The Miles Circuit....
written by Sharon Muza
posted by Cindy Hansen
About the Circuit.......
""I named this "circuit" after my friend Megan Miles, who shared and discussed it with me when I was working with a client whose labor seemed to be stalled out and no longer progressing. On the phone, we brainstormed some strategies and Megan shared this set of positions that she favored. My client did the circuit and soon we had a baby! I started calling it the "Miles Circuit" and teaching it in doula trainings, childbirth classes and using it with clients.
This circuit is useful to help get the baby lined up, ideally, in the "Left Occiput Anterior" (LOA) Position, both before labor begins and when some corrections need to be done during labor.
Prenatally, this position set can help to rotate a baby. As a natural method of induction, this can help get things going if baby just needed a gentle nudge of position to set things off.
In labor, i often suggest this set of postions when labor seems to be not progressing. (ie contractions are not getting stronger, longer and closer together) mom has back labor, or the postion is determined to be not LOA, either by vaginal exam or external palpation.
To the best of my knowledge, this group of positions will not "hurt" a baby that is already lined up correctly."
- Sharon Muza, CD(DONA), LCCE, DONA Approved Birth Doula Trainer
http://www.milescircuit.com/index.html
Exploring Waterbirth
By Nicole Katerberg Colibaba
The idea of settling in to a deep hot bath appeals to the majority of women at various times in their lives. Whether dealing with menstrual cramps or a broken heart, generations of women have escaped to a deep tub and the relief of warm water. It should come as no surprise, then, that many women feel drawn to the water to labour, and even for the birth of their baby.
When I first came across the concept of waterbirth, it didn’t strike me as something I would choose. Still, as I researched birth and investigated options for the gentle homebirth I wanted, I came across more and more information about the benefits of waterbirth.
How is Waterbirth Even Possible?
As soon as waterbirth even became a possibility in my mind, the obvious question came to mind… Won’t the baby drown?
Babies spend the first 9 months of their lives in water. Just as when they were embraced in amniotic fluid in utero, waterbabies continue to receive their oxygen through the umbilical cord when they are born. The initiation of breathing is not triggered until they are either exposed to air, or the umbilical cord stops providing them with their oxygen. The cord is not clamped or cut until the baby has initiated breathing. This not only prevents the newborn from drowning, but allows the baby to learn to breathe gradually and gently. Though the baby is generally brought to the surface directly, it is not rushed, and the baby benefits from a gentle transition to the air, light and sound.
What Are the Benefits?
While baby benefits from going from like to like (amniotic fluid to water), the mother also benefits from immersion.
Immediately upon entering the water, many women feel a sense of relief. Though the water does not take the labour away, mothers report feeling better able to cope in the water. Sometimes the difference is not noticed until the woman tries to get out of the water- many women report being desperate to get back in. The water, when deep enough, reduces the effects of gravity, which provides the woman with a sense of weightlessness.
The water also distributes the pressure of the contractions on her body, further increasing her ability to manage her labour.
Other benefits include: lowering raised blood pressure, increased elasticity (less chance of tearing, ladies!), faster labours, and, contrary to one of the common concerns about waterbirth, there may even be the possibility of reduced chance of infection, due to the dilution of any germs or bacteria which could be present.
Why Isn’t Everyone Jumping in?
Waterbirth isn’t for everyone. It just doesn’t appeal to some. Others very much enjoy labouring in the water, but feel the need to get out for the birth. Just as with any birth option or ‘method’, it is important for each individual woman to listen to her body and what feels right for her. There are also situations that contraindicate underwater birth, and women should consult with their caregivers if any concerns arise.
Unfortunately, waterbirth is not always an available option to all who wish it. Although most midwives will gladly attend a waterbirth, there are very few hospitals in our province that will allow it. Some simply do not yet have protocols, so if you would like a waterbirth- ask! Let them know you would like it. Many hospitals around the province have started to install tubs in their birthing rooms, but even if yours doesn’t, inquire as to whether you can bring in your own.
Options to Consider
A variety of venues may be used for waterbirths. Though in other parts of the world waterbirths may take place in a warm sea, here in Canada, most waterbirths require some kind of tub or pool. Some women are happy to merely sit in water in their bath tub or a children’s paddling pool, this provides them with the comfort of water, heat and the tissue elasticity. However, for the all the benefits of deep immersion, as well as increased mobility, the water should ideally come to at least nipple height, when sitting. There are pools and tubs available for rent or sale. They vary in size, price, and features which may include firmness of walls, heaters and even jets.
