Q&A with a Midwife

Today we have the ever-effervescent Ailsa on deck for a guest blog post! Ailsa and I have been Instagram friends until we met in person just before COVID hit. She’s incredibly supportive, loving, positive, and all-around wonderful, and if you don’t already follow her @_happygocurly_ I highly recommend you do now!

In addition to running her fashion/lifestyle Instagram page, she’s a Certified Nurse Midwife and helped answer a ton of questions for me at the end of my pregnancy. I asked her to share a little Q&A with her most frequently asked questions as a midwife. Ailsa, take it away!

Also just looking at this photo makes my body hurt 🙂

Hi guys! I am not sure where to start, since this is the first blog post I’ve ever written. I don’t have my own blog, and yet I do so much teaching on my page @_happygocurly_ and totally should. I am a Certified Nurse Midwife, military spouse, mother of twins, and a woman who still struggles to find her place in life… and on Instagram.

I’m here today on Lemon Stripes to share some of the most commonly asked questions I receive as a midwife and hope to “pull the curtain back” a bit on everything from pregnancy to labor to postpartum concerns.

How much weight should I gain? It depends on where you started the pregnancy and what your nutrition is like.

Start a journal or get a cute notebook. You will undoubtedly have a lot of questions and in the first and second trimester will not be going to appointments as frequently. I love when patients come ready with their questions, so that I can customize their care. We, as providers, don’t know what you know or what your concerns are- this allows us the opportunity to delve a little bit more.

Do I really need to eat for two? There is no such thing! I find this to be extremely cultural and have to explain that you don’t have to increase your caloric intake by more than 300 kcal daily.

When will my cervix be checked? So, I am a very hands-off sort of practitioner, especially if you’re not in labor. Typically, when a woman is 35-36 weeks you will have a GBS swab and you can ask your provider if they can check you. This is provider preference and if you’re not having contractions there really is no indication to do so. But most will check since they are already down there.

Belly or Vaginal Birth? Both work and will give you a baby. I know we get so caught up with the glory or the achievement of it all. The no epidural or the vaginal delivery. It isn’t about shaming or bashing any mode. I have to remind my patients none of us have any control over what happens. I like to ensure that you are kept abreast of everything we are doing in the labor and delivery setting and are comfortable with any and all interventions. It is essential that you remember that we are the professionals, but this is your body. You can consent or decline once medical guidance has been given. You can also take your time to make any and all decisions.

What are the most common pregnancy pains?

Ligament pain: You may experience this end of first trimester and again at the end of the second. It is a lower abdominal pain that may frightening but it isn’t cause for alarm. The ligaments that support the uterus start to soften and stretch. Always be aware if you are leaking fluid, any vaginal bleeding, or something doesn’t feel right. And even if your provider tells you everything is fine, you should feel great about honoring your gut.

Nausea: This is the one of the first introductions to pregnancy that isn’t fun. Please be sure if you are having a hard time keeping anything down to speak to your provider. We can make suggestions, but also want to be sure that your lab work doesn’t indicate another issue. So, don’t endure this symptom for very long.

Fatigue: We typically see this in the first and third trimester. Your provider will check your complete blood count at your initial visit and also check your iron levels at 28 weeks with your glucose test. We see fatigue develop in the third trimester as your blood volume doubles and iron stores are less. So, keep taking your prenatal vitamins, ladies, and you may need to supplement with an iron rich diet as well as an iron pill. It is very common to develop anemia at this time. There are no quick ways to increase your iron levels, so be sure you are eating a balanced diet during your pregnancy.

How much water do I need to drink when pregnant? So many pregnant mommas are so bad about hydrating. I tell them to get a fun water bottle and plan out their water intake for the day. It is essential to drink 8-10 glasses of water. You can get an indication of your hydration status by looking at your urine. If your urine is dark amber, you are way behind. The goal is for light yellow urine. This will also help to decrease any unnecessary uterine irritability and discomfort. Entering your second trimester your uterus is much more sensitive to dehydration. You don’t want to have preterm contractions.

What happens at every midwife/OB visit? Every appointment you will be weighed, and your urine will be sampled. Please don’t pee prior to your appointment or if you’re waiting be sure you give a sample. At every visit we will be assessing your urine for sugar and protein. We will also note if you are dehydrated and not eating if you start to spill ketones. So, drink up, ladies. After 10 weeks we can hear your baby’s heart tones. This is so exciting and definitely something to look forward to at your visit.

What are your thoughts on breast or bottle fed? It all depends on what works for you. I know many have visions of breastfeeding and it simply doesn’t work out and that is okay too. I am here to provide support and guidance. Some would love to breast and cannot. I always want to be sure mommas are able to express their desire and then guide them for all possibilities.

Epidural or natural labor? Either works and is totally up to the mom. Most patients think that because I am a CNM I will want her to have an au natural birth, that isn’t the case. I am here to guide and usher mommas through labor to make decisions that are best for her.

What is Group beta strep? A lot of mommas want to know what to do to avoid getting it. This is a normal bacteria that lives in your perineal area (Group beta strep) at 36 weeks we will do a vaginal and rectal swab to check for colonization. If your test comes back positive there is nothing to be concerned about, it isn’t an STD nor is something that will negatively label you. We just want to ensure we give you antibiotics to reduce the bacteria for when the baby is born.

What will induce labor? Nothing. I know we have heard so many home remedies and tricks to inducing labor. Go ahead and humor yourself, but in my 15 years as a CNM I have yet to find that one thing that works. You need to accept this time and rest. I often tell my patients that rest, catching up on shows, and spending time with your SO is the best thing you can do to prepare for labor.

What should I bring to the hospital? I would tell you as minimal as possible. If you insist, pack one bag with extraneous items and leave them in the car. You don’t need to bring your stroller and all infant items upstairs. I assure you the labor room can feel very crowded and it is a lot to then transfer to your postpartum room ( if you go to a different room after delivery). I will say old pairs of underwear, shower shoes, a robe, and specific pads are the most basic items you will need in addition to your toiletry bag.

When should I have visitors at the hospital? Whenever you are ready. I think we forget how labor intensive ( pardon the pun, ha ha ) company can be soon after bringing baby home. I always tell mommas to honor themselves. It is okay to take people’s offer for food or house cleaning and it doesn’t have to include a visit. I often worry about a momma’s sleep deprivation coupled with the physical changes during the postpartum period. We, as a society, need to allow the time to heal and adapt and not place more burden on mommas.

Episiotomy or natural tear? Definitely talk to your provider and listen to their view on this topic. You don’t want to get caught and not have any idea on their view.

There is so much to pregnancy and delivery that needs to be discussed. I highly encourage you to get a journal and jot your questions down. We, as providers, are here to guide you and help usher your baby into the world as safely as possible. I hope I have given a brief overview if you are TTC or currently pregnant. You can always find me @_happygocurly_ or send me an email happygocurlyae @gmail.com

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  1. Katie said:

    I am 37 weeks pregnant with my third but still found this so helpful! I also follow Ailsa on Instagram and love how even if she is having a bad day, she just radiates sunshine and you leave her feed feeling happy. She is the best!

    7.22.21 · Reply