Early Labor | What Should I Do?

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Early labor can often leave us with the question of, “When do I head to the hospital?”. Clever reminders like “511” remind us that contractions should be 5 minutes apart and 1 minute long for 1 full hour before you head in. As doulas, we are huge advocates for distraction through early labor. Often, when you focus on distractions you’re able to discern when you can’t ignore labor anymore.

When your pregnancy is healthy and labor is going normally, we love to encourage clients to try to make their contractions go away. True labor won’t stop just because you put your feet up! In addition to staying hydrated, eating nourishing food that feels good to you, and laying down for a bit, here are a few of our favorite ways to enjoy a distraction during early labor.

Schedule an Appointment

An excellent way to relax and distract yourself is to get yourself to a self-care appointment. Book a pedicure, a prenatal massage, or find a salon near you that does blow outs. These appointments are wonderful for distraction but they also help create a flow of oxytocin in your body. Oxytocin is a wonderful pain relief and also calming hormone and it can be stimulated by skin-to-skin contact. Be sure you’re in contact with your birth team and consider having someone else drive (just in case!)

Warm Shower or Bath

The warmth of a shower or bath can ease tension and relax your muscles, helping you stay comfortable as early labor progresses. Water has a calming effect and can provide gentle relief, especially for back pain or cramps. Sitting or standing under a warm shower allows the heat to target your back and abdomen, while a bath can create a more immersive, weightless experience that helps you relax between contractions.

Safety Note: Be sure to keep the water at a comfortable, warm temperature (not hot) and stay hydrated if you’re soaking for a while.

A pregnant individual does a yoga and meditation routine.

Movement and Gentle Exercise

Moving around can be surprisingly effective in early labor. Gentle stretches, walking, a prenatal yoga video, or using a yoga ball can help release muscle tension, encourage a more optimal baby position, and may even help labor progress. Slow dancing with a partner or swaying your hips in a figure-eight motion can bring comfort and connection, grounding you through each contraction.

Tip: If you have a yoga or birth ball, sit and gently rock your hips, move them in a figure 8 motion, or bounce lightly to ease any pressure in your lower back or hips.

Create a Calming Environment

A soothing environment can make a big difference in how you feel. Dim the lights, play calming music or sounds, and use soft, cozy blankets or a favorite pillow. Try lighting a candle that has a soothing scent to create a spa-like atmosphere if you’re interested in aromatherapy. Choose things that bring you comfort and help you feel safe.

Tip: Make a playlist with a mix of calming and upbeat songs. The calming ones can help you relax, while the upbeat tracks can lift your mood if you’re feeling restless.

A pregnant woman in early labor reads a book sitting on a couch.

Mindful Distractions

Early labor is the perfect time to engage in activities that keep your mind occupied without draining your energy. Simple activities like reading a favorite book, watching a comforting movie, or doing a craft project can keep your focus off contractions while still allowing you to relax. Some people enjoy adult coloring books, knitting, or easy puzzles that bring a sense of calm.

Tip: Make a list of short, enjoyable tasks you can do easily and stop anytime, so you’re prepared with options if labor progresses quickly or you start needing to focus more on your contractions.

These techniques can help you stay comfortable and relaxed at home as labor begins. Remember, there’s no right or wrong way to experience early labor; do what feels best for you. Take things one contraction at a time, stay connected to your body, and know that each step brings you closer to meeting your baby.

Unsure if it’s really labor? Check out our blog “Am I actually in labor?”

Hypertension in Pregnancy | Preeclampsia and HELLP

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Hypertension in pregnancy and its related complications, such as Preeclampsia, can have significant implications in the health and safety of birthing individuals and their babies. Prior to 2007, these conditions were more rare in otherwise healthy pregnancies. Studies have shown, though, that Chronic Hypertension in Pregnancy doubled between 2007-2021 (source). 

Understanding what these conditions are, how they are diagnosed, and what symptoms to watch for is key to early detection and effective treatment. With early intervention and treatment, pregnancy outcomes have a high probability to be positive even after diagnosis. In this post, we will explore hypertension in pregnancy and preeclampsia including symptoms, how these conditions are diagnosed, and variations or other related diagnoses.

A doctor takes the blood pressure of a pregnant patient in their office.

Hypertension in Pregnancy

What is Chronic Hypertension in Pregnancy?

Chronic hypertension in pregnancy is defined as high blood pressure that either exists prior to pregnancy, is diagnosed within the first 20 weeks of pregnancy, or does not resolve by the 12-week postpartum checkup. According to this article, Chronic Hypertension affects at estimated 5% of pregnancies.

What is Gestational Hypertension in Pregnancy?

