Ultrasounds. Sonograms. Whatever you call them, they are the grainy black and white pictures that many women get of their unborn babies.

Ultrasounds were traditionally taken if there was a suspected problem with a woman’s baby, or perhaps to see if there was more than one kid in there.

Then, they started being used routinely to ‘confirm’ or ‘date’ a pregnancy.

And seemingly all of sudden, women are having multiple ultrasounds to check if baby is ‘too big’ (btw – what’s too big?), or just to have another photo to add to the picture album.

Does any of this improve outcomes for mom or baby? Not so much.

Before you start screaming at me, please know that I think an ultrasound is a great tool to use if there is a suspected or known complication of pregnancy. For sure. However, the vast majority of pregnant moms are ‘no’ or ‘low-risk’.

Not to mention, ultrasounds in fact do a really poor job of determining the size of baby in utero. How many of you know someone (or are someone!) who had their baby induced early because an ultrasound estimated that he or she was getting ‘too big’ to deliver vaginally, only to have a petite 6 pounder? And again, what the heck is too big? A 4’11” friend of mine had a 12 pound baby. At home. With no drugs.   No problem!

And let’s not get into the false positives that happen all too often. I was in the room when a good friend had an ultrasound.  She was told that her baby would have one leg that was significantly shorter than the other. It’s no surprise that she was a nervous wreck for months before the baby was born – perfectly healthy, with no leg issues. Or my friend who was told in no uncertain terms that her baby had multiple physical deformities – to the point where they considered termination of the pregnancy – only to delivery a healthy baby.

My advice to you? Ask questions and be an informed consumer.

• “What is the indication for this test?”
• “What will you do differently with the information gained from this test?”
• “What are the side effects?”

To this last question, I’m quite sure most doctors will say there are no negative side effects. However, I will leave you with this direct quote from the National Institutes of Health: “Despite widespread application of ultrasound imaging and Doppler blood flow studies, the effects of their frequent and repeated use in pregnancy have not been evaluated in controlled trials.”

I’ll pass, thank you very much.

If you are pregnant, fuggedabout your due date.

It’s a myth. Mmm-hmmmm, you heard me right. Due dates don’t really mean anything.

Think of how unique each of us are; we are many different combinations of height, weight, hair and eye color. No two noses look exactly alike, and let’s not even get into how different Kim Kardashian’s rear end is from Chelsea Handler’s.

So why do we think that each and every baby should be born exactly 280 days from the onset of their mom’s last period? That, my friends, is the myth of the due date.

There is, in fact, a window of 4-5 weeks in which babies can be expected to come and be considered full-term, with no complications.

Why babies come when they do is a little-understood science. Some theorize that when a baby’s lungs are mature, this triggers a hormone that starts labor. Others say that since those last weeks are when baby shows the most growth, they come when they are at their peak survival time – fat stores, brain growth and reflexes are ready for the outside world.

So if most babies will be born healthy and happy between 38-42 weeks, why do so many doctors start talking induction 38 weeks (or earlier!)?

I dunno, but I can guess.  

An induced labor is a controlled labor. There is no mystery about when, where or how labor will start. It’s all nice and tidy, tied up in a package of hospital gowns, Pitocin and a 9-to-5 work day. Nice for the doctor, but is it good for the baby or mama? I think not.

The contractions stimulated by Pitocin are waaaaay stronger and more painful than those you would have had if labor had started naturally. The use of Pitocin also necessitates that you have other interventions like an IV and constant fetal monitoring, not to mention it increases the likelihood of the need for a C-section.

Not. Cool.

Who are we to think we know better than nature about when a baby should be born? In a complicated, high-risk pregnancy, perhaps yes. But in the vast majority of healthy pregnancies? Step away from the induction, please!

Our belly buttons may pop out toward the end of pregnancy, but alas, it’s not the same as the turkey thermometer. There is no “done” button.

