11 Ways to Avoid Induction

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      As a doula and a student midwife the most common scenario that creates a complication towards the end of pregnancy is the issue of being “post dates”, which is defined as being past 40 weeks gestation. The time period in between the end of week 41 and the beginning of week 42 is the most precarious, where most women are pressured by their care providers to be induced chemically with pitocin, cervadil, artificial rupture of membranes or a foley bulb, or a combination of all of them. It’s certainly not an ideal start to labor if you were planning a natural birth to have the added stress of being a ticking time bomb, so here are 11 ways to prevent this scenario from occurring.

 

1. Get your dates right. An early ultrasound prior to 10 weeks will give the most accurate dating information to create a due date by. Your last menstrual period, when combined with the actual length of your cycle, ideally based on your conception date, will give the most accurate date that will also most likely give you the most lenient due date window. When there is an option of dating method, opt for the one that will give you the most time.

 

2. Choose a care provider who isn’t a scare provider. This usually means a midwife who isn’t an agent of the hospital, abiding by their standards. There are midwives who work in birth centers and attend birth at home who will go by your most lenient due date, and support you holistically in the ways I’m about to list below to ensure your baby arrives in divine time. 

 

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3. Eat dates! There is actually a scientific study about this: Women who ate dates daily between 36-40 weeks were more effaced and dilated going into labor than women who did not, had a higher incidence of intact membranes (less change of premature water breaking), and a significantly reduced need for augmentation of labor. 

 

4. Get regular chiropractic, acupuncture and bodywork. A body that is aligned, balanced and relaxed has a better opportunity to get baby into prime position to engage labor, and when a mama’s mind is relaxed she is less likely to be in a state of stress, hypothetically preventing labor from occurring naturally.

 

5. Walk 3 miles a day, minimum. There is a reason there are so many stories from our great great grandmothers working in the fields and just squatting down and birthing a baby. Physical, upright, dynamic activity strengthens, stretches and tones the muscles, helps baby drop down and engage, putting pressure on the cervix and makes for a theoretically easier and more timely birth.

 

6. Know your tests. Once you pass the 40 week mark, if you are under an obstetrician’s care, a hospital-based midwife’s care or some out of hospital based midwifes care, you may be asked to get regular non-stress tests on baby to ensure they are doing well. If you are labeled “high risk” for any reason there will be even more stress on you to get non-stress tests. Even more accurate that an NST, is a biophysical profile. If there is any question of the baby’s health and induction is being pressed, request a BPP. This test measures 5 factors of health that help you see the big picture. The most common reason I hear for induction is “low fluid”. The thing is, if you were to be induced, most likely they would AROM you any way at a certain point to “get things moving”. Plenty of labors start off with a natural rupture of membranes and release of fluid and healthy babies tolerate contractions just fine with low fluid inside during labor. Low fluid is diagnosed via ultrasound in most cases, which is commonly incorrect. A midwife will palpate your belly and will be used to the feeling of how much fluid is around baby, and will notice if there is a detectable dip in the amount that would warrant concern. It is normal for fluid levels to decrease slightly before the onset of labor! Seek a second (and third) opinion. Increase your fluid intake if this is a concern and eat lots of high-water fruits and vegetables along with electrolytes to stay very well hydrated.

 

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7. Have sex. Once you hit 37 weeks, you are considered at term, and its time to start ripening up. Ripening means that the cervix gets softer, thins out, and starts to dilate, and baby beings to drop… like a ripe fruit. Sex releases oxytocin, which is released during labor. Orgasms can get oxytocin flowing and you might notice an increase in the intensity and frequency of your toning contractions aka Braxton Hicks. Sex with ejaculation if you are in a hetero relationship releases prostaglandins which help to ripen the cervix. Having sex also loosens up the hips and increases circulation in the whole body, reducing stress and relaxed mamas tend to go into labor in a timely fashion.

 

8. Get acupuncture. Starting at 37 weeks, see your acupuncturist for ripening treatments. If you don’t like needles you can have your practitioner use the electrostimulator instead, with seed stickers that can stay on the points after your session so you can stimulate the points yourself.