Nicole Katerberg Colibaba is a mother to three waterbabies, and owner of With Child: Birthing and Parenting Services. With Child specializes in rentals and sales of waterbirth pools and accessories. She also advocates for the availability of waterbirth in a variety of settings. For more information, go to www.withchild.ca
Agnes Gereb, Hungarian Midwife imprisoned
There's a signature petition site: http://www.peticionpublica.es/?pi=P2010N3869
This is a letter from Hungarian support group:
Dear Midwifery Organistion,
I am writing on behalf of the campaign group here in Hungary supporting the release of the midwife Dr, Agnes Gereb and seeking the introduction of legislation to allow midwives perform out of hospital births legally. The implementation of this legislation would also give practical effect to the constitutional right of a Hungarian mother to choose to birth at home, a right that she is currently denied and deprived, as it is still illegal for any midwife to provide her professional service in an out of hospital situation.
One of the key observations that we must make through this letter to all professional midwife organisation is the alarming fact that despite protests from international government organisations, homebirth groups, human rights and women's rights groups, non-governmental groups, politicians, media, and civil society generally, the voice of the midwifery community internationally has been remarkably and shockingly silent. Shocking, not least because at the very basis level this is a woman giving service to women in her community and she is blatantly being abused and unjustly punished for standing up for the rights of Hungarian women. And still your organisations have been deafening in your silence. Hence, the need for this letter. My enquiries have led to two issues that may have been hampering your organisation from finding its rightful voice of protest and condemnation for the manner in which Agnes Gereb has been arrested, imprisoned and mistreated while there. The first is the "confusion " as to where the Hungarian Midwives Association (HMA) stand in all of this and the second concerns whether Agnes Gereb is or is not a midwife.
With regard to the HMA position I am attaching an English translation of a statement issued by the Presidents of the HMA on October 18th, , and while it is clear that the respective Hungarian hosptital midwife and independent midwife organisations need to work better together on areas of mutual interest and benefit, it is also clear that the HMA are very unhappy with the mistreatment of Agnes Gereb by the Hungarian Authorities. The following extract from their statement relays their serious concerns in this regard "The Association of Hungarian Midwives does not agree with the severe conditions under which Dr. Ágnes Geréb is held. It is inexplicable that as a non-dangerous criminal why she has to wear leg shackles, handcuffs and shackles around her waist. It might only serve one goal: to humiliate her and to break her in – it is not to prevent her from escape or the re-enactment of a criminal deed".
On the matter of the 2nd point, relating to Agnes Gereb's status as a midwife let me refer to the 2nd attached document, issued this month, which is from the Federation of Independent Midwives in Hungary. This is a document that covers a range of good points but specific to the question of Agnes Gereb's midwifery status let me extract the following "In addition to her general medical degree and her specialist qualifications as an obstetrician-gynaecologist and a psychologist, Ágnes Geréb is also not only qualified as a Hungarian nurse-midwife (this is the formal title of all Hungarian hospital midwives) but additionally she holds a higher educational diploma in midwifery as well. To date, the latter qualification has only been achieved by some 35 hospital nurse-midwives in all of Hungary". I have also attached a 3rd document which is relevant to this point and it is Agnes Gereb's C.V. which confirms all of her educational qualifications. So, what is clearly not in dispute is that Agnes Gereb is fully qualified to be registered and to work as a midwife in the Hungarian hospital system.
However, Agnes is not registered as a midwife as the Hungarian authorities will not allow ANY midwife (hospital or independent) to provide professional services in the home or in out of hospital circumstances. And, after 22 years of serving the needs of parents who wish to homebirth, it is hardly surprising that Agnes Gereb would be entirely unwilling to seek registration into a professional group whose very rules would demand of her not provide homebirth services. For anyone in your organisation who wishes to get fixated on the point that she is "not registered" let me additionally include the opinion our international legal experts working on the Agnes Gereb case, in the context of European Law violations, who make the following important point "Agnes Gereb has not been allowed to register as a midwife because she helps women give birth at home. This is a violation of her European law rights under the European Directive 2005/36/EC which establishes uniform qualifications for midwives across Europe. If a midwife achieves that minimum standard she must be allowed to register and practice anywhere in the EU. Agnes has achieved this standard and the fact that she wants to attend home births should not be allowed to frustrate her rights under EU law".
