Marathon training, Home Birth style

[shannon_na_gig]

I'm pregnant with my first, and after much research, my hubbie and I are settled on a home birth. I'm due mid-August. My midwife tells me that she has a 20% transfer rate for first time moms (most of them just get too pooped to go on, so transfer to hospital for an epidural).

I find myself thinking.. what can I do to prepare physically? Yes, I am eating well. Yes, I am working out regularly. But birth will be the most challenging physical experience of my life! When people train for a marathon (which only takes 5 hours to do, not 24 or more!) they do all kinds of prep work. And they start months in advance.

Anyone know of any good books to help me prepare?
Or does anyone have a regimen that they are doing?

I'm looking for something very detailed and organized, with proven activities and exercises that work. I'm also looking for mental preparation. I have Birthing from Within (which is wonderful), and we're taking Bradley classes.. but I'd like something more hard core and organized - Grrrr.. I'm ready to train!

Thanks so very much!

[Sarahstw]

I personally, would find another midwife. 20% transfer rates for first timers?! No, thank you. Unacceptable.

[mrsfrenchy]

Originally Posted by Sarahstw

I personally, would find another midwife. 20% transfer rates for first timers?! No, thank you. Unacceptable.

I was thinking the same thing.

As far as preparing for birth, I think the main thing is making sure you have good drinks and labor snacks available. A lot of it is the mindset though, IMO. Know that it can be hard and practice relaxation techniques.

But really, 20% transfer rate is a red flag to me. It shows me that there's something else going on there, whether its that the MW isn't patient enough during birth and then (maybe even subconciously) enourages clients to transfer. Or that she doesn't provide much labor support. 20% is waaaaay to high.

[jennyfah]

Oh, you sound like you are doing all the right things!

I highly recommend the Bradley classes. They really helped my husband and I understand what to expect in labor and how I can work with my body.

Do your exercises, get chiropractic adjustments, and learn about fetal positioning to help get and keep the baby in a good place. A baby that is in an optimal position will have an easier time finding its way out and may make labor easier on mama. The author of spinningbabies.com recommends doing inversions every day in addition to getting body work to help with fetal positioning: http://www.spinningbabies.com/techniques

I also recommend a doula. Mine was immensely helpful during my long homebirth labor, and she was EXTREMELY helpful after the birth! :

Everyone recommends Ina May's Guide to Childbirth, and I do too! Journal, pray, meditate, paint, draw, sew---find an outlet for your emotions about the birth so that you can be in a good place mentally and emotionally when labor begins. Create a peaceful, beautiful, safe birth space for yourself in any way that feels right.

In early labor, try to rest as much as possible, and sleep if you can. Also, eat and drink what you feel like eating and drinking, which will help you avoid exhaustion.

You're going to do wonderfully mama! Best wishes for a lovely birth!

Jen

[dogmom327]

20% is really high...I'd interview a few more midwives.

[shannon_na_gig]

normal transfer rates??

Hmm.. so 20% transfer rate for first time Moms is high?
I was feeling sorta reassured and thinking that the midwife wasn't taking any risks, but maybe I should interview other midwives!
I'm in Maryland, which requires home births to be done by CNM. I wonder if that contributes to the high transfer rate (more comfortable with hospitals)??

What would you say is a "normal" transfer rate, for first time Moms?
Thanks!

[RachaelsMommy]

Originally Posted by shannon_na_gig

I'm in Maryland, which requires home births to be done by CNM. I wonder if that contributes to the high transfer rate (more comfortable with hospitals)??


Thanks!

I don't have the stats to back it up but it seems to me like that could be a reason. Plus I would think a CNM would have liability issues to worry about.

My advice, in early labor, rest as much as possible, and eat foods high in protein for energy. I've heard wonderful things about hypnobabies too.

[clintonhillmama]

this is a red flag for me, too - 20% seems high, although i have no idea what my MW's stats are. also, "too pooped to go on" and transferring for an epi seems like a very non-HB approach to things. your mw should be helping you from becoming exhausted, and pain meds are not usually a cause for transfer.

a huge part of exhaustion is dehydration. my doula and MW were making me drink fluids after every single contraction, which i think was crucial in how i felt during and after labor.

[mrsfrenchy]

I'm not sure what my MWs transfer rates are specifically for first time moms, but I know that overall, they're around 4-6%. I think that her assistant (who is always there for first time homebirthers, sometimes there for 'veterans') mentioned in our class that she's been with her a few years and she had only seen her transfer a few times. (so i'm guessing less than 5ish) My MW is a CNM too if it makes a difference.

It just sounds as thought your MW has a very medicallized view of childbirth. I would try to ask her some more questions to see what her views on birth really are, as well as talking to a few other MWs in your area (even if they're too far away/too booked to be your MW ask them what their transfer rates are for 1st time moms--that way you have something to compare by for your area.)