Only Mother Nature knows when the time is right for your baby to come. So, Listen to your mother, ya hear?

Unless you are or know someone who has nursed a baby, you may think mastitis is something that has to do with a sailboat. If only that were so.

Mastitis is an inflammation in one or more mammary glands in the breast, usually caused by a clogged or infected milk duct. And it hurts like hell.

Imagine the biggest, reddest zit that you’ve ever had. Now imagine it about 10 times bigger, on your boob, and so sensitive that even the lightest touch from a baby’s hand or brush of a shirt has you cringing. Oh yeah, and you’ll probably have a fever and flu-like symptoms, too.  

Lucky you, am I right?

Treatment may include antibiotic therapy, which is not great for a breastfeeding mom, so you’ll want to do all you can to avoid it. If left untreated, mastitis can lead to an abscess, which may even need surgical intervention. Though sometimes it’ll get you even if you do everything right, there are a few things you can do to minimize the chances that you’ll get mastitis.

They include:

Breastfeeding in different positions. There are many milk ducts that lead to the nipple. If baby only nurses in one position, he or she may only be draining certain ducts, making it more likely that other ducts go stagnant and get clogged. Moving baby around will give you the best chances of avoiding this.

Allowing baby to fully empty one breast before moving on to the other. Milk retained in one breast, especially the rich hindmilk — (the secondary milk that comes in after the foremilk that typically has a higher concentration of lactose) — is the milk you need to worry about. If baby gets full on the foremilk (which typically happens), he or she may have trouble digesting all of the rich hindmilk, and if you don’t go back so baby can finish before going to the other breast, it can become a serious milk-duct-clogging culpri

Wearing supportive (though not tight) undergarments. Heavy lactating breasts require a little extra support, but squeezing them into a bra that’s too small may contribute to mastitis.

If all fails and you end up with mastitis, please remember to visit your healthcare provider, pronto-stat!

Much love, my new mommy bunch!

Epidurals are not all that they are cracked up to be.

Yeah sure, they are great for pain management in childbirth. But how many of you realize that there are A LOT of potential downsides to epidurals – many of them serious and long-lasting – for an upside of short-term pain management?

For instance, did you know that an epidural increases your need for interventions like vacuum extraction and forceps to be used during childbirth? 

And how about the increased likelihood that you will end up with a C-section? Had you heard of that one?

It can also cause long-term back pain and nerve damage – we see this a lot in our practice!

Oh! And let’s not forget about fetal heart rate changes and potentially dangerous drops in blood pressure – scary stuff!

Those are just a few. For a more comprehensive list of pros and cons, check this out: http://www.epidural.net/prosandcons.html

There is even some talk that when you have an epidural, you rob your baby of endorphins to protect them against the stress and pain of childbirth. Let me explain: when you or I have a painful stimulus, our bodies secret endorphins to help manage that pain (which is why sharkbite or accident victims often report not feeling pain at first). Those endorphins flow throughout our body, and allow baby to benefit from them as well.

If we artificially numb that pain with anesthesia, we no longer secrete endorphins. So though we don’t feel pain, the anesthesia does not numb baby, so he or she does feel pain.

In my article Natural Childbirth, I talk about how cool it really is to have an active part in your birth. And to be honest with you, though my two unmedicated births were, uh, not particularly comfortable – it was very transient, and very manageable pain with a purpose.

And for you guys? Let me give you an example of why epidurals might not be a good idea. Let’s say you’re constipated. Really, really constipated, and you’re determined that today is the day – you’re going to finally poop. Let’s put you in bed, on your back, with your feet up in the air. And, yeah, let’s numb you from the waist down.

How successful do you think you’ll be? Not. At. All.

Which is why it makes no sense at all to me that we would put a pregnant woman on her back, numb her from the waist down, and expect her to push out a baby. Which is ultimately why this one intervention often leads to many others.

So in answer to my question, is an epidural worth the trip? No way in hell.

But thanks for coming!