When I found out I was pregnant, I did the only thing I knew to do: made an appointment with my OBGYN. I waited anxiously until I was seven weeks along so that I could go in for my ultrasound to confirm that I was pregnant. During the appointment, I asked my doctor — who I adored — what I should do to stay healthy during this critical time. Her response? Take your prenatal vitamins and stay hydrated. That advice seemed superficial to me. I was two months removed from a miscarriage and determined to do everything in my power to support this new life. Also, my body was creating a new human from scratch…surely there was more to it than a multivitamin.
Three months later, a cross-country drive changed my entire outlook on pregnancy and the medical system intended to support childbirth. During the journey, my husband and I stumbled upon the Free Birth Society podcast, and episode after episode, my mind was blown as women shared their experience with traditional Western hospital births that led them to leave that system behind and free birth children. At the time, I wasn’t even aware that people still gave birth at home; the idea that you were allowed to free birth (give birth without a birth worker present) was totally unnerving. This was the foundational concept of my breakthrough — which in hindsight seems completely ridiculous: you have the right to give birth how and where you want to, you don’t need permission from anyone, and no one has the right to take that from you. The same goes for every step of your pregnancy, too.
That realization sent me on a journey of deep research, self reflection and deprogramming of many of my beliefs. For the last two trimesters, I devoted myself to creating an informed pregnancy and a birth plan that was customized for me. In this article, I’ve tried to summarize what I learned to help other birthers on their journeys. The details of when and where and how are irrelevant; what matters is that each birther has the information they need to create an empowered birth.
1. Know that you have a choice. When I got pregnant, I assumed that going to an OBGYN and having a hospital birth were my only options. Once I started doing my research, I realized how uninformed I was. You have a choice on who delivers your baby (doctor, midwife, doula, yourself, etc.) and where (hospital, birth center, home, etc.). But more importantly, you also have the right to informed consent. That means you can and should have the right to choose every aspect of the type of care you and your baby receive and that each decision is ultimately yours to make.
Once I started to do my own research, I began to question the standard of care practices of typical prenatal care and the labor itself. I wrongly assumed the practices were all evidence based, and I was disappointed to find out that they’re not. I’m not here to build a case against Western medicine, and I have a deep respect for healthcare workers. The care team where I delivered my baby was outstanding. But as birthers, we often put all of the responsibility of our prenatal care and birth in the hands of medical professionals. Going into my pregnancy, I had the mentality that I didn’t need to do anything in between prenatal appointments with my doctor and assumed that when the time came, my doctor would deliver my baby. In this scenario, my doctor was doing 95% of the work, and I was contributing 5% by showing up, taking my prenatal vitamins, and staying hydrated. During the last two trimesters of my pregnancy, that ratio reversed. It is our job to take ownership of our own well being. The first step in taking ownership is by becoming informed.
2. Do your homework. Admittedly, this is the hardest and most time-consuming step, but it’s the foundation for everything that follows. I’ll categorize the homework I did into two buckets: the care given by medical professionals and the at-home care I gave myself. In the first bucket, I looked at prenatal care as well as labor and delivery. In my own research, I found that several standard of care practices are considered controversial and that I could decline them. Here is a starter list for your consideration:
- Ultrasounds, particularly the 20-week anatomy scan
- Glucose test during the third trimester to test for gestational diabetes (There are alternatives to the typical formula; my midwife gave me grape juice.)
- Daily baby aspirin (81 mg) for birthers over 35 years old
- Hepatitis B vaccine for newborns, administered immediately after birth
- Vitamin K shot for newborns, administered immediately after birth
- Eye cream for newborns, administered immediately after birth
This list is by no means exhaustive, but I hope that it illustrates the point: you have the right to question what goes into your body and the body of your baby, particularly if your gut instinct says no. For instance, my OBGYN told me at the end of my first trimester to start taking Baby Aspirin every day. She said that it has been shown to decrease the risk of preeclampsia in older birthers. Preeclampsia is a very serious condition, but one that I don’t fit the risk profile for. And as someone who rarely takes medicine when I’m not pregnant, the idea of taking medicine every single day for my last two trimesters made me very uneasy. I followed her advice and began taking it but stopped after a couple of months because I had a nagging feeling in my body that it wasn’t the right thing to do for me. Listen to that voice and find resources that help you make informed decisions that are right for you. My doula recommended Evidence Based Birth as a resource, and I found it incredibly balanced and helpful.