 

9. Get an induction massage. A good induction massage will pay attention to the acupressure points in your upper shoulders, feet, ankles and sacrum as well as help relax and release muscle tension in the piriformis, obturator and hip flexors. Application of massage oil with clary sage and jasmine can also help get contractions going.

 

10. Practice spinning babies exercises starting at 24 weeks. The three sisters, rebozo sifting, forward leaning inversion and side lying release are all wonderful and safe exercises to do on a daily basis as you are preparing your labor. These exercises help release ligaments and muscles that hold your uterus and skeleton and patterns that do not encourage ideal alignment. Often a labor may be stalled from initiating because baby is still working on turning and dropping down into an ideal position to start labor. This is where inducing can really mess things up- if baby hasn’t dropped yet and is in a posterior position at the beginning of labor and pitocin is started, the waters are artificially released and mama is made to lie down with an IV and is on drugs because of the strong effect of pitocin, that baby doesn’t have a very good change of turning and dropping down into a more preferable and smaller diameter anterior position. Babies certainly do come out posterior or “sunny side up”, but any mama who has had this type of presentation or labor (sometimes they turn mid-way through labor) will attest to the insanely excruciating pain that back labor is! Posterior babies skulls press on your spine as they move down, as opposed to the face and belly of an anteriorly positioned baby. 

 

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11. Surrender. Surrender is trusting and accepting. If baby is fine and mama is fine, there is no need to rush nature. Of course if there is a legitimate medical concern and baby must come out, baby must come out, I just implore you to consider all your alternatives, all your choices, seek second and third opinions, and always follow your own intuition.

Boundaries— How to not lose yourself in motherhood and in love

Where do I end and where do you begin? 

    It’s so romantic, the notion of being in union with a romantic partner so much so that when your skin is on theirs it’s hard to tell what is yours and what is theirs.

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 I’ve had a similar experience with my daughter when she was a baby; cuddling in bed nursing, I had the oddest sensation of stroking her chubby little wrist and feeling like I could feel myself touching her, even though visually and logically I knew we were separate, we were so connected. In the middle of the night I would wake up seconds before her, we got the hiccups at the same time, when she learned to crawl I would wake up moments before she was about to fall off the bed (this was before we got a bed railing!), and recently in her toddler years this entanglement has expressed itself in not so endearing ways. Her extreme and unbridled expression of emotion was taken so personally that I felt worn down, exhausted and like a failure if she was having a challenging day or even a challenging moment. Her rollercoaster of emotions pass through her like clouds and don’t seem to phase her, while they left me traumatized, waiting anxiously for the next outburst or crying spell. 

    In romantic relationships in the past I’ve been completely swept up in falling in love, giving endlessly to ensure I won’t be abandoned, enduring and tolerating physical and emotional abuse, shame, blame, neglect and criticism,  literally driving across the country or flying thousands of miles away in the name of ‘love’ all so that I won’t be left alone. My single girlfriends have remarked almost spitefully that I have never had a problem “finding a guy”, which has been true, the problem has been I also never found anything wrong with losing myself in one either, until now. 

    It’s not okay to lose yourself to a partner, to a baby, to an identity, to a job, to anything, and I have had to learn this the hard way. The word boundaries has always been elusive, one of those words that kept popping up all my life and I never bothered to look deeper. What exactly does “setting boundaries” mean?, I tell someone they can’t do something and they just won’t do it? What would I even say they can’t do? Until this past year, I honestly had no idea what a boundary was or why it is so important.

    Having dealt with both childhood abandonment issues and traumatic abusive relationships involving addiction, I have had a tendency to become codependent in relationships. I also have had a tendency to choose partners, friends and situations that put me in a place of over giving to prove my worth, of overcommitting and letting things go and go and go until I get resentful and just stop everything and I go, usually by running away or burning bridges, usually both. I also have had a tendency to caretake my romantic partners, making sure their needs are met, which is also a form of control, so I know they won’t abandon me, because I have enabled them and their abusive ways- whether physical or emotional. The latter is more sneaky, emotional abuse doesn’t feel like abuse when you’re in it. There’s no shock factor of a smack or a burn to run adrenaline through your body and wake you up. The only way to stop the cycle is to set boundaries.