I hope, therefore, that the clarifications I have offered to the two obstacles which were apparently in the way of professional midwife organisations can now be thrown aside and that your organisations can find the the moral outrage and voice that your members should surely wish to raise loud and powerfully towards the Hungarian government and the relevant ministries here. To that end I am including a 4th attachment which outlines the key changes that our campaign is trying to achieve in respect of Agnes Gereb and of midwives and women in Hungary. Additionally, this attachment identifies the key political Hungarian Ministers who need to be targetted and it also provides their contact details. However, I would respectfully ask that each national organisation would also formally write to the Hungarian Ambassador in your country to insist that s/he convey the concerns of your organisation and of your members back to the Hungarian government.
Finally, in case anyone in your organisation is still unclear as to how badly Agnes Gereb has been treated since her imprisonment (now in her 37th day)(with a minimum of 56 still to go) let me cite the following:
"After the 72 hours in detention, she was taken before a closed criminal court and charged with "reckless endangerment committed in the line of duty" and remanded in custody without bail for a further 30 days. It took 28 days before Agnes was allowed to see just 2 members of her family (her mother and eldest son) for one hour (Agnes has four children). She has been subject to strip searches after visits from her lawyer, is confined to her cell 23 hours a day, has been refused access to the library and medicines, is permitted 10 minutes of phone call time weekly. When Agnes subsequently appeared before a public court, for separate criminal charges related to other birth cases, she was chained to a policeman, handcuffed and leg shackled so tightly that she had a 10cm bleeding wound on her leg. Agnes has also been denied the visitation rights of Parliamentary Deputies.
(Please also read attachment 5 for a full legal and background overview of all matters related to Agnes Gereb and to the criminalisation of midwives in their services to homebirth mothers).
I will leave the last words, perhaps appropriately, to the voices of the Federation of Independent Midwives of Hungary who call on you to "use every viable means to aid and support us in our endeavour to obtain the release of Ágnes Geréb, our fellow midwife, friend and midwifery teacher as soon as possible. Please show your support for Ágnes Geréb on your websites, in your domestic press and in the international community of midwives and lend publicity to the fact that with a track record of over 3500 healthy home births she remains and is internationally recognised as one of the most experienced midwives in the world".
Thanking you in advance for your positive response and support.
Sincerely yours
Donal Kerry
International Spokesperson
Freebirth Support Group
Email: Freebirth.hu
Website: freegereb.org
November, 13th, 2010
This is a letter from Hungarian support group:
Dear Midwifery Organistion,
I am writing on behalf of the campaign group here in Hungary supporting the release of the midwife Dr, Agnes Gereb and seeking the introduction of legislation to allow midwives perform out of hospital births legally. The implementation of this legislation would also give practical effect to the constitutional right of a Hungarian mother to choose to birth at home, a right that she is currently denied and deprived, as it is still illegal for any midwife to provide her professional service in an out of hospital situation.
One of the key observations that we must make through this letter to all professional midwife organisation is the alarming fact that despite protests from international government organisations, homebirth groups, human rights and women's rights groups, non-governmental groups, politicians, media, and civil society generally, the voice of the midwifery community internationally has been remarkably and shockingly silent. Shocking, not least because at the very basis level this is a woman giving service to women in her community and she is blatantly being abused and unjustly punished for standing up for the rights of Hungarian women. And still your organisations have been deafening in your silence. Hence, the need for this letter. My enquiries have led to two issues that may have been hampering your organisation from finding its rightful voice of protest and condemnation for the manner in which Agnes Gereb has been arrested, imprisoned and mistreated while there. The first is the "confusion " as to where the Hungarian Midwives Association (HMA) stand in all of this and the second concerns whether Agnes Gereb is or is not a midwife.
With regard to the HMA position I am attaching an English translation of a statement issued by the Presidents of the HMA on October 18th, , and while it is clear that the respective Hungarian hosptital midwife and independent midwife organisations need to work better together on areas of mutual interest and benefit, it is also clear that the HMA are very unhappy with the mistreatment of Agnes Gereb by the Hungarian Authorities. The following extract from their statement relays their serious concerns in this regard "The Association of Hungarian Midwives does not agree with the severe conditions under which Dr. Ágnes Geréb is held. It is inexplicable that as a non-dangerous criminal why she has to wear leg shackles, handcuffs and shackles around her waist. It might only serve one goal: to humiliate her and to break her in – it is not to prevent her from escape or the re-enactment of a criminal deed".