[alegna]

Originally Posted by Sarahstw

I personally, would find another midwife. 20% transfer rates for first timers?! No, thank you. Unacceptable.

:

Personally, I'd be uncomfortable with a transfer rate much above 10%.

-Angela

[alegna]

oops! double post

-Angela

[Viola]

I didn't really do too much to prepare, other than read books, but one of the things I found helpful and did try to follow was the exercises for optimal fetal positioning. I mostly just took care in how I sat in the last month or so, because my first baby was OP.

http://www.betterbirthpartners.com/O...sitioning.html

I just realized that someone has already mentioned it, so I'll just second it!

[Peony]

Not all CNM are more of a medical mindset. I've personally had a wonderful HB with a CNM who was much more hands off then all the other CPMs in my area. I think any MW, regardless of type, has the potential to do more interventions then need be.


I agree with all the posters that said a 20% transfer rate is really high, I'd keep looking for another MW.

[Lizbiz]

The title of this post caught my eye... Partly because I finished a marathon a month before I got pregnant with Leo, and I was just in that "training" mindset going into pregnancy.

I also viewed pregnancy as "training for a marathon" - in fact - that was the analogy I used all the way through...

Here's what I did:

1) I ate well. Plenty of protein, lots of calcium, lots of fruit, tons of water... Plenty of Ice Cream! Yay! I did not count calories, but I tried to really eat smart so I gained steadily throughout my pregnancy.

2) I exercised very regularly. I ran until 32 weeks, BUT I was in marathon shape going into the pregnancy, so I know this isn't for everyone. I really paced myself, and after I stopped running, I walked with weights. I also did prenatal yoga as much as possible to stay flexible and strong. I LOVED this.

3) I read a lot of home birth stories - including Ina May's entire book. This was fun/helpful/funny/inspiring.

4) I rested when I could. I tried to stay well rested throughout. Not always an easy task, but I did my best.

5) I took a great birth class. It was invaluable.

6) I simply believed I could birth my baby all along. I really never doubted that, but then again, self confidence has never really been my problem (sometimes I could use a little more self doubt). In this case, it helped tremendously.

7) I trusted my midwife implicitly, and her assistant, and loved them both. They had my best interests in mind, and I knew that.

8) My husband believed in me too, and was fully supportive... I needed that.

9) During the birth, my husband gave me sips of Gu2O (an electrolyte replacement drink we used during marathon training) and I ate Balance Bars and bananas. This kept me going through 31 hours of labor.

10) I prayed. More than any of the points above, I know God got me through labor. If you're a believer, I highly recommend asking for God's help.

I think it's important to prepare yourself during your pregnancy. The better shape you're in physically and mentally and spiritually, the better you can face the challenge.

[mrsfrenchy]

Originally Posted by Peony

Not all CNM are more of a medical mindset. I've personally had a wonderful HB with a CNM who was much more hands off then all the other CPMs in my area. I think any MW, regardless of type, has the potential to do more interventions then need be.


I agree with all the posters that said a 20% transfer rate is really high, I'd keep looking for another MW.

I think that what one of the PPs was saying is that CNMs often feel they have more constraints/liablilty because they have OBs backing them and, from my understanding, a sort of contract with the OB outlining when to transfer/risk out. I don't think that CPMs have that. (I could be totally wrong, if so call me on it)


But i had a great cnm and i agree theyre not all medwives

[groovynaturemama]

as a midwifery apprentice and someone who was a first timer who had a homebirth (and will again in june), there are two things that i think are of utmost importance when having a hoembirth:

before labor: mental preparation. mind over matter kind of thing, only it's like allowing your thinking mind to step to the side as you labor. i think we have to get out of our heads enough to let just our physical body do the work it needs to do to birth a baby. letting go of control is a big part of this. reading/listening to positive birth stories, telling yourself repeatedly that you can do it, affirmations (i took all of my fears and wrote them down in a positive affirmation), meditation, visualization. a combination of these things or one of them; find what works for you and instills confidence in your ability to birth a baby at home.

during early labor: sleep!! my general experience is that first time moms (and even some moms with more than one baby) have a long, slow, lead in, prodromal labor for a couple of days where there are contractions, but not much dilation going on, etc. a lot of what i see is that these moms think that early labor is active labor (they've never done it before, so how are they supposed to know until they get there?), and they spend their time breathing through contractions that aren't doing the bulk of the work, and they exhaust themselves just as active labor begins, and are unable to sustain. also, the excitement of "is this really it?!?" can get your adrenaline going and keep you from resting.

oh yeah:
relaxing, making your body soft (which is part of letting go) during contractions will also help during labor. have your partner keep an eye on you as you have a contraction. something as simple as him touching the part of you that tenses up during a contraction can be a nice non-verbal reminder to relax and be soft. tension works against you in labor, so you really want to try your best to just allow it to take hold and welcome the sensations. i fouind that the more i allowed, let go, and got out of my body's way (with my mind), the easier my labor was. i had a 4 hour active labor with dd, but about 2 days of the prodromal stuff. i rested, i ate, and i just stayed as relaxed as i could, despite my excitement of the impending birth during the early part. once active labor began i remember being very glad i had taken it easy all the hours before, b/c active labor was when the real work began.

