A guide to pregnancy and childbirth
Weathering the Changes
Oh, ancient Spirit
That fire cannot burn, water cannot wet,
And wind cannot dry.
Your soul of unblemished joy has danced and cavorted
Across the vast ocean of consciousness
And stranded on my heart.
Beyond memories and anticipations,
The universe has conspired to create you.
Child of the universe, child of mine,
You are the eternal taking birth in time.
You are the Supreme Being
Creating a new world.
Pregnancy is a time of dramatic change. Major transformations are taking place in your physiology as your unborn baby develops. Riding these waves of change can, at times, be challenging, and it is natural to experience emotional and physical ups and downs during pregnancy. Remember that although the ride may be bumpy at times, a smoother patch is right around the corner. Try not to compound your discomfort by being hard on yourself for feeling emotionally and physically unstable.
Although at other times of life you might be tempted to reach for a medication to soothe digestive upset, relieve muscular aches and pains, or overcome sleeping difficulties, most drugs are best avoided during pregnancy. Pregnancy, therefore, offers a great opportunity to experience the power of natural healing. The suggestions outlined in this chapter are offered as first-line approaches to common concerns during pregnancy. They are not intended as a substitute for appropriate medical advice. Incubating a new life is a sacred responsibility and, therefore, you do not want to take risks with your unborn baby’s life. This means not taking pharmaceutical agents unnecessarily and not avoiding them when they are deemed essential.
A good channel of communication between you and your health care provider is an important component of a conscious pregnancy. We encourage you to discuss all options you are pursuing with your doctor or midwife throughout your pregnancy and labor. In most cases, your health advisor will support your use of gentle, natural approaches for common minor concerns that arise during pregnancy.
Almost three out of four women experience nausea during the first trimester of pregnancy, and about half of women who have nausea will be sick enough to vomit. Although this condition is most commonly referred to as morning sickness, the stomach queasiness in the beginning of pregnancy, which may last throughout the day, is often called nausea and vomiting in pregnancy (NVP). Although this condition has been carefully studied, it is still not certain what actually causes it. No pregnant woman welcomes the uncomfortable sensations of morning sickness, but it appears to actually have a positive impact. Women who experience morning sickness have a substantially lower risk of miscarriage than those who do not.
The nausea usually begins in the fifth week of gestation, peaks by eleven weeks, and typically subsides by the fifteenth or sixteenth week. Most women are no longer bothered by nausea during the second half of pregnancy, but for a small percentage of women, it lasts the entire forty weeks. On a scale of one to five, with five being most severe, the majority of women rate their symptoms of nausea at a level two or three; that is, enough to be really uncomfortable without being fully intolerable.
Several scientists have suggested that morning sickness provides a protective mechanism for the early embryo. The mother’s sensitivity to many foods may keep her from ingesting substances that could potentially harm the unborn baby. The most common foods that pregnant women express aversion to during the first trimester are meat, poultry and fish, caffeine-containing beverages, and vegetables. From an evolutionary standpoint, avoidance by our ancestral mothers of potentially parasite-laden meat and phytochemically potent vegetables may have conferred protection for their vulnerable embryos. The tendency of modern mothers to crave fruits and fruit juices, grains, starches, sweets, and dairy may result from a selection process that increased the likelihood that nutritional, safe, calorically rich foods became the nourishment of choice.
Studies have shown repeatedly that the rates of miscarriages and stillbirths are lower in women who have nausea. Although some reports suggest that nausea is also associated with fewer premature deliveries, higher birth weights, reduced birth defects, and improved survival of infants, there have been an equal number of contradictory reports that fail to show any definite benefits related to these outcomes. We do know that mothers with nausea eat less during their first trimester and gain less weight. You might think that this would be associated with smaller and less-healthy babies. As it turns out, less weight gain in the first trimester results in an increase in the size of the placenta, which supplies blood to the developing fetus. As the nausea subsides, mothers increase their food intake during the second and third trimesters, their babies catch up, and the bigger placenta ensures a healthy supply of food and oxygen. Similar patterns of food intake have been reported in other mammals, including dogs, monkeys, and chimpanzees, supporting the idea that NVP has a purpose.
