hours is more like our four or five hours. And then somebody just like, put a piece of cheesecake in front of you. And like tried to get you to just eat cheesecake, you'd be like, well, like, give me some water. Give me a glass of water before I start eating this heavy creamy food. So yes, the hydration comes first. It's designed perfectly.

Alright, well that concludes the regular version of the August q&a. If you are a Patreon member or if you subscribe on Apple podcasts. You will get the extended questions coming up next. If not, we are on the quickies.

Wiki time. We love quickies. All right. All right. Here we go. quickie one. If I have very painful menses, menstrual cramps, does that equate to very bad contractions? Is that a wives tale? Or is that just someone who's more hormonal? And then they may in that in that it's true? What have you heard about this? Well, anecdotally, I think it's sort of the opposite. I think women who have really strong period cramps have slightly easier, Labor's totally just my personal opinion, your theory.

My observation? So I guess the answer to your question is no, you don't believe that? That is true. You're going even further to say you think that the opposite opposite is true.

Which means everyone we have no idea. Probably none of it is true. And there's probably no rhyme there's way too many. There's way too many variables in the picture. But I have just in observed that a little bit. It's good we weren't we want her to attach her mind to your theory rather than the one that was planted in her head. Because what she believes she's going to experience is going to actually affect her experience. To some extent, we do know that. Alright, what's next? Do you have any tips to forgive yourself after the vitamin K shot was given when you were too tired to fight anymore?

Forgive yourself for things you don't know. I mean, we have to forgive ourselves in life for so many things that we didn't know when we didn't know. And then we learn and we do better the next time. Unfortunately, it is a part of parenting, you're going to feel guilty, you're just going to feel it's it's going to be somewhat of a lifestyle. I don't think that goes away. I what I think is very helpful when you have a regret like this. Because we have women who have taken, let's say the gestational diabetes drink. And then they learned later they had other options. And they feel very guilty that they had that drink even we don't want them to feel guilty or think they should feel guilty, but they feel guilty. And what I like to do is say well, because I had that experience, or because I gave the baby vitamin K and I now regret it. That's the assumption here. Now I'm going to do something for my baby's health, to more than make up for it. You know whether you go to a naturopathic doctor and you just like, learn some things and feed them, especially healthy things, just visualize making them better off, because you regretted that. And that can really help the guilt to go away. Because when you feel really good about taking care of their health, and making new decisions, specifically, because you're on the quest for doing some healthy new things you can be the guilt kind of goes away. It's like oh, that in a way that was a blessing in disguise. Because then I learned about this or I was determined to do that. Good advice. Next, what do you do while waiting for the placenta to come out? When it takes three or four hours, you breastfeed and you stay skinny, skinny with your baby.

Next, you stay focused. If you had a small for gestational age, baby, is there an increased risk of that happening again in future pregnancies? I wouldn't call it like Liske. Is it a risk?

Is there an increased risk to have an SGA? Baby? I mean, is it a risk? Or is it just a likelihood? Is it really a risk? Is SGA a risk? Some babies are just small?

Yes. Yes. Yes. I mean, maybe she's maybe she's talking about IUGR? I don't think she would get those two confused, because if someone had IUGR, they would know exactly that. It's intrauterine growth restriction. And SGA is small for gestational age, which I My understanding is it is a variation of normal. It's just small. As some babies are big, it's small for gestational age. That's what that's all it is. It's not linked to so your your right risk is probably not the right word. But is there a more? Is there a higher chance of it happening again in future pregnancies? Probably Probably genetic? Yes. What is the likelihood that my provider accidentally broke my water? I hate to make anyone feel bad about this. But I in being honest, I absolutely. Absolutely believe this has happens to women. I've had it happen to a couple of my clients where there's not going to ever be evidence of it, but there's such but it really seems to have been the case where they'll go let's just see how dilated you are.

And then as the hand is coming out, all the membranes rupture, and in each case where that I'm thinking of the providers were like, Oh, that's a total coincidence. They really were trying to disrupt the process in some way, I think, I guess what does your intuition tell you? Because we don't know. There's no way to know. It can happen by accident, too. I just don't think it's ethical for them to deny it, whether it was by accident, or intentional. I don't think it's ethical for them to deny it. Right. And they can't do that without your consent. This is why one intervention leads to another. This is why vaginal exams are a bigger deal than we are led to believe. Because they can be tied to this other stuff. Yes.

Yes, yes, yes, yes. Do I need to train? Do I need to train do special breathing training before birth? Or do I just do what feels natural, do what feels natural, but know that the longer and slower and deeper you breathe, the more oxygenated your blood, the less likely your baby is to experience fetal distress, and the less likely you are to stop secreting oxytocin and switch over to adrenaline. It's kind of like going to a yoga class. You don't have to do any kind of training. But the basic thing you're going to learn in yoga is just learn to calm and deepen your breath. Enough. That's it. That's the takeaway.

You're going to do great. You don't need any special training. first trimester exercise, how high can my heart rate go? One doctor says 110 and another says 120 Oh my gosh, we're splitting hairs. I mean, come on. Yeah, like you know your fitness. You don't have to check with anyone about your heart rate. Yeah, don't go to 240 K, right just

but please do not worry about EQ a little bit exercise. Listen to your body. What do they know about that as I mean, come on. Like the doctors have research on that.

This article says 110 And after that what happens exactly one what and what what did we learn about research today anyway? Yeah, totally. Amazing. Yeah. All right. Hint hint in an upcoming episode, people. Okay. The Shoulder Dystocia happened in free birth? It absolutely can.

It can. Yes.

Yeah, it can happen of course. Any birth.

That's can can being pregnant with boys making more fight versus flight. I was never like this with my daughter.

No,

I don't even know what she means.

More more adrenaline more now. She must think like all the testosterone she thinks she's carrying around now or something. I don't think that would even have that. I think if she were creating a theory it would be around being more aggressive or argumentative with it. More belligerent.

I don't know. I don't think so. I mean, I can tell you when I was in my first two pregnancies I felt so completely different that I was absolutely sure that I was having a boy the second time around because I felt nothing like I did with my first pregnancy and I had another girl Hmm. So yeah, I'm not sure I don't think there's a whole lot to that. I don't think so. How are your teeth so white?

said that. Yeah, they're just normal human teeth. I don't they're not bleached nor nor mine. But maybe maybe it was just a good light hitting our smile. I think so. I think his lighting we both had pretty white teeth now that I think

thank you. Let's just say thank you but if she didn't mean that that's a compliment

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