Pregnancy FAQs

written & illustrated by
Midwife Bekah

-Do you work alone or in a team during labor?

-Do you recommend hiring a doula?

-How much time do you schedule for each prenatal appointment?

-What requirements do you have when accepting a client under your care?

-Do you practice delayed cord clamping?

-Under what circumstances would my care be transferred to an OB (if interviewing a midwife)?

-Do you have limits regarding how many people attend the birth?

-What is your hospital transfer rate (if interviewing a midwife)?

-What is your C-Section rate?

-What is your episiotomy rate?

-If I transfer during labor, will you do my postpartum care?

-What medications do you carry for emergencies?

-What is the total cost of care and what is included?

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Contrary to what's often shown on TV, your water breaking is not very often the first sign of labor. Does that happen sometimes. Absolutely. But more often than not, your water will break once you are already in labor.

If you water breaks - whether before or during labor - there are some things you should know to look for:

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-What color is it? The fluid should look clear. Describing the color and consistency to your midwife is helpful for her to get an idea of your baby's wellbeing.

-How much? Sometimes there may be a trickle, and sometimes it's a gush all at once! Take note of how much fluid comes out. When you first notice it, wear a pad so you can keep track of the amount and the color. Sometimes what seems like your water breaking may actually be urine. During pregnancy, not only does the weight of the baby put pressure on your bladder, your progesterone levels also increase which loosen parts of the pelvis that would normally hold in urine. This is a distinction your midwife will be able to help you with, if needed.

-Call your midwife! Whether or not you are already having contractions, you should let your midwife know if you think your water broke.  They will ask you some questions and move forward based on your conversation.

-Pay attention to baby's movement. That is the number one way for you to assess your baby's wellbeing while they are inside you. You should feel at least 10 movements within 1 hour. 

-Hydrate! If your water broke, it is even more important to stay hydrated to replenish fluids. Keep a glass of water or coconut water in hand and try to hit 80-100oz of water in a day.

-Check your temperature every hour. Once the bag of water breaks, that barrier between inside and outside has gone and leaves you at a higher risk of infection. While preparing your body for birth, it's important to make sure you don't develop a fever.

When you are in labor, your midwife may offer to do a vaginal exam. What can you find out from a vaginal exam?

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-Dilation: How far open the cervix is. The cervix is the bottom of the uterus which opens during labor to allow the baby to pass through

-Effacement: Not only does your cervix open during labor, it also thins. The top of the uterus pulls up during contractions to allow opening and thinning to occur in the lower portion

-Station: How low your baby's head is in your pelvis. Using landmarks in your pelvis, your midwife is able to tell how far down the baby has come

-Your midwife is also usually able to tell from this if your water has broken or is still intact

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As will everything performed by any medical professional, you have the right to decline or consent to a vaginal exam. Labor can progress slowly or very quickly, and while a vaginal exam provides helpful information for that moment, it cannot determine how things will progress.

20-30% of births involve a nuchal cord, or, cord wrapped around the baby's neck.

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While living in your uterus, babies receive all nutrients, blood, and oxygen through the umbilical cord. The cord is attached on one end at the baby's bellybutton, and on the other end to the placenta which is implanted on the inner wall of the uterus.

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The umbilical cord is made up of 3 blood vessels wrapped in a thick layer of Wharton's Jelly. Wharton's Jelly is a squishy substance which serves to protect and insulate the vessels within. Its flexible, cushioning properties allow the umbilical cord to undergo a degree of compression and friction without damage or hindering blood flow.

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Your midwife will listen to your baby's heartbeat pattern and is trained to pick up signs of irregularity which present if the cord wrap is causing a problem.

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If the cord is wrapped around the baby's neck and/or body at the time of birth, your midwife will carefully unwrap it as they are born before brining them up to your chest. By this time, your baby is transitioning to breathing with their lungs instead of receiving oxygen solely through the cord.