Doing your homework is critical, regardless of whether or not you follow medical advice. One decision that was especially complicated for me was the 20-week anatomy scan. Ultimately, the uneasiness about exposing the baby to the ultrasound outweighed any benefits of the scan for me..It was a difficult decision. In fact, I scheduled and then canceled multiple appointments. I was torn because at that point in my pregnancy, I found a birth center where I wanted to deliver, but they couldn’t take me as a patient unless I agreed to the 20-week anatomy scan. (The birth center made it very clear that their requirements were set by the state, and that in most cases, not evidence based), but knowing that one decision would change my entire birth plan made it complicated. Make sure you know in advance so that you can make those tradeoffs for yourself.
Now, let’s move on to the second bucket of at-home care I gave myself. Let me start by saying how disappointed I am at the lack of information I received from my OBGYN on this topic. I don’t expect doctors to proactively tell every patient what their lifestyle choices should be in between visits because that might be overwhelming for some people. But when a patient asks “What should I be doing to take care of myself during my first trimester?” or “What should I be doing to support my health before I get pregnant?” like I did, that should open the door to a conversation beyond “Take prenatal vitamins, and you should be fine.” That answer implies that there’s nothing else you could be doing, which is just flat out wrong. And it’s dangerous because it reinforces the idea that birthers should rely on medical professionals alone for their care.
A more systematic example of this hands-off approach were the weekly emails I received during my pregnancy from my healthcare provider. Each email covered what I could expect for that week in terms of the baby’s growth and changes in my body, as well as tips for staying healthy that week. The email overall was too basic for my taste, but the tips for staying healthy were especially lackluster. They included advice like “drink plenty of water,” “rest when you get tired,” and my favorite: “use gentle cleanser on your face to prevent pregnancy-related acne.” I compared those emails to other resources like Mama Natural’s Week-by-Week Guide to Pregnancy and Childbirth that I came across in my second trimester, and I realized just how much I had missed by relying on my healthcare provider. After I found those resources, I began cooking foods with nutrients that my baby needed that week, I took supplements customized for me, and I did exercises designed to prepare my body for labor and delivery. I also reevaluated my personal care products. More on that here.
3. Define what works for you. Once you’ve gathered information and found resources that you trust, now is the time to dig deep and determine what works for you. Do you have a low pain tolerance? Anxiety? Need to be in control? How much time do you have to prepare for your labor and delivery? Are you comfortable in a hospital setting? Take a long, hard look at your lifestyle and get very honest with yourself about what you might struggle with in any scenario. An issue that I hear often is that soft spoken birtheres can get railroaded in a hospital setting; I was concerned about that for myself and knew I would need an advocate to help me fight for the birth I wanted. If that’s you, consider hiring a midwife or doula. Spend time visualizing what feels right for you, then do everything you can to create it. Remember, it’s your body, your baby and your choice. That doesn’t change, no matter where you give birth.
4. Build the birth team you want. Pregnancy, childbirth and the postpartum period are incredibly vulnerable, raw and transformative times for birthers. Now is not the time to settle with substandard care. You should feel supported, safe and free to be honest about your questions and concerns. If you aren’t happy with your provider, find a new one. And if you have the resources, consider building a team of support, or at a minimum, do your research so that you have contacts on standby as needed. Several you might want to consider are:
- Chiropractor – Can help with baby’s birth position, back pain and pubic pain during pregnancy, postpartum recovery, pelvic positioning, etc.
- Postpartum doula
- Physical therapist – Highly recommend finding a pelvic floor specialist
- Lactation consultant
- Therapist – This time can bring up a lot of unresolved trauma, family issues, conflict with your partner, etc.
- Acupuncturist – I started seeing an acupuncturist postpartum to address my depletion and regain my vitality. It alleviated my sleep issues and exhaustion and helped me feel like myself again . It also can help with morning sickness.