On the matter of the 2nd point, relating to Agnes Gereb's status as a midwife let me refer to the 2nd attached document, issued this month, which is from the Federation of Independent Midwives in Hungary. This is a document that covers a range of good points but specific to the question of Agnes Gereb's midwifery status let me extract the following "In addition to her general medical degree and her specialist qualifications as an obstetrician-gynaecologist and a psychologist, Ágnes Geréb is also not only qualified as a Hungarian nurse-midwife (this is the formal title of all Hungarian hospital midwives) but additionally she holds a higher educational diploma in midwifery as well. To date, the latter qualification has only been achieved by some 35 hospital nurse-midwives in all of Hungary". I have also attached a 3rd document which is relevant to this point and it is Agnes Gereb's C.V. which confirms all of her educational qualifications. So, what is clearly not in dispute is that Agnes Gereb is fully qualified to be registered and to work as a midwife in the Hungarian hospital system.
However, Agnes is not registered as a midwife as the Hungarian authorities will not allow ANY midwife (hospital or independent) to provide professional services in the home or in out of hospital circumstances. And, after 22 years of serving the needs of parents who wish to homebirth, it is hardly surprising that Agnes Gereb would be entirely unwilling to seek registration into a professional group whose very rules would demand of her not provide homebirth services. For anyone in your organisation who wishes to get fixated on the point that she is "not registered" let me additionally include the opinion our international legal experts working on the Agnes Gereb case, in the context of European Law violations, who make the following important point "Agnes Gereb has not been allowed to register as a midwife because she helps women give birth at home. This is a violation of her European law rights under the European Directive 2005/36/EC which establishes uniform qualifications for midwives across Europe. If a midwife achieves that minimum standard she must be allowed to register and practice anywhere in the EU. Agnes has achieved this standard and the fact that she wants to attend home births should not be allowed to frustrate her rights under EU law".
I hope, therefore, that the clarifications I have offered to the two obstacles which were apparently in the way of professional midwife organisations can now be thrown aside and that your organisations can find the the moral outrage and voice that your members should surely wish to raise loud and powerfully towards the Hungarian government and the relevant ministries here. To that end I am including a 4th attachment which outlines the key changes that our campaign is trying to achieve in respect of Agnes Gereb and of midwives and women in Hungary. Additionally, this attachment identifies the key political Hungarian Ministers who need to be targetted and it also provides their contact details. However, I would respectfully ask that each national organisation would also formally write to the Hungarian Ambassador in your country to insist that s/he convey the concerns of your organisation and of your members back to the Hungarian government.
Finally, in case anyone in your organisation is still unclear as to how badly Agnes Gereb has been treated since her imprisonment (now in her 37th day)(with a minimum of 56 still to go) let me cite the following:
"After the 72 hours in detention, she was taken before a closed criminal court and charged with "reckless endangerment committed in the line of duty" and remanded in custody without bail for a further 30 days. It took 28 days before Agnes was allowed to see just 2 members of her family (her mother and eldest son) for one hour (Agnes has four children). She has been subject to strip searches after visits from her lawyer, is confined to her cell 23 hours a day, has been refused access to the library and medicines, is permitted 10 minutes of phone call time weekly. When Agnes subsequently appeared before a public court, for separate criminal charges related to other birth cases, she was chained to a policeman, handcuffed and leg shackled so tightly that she had a 10cm bleeding wound on her leg. Agnes has also been denied the visitation rights of Parliamentary Deputies.
(Please also read attachment 5 for a full legal and background overview of all matters related to Agnes Gereb and to the criminalisation of midwives in their services to homebirth mothers).
I will leave the last words, perhaps appropriately, to the voices of the Federation of Independent Midwives of Hungary who call on you to "use every viable means to aid and support us in our endeavour to obtain the release of Ágnes Geréb, our fellow midwife, friend and midwifery teacher as soon as possible. Please show your support for Ágnes Geréb on your websites, in your domestic press and in the international community of midwives and lend publicity to the fact that with a track record of over 3500 healthy home births she remains and is internationally recognised as one of the most experienced midwives in the world".
Thanking you in advance for your positive response and support.
