prenatal nurturing vs. prenatal (s)care
yes! you can give yourself good prenatal care! i like to use the term "prenatal nurturing" :) "good prenatal care/nurturing" and what goes on at doctor/midwife visits are not necessarily the same thing, but here's what happens at a normal prenatal visit:
- step on the scale
- pee in a cup
- blood pressure, pulse, maybe temp
- stick your finger (not necessarily at every visit)
- listen to baby
- measure your uterus (maybe, many docs don't anymore)
- feel for baby's position (again, most doc's don't)
- go home
a midwife will often spend more time talking with you, and both a midwife and a doctor will occasionally have other tests they want to do (some of these might include various blood tests, ultrasound, amniocentesis, etc.). and of course, a good practitioner will really look at you and listen to you and assess you based on their relationship with you and how you seem to be handling things and feeling, physically and emotionally. but a good friend or partner can do the same thing, you won't have to pay them for it, and they will be much less likely to try to scare you or manipulate you into doing things their way!
none of these counts as prenatal nurturing in my book! prenatal nurturing, good prenatal care in my book is eating well, resting when you need to, getting emotional space to take care of yourself, dealing with issues that may come up during labor, and connecting with your baby often and deeply, if you can. now, i'm going to talk about each of the things i listed above...remember that some who choose unassisted homebirth choose prenatal care with a doctor or midwife...those who do this should know that they can refuse any and/or all of these things if they want to!! it's your body & baby, your decision!
- step on the scale
why? yes, a rapid weight gain, especially in the last trimester, and if accompanied by protein in the urine and high blood pressure can be an indicator of problems...or it can be no big deal. many of us as women are very self-conscious about our weight. pregnancy is one time when we can relax about it and gain weight without being worried about our looks (most of us). there's no need for stepping on the scale.
- pee in a cup
your urine is tested for a number of things, most notably protein (for pre-eclampsia), glucose (for gestational diabetes...a disease of questionable existence or importance), leukocytes (could signal a urinary infection), ketones (dehydration, usually). all of these things are things that would normally make you feel bad or show other symptoms. if you are in touch with your body, urinalysis isn't probably too important either.
- blood pressure, pulse, maybe temp
again, these things, if significantly out of normal range, would probably cause other symptoms that would make you feel bad. and you have to wonder, if they don't, are they really important? if you feel bad, you owe it to yourself, your baby, your family to try to figure out why. but often we have high or low blood pressure, high or low pulse, and/or an elevated temp because we are not nurturing ourselves as much as we could.
- stick your finger
this is to check your hemoglobin/hematocrit level. these tests can tell whether or not you are anemic. i honestly agree with those doctors and midwives who've said that slightly lower iron levels in pregnancy are the normal result of the increased blood volume and that taking iron is not the answer—getting more rest is! lower iron levels can result in fatigue, which is the perfect way for mother nature to convince us to rest & nurture ourselves.
- poke your ankles for swelling (esp. late in pregnancy)
certainly something you can see for yourself...if you are swelling in the extreme, especially if it includes your face and upper body, you might ask someone to check you over, just for reassurance. but again, if you don't feel too bad, is it really something to worry about? if your feet are swollen, put them up and relax more often!
- listen to baby
this is very reassuring for lots of moms and their families. if you feel this is important, it's pretty easy to do at home. a fetoscope is fairly inexpensive. one that lets mom hear her own baby is a bit more expensive, but still waaaay cheaper than a doctor's or midwife's care!! and late in pregnancy the human ear can often hear the baby's heartbeat.
- measure your uterus (maybe, most docs don't anymore)
the "average" is that, after the 20th week of pregnancy, the fundus, or top, of the uterus will measure 20 centimeters from the pubic bone, and it will increase 1 cm per week until the last month of pregnancy, when the baby may drop and change the measurement. however, many women get very scared when their measurements don't match their dates...this is extremely common and not usually cause for concern. being "large for dates" can indicate inaccurate dates, multiple birth, gestational diabetes (again, questionable!) or polyhydramnios, or a large amount of amniotic fluid, which statistically occurs often in conjunction with some birth defects...but actually just as often occurs with no defect at all. it can also indicate a very healthy mom & baby, with a healthy diet!!! or perhaps just an above average sized baby/mom, or a mom whose uterus carries babies differently from the "norm"! being "small for dates" can indicate inaccurate dates, intrauterine growth retardation, oligohydramnios (not enough fluid), etc. or it can simply indicate a smaller mom, smaller baby, baby in a less common position, etc. ultimately, this is one more time where you trust your intuition: if you don't measure, you have nothing to worry about, and if your baby and/or uterus are not growing or are growing "too much", you'll probably notice. it probably won't be anything to worry about anyway.
- feel for baby's position (again, most doc's don't)
this is something that's hard to do on yourself and takes some practice to learn to interpret. it's not necessary but it's often reassuring to mom to have someone palpate once in a while when she's concerned about something like the baby's position or whether there might be more than one in there :) if you really feel a need for this, a single visit to a midwife experienced in palpation might ease your mind. try to keep in mind that there are no "malpresentations"...just different ones. breech, for example, is not wrong, it's just another way for babies to come out. often breech babies are breech for very good reasons.
- go home
how about stay home? ::grin:: you are perfectly capable of providing everything your body needs to grow a healthy baby. nurture yourself, love yourself, do whatever you need to do to get what you need.
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