The main difference between Chronic Hypertension and Gestational Hypertension in pregnancy is that Gestational Hypertension (formerly known as Pregnancy-Induced Hypertension or PIH) is new Hypertension that is diagnosed after 20 weeks of pregnancy. This condition is unique in that it is diagnosed after birth if you don’t develop preeclampsia and your blood pressure returns to normal after 12 weeks postpartum.

While this makes it sound less severe than Preeclampsia, it’s of note that if this condition progresses from mild to severe Gestational Hypertension the treatment is very similar to severe Preeclampsia. Both conditions are important to monitor and intervene if necessary.

Unlike Preeclampsia, Chronic and Gestational Hypertension may not always present with symptoms. However, regular monitoring of blood pressure is essential to ensure early detection. 

What Symptoms Should You Watch for?

Pregnant individuals who experience high blood pressure readings (140/90 mmHg or higher), headaches, visual disturbances, or swelling of the face, hands, or feet should discuss with their healthcare provider if further testing is needed.

How are Chronic and Gestational Hypertension Diagnosed?

Both Chronic and Gestational Hypertension are diagnosed via blood pressure measurement, urine analysis, and blood tests. Blood pressure tests are always the first line of defense as they’re taken at each routine visit. Urine analysis is also routine however they’ll do a more intensive analysis to rule out Preeclampsia. Blood tests may also be taken to check on organ function.

How Common is Hypertension in Pregnancy?

Hypertension occurs in about 10% of pregnancies in the United States. Chronic Hypertension affects about 1-5% of pregnancies, while Gestational Hypertension affects approximately 6-8%.

Pregnant individual takes their own blood pressure at home to monitor for hypertension, preeclampsia, and hellp in pregnancy

Preeclampsia

What is Preeclampsia?

Preeclampsia is a serious condition that typically develops after the 20th week of pregnancy. It is characterized by high blood pressure and damage to organs, most commonly the liver and kidneys. This condition can progress rapidly and pose significant risks to both the pregnant person and the baby. It can potentially lead to complications like preterm birth or placental abruption and can even be fatal if left untreated.

What Symptoms Should You Watch for?

The symptoms of Preeclampsia can range from mild to severe. It’s important that individuals share their symptoms with their healthcare provider no matter the level of intensity. It is possible, however, to have Preeclampsia without these symptoms which is why routine prenatal appointments are important! Just like with Hypertension in Pregnancy, persistent high blood pressure (140/90 mmHg or higher), headaches, visual disturbances, and swelling of face, feet, or hands are common. 

Other things to watch for include:

  • Excess protein in the urine (proteinuria)
  • Upper abdominal pain, particularly under the ribs on the right side
  • Nausea or vomiting
  • Sudden weight gain
  • Shortness of breath

How is Preeclampsia Diagnosed?

If Preeclampsia is suspected, the first step will typically be to get a reading on blood pressure followed by a urine analysis. When readings are consistently at 140/90 mmHg or higher and there is protein present in the urine, healthcare providers will typically move forward with a blood test to check on liver and kidney function and platelet counts as well as an ultrasound and non-stress test (NST) to monitor the baby’s growth as restricted fetal development can be common in Preeclampsia.

How Common is Preeclampsia?

Preeclampsia affects about 5-8% of pregnancies in the U.S. It is most common in first-time pregnancies, but risk factors include being pregnant with multiples (twins or more) and a history of hypertension or kidney disease.

How Common is Postpartum Preeclampsia?

Postpartum Preeclampsia is rare, occurring in about 0.3-0.7% of pregnancies. It can occur in individuals who had Preeclampsia during pregnancy, but it may also develop in individuals with no prior related history. The symptoms remain the same during pregnancy and after delivery. Postpartum Preeclampsia can develop after a baby has been delivered. The highest risk is 48 hours after delivery but it’s important to pay attention to symptoms that develop once you’ve arrived home and seek care immediately if something appears to be off.

Are There Other Conditions I Need to be Aware of?

The other main hypertension-related condition to be aware of is HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome. HELLP previously was thought to be its own classification. It is now thought to fall under the hypertension umbrella as a variation of Preeclampsia. This condition can be more difficult to diagnose because the early symptoms present just like Preeclampsia symptoms. This is why it’s important to know the symptoms, attend your routine prenatal appointments, and intervene early. Preeclampsia.org estimates that of the 5-8% of pregnancies that develop Preeclampsia, 15% of these people develop HELLP (source).

Hypertension and its related conditions are significant health concerns for pregnant and postpartum individuals. These conditions, while statistically more rare, are still important to pay attention to and know the symptoms of.

During pregnancy it is important to attend routine appointments for a whole host of reasons! Early detection of conditions like Hypertension is just one. Remember, even if a pregnant individual develops one of the conditions we’ve noted here, treatment is possible! Outcomes are greatly impacted by early intervention.