Sincerely yours
Donal Kerry
International Spokesperson
Freebirth Support Group
Email: Freebirth.hu
Website: freegereb.org
November, 13th, 2010
~Birth...In the Hands of the Woman~
~Birth....in the hands of the woman~
written by
Cindy Hansen
After two weeks of feeling like labor was beginning, this lovely, intelligent client of mine, came down from her mountain top home to have her baby with her husband, midwife and doula.
It was without a doubt one of the top most gentle births I have ever had the privilege....and I mean privilege, of being raptured into witnessing.
With lights low, door closed, mom's music sofly playing and dad humming along beside mom, we quietly chatted about baby , the meaning of the songs she chose and "wouldn't it be lovely if baby were to come now to this song" These peacful moments were just after water had broken and for the next 30 minutes mom reclines quiescent on the bed in a halo of peaceful pleasure....the room felt enveloped into it's own little bubble with calm serenity eminating from this beautiful laboring woman.
In the world of birth we hear about this time between where a woman is fully dilated and ready to push and the actual delivery of her baby....a time where it is quiet....where everything seems to rest before the stunning appearance of this new life coming to "be" in our presence.
It is called passive decent or laboring down the baby .No pushing at this point no urgency to "get baby out" just relaxed trust in the ability of this woman's body and baby to do what it needs to do.
Small pushes ,feeling things out, she starts to allow her body's need to become more active in deliverying her baby....I suggest she moves onto her knees and up over the back of the raised bed....with pillows for her head she rests ....then her face takes on a dreamy look and her eyes unfocus as she pushes gently into her urge......"now" she says" now he is coming....." The midwife looks to see what is happening and tells her to reach down and feel her baby's head....she does and is amazed at what she feels....more stronger urges move her to push lower, harder into her vagina and as the head slowly is born her midwife encourages her to reach down and hold her baby as he is born....with a few more natural intense pushes, she brings her baby up between her legs and sits back cradling her newest son in her arms, over come with euphoria at delivering her own baby....dad's face and eyes shine with pride at watching his wife so competently bring their son into this life...so completely in love with her and their baby.
All the while the midwife and I smile and watch and marvel at this most natural and amazing event. Within 9 minutes of being born this baby,un-handled by anyone else but mom, latched himself to her breast and began nursing on his own.
This, is what birth is. This ,is what birth should look like for most women. Uninterrupeted, no interventions, inductions or constant monitoring....this is what birth is....pure and natural....the very way God designed it to be.
You are thinking this must have been a home birth....in fact it was in a hosptial.....yes that is right....in a hosptial!
It isn't so much where you are as it is the choices you make in how it is done and what you allow to be "done" to you....choose your care givers with knowledge and wisdom......understand their philosophy and that it matches your own desires and needs.
Trust your instincts...give in to your "gut feelings" and know it can be done.......naturally, peacefully, lovingly...the way it was meant to be xox
Written by Cindy Hansen
based on her experiences as a Birth Doula
Birth/Postpartum Doula
You might also like:
http://firstbreathdoulaservices.blogspot.com/2010/10/birthin-hands-of-woman.html
written by
Cindy Hansen
After two weeks of feeling like labor was beginning, this lovely, intelligent client of mine, came down from her mountain top home to have her baby with her husband, midwife and doula.
It was without a doubt one of the top most gentle births I have ever had the privilege....and I mean privilege, of being raptured into witnessing.
With lights low, door closed, mom's music sofly playing and dad humming along beside mom, we quietly chatted about baby , the meaning of the songs she chose and "wouldn't it be lovely if baby were to come now to this song" These peacful moments were just after water had broken and for the next 30 minutes mom reclines quiescent on the bed in a halo of peaceful pleasure....the room felt enveloped into it's own little bubble with calm serenity eminating from this beautiful laboring woman.
In the world of birth we hear about this time between where a woman is fully dilated and ready to push and the actual delivery of her baby....a time where it is quiet....where everything seems to rest before the stunning appearance of this new life coming to "be" in our presence.
It is called passive decent or laboring down the baby .No pushing at this point no urgency to "get baby out" just relaxed trust in the ability of this woman's body and baby to do what it needs to do.