Relieving the Upset
Knowing that nausea during the first part of pregnancy is protective may give you some consolation, but most mothers would still be glad to see it subside. Medications used to treat nausea in the past have notoriously bad reputations, and pharmaceutical companies have essentially abandoned efforts to find new drugs. This has opened the door to other, more natural, approaches.
Most women with nausea try a variety of techniques to quiet their queasy stomachs. A recent study from Canada found that the most common approaches that pregnant moms use to fight nausea are these:
Eating dry foods
Helpful or somewhat helpful in 64%
Helpful or somewhat helpful in 59%
Clear or carbonated liquids
Helpful or somewhat helpful in 52%
Getting fresh air
Helpful or somewhat helpful in 40%
Helpful or somewhat helpful in 33%
It is worth trying these simple approaches to reduce the nausea and vomiting of pregnancy. An expanded list of possible remedies includes ginger, other aromatic herbs, vitamin B6, and acupressure, which we discuss in more detail below.
The spicy rootstock of ginger has been prized around the world for thousands of years. With a number of unique natural chemicals, ginger is most often used to aid digestion and improve circulation. Studies from Denmark found that almost three out of four pregnant women received some relief of their nausea from ginger, without any limiting side effects. Another study from Thailand reported that more than 87 percent of pregnant women using ginger had reduced nausea and vomiting (versus less than a third of those who took a placebo). Ginger appears to be safe for pregnancy. A Danish study found that ginger did not cause problems when given to pregnant rats at many times the dosage that a woman would normally take.
The easiest way to take ginger is to make a tea using 1 teaspoon of freshly grated gingerroot to 2 cups of hot water. Sweeten the tea with honey and sip it throughout the day. You can also chew on 1⁄2 teaspoon of grated gingerroot mixed with maple syrup when you are feeling nauseated.
OTHER AROMATIC HERBS
Aromatic herbs are used traditionally to stimulate diges-tion and have been promoted to relieve morning sickness. Peppermint, chamomile, and cinnamon teas can sometimes soothe an upset stomach, as can alfalfa. Try making a tea out of these herbs. Alternatively, try sucking on a clove bud.
Vitamin B6 or pyridoxine was a component of the morning sickness drug Bendectin, which contained the antihistamine doxylamine. Despite the absence of convincing evidence of toxicity, Bendectin was taken off the market due to legal concerns. There is some evidence that B6 alone may be helpful in reducing the nausea and vomiting of pregnancy at dosages of 25 milligrams every eight hours. Most prenatal vitamins contain between 20 milligrams and 50 milligrams of B6. Although it is generally safe, B6 can cause nerve toxicity at very high doses. Therefore, if you find B6 helpful in reducing your morning sickness, limit your intake to not more than a total of 75 milligrams per day. Of interest, a study that attempted to correlate morning sickness with low blood B6 levels could not find any relationship between vitamin B6 status and the incidence or degree of morning sickness.
A number of studies have suggested that stimulation of the acupuncture point Pericardium 6 (P6) has an antinausea effect. This point, known as Neiguan, is located two finger widths above the crease of your wrist in the middle of the palm side of your lower arm. You can stimulate the point by massaging it with your thumb or wearing an elastic band designed to stimulate the point. There is an inexpensive product on the market called the Sea-Band Wristband, which is commonly used by people prone to seasickness.
Try eating a few unsalted crackers or have a piece of toast upon arising in the morning. Light, easily digested foods are generally better tolerated than heavier ones. Eat protein-rich snacks and do your best to avoid greasy, fatty, or fried foods. Heed the messages your body is sending.
Other Digestive Disturbances
Your growing baby puts pressure on your digestive organs, commonly leading to indigestion, heartburn, bloating, and constipation. These minor but annoying digestive concerns are often amenable to simple, natural approaches.
