We are spoiled in this country – and we are control freaks. (ouch…what a way to start off a blog post) Think about our typical lifestyle – air conditioning, flat screen televisions, computers with internet, prepackaged foods fill our pantries, at least one car…and these are common even in those considered “underprivileged”. Many have PDA’s to help schedule our days, dishwashers and washing machines and microwaves. We spend our entire lives (whether we know it or not) trying to control our environment and keeping things as predictable as possible.

And then there’s pregnancy and childbirth – and does that throw a lot of people for a loop. So many people will scour the internet for information to help them feel ‘in control’…..the rules of what to eat, the rules of what not to do, preparations to do, rituals to perform…anything to make them feel in control of this new and uncontrollable situation. Some go so far as to SCHEDULE their delivery date either by induction or cesareans (regardless of the true risks of doing this). Unpredictable, it seems, is unacceptable.

I’d like to talk about some of the ways that I’ve heard women trying to control this wonderful and amazing process that needs very little control to be perfect. It starts in the beginning of pregnancy – trying to control every bite that goes into their mouth, every sip that passes their lips. Women have somehow gotten the message that pregnancy is a delicate and fragile thing and if we take too deep of a breath we will somehow cause harm to the baby. It wouldn’t make good biological sense for our babies or bodies to be that fragile! Babies survive nicely even in a variety of settings…from the aboriginals to those dangerous Asians who actually eat sushi while pregnant! I see mothers all the time worried about the glass of wine they had before they found out they were pregnant – it has only been in the last 30-40 years that women even KNEW they were pregnant as early as they do!!! Historically we waited until we felt the baby move or at least were showing and could physically feel an enlarged uterus. (the old “rabbit died” saying? You should look up and see where that came from – I will spare you the details). I’m not saying that I think you should not pay attention to what you eat, I think you absolutely should – but I think you should every day and not eat special JUST because you are pregnant. If you don’t know what is healthy and what is not healthy then I would be happy to explain it to you (and would wonder where you’ve been….since I do believe most of us KNOW what we should be eating, whether we actually do it or not.)

At the end of pregnancy, many people expect some sort of regime to try to control the process – something that will make them healthier, birth sooner, birth faster. Even a lot of midwives seem to encourage this end-of-pregnancy control, and I actually don’t understand it. I recently read online where someone said that the midwife they work with recommends:

“Use in the last 6 wks of pregnancy, 2 times a day at breakfast & dinner

a.. Acidophilus (or mixed probiotics), the kind that require refrigeration, 4 billion cells
b.. Echinacea tincture, one full dropper, 10 days on, 10 days off
c.. Garlic, deodorized capsules, 500-600 mgs per day
d.. Vitamin C, 500 mgs with Bioflavinoids, 200 mgs, can be purchased together or separate
e.. Propolis, a.k.a. bee pollen, 1 capsule/tablet
f.. Grapefruit seed extract, 15 drops, preferably with OJ because it is bitter by itself!”

(I would be happy to give credit where credit is due – with what I’m about to say I wasn’t sure if she wanted to be ‘called out’ or not)


I don’t understand this midwife’s recommendation. I practice the “midwifery model of care” which means that I believe you are innocent until proven guilty. In other words…I believe that you are pregnant with a perfect and healthy baby, and will have a beautiful pregnancy and birth without any issues….only being watchful for issues and challenges, not preempting them. I don’t ASSUME you WILL have problems…I assume you will NOT have problems.  I have an herbal shop not too far away, and I regularly use them as issues come up and appreciate the effectiveness of many of the herbal remedies.  The the absense of a problem, however…why are you treating something that doesn’t exist?  The above regime seems like quite a lot to do…for no reason but just because you’re 34+ weeks pregnant.  Many regimes are to PREVENT issues, but I have the same concerns that why are we treating something that hasn’t come up yet?

I see women doing hands-and-knees every day the last few weeks just out of fear of having a posterior baby (forget the fact that their baby has been anterior the whole time) and having sex with their partner not because they enjoy intimacy but because they want the semen to bathe their cervix in prostaglandins.

Then there’s prenatal perineal massage….a whole other fear/control issue that I actually actively disagree with doing. (of course I will tell you why!) First lets define it – prenatal perineal massage is when you or your partner us fingers to ‘stretch open’ the vaginal opening during the last few weeks of pregnancy with the goal of stretching the vaginal opening enough so that the birth of the baby will not cause it to tear.

Sounds good in theory, so let’s explore why I disagree with doing it. First off all, it can undermine your confidence in your body’s ability to birth your baby. The hormones of LABOR will physically change your tissues and make them stretchy in a way that they are not beforehand, so it is common for women to needlessly become fearful because if they can’t comfortably fit 2-3 fingers in there, HOW WILL A BABY FIT! I have seen time and time again that a woman want a cervical exam while pregnant (see my blog post on internal exams) and yes, it’s tight for me to get two fingers in there. That same woman in labor I could practically fit my entire hand inside of her and she would scarcely notice. Our bodies change throughout the birthing process in a beautiful and magical way!

Secondly, it can actually have a damaging effect on the tissue and therefore I fear it can make it more likely to have trauma/injury. Our bodies heal…it’s what it does with any injury. When someone does perineal massage too vigorously they can cause little tiny ‘microtears’ to the skin – and your body will heal any that you cause. The problem is that our bodies heal with scar tissue, and scar tissue isn’t as flexible and stretchy as our skin is. We don’t want the perineum “toughened up”, we want it soft and stretchy! Which it will usually do just fine if we leave it alone!

Oh…and speaking of toughening up! Please, ladies….please please….I’m begging you…please do not try and ‘toughen up” your nipples by rubbing them with washcloths the last few weeks of pregnancy, or sunbathing without a top on, or rubbing with sandpaper (YIKES!!). Yes, I’ve heard all of the above recommended, and my nipples suck back towards my ribcage when I hear these recommendations. NO, you do not need to ‘toughen up’ your nipples – in fact, we don’t want tough nipples, we want soft stretchy nipples, too. The sensitivity you might feel the first few weeks is HORMONAL, not related in any way to the lack of toughness of the skin.

Most women are on the lookout for any sign that will PREDICT when they will have their baby. In another post I mentioned that I think the belly button is a wasted opportunity! If I’d made our bodies I would have made our belly buttons glow bright green starting 24 hours before labor begins! As it is, women look for ANY sign that will tell them that their baby is making his/her way. Vaginal exams, baby ‘dropping’, mucus plug, nesting, mood swings, weight loss….any clue, any sign. The thing is you aren’t in labor …. until you are. There may be a ton of signs and no labor, or no signs and your baby could be born in a matter of hours. It is, by its very nature, unpredictable.

I know that this will not be well received – but my recommendations for the last 2 months of your pregnancy are these….
* continue to eat healthy and be happy and active as you hopefully have been throughout the pregnancy- inf act, as I hope you have been throughout your life!
* respect your body and your baby and try and enjoy the unpredictable nature of this precious time
* treat problems as they come up, but also be happy and appreciative when you are perfect and healthy and enjoy the fact that you can “do nothing’ because nothing is wrong with you
* do everything you can to make yourself happy and well rested and to enjoy this miraculous time – it’s over before you realize it!