I’ve gotten some questions and heard some stories from women lately about their mainstream pregnancy experiences that I’ve found, honestly, extremely disturbing.
In one story, a mama showed up at the hospital dilated to 10 cm with baby crowning…and the staff put her under and performed a c-section because “we don’t do VBACs.” That is unbelievable.
Another mama was told her baby was “too small” during a 32-week ultrasound (who even does 32-week ultrasounds routinely?) and that she needed ultrasounds every five days for the remainder of her pregnancy. Oh, and she should eat lots of junk food to help herself and the baby gain weight.
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Mamas. You have choices in pregnancy and birth. You have the right to accurate information, bodily autonomy (meaning you own your body and have the right to make decisions for it), and informed consent. You have the right to refuse things if you do not want them.
Some common themes keep coming up in pregnancy and birth that I need to address — some of the most common lies, which you’ve likely heard and even believe. It is so important to get this information out there.
Pregnancy Lies You Likely Believe
1. Internal Exams are Beneficial and Necessary
It’s fairly common for doctors to perform internal exams at different points in pregnancy — often at an initial appointment, and then again in the final weeks of pregnancy to check for dilation. But there is no evidence that these exams are in any way beneficial. Nobody needs to know if everything “feels okay” on the inside (so long as the pregnancy is progressing normally) and any exam runs the risk of introducing bacteria and causing an infection.
Dilation also does not matter and does not give any indication of when the baby will actually come. Many women feel hopeful to learn they are, for example, 70% effaced and 3 cm dilated. Or they are disappointed to learn they are not effaced and only 1 cm dilated in the final weeks of pregnancy. Ladies, this has absolutely nothing to do with anything. It is possible to be 90% effaced and 5 cm dilated for weeks before labor begins. It is possible to be not dilated or effaced at all and have a baby mere hours later. There is simply nothing to be gained from this information.
In general, unless there is an actual problem, internal exams are not necessary and are even potentially harmful.
2. Ultrasound Measurements Are Accurate
In the very early weeks of pregnancy — generally, the first trimester — ultrasound measurements are, for many women, fairly accurate at dating a pregnancy. The further a pregnancy progresses, however, the less accurate these measurements are. By term, ultrasound measurements can be off by 2 lbs. in either direction on weight (which is a lot when the average newborn is 7.5 lbs!). Measuring fluid pockets near term is also likely to be off because the baby’s so big that fluid can “hide” behind baby or in places where it can’t be seen on ultrasound.
Some doctors give measurements of baby’s size in the final weeks of pregnancy based on ultrasounds and announce this like it’s definitive. Some even recommend induction or c-sections based on these measurements. But, believe me, the world is filled with stories of women who “needed” a c-section because of a “big baby” (8 – 9 lbs., which is really not even that big) and then their babies turned out to weigh only 6 – 7 lbs. at birth.
That’s why this is so important. Doctors should not be pushing for early induction or scheduled c-sections based on ultrasound measurements alone because they are highly inaccurate and can lead to worse outcomes and certainly more risk to mom and baby. (It may happen that an ultrasound measurement is used *along with* other signs, symptoms or tests to make the decision to intervene, and this may be okay, but ultrasound alone should not be.)
3. GD Testing is Accurate and Necessary
Everyone is worried about gestational diabetes in pregnancy because uncontrolled blood sugar can lead to macrosomia (heavier than normal baby) and baby having blood sugar issues after birth. But, the GD test really isn’t a good way to test…and the standard “treatment” for GD isn’t really healthy, either.
For women who usually eat well and do not have much sugar, the GD test is likely to come back high. Their bodies do not know how to cope with the sudden, unusual sugar rush. However, those women are unlikely to have problems on their normal diets, simply because they are low in sugar. (Plus, magnesium deficiency, which is really common in all adults and even more so in pregnant women, can cause trouble controlling blood sugar. That happened to me in my second and third pregnancies, but after I began supplementing my fourth and fifth pregnancies I had no more issues.)
If a problem with blood sugar is suspected, it would be more accurate to take blood sugar readings several times a day, after meals, to see how the numbers are in a real-life setting. Then, if treatment is needed, it can occur. This is much more accurate than the one-hour GD test.
4. You Can’t Breastfeed While Pregnant
While there are *rare* circumstances where women shouldn’t breastfeed while pregnant, in most cases it is perfectly fine. Breastfeeding does cause an oxytocin release, but it’s not nearly enough to cause contractions and lose the baby. It’s no more (and possibly less) than is released during sex. So if you haven’t been told to avoid sex/orgasm, then you don’t need to stop breastfeeding, either.
Personally, I have breastfed through four pregnancies, and have carried basically to 40 weeks three of those times, with no spotting, no miscarriages, no “scares” of any kind. Many other women have done the same.
5. Repeat C-Sections are Safer Than VBACs
Actually, for the majority of women, no.