HEARTBURN AND INDIGESTION
Heartburn and indigestion are frequent complaints during pregnancy, experienced most often during the last trimester. The growing womb squeezes the digestive tract, leading to congestion and bloating, and compresses the stomach, forcing acid into the esophagus and resulting in heartburn.
• Eat smaller meals throughout the day.
• Chew your food well. Don’t swallow until it is fully liquefied.
• Reduce fatty and greasy foods.
• Eat or suck on slippery elm lozenges, an herb that can soothe an acidic stomach.
• Alfalfa, in the form of a pill, tea, or sprout, can help relieve indigestion and heartburn. Alfalfa contains eight different digestive enzymes and is rich in vitamins A, D, E, and K.
• Consume some milk or freshly made yogurt during the day.
• Drink fennel tea at the end of meals.
• Eat chewable calcium tablets to neutralize stomach acid.
• Chew on some orange peel after meals.
• Try dry-roasted coriander, cumin, or fennel seeds and chew on a pinch of them after each meal.
• Drink carbonated fluids.
• Use the herbs cardamom, cinnamon, and bay to dispel gas.
Many women develop constipation during pregnancy. It is attributed in part to the hormone progesterone, which relaxes the smooth muscles of the gastrointestinal tract. Pressure placed by the growing baby on the intestines also contributes to constipation.
• Drink lots of fresh water and juices.
• Exercise daily.
• Increase your intake of fresh fruits, salads, and vegetables.
• Include in your diet foods rich in fiber.
• Consider taking alfalfa, which may help relieve constipation.
• Eat several prunes and raisins each day.
Due to the buildup of abdominal pressure throughout pregnancy, hemorrhoids are a common concern. With the straining that occurs during labor, they often worsen after birth. Pressure in the belly and pelvis impedes the return of blood supply, causing rectal blood vessels to dilate. Also, increased levels of progesterone during pregnancy relax smooth muscles, slowing blood flow through the veins.
• Exercise regularly to improve circulation and muscle tone.
• Drink plenty of fluids.
• Eat more fiber-rich foods to reduce constipation and the need for forceful evacuation.
• Consider vitamin E, which may be helpful in maintaining elasticity in the veins.
• Use fresh garlic, which also may be helpful in retaining vein elasticity.
• Reduce spicy foods.
• Support healthy blood vessels with the natural chemicals in berries and cherries.
• Sip nettle tea throughout the day—it is great for vein elasticity.
• Avoid sitting for long periods of time.
• Use witch hazel for pain or itching hemorrhoids. Presoaked pads are available at pharmacies. You can apply witch hazel directly to your bottom or soak an ice pack in witch hazel and apply it.
• Try a comfrey compress on your bottom by brewing some leaves and soaking a clean washcloth in the decoction. (Comfrey is known for its healing and pain-relieving qualities.)
• Do Kegel exercises throughout the day to increase circulation in the perineum.
Restless sleep is almost universal during pregnancy, particularly during the last trimester.
• Exercise each day.
• Wind down intense mental activity at least one hour before your regular bedtime.
• Perform a self-massage, followed by a warm aroma bath with lavender or vanilla.
• Drink a cup of chamomile tea before bed.
• Try a glass of warm milk with cardamom, nutmeg, or a pinch of saffron before bed.
• Listen to relaxing music.
• Place pillows under your belly and between your legs. A body pillow works great at the end of pregnancy.
More than one in five pregnant women complain of nasal congestion, which is often most disturbing in the evening hours and may interfere with sleep. The exact cause of this problem is not clear. Nasal congestion in pregnancy does not seem to be an allergic reaction and does not respond to the usual medications. Circulating hormones may contribute to the swelling of mucous membranes inside the nose, resulting in congestion and a runny nose.
• Drink plenty of fluids.
• Get plenty of fresh air.
• Try a vaporizer or humidifier.
• Use a neti pot. Add some warm salt water to the pot and administer to the nasal passages. Follow this by applying some sesame oil or ghee to your nose.