Small pushes ,feeling things out, she starts to allow her body's need to become more active in deliverying her baby....I suggest she moves onto her knees and up over the back of the raised bed....with pillows for her head she rests ....then her face takes on a dreamy look and her eyes unfocus as she pushes gently into her urge......"now" she says" now he is coming....." The midwife looks to see what is happening and tells her to reach down and feel her baby's head....she does and is amazed at what she feels....more stronger urges move her to push lower, harder into her vagina and as the head slowly is born her midwife encourages her to reach down and hold her baby as he is born....with a few more natural intense pushes, she brings her baby up between her legs and sits back cradling her newest son in her arms, over come with euphoria at delivering her own baby....dad's face and eyes shine with pride at watching his wife so competently bring their son into this life...so completely in love with her and their baby.
All the while the midwife and I smile and watch and marvel at this most natural and amazing event. Within 9 minutes of being born this baby,un-handled by anyone else but mom, latched himself to her breast and began nursing on his own.
This, is what birth is. This ,is what birth should look like for most women. Uninterrupeted, no interventions, inductions or constant monitoring....this is what birth is....pure and natural....the very way God designed it to be.
You are thinking this must have been a home birth....in fact it was in a hosptial.....yes that is right....in a hosptial!
It isn't so much where you are as it is the choices you make in how it is done and what you allow to be "done" to you....choose your care givers with knowledge and wisdom......understand their philosophy and that it matches your own desires and needs.
Trust your instincts...give in to your "gut feelings" and know it can be done.......naturally, peacefully, lovingly...the way it was meant to be xox
Written by Cindy Hansen
based on her experiences as a Birth Doula
Birth/Postpartum Doula
You might also like:
http://firstbreathdoulaservices.blogspot.com/2010/10/birthin-hands-of-woman.html
The Lie of the EDD
Why Your Due Date Isn’t when You Think
By Misha Safranski
We have it ingrained in our heads throughout our entire adult lives-pregnancy is 40 weeks. The “due date” we are given at that first prenatal visit is based upon that 40 weeks, and we look forward to it with great anticipation. When we are still pregnant after that magical date, we call ourselves “overdue” and the days seem to drag on like years. The problem with this belief about the 40 week EDD is that it is not based in fact. It is one of many pregnancy and childbirth myths which has wormed its way into the standard of practice over the years-something that is still believed because “that’s the way it’s always been done”.
The folly of Naegele’s Rule
The 40 week due date is based upon Naegele’s Rule. This theory was originated by Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele and since has become the accepted norm for calculating the due date. There is one glaring flaw in Naegele’s rule. Strictly speaking, a lunar (or synodic – from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we’ve been lead to believe is average. In fact, if left alone, 50-80% of mothers will gestate beyond 40 weeks.
Variants in cycle length
Aside from the gross miscalculation of the lunar due date, there is another common problem associated with formulating a woman’s EDD: most methods of calculating gestational length are based upon a 28 day cycle. Not all women have a 28 day cycle; some are longer, some are shorter, and even those with a 28 day cycle do not always ovulate right on day 14. If a woman has a cycle which is significantly longer than 28 days and the baby is forced out too soon because her due date is calculated according to her LMP (last menstrual period), this can result in a premature baby with potential health problems at birth.
The inaccuracy of ultrasound
First trimester: 7 days
14 – 20 weeks: 10 days
21 – 30 weeks: 14 days
31 – 42 weeks: 21 days
Calculating an accurate EDD
Recent research offers a more accurate method of approximating gestational length. In 1990 Mittendorf et Al. undertook a study to calculate the average length of uncomplicated human pregnancy. They found that for first time mothers (nulliparas) pregnancy lasted an average of 288 days (41 weeks 1 day). For multiparas, mothers who had previously given birth, the average gestational length was 283 days or 40 weeks 3 days. To easily calculate this EDD formula, a nullipara would take the LMP, subtract 3 months, then add 15 days. Multiparas start with LMP, subtract 3 months and add 10 days. The best way to determine an accurate due date, no matter which method you use, is to chart your cycles so that you know what day you ovulate. There are online programs available for this purpose (refer to links in resources section). Complete classes on tracking your cycle are also available through the Couple to Couple League.
ACOG and postdates
One of the most vital pieces of information to know when you are expecting is that ACOG itself (American College of Obstetricians and Gynecologists) does not recommend interfering with a normal pregnancy before 42 completed weeks. This is why knowing your true conception date and EDD is very important; if you come under pressure from a care provider to deliver at a certain point, you can be armed with ACOG’s official recommendations as well as your own exact due date. This can help you and your baby avoid much unnecessary trauma throughout the labor and delivery. Remember, babies can’t read calendars; they come on their own time and almost always without complication when left alone to be born when they are truly ready.