Newer research shows that there are no increased risks for most women with a VBAC vs. repeat c-section. The risks go up some (for uterine rupture, blood transfusions, NICU admissions, etc.) after two c-sections, but maternal mortality is basically the same between VBAC and repeat c-section.
Women who want a VBAC should talk to their care provider about their specific circumstances, but unless there is some special factor that necessitated the first c-section that is likely or certainly happening again, VBAC is just as safe, if not safer, than repeat c-sections.
6. “Baby is Too Big” is a Reason to Induce Early
Just no. First of all, as mentioned above, there is no way to accurately measure baby’s size, especially in the final weeks of pregnancy. Measurements can be off by multiple pounds, meaning a “9 lb” baby may only be 6 or 7 lbs. Plus, a woman’s body is meant to stretch and open for a baby. And, baby’s bone structure and size of the head has much more to do with how well it fits (along with the size/shape of a woman’s pelvis) than baby’s weight.
Baby’s expected size alone is never a reason to induce early.
7. Elective Induction is Safe
Not exactly. One study found that elective induction was associated with greater risk of a cesarean, more labor interventions, and a longer hospital stay. An article in a medical journal by a Ph.D. RN explains the benefits of waiting for spontaneous labor.
While elective induction is safer after 39 weeks, it is not the safest plan. Induction for medical reasons is, of course, different.
8. Eating Junk Food is Safe or Beneficial for Weight Gain
Mothers do typically need to gain weight while pregnant unless they were significantly overweight before becoming pregnant. If significantly overweight, they may be considered higher risk and their weight will be managed by a doctor based on their personal needs. But this weight should be primarily muscle tissue, blood, amniotic fluid, and the baby. It will be some healthy fat, especially in the hips and thighs.
It shouldn’t be based on eating a diet of junk food, though. Women’s bodies need nutrients to build all that additional muscle, blood, and baby. Junk food does not provide those nutrients. Junk food only adds unhealthy fat. This unhealthy fat doesn’t help baby and it will be hard for the woman to lose after birth.
Instead, if a woman is struggling to gain weight, she should look for nutrient-dense foods such as grass-fed butter, avocado oil, whole avocados, nuts, grass-fed beef, etc. These foods are not only rich in fat and calories, but also rich in vitamins and minerals needed to build a healthy baby (and keep mama healthy too). All weight gain is not equal.
9. Herbs are Dangerous in Pregnancy and Should be Avoided
While there are certainly some herbs that we know are not safe during pregnancy, there is no reason to avoid all herbs.
Unfortunately, many doctors are not familiar with herbs, and many are herbs are not rigorously tested in pregnancy despite being used by pregnant women for hundreds of years with no known adverse effects. Therefore, many doctors will recommend staying away from herbs — even while recommending much newer, unproven drugs and procedures!
Exercise caution with herbs. Check for known contraindications from well-studied herbalists before taking anything. Stick to basic herbs that are mild and safe during pregnancy. Herbs like lavender, nettles, and red raspberry leaf are commonly used in pregnancy and are even beneficial during pregnancy. Ginger, mullein, and others are safe and good to use for cold symptoms. I keep several on hand that I know are safe for pregnancy and breastfeeding and avoid ones that I know are not safe or that I am unsure of.
10. Vaccines in Pregnancy are Safe and Well-Tested/Necessary
In just the last 10 years, flu shots and then Tdap shots have been recommended for pregnant women. The flu shot recommendation was fairly new when I was pregnant with my oldest (2007), and Tdap didn’t come into play until I was pregnant with my third or fourth. I know the push was big with my fourth.
The act of vaccinating pregnant women used to be one that was treated with caution — it was basically never done. But now it’s done routinely. There are no quality safety studies on this practice. And, there’s no guarantee — especially for the flu shot which can have extremely low efficacy even by mainstream standards — that it will protect mom/baby against anything.
There are safer ways to stay healthy in pregnancy, in my opinion. I chose to take cod liver oil, get light exercise, and enough sleep.
11. “Your Fluid is Low” is Accurate
Remember what I said above about ultrasound measurements? They’re notoriously inaccurate. That goes for fluid measurements, too. Besides, a study shows that fluid measurement is not an accurate predictor of risk or outcome. And, another study shows that drinking more fluids at home improves the fluid levels — and women can do that easily enough. This article explains it better than I can — and this is important, because doctors sometimes try to induce because of “low fluid,” but this doesn’t actually improve outcomes for most women.
12. Going “Overdue” is Dangerous
Many women are told that once they hit 40 weeks, they have to deliver, often by induction, because otherwise, it is “dangerous.” However, a 2009 study shows that there is not adequate evidence to say what the best course of action is with pregnancy at 41 weeks and beyond — “management” (AKA ‘wait and see’) vs. induction.
There is some increased risk of stillbirth beyond 41 weeks, but there are risks associated with induction and/or c-section that may not outweigh those risks until 42 weeks or even beyond that. There is no evidence that automatic induction at 40 weeks is the best plan.
Believe it or not, these are only some of the myths out there! Next week we’ll be covering 12 more. (Here’s part 2!)
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