Struggling with one or more of the symptoms above? We want to encourage you to reach out to your doula and healthcare provider immediately. Chances are you’re okay (statistically speaking!) but the peace of mind from double checking is invaluable.

More Than Massage: Prenatal Spa Day

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This blog was last updated March 2024

It isn’t difficult these days to find a prenatal massage near you. What proves hard to find is providers that truly cater to pregnant clientele with their services. If you were a regular spa-goer pre-pregnancy, it can be disappointing to lose a routine for relaxation you’ve become accustomed to.

Not to mention, pregnancy often brings a host of discomforts and changes along with it.

The Prenatal Massage benefits extend far beyond days of relaxation. Through the art and science of touch, pregnant individuals can experience pain reduction and relief, mental relaxation, and tap into their parasympathetic nervous system via increase in Oxytocin in the body. By activating our “rest and digest” hormones, we can experience lowered levels of stress overall, which impacts every system of our bodies.

We did the heavy lifting for you and found some of the best options for locally owned pregnancy spa treatments in and around Baltimore. These local options offer a variety of Prenatal Massage techniques. We’re sure you’ll find one that matches your needs perfectly.

For the Holistic-Minded: Anhata Massage

Logo of Anahata Massage Therapy located in Baltimore, Maryland

Sanskrit for “heart”, Anhata Massage is owned by Joshua Gosnell. Offering a holistic approach, this massage will focus on more than just physical wellness, venturing into spiritual wellness as well to treat you as a whole person.

Instagram: @anahatamassagetherapy

 

 

For a Full Spectrum: Sweet Willow Massage

Logo for Sweet Willow Massage + Wellness

Sweet Willow offers services not only during pregnancy but preconception as well. Owner Jessie Bernstein-Newton additionally offers Infant Massage Classes for when your little one arrives! These classes can be incredibly beneficial for connecting with your baby and helping to relieve discomfort from things like gas after feedings.

Instagram: @sweetwillowmassage

For an Integrative Massage with Options: Metta Integrative Wellness Co-Op

Employee owned wellness co-op, Metta, in Baltimore, Maryland

An employee-owned cooperative, Metta offers a host of Integrative Health services including Prenatal Massage. Co-owner Molly Farwell creates an experience that can be adapted to all stages of pregnancy and all levels of comfort.

Instagram: @mettawellness

 

 

For Massage and Bodywork: Charm City Integrative Health

Logo for Charm City Integrative Health, a wellness business in Baltimore, Maryland

Charm City Integrative Health has been consistently voted Best in Baltimore by Expertise.com! Offering Prenatal Massage and Bodywork, they focus primarily on comfort for the expectant parent.

Instagram: @ccintegrative

 

 

For Massage with Optional Add-on Personal Care Services: Indu Wellness

Logo for Indu Wellness, located in Baltimore, Maryland.

Indu Wellness places emphasis on treating the whole person as a part of a comprehensive approach to wellness. While you’ll find Prenatal Massage there, you might also add on your routine personal care services such as Facials, Waxing, or Acupuncture.

Instagram: @indu_wellness

 

Massage can be a key part of nurturing your wellbeing. With the right provider, incorporating this science-based approach to care during pregnancy is an easy choice.

Looking for referrals to other professionals? Check out our Growing Family Professionals resource page for vetted local individuals and businesses.

Safety Note: Wherever you have your prenatal spa day, be sure to check in with your provider about any treatments you plan to receive, inform your spa technician that you are pregnant and need accommodations, and speak up if something doesn’t feel right. You are the expert on your body and baby!

Nausea Beyond the First Trimester

Nausea in the first trimester is pretty common. From strangers at the store to your family members, you’ll often hear, “Are you having morning sickness?”

A misnomer, many pregnant people are shocked to find that their “morning sickness” hits at lunch time or persists into the evening. Accompanying every interaction is likely to be a reassuring “At least it’s almost over! A few more weeks and you’ll feel much better!”

However, the truth is a little more complicated than that.

Why isn’t this nausea going away?

For some with “morning sickness”, they will indeed find that it resolves as they enter the second trimester. On the other hand, some will experience nausea that continues for the duration of the pregnancy. Alternatively, many will find that it fades for months and returns in the third trimester.

Usually the reappearance of nausea is benign and does not signal a cause for concern. Since late nausea may be a sign of Preeclampsia we still recommend discussing any new symptoms with a trusted healthcare provider.

Please note that this blog covers typical nausea or “morning sickness”, and not the more serious Hyperemesis Gravidarum. HG occurs in up to 3% of pregnancies. If you suspect you have HG we recommend contacting your provider immediately to receive care for this severe form of nausea, dehydration, and weight loss.

Third trimester nausea: Cameron’s story

Cameron experienced nausea in late pregnancy. A mother of three, she had routine first trimester morning sickness with all three pregnancies, which faded away with the first two babies by 16 weeks. With the third pregnancy, however, she had some memorable bouts with nausea in the last 5 weeks before delivery.