Most mothers start feeling their baby move between 16 and 20 weeks of pregnancy. The feeling starts as subtle butterfly flutters and eventually becomes very noticeable rolling or kicking movements.

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In your third trimester, you may start doing what is called "kick counts". The best way for you to check on your baby's wellbeing is to monitor their movement. According to ACOG (American Congress of Obstetricians & Gynecologists), you should feel at least 10 movements within 1 hour. This is a general rule of thumb, and babies - just like all living things - will have sleeping periods where you won't feel as much movement. There will also be plenty of times when your baby will make far more than 10 movements in 1 hour!

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If you are having trouble feeling for those 10 movements, try reclining in a quiet place and eat something cold and/or sweet. That will usually help wake up baby! If you've tried this in your third trimester and are still not feeling much or any movement, contact your midwife.

During your prenatal visits, your midwife will be feeling for the position of your baby. As you draw close to being "in dates", or 37-42 weeks, it is ideal for your baby to be head-down. If your baby is bottom-down instead, there are ways to help encourage them to turn before birth! Some ideas include:

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-Somersaults in the swimming pool

-Holding positions where your hips are higher than your chest for 15-20 minutes a few times a day. You can do this by laying with your back or side on a flat surface and put a few pillows under your hips. You could also kneel and bring your chest as close to the floor as you can.

-Having your partner speak to the baby from down low where the head should be

-Seeing an experienced prenatal body worker

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Most of the time, these will work to switch your baby into a head-down position. In the state of California, out-of-hospital midwives are not permitted to assist a breech birth, but they are trained to manage in the case of a surprise breech!

-Your body produces more fluids during pregnancy.

-The hormone hCG increases blood flow to your kidneys, causing them to work more efficiently. This allows the body to eliminate waste more quickly.

-Progesterone softens parts of the pelvis that normally work to hold in urine.

-As the baby grows, they place more and more pressure on the bladder.

-Reduced space makes it so that you cannot always fully empty your bladder.

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Tip: If you experience pain while urinating alongside that frequency, contact your midwife as this may indicate a UTI. Your midwife can offer helpful suggestions to hopefully eliminate this issue.

-Contains proteins, electrolytes, immunoglobulins, and vitamins from mom.

-Baby swallows in and eliminates amniotic fluid starting around 13 weeks, at the end of your first trimester.

-Largely made up of fetal urine and lung secretions.

-Moderates temperature for baby.

-Has antibacterial properties and creates a protective measure against infection for baby.

-Acts as a cushion to help prevent injury to baby or compression to the cord.

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*Disclaimer: your baby does not breathe through a snorkel during pregnancy!

I would like to begin by clarifying that both in and out of hospital, the term "EDD" or ESTIMATED due date is used to label the end date calculated at the beginning of pregnancy.

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-Only 5% of babies are born on their due date.

-On average, first time moms will naturally give birth at 41 weeks and 1 day.

-You are considered "term" or "in dates" from 37-42 weeks, which gives you a 5 week window for giving birth outside a hospital.

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What if I go past my due date?

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Your midwife will recommend a variety of options to hopefully get labor going if your body and baby are ready. Out-of-hospital midwives do not use Pitocin to induce labor, but we use natural methods that can work with your body's systems to encourage labor. If these methods are unsuccessful by 41 weeks and 6 days (which is uncommon), in the state of California your midwife is required to refer you to an OB for care.

The general rule is: no more than 200mg of caffeine per day during pregnancy. This is the equivalent of about 1.5 cups of coffee.

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Studies have shown that women who exceed this amount may have babies who are small for their gestational age. This is believed to be due to caffeine constricting blood vessels which supply blood and nutrients to the baby. Smaller birth size has been seen to put the child at a higher risk of obesity, diabetes, and heart disease later on in life.

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That said, enjoying a cup of coffee once a day is not shown to harm your baby. Go have yourself a cup of joe!