• Try the Breathing Easy nasal patches when you sleep or lie down. These are available in most pharmacies.
It is not unusual to experience leg cramps as your body attempts to adjust to the rapid physical and hormonal changes of pregnancy. Studies have shown that almost half of all pregnant woman experience leg cramps, most often in the second half of pregnancy. Although they can occur throughout the day, they are most common and most severe at night.
• Exercise every day.
• Elevate your legs frequently during the day.
• Massage your calves and thighs with oil on a daily basis.
• Ensure that you are receiving abundant calcium and magnesium in your diet. Good natural calcium sources are dark leafy greens, kelp, cheese, yogurt, soy milk, nuts, and fruits. Magnesium-rich foods include nuts, legumes, whole-grain cereals, dark green vegetables, soybeans, and seafood.
• Discuss with your health provider the need for magnesium supplementation.
• Sip raspberry leaf or nettle tea.
• Include vitamin E–rich foods such as wheat germ, spinach, and dried fruit in your diet.
• To relieve leg cramps as they occur, stretch your calf muscle by bending your foot toward your head and rotating your ankle.
• Apply warm compresses to the cramped area.
As pregnancy progresses, your body secretes chemicals that loosen the joints and ligaments in preparation for birth. The increased weight of your growing baby along with the laxity of the ligaments may cause your back to ache.
• Exercise daily.
• Avoid heavy lifting and always bend your knees when lifting objects below your waist.
• Practice yoga.
• Relax in a warm aroma bath.
• Receive back massages to relax and release tight muscles.
• Take time out to rest a little while each day.
• Apply warm heat to your back.
• Ensure adequate calcium and magnesium in your diet.
• Drink plenty of fluids.
• Sleep with pillows under your knees and use pillows to support your back and growing belly.
Fluctuating moods are common during pregnancy. There are a lot of changes taking place in your body, which affect your emotions. Be gentle with yourself and know that some emotional turbulence is normal. Having a baby will change your life, and some anxiety over these changes is healthy.
• Meditate regularly.
• Practice yoga.
• Exercise daily.
• Take time to relax by listening to soothing music or guided visualizations.
• Take naps when you are tired.
• Soak in a warm aroma bath.
• Honor the changes you are experiencing and find ways to nurture yourself.
• Communicate your needs and concerns to your family and your social support network.
• Journal about your feelings each day.
• Increase your energy by eating high-protein snacks.
• Drink plenty of fluids.
• Sip chamomile or raspberry leaf tea.
• If anxiety or depression is interfering with your daily life, be sure to promptly communicate your concerns to your health care provider.
Minor swelling of the hands, ankles, and feet is common during the final weeks of pregnancy. The hormonal changes associated with pregnancy may result in fluid retention, and your enlarging womb places pressure on the large veins that return blood to the heart.
• Rest with your feet elevated.
• Exercise daily.
• Avoid tight-fitting clothes.
• Avoid sitting for long periods of time, particularly with your knees bent and your feet on the floor.
• Massage your feet, legs, arms, and hands.
• Soak your feet in a tub.
• Limit your intake of salty foods such as potato chips and pretzels.
If swelling becomes excessive, call your health care provider.
URINARY TRACT INFECTIONS
Urinary tract infections (UTI) are not uncommon during pregnancy. The growing uterus compresses the bladder, which can inhibit complete emptying. When urine stagnates in the bladder, it is easier for bacteria to grow. The composition of urine becomes less acidic during pregnancy and contains higher levels of hormones, predisposing you to bacterial infections. Untreated UTIs are potentially dangerous for both the mother and the fetus.
• Drink plenty of fluids.
• Drink cranberry juice, which has been shown to reduce the adherence of bacteria to the bladder lining.
• Urinate frequently.
• Wipe yourself from front to back to reduce the risk of introducing bacteria into the bladder.
• Use cotton underwear. Cotton breathes easier than other materials.
• If you have any burning or discomfort during urination, call your health care provider.