5. Plan for postpartum, then plan again. Several months before I got pregnant, I was trained and certified as a postpartum doula with a focus on Ayurvedic principles. The course was incredibly thorough, and I felt fairly prepared for and curious about my own postpartum journey. It was my chance to put all of my learnings to the test. As I’m writing this, I’m almost six months postpartum and probably still processing my experience. My main piece of advice is that there are so many factors that contribute to your postpartum experience — your labor and delivery, the health of your baby, the resources you have at home, your physical and emotional state — and there’s no way to predict the outcomes. I was determined to stay in bed for at least two weeks after the birth of my daughter, but my airtight plan was thrown into a tailspin when my mom, who was staying with us to cook for and care for me, broke her foot within 24 hours of us coming home from the hospital. My partner and I managed to feed ourselves, but in hindsight, I wish we had found a caterer or prepared meals in advance. In the moment, we went into survival mode, and I ultimately cut my two weeks down to seven days.
That said, a good framework for your postpartum care plans is the core belief that a baby can only be happy and whole if its mother is happy and whole, and there are several primary ways to support a mother to ensure her physical and emotional recovery and wellbeing. As you devise a plan that works for you, consider these tenants:
- Rest is key, particularly in the 42-day window following birth. Stay in bed as long as you can, and avoid the urge to clean, entertain guests, go outside or look presentable. This is an important time to practice setting boundaries. Plan ahead by setting expectations with loved ones, preparing your bedroom and discussing chores and other household duties with your significant other and/or loved ones.
- Plan to eat nourishing, healthy food that’s easy to digest. (Your digestion likely will experience a bit of a setback after childbirth.) I made a full menu and grocery lists for my six week postpartum window. Have recipes ready to give to loved ones who offer to prepare meals for you, make and freeze meals in advance and brainstorm other ways to reduce the time and stress of cooking.
- Make a list of self-care practices that feel nourishing to you. It might sound ridiculous, but I found myself struggling to think of self-care activities to do when I had short breaks, usually during my daughter’s nap times. Without a clear purpose, I defaulted into doing housework or worse, mindlessly scrolling on social media. I created a list in my phone as a constant source of inspiration. If you decide to do the same, I recommend including the typical self care activities (doing an at-home facial, taking a bubble bath, enjoying a cup of tea) but also consider what feels replenishing to your soul (a morning devotional, journaling, calling a close friend). Interestingly enough, the things I thought I’d want, like a massage, weren’t appealing to me at all immediately postpartum, so make sure your list is long and diverse!
- Ensure that your significant other and/or loved ones know the signs of postpartum depression and postpartum anxiety. They will likely recognize a change in you before you see it in yourself. The Postnatal Depletion Cure is an excellent resource.
- Have a care team in mind, even if you don’t end up needing them. While I was pregnant, I found a physical therapist who focuses on women’s health, particularly the pelvic floor and core muscles.She was an incredible resource postpartum, especially in helping me heal my diastasis recti. My acupuncturist worked miracles in helping restore my vitality. And my chiropractor addressed the neck and back issues I felt from my weakened core and carrying a baby around all day.
Out of all of the books that I’ve read, specialists I’ve met with, classes I’ve taken and personal experiences I’ve had, one truth emerged for me, connecting them all together: pregnancy and childbirth have the potential to be deeply transformative. Not just the change from a woman into a mother, although that is incredibly profound. From the day I found out I was pregnant, my experience has continued to challenge me in specific ways to help me grow and set new habits. Being present. Slowing down. Letting go of control (or the illusion of it). Existing more in my body and less in my mind. Although I hope you find the information in this article empowering, I hope that it doesn’t distract you from this equally important aspect of your experience — the amazingly transformative and magical gift of bringing life into the world. You will likely be tested, pushed to your limits, elated, and so in love that it terrifies you. But through that, I hope that you feel powerful. That you embrace your inner goddess. You are a microcosm of the Universe. You are Mother Nature, personified. Even though babies are born all the time, the experience is anything but routine, and every day that my daughter gets older, my awe of the female body and our ability to create life increases. Taking care of ourselves and setting ourselves up for success through this transformative time is a gift to ourselves, our families and the world. Many blessings to you in your journey!
- The Postnatal Depletion Cure
- Mama Natural’s Week-by-Week Guide to Pregnancy and Childbirth
- Evidence Based Birth website
- Virtual yoga classes with Hana Raftery