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    It took until my daughter’s toddler years for me to realize how important setting boundaries is. Up until about age 2, I could get away with not really needing to set limits because her needs were so basic- love, comfort, breastfeeding, sunshine, playtime, diapers, sleep. Upon toddlerhood it got much more complicated—lots of words (especially NO!, lots of desired independence without competency in doing things she wanted to do, and lots of feelings. Young children are naturally self-protective and ego-centric, which is healthy, the ego has to develop first so there is a rooted sense of self and with that, security in the world. It’s wonderful to see her expressing her preferences for things, physical affection, socializing, going places, what clothes to wear, what food to eat (but mostly not!). She’s a healthy, strong and confident almost 4 year old girl who knows her boundaries and sets them proudly without any apology or shrinking away, she literally has no shame, she loves every part of herself and tells me all the time. I have managed to do one thing right in this parenting thing— to not ingrain shame or blame. I learned from her how to set boundaries. I have rightful desires and needs, and I’m suffering not expressing them.

    It started with a list, a very long list of all my needs in relationship, then I moved on to desires, and to all that I require in order to feel in balance in my friendships and work relationships. I realized that while I had a handful of my needs met, over half of them were completely unmet, and my desires were for the most part completely unmet as well. This is the cost of losing yourself, a side effect of serving and giving endlessly as a mother and a wife. As a side effect of this, I’ve also struggled with complete adrenal exhaustion, severe anxiety, suppressed immune system where I was literally sick with one virus into the next for 4 months straight, and other mystery symptoms. The body and mind are completely linked, and I know that setting boundaries initiated the healing process. There is a lot of healing to be done, once you begin, you realize the more you dive in the more there is to do… much like cleaning!

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    Setting boundaries can sound like “I’d prefer not to talk about this right now, let’s talk about it tomorrow afternoon after some sleep” and “That feels like a no for me”, and “My rate is $40/hour and the total is due upon completion”. With my daughter it sounds like, “ I’m not going to allow you to speak to me that way, it’s not kind”, and “We have 5 more minutes here and then we are leaving, when you hear the bell, we go”, and “I’m going to go lay down for 20 minutes and rest, you are welcome to play quietly or take a nap with me but it is time for rest”. Setting boundaries ensures no emotional energy is leaked, my physical energy is conserved, and my resources are protected and in a constant flow of abundance, rather than discounted, given away and devalued.

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    Losing yourself to motherhood, to the role of someone’s wife, partner or girlfriend, to an all-consuming job or just to the rush of life flowing on costs you and can be prevented with healthy boundaries. We don’t have to lose ourselves when we become mothers, it’s so difficult in this culture where motherhood is a viciously consuming role that doesn’t leave any room for error and so much room for judgment. We can’t be perfect, we aren’t. We were wild once. I won’t lose that. I’m not saying to go back to who you were before, because I personally wouldn’t trade anything to go back to her, I want to take just the parts I loved and integrate them into this embodiment of the woman I am now, having created so much— a whole human from my body, several businesses, some long, transformative relationships, several homes, beautiful community. I want to take all my favorite parts of myself from the last decade and assemble them as I wish into this new identity, and even then once I’ve created it, this identity isn’t one I want to completely lose myself in, it’s a state of flux, always evolving. My best friend says she’s never identified with being a mom. How wonderful! It must feel so free, to just ‘be’ a woman who happens to have a child, and still has all her desires and dreams and life intact. We aren’t bound by our children to create this ideal identity of motherhood, and I don’t want my daughter to be looking up to me in that way either, I’d prefer she see me as the badass, independent, activist, almost-midwife, healer, dancer & artist that I am. 

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    As for the blissful feeling of not knowing where one ends and the other begins, it feels even better once you’ve freed yourself of needing the other. You are free to LOVE with vulnerability, integrity and authenticity, to witness and experience the present moment, without the anxious mind carrying you away to the future or the past. Boundaries allow you to surrender. Surrender is not giving up, it is trusting and accepting, which allows the most delicious presence and expansion of pleasure in the moment.