When to Call Your Health Care Advisor
An open channel of communication between you and your health care provider is an important component of a conscious pregnancy. You should have a low threshold for calling your doctor or midwife, as it is better to be overly cautious and learn that your concern is a normal variation, than to be dismissive of a symptom that may be an important warning signal. The following are certain signs and symptoms that should be brought to the immediate attention of your health care provider:
• vaginal bleeding
• severe or persistent abdominal pain or cramping
• severe headaches or blurred vision
• shortness of breath or chest pain
• swelling of your ankles, hands, or face
• reduced urine output
• burning or discomfort during urination
• fever of 101° Fahrenheit or higher
• fluid leaking from your vagina
• an increased or foul-smelling vaginal discharge
• a decrease in fetal movements
• marked gain in weight
• an increase in pelvic pressure before thirty-five weeks of gestation
• contractions occurring more than four times per hour
• any other symptom that worries you or seems abnormal.
ENVISIONING YOUR BODY
Have your journal, some colored markers, and a pen nearby.
Start by closing your eyes for a few minutes and connect to your body and breath. Allow your awareness to journey through your body from the top of your head to your toes. Notice where you feel tight and where you feel open. Feel where your breath most easily moves. Stay with your breath for a few moments, inhaling and exhaling. Feel each breath bringing you nourishment and energy.
As you sit, quietly feel how your belly is becoming rounder and fuller. Bring your awareness to your belly and feel the sensations there. Feel your breath in your belly and acknowledge how it feels to have your belly becoming rounder and your body becoming fuller. Feel how your baby is being held and cradled safely inside of your womb. Notice what it feels like to have a baby growing inside your belly. Feel your breath rising and falling within you and notice your feelings about your body changing in shape and size.
As you continue to feel your breath, allow your awareness to flow to your genitals and your breasts. Notice how you feel about yourself as a woman and how you feel about your sexuality. With your next breath acknowledge yourself as the mother of this tiny baby. Feel your connection to all mothers and to all women. Take as much time as you need to explore your sensations and feelings. When you feel complete and ready, slowly open your eyes.
Now retrieve your colored markers and draw a picture of your pregnant body. For example, you might want to mark where you feel tight and where you feel open in your body. Pick a color to express how you are feeling in your belly and inside your womb. Allow the picture to describe what you experience. Let go of the need to be a great artist and have fun.
Take some time to journal about your picture and your feelings. Allow your thoughts to flow freely without holding back anything. Release any judgment or criticism about your feelings or sensations. Honor yourself completely.
Enliven Through Your Attention
• Place your hands on your belly a few times throughout the day and send loving thoughts to your unborn baby.
• Journal each day about your experiences.
• Early in your pregnancy, plant a tree or flowering bush to symbolize the growth of your baby in the womb. After your child is born, you can take care of the plant together.
• Read enchanting stories and heartfelt poetry aloud to your baby and listen to beautiful, relaxing music each day.
• Perform a daily oil massage on yourself before you bathe or shower.
• Diffuse an aroma while listening to music, while soaking in a tub, or while meditating to create the association between the fragrance and the relaxed state of awareness.
• Ensure that you have all six tastes available during your meals throughout the day.
• Choose to eat meals that are rich in color, aroma, and texture.
• Be mindful as you eat your meals. Eat at least one meal each week in silence with your full awareness.
• Practice meditation for twenty to thirty minutes twice daily.
• Pay attention to signals of stress that you experience during the day and employ stress-reducing behaviors to minimize the harmful effects of stress on you and your unborn baby.
• Perform yoga postures with awareness on a regular basis, being gentle and respectful of your body.
• Embrace your pregnancy as an opportunity to experience more natural healing approaches to common minor health concerns.
• Whenever an uncomfortable symptom arises, go through a mental checklist to ensure that you are taking time to relax, eating properly, drinking enough fluids, and exercising regularly.
• Develop an open line of communication with your health care provider and have a low threshold for calling about any emotional or physical concern that may arise.