[zoebird]

i believe that we often create our own realities. when you say "birth will be ..." then you are creating that for yourself. you expect it, so it likely will be that way.

so, what if you change your expectations to "i can handle birth, no matter what!" and "whatever physical demands there are for birth, i will be able to do them!"

this simple change in mindset can make all of the difference in how you approach your birth.

for my own part, i not only did this, but asserted that birth could be pleasurable and ecstatic. and, that's exactly the birth that i had.

so, from the mind stand-point, i held that whatever demands birth had, i could handle, and with this, i was open to accepting that birth could be pleasurable.

it was also helpful for me to get out of my head and into a place of body trust. i used cranio-sacral therapy to help with that. for me, it's really about ecstatic movement.

[MegBoz]

Originally Posted by shannon_na_gig

I'm in Maryland, which requires home births to be done by CNM.

True, the CPM designation is illegal in our state, but there are some CPMs who hold licensure in neighboring states (VA, PA, DE) and practice here anyway.

Personally, when I first learned of this, I was a little freaked out at the idea of using a renegade "illegal" midwife. It didn't seem "on the up & up" & spooked me.

Now that I know the truth about the ridiculous politics of birth in America, I have NO problem with it!! Reading "Born in the USA" By Dr. Marsden Wagner clarifies it best, IMO.

So - just wanted to point out, you CAN look into other options, including CPMs if you are open to it. It's not illegal for you to HB with a CPM, it's just illegal for the CPM. Just PM me or someone in our tribal area for contact info for some in your area.

As for your original question, as a certified fitness instructor & personal training, I DO think it helps to train for birth like you'd train for a marathon! Seriously! Work to increase your cardiovascular endurance.

WRT specifically how to do that, basically any cardio exercise works - so long as your heart rate is in the training zone. You can add high-intensity intervals (like the equivalent of sprinting a minute, jogging 3 minutes). Vary duration (sometimes longer, sometimes shorter & more intense.) Mixing up format is always good too (kickboxing, jogging, cycling, aerobics, etc.)

Strength training contributes to an increase in cardio endurance as well. (lifting HEAVY - max out in 8-12 reps.)

Food in labor, I don't know what the pros recomend, but I would think you'd want high-GI (Glycemic index) stuff that is going to hit your bloodstream fast & not sit in your tummy. Like fruit juice & honey straws. Anything with protein or fat is going to sit in your stomach & take time to digest - and I think digestion slows in labor anyway.

[Peony]

Originally Posted by mrsfrenchy

I think that what one of the PPs was saying is that CNMs often feel they have more constraints/liablilty because they have OBs backing them and, from my understanding, a sort of contract with the OB outlining when to transfer/risk out. I don't think that CPMs have that. (I could be totally wrong, if so call me on it)


But i had a great cnm and i agree theyre not all medwives

I didn't take offense at all. Not all CNM have OB's backing them, maybe in some states, but it's not a requirement in others. I do know what people were saying, CNM are generally trained in a hospital and can have more of a medical mindset because of their background where RM or CPM are trained on the job doing homebirths.



And there are almost always other options besides what is "legal" in your state. They might not be widely advertised but rather ones you have to seek out. Good luck!

[cathicog]

Originally Posted by shannon_na_gig

Hmm.. so 20% transfer rate for first time Moms is high?

Yes, it is. Usually no more than 5-10% and I think 10 is high. Sounds like she doesn't like to wait on a first time mom, and that is a HUGE red flag to me. The other red flag is she may be having to work within the medical guidelines to such an extent(to protect her licence) that she is acting more like a doc than a midwife..

I was feeling sorta reassured and thinking that the midwife wasn't taking any risks, but maybe I should interview other midwives!
I'm in Maryland, which requires home births to be done by CNM. I wonder if that contributes to the high transfer rate (more comfortable with hospitals)??

I don't know if it is "more comfortable" as much as " to keep my licence I have to work within the boundaries set by doctors, whose best interests are served by having all babies in the hospital"....I think I would look for another midwife, preferably a CPM, Certified Professional Midwife..

What would you say is a "normal" transfer rate, for first time Moms?
Thanks!

No more than 5%, if that. It is possible that the moms may be encouraged to work with labor, when they are still in prodromal labor, therefore exhausting themselves at home, and then having to transfer. Most mws I know encourage the mom to rest, eat, and consider it false til it proves itself otherwise, when it really *is* labor, and then the moms aren't so tired by the end.I also think that is the reason for so many "failure to progress" c/sections in the hospital. the moms really weren't ready yet. FWIW, There are risks no matter where you birth. It's the nature of life. But the risks are fewer at home, generally.