“I was so tired all the time, with two young children at home and a traveling husband. I wasn’t taking time to eat well or to sit and put my feet up, so I shouldn’t have been surprised one morning when I had to bolt for the front door and throw up in the bushes.”

Her next unexpected attack was the following week, at Christmas at her mother’s house. With so much going on and a crowded house full of relatives, she and her husband were sharing a bathroom. “He farted in there, and the whole house heard me throw up. Funny in hindsight, but it wasn’t pretty at the time!”

Cameron said she frequently felt queasy during those weeks, and struggled to find enough to eat to fuel her body and combat the fatigue that built every afternoon. In her 36th week she caught a stomach virus. After 3 days of struggling to keep anything down, IV fluids and anti-nausea medication were administered.

Despite the extreme nausea Cameron’s baby was born healthy at 38 weeks after an induction for hypertension, and the nausea disappeared.

What if you find yourself in Cameron’s shoes?

Identifying causes may be helpful so that you can target your treatment, but many times the cause is a combination of hormones and the physical changes when growing a baby. If this is the case, there are many coping strategies but the only real “cure” is birth!

Keep a Food/Supplement Journal

Writing down what you eat for a period of time can be an excellent way to find patterns in your eating and when they correlate with nausea. Additionally, some people find that their supplements (such as a prenatal vitamin) make them feel sick. If this is the case, try taking your supplements in the evening.

Drink Water!

Are you staying well hydrated? Dehydration can worsen your nausea symptoms and, if you are actually vomiting, you’ll be losing a lot of fluids needed for your body functions. Try keeping a refillable water bottle near you full of ice water so it’s easy to remember.

Try Snacks or Smaller Meals

Eating smaller amounts of food more frequently could help keep nausea under control. Part of the reason this works is because it keeps your blood sugars stable. Try making sure each snack or meal has some high quality carbs and protein to assist in balancing the sugars.

On the other hand, if all you can stomach is cereal, eat cereal. Fed is best for you, too.

Buy Yourself Some Candy

Ginger and peppermint have long been touted as helpful things to combat a queasy stomach. There are hard and soft versions of these candies, though many pregnant individuals swear by sucking on hard candies. Alternatively, sour candies have been reported as helpful too.

Above all, finding some time to rest is helpful for coping with nausea, and is also an essential component of preparing yourself for labor. When in doubt, reach out to your doula for suggestions or to discuss steps you can take. Remember, it will end! Until then, you’re doing great hanging in there.

3 Tips for a Healthy Third Trimester

The third trimester is between 28 and 42 weeks of pregnancy, and the final weeks before delivery. While your baby is growing and getting ready for their birth day, you might be experiencing more discomforts. With difficulty sleeping, feeling full after a few bites, heartburn, and frequent urination, how do you have a healthy third trimester? Here are some tips for keeping you and your baby healthy as delivery day approaches. 

Continue eating a healthy and balanced diet–and getting your vitamins and minerals.

During the third trimester, the Office of Disease Prevention and Health Promotion notes that pregnant people may need to consume 450 more calories than their normal diet. They recommend that this come in the form of vegetables, whole grains, and proteins–not sugars and fats. As your baby gets bigger, they may start to compress your stomach, and you can feel full after eating only a little bit. Consider high-protein snacks in between meals if you are having trouble eating what you normally might at a meal. 

You may have been taking a prenatal vitamin, and you can continue that into the third trimester. You want to keep getting proper amounts of folate, iron, and calcium. Check with your care provider about what your diet and calorie consumption should look like during a healthy third trimester. 

Stay physically active for a healthy third trimester. 

The National Institutes of Health recommend that people try to be as physically active during pregnancy as they were before. With the physical changes that your body is going through as you prepare for labor (link to blog), you may find the exercise harder or more uncomfortable. However, studies show that exercise can help reduce bloating, leg cramps, and backaches, and reduce other conditions like gestational diabetes, preeclampsia, and postpartum depression. Consider moderate exercise, like a walk around the neighborhood, a water aerobics class, or a prenatal yoga class. 

Listen to your body and your body’s signals.

By the end of your pregnancy, you may feel bloated, with pains in your belly and back, among other places, and tired from a lack of sleep. You might be uncomfortable, but your body is preparing for birth. While it might be hard to imagine getting comfortable before baby is born, you can try a number of things to relieve the aches. A warm bath or shower can help you relax, and relax your muscles. Pregnancy pillows or other support pillows can make sitting or sleeping more comfortable. Wear loose fitting clothes and don’t be afraid to fan yourself if you are hot! 

Learn more about what to expect during a healthy third trimester in our four week Complete Childbirth Education class or our intensive, one-day Birth Basics.