Sources:
Mittendorf, R. et al., “The length of uncomplicated human gestation,” OB/GYN, Vol. 75, No., 6 June, 1990, pp. 907-932.
By Misha Safranski
We have it ingrained in our heads throughout our entire adult lives-pregnancy is 40 weeks. The “due date” we are given at that first prenatal visit is based upon that 40 weeks, and we look forward to it with great anticipation. When we are still pregnant after that magical date, we call ourselves “overdue” and the days seem to drag on like years. The problem with this belief about the 40 week EDD is that it is not based in fact. It is one of many pregnancy and childbirth myths which has wormed its way into the standard of practice over the years-something that is still believed because “that’s the way it’s always been done”.
The folly of Naegele’s Rule
The 40 week due date is based upon Naegele’s Rule. This theory was originated by Harmanni Boerhaave, a botanist who in 1744 came up with a method of calculating the EDD based upon evidence in the Bible that human gestation lasts approximately 10 lunar months. The formula was publicized around 1812 by German obstetrician Franz Naegele and since has become the accepted norm for calculating the due date. There is one glaring flaw in Naegele’s rule. Strictly speaking, a lunar (or synodic – from new moon to new moon) month is actually 29.53 days, which makes 10 lunar months roughly 295 days, a full 15 days longer than the 280 days gestation we’ve been lead to believe is average. In fact, if left alone, 50-80% of mothers will gestate beyond 40 weeks.
Variants in cycle length
Aside from the gross miscalculation of the lunar due date, there is another common problem associated with formulating a woman’s EDD: most methods of calculating gestational length are based upon a 28 day cycle. Not all women have a 28 day cycle; some are longer, some are shorter, and even those with a 28 day cycle do not always ovulate right on day 14. If a woman has a cycle which is significantly longer than 28 days and the baby is forced out too soon because her due date is calculated according to her LMP (last menstrual period), this can result in a premature baby with potential health problems at birth.
The inaccuracy of ultrasound
First trimester: 7 days
14 – 20 weeks: 10 days
21 – 30 weeks: 14 days
31 – 42 weeks: 21 days
Calculating an accurate EDD
Recent research offers a more accurate method of approximating gestational length. In 1990 Mittendorf et Al. undertook a study to calculate the average length of uncomplicated human pregnancy. They found that for first time mothers (nulliparas) pregnancy lasted an average of 288 days (41 weeks 1 day). For multiparas, mothers who had previously given birth, the average gestational length was 283 days or 40 weeks 3 days. To easily calculate this EDD formula, a nullipara would take the LMP, subtract 3 months, then add 15 days. Multiparas start with LMP, subtract 3 months and add 10 days. The best way to determine an accurate due date, no matter which method you use, is to chart your cycles so that you know what day you ovulate. There are online programs available for this purpose (refer to links in resources section). Complete classes on tracking your cycle are also available through the Couple to Couple League.
ACOG and postdates
One of the most vital pieces of information to know when you are expecting is that ACOG itself (American College of Obstetricians and Gynecologists) does not recommend interfering with a normal pregnancy before 42 completed weeks. This is why knowing your true conception date and EDD is very important; if you come under pressure from a care provider to deliver at a certain point, you can be armed with ACOG’s official recommendations as well as your own exact due date. This can help you and your baby avoid much unnecessary trauma throughout the labor and delivery. Remember, babies can’t read calendars; they come on their own time and almost always without complication when left alone to be born when they are truly ready.
Sources:
Mittendorf, R. et al., “The length of uncomplicated human gestation,” OB/GYN, Vol. 75, No., 6 June, 1990, pp. 907-932.
June Birth Network Meeting
Our June meeting will be on Monday, June 21st at 7:30pm. Our guest speaker this month will be Erin Price of Mission Midwifery. She has graciously offered to host our gathering for a meet and greet at her new clinic in Mission. The address is 7442 Grand St. 604-820-2424. Considering the fact that Erin is a midwife on call and birth can happen at any moment, we have chosen a backup date of Wednesday, June 23rd if need be. Please check your email before leaving for the meeting to ensure it's still on. Erin welcomes you to bring your business cards and contact information to display in her office. A great opportunity for networking and advertising!
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