Baby Special Section: Prenatal healthcare includes both body and mind

A woman’s whole world gets flipped upside down when she finds she is pregnant. Aside from the obvious physiological changes in her body, she also faces mood change following a swing in hormones, plus new stresses and concerns about what is to come.
Even with a strong partner and other support systems, women can often feel alone in the process and uneasy about how to cope.
According to Tapestry Midwifery’s co-founder and Certified Nurse Midwife (CNM) Martha Redpath, that is all quite normal. The experiences are all new and that means in a lot of cases they are scary, Redpath says.
“One important goal during pregnancy is to take away the fear. It is important to communicate that the process is both unique and incredibly universal. If you can learn to trust it, it is incredibly powerful.”
Redpath, who helped to open Tapestry Midwifery (a division of Porter hospital) in 2007, says that finding a health practice that is natural and comfortable for the patient is an important early step in guiding a new mother through pregnancy.
It can be challenging to find a practice that feels encouraging and supportive, she says, but establishing a relationship of trust with the practitioner is something that can make a huge difference in a woman’s sense of calmness and respect for her pregnancy.
“I say if you don’t feel encouraged, supported, happy and confident, you should listen to that and keep looking,” said Redpath.
As a midwifery clinic, Tapestry is focused on low-intervention care that works with the psycho-social components of pregnancy along with the physiological.
Pregnancy can be a highly motivating time for women, Redpath explains, and helping to channel that energy and encourage women to make healthy life changes — not just for pregnancy — is part of what a good practitioner can do.
“In this practice we work on creating a safe space where patients can expose their truths and be accepted.”
Questions are common and natural throughout the process, even for women who have given birth before, she says. As a standard of care at Tapestry, the shortest visit is 30 minutes, which helps to build in time for the inevitable questions.
The American Congress of Obstetricians and Gynecologists (ACOG) has a current standard of prenatal care, which includes visits every four weeks through the first 28 weeks of pregnancy, every two weeks through week 36 and weekly for the rest of the term.
“A lot of what we do throughout those visits is education,” Redpath says. “Women tend to naturally be hungry for reinforcement and knowledge. Most tend to appreciate the frequency of care.”
While the primary focus of prenatal education is on physical health and helping women identify warning signs or milestones along the way, it is also an important time to pay attention to general lifestyle habits such as diet, exercise and stress.
Certain foods (especially those high in fats and heavy sauces) increase the risk of nausea, for example, whereas other foods can help specifically replace nutrients lost or those that are easily depleted in pregnancy. There are some foods, herbs and tinctures that doctors recommend eliminating throughout pregnancy, such as lunch meat, sprouts, unpasteurized dairy and some fish.
Weight gain is natural and important during pregnancy, but many women do not know how much and when they should be gaining weight. It is easy to overestimate, which makes it much harder to lose that weight once the baby is born.
Many women know that they are more susceptible to disease during pregnancy. Certain bacteria, such as listeria, that normally may not make a person ill can be dangerous for pregnant women as well as their unborn baby due to hormonal changes that affect the mother’s immune system.
However, to avoid undue stress or panic, it is important to review each patient’s specific risk factors and outline how to avoid contact at the beginning of pregnancy.
Questions also arise around what medicines or drugs are safe during pregnancy. Some drugs are listed on the “X” list, such as hormonal medications as well as alcohol and illegal drugs such as cocaine. Others are listed on cautionary lists with recommendations for doses if or when they are required. Still others are listed as fine to continue with throughout the pregnancy.
Nicotine and other addictive drugs are explained as detrimental to a baby’s health as well as the mother’s, and the practice provides tips and resources for quitting.
Redpath says that with the Internet many patients have easier access to information, but can also become unnecessarily alarmed by something that is actually quite normal.
That’s another reason why is it important for each mother-to-be to have resources at hand so that she can answer quickly whether something new she is experiencing is normal.
“Most women are put at ease if they can look on the list of common discomforts and find their problem,” she says. “What they want more than a cure for that discomfort is an affirmation that nothing is going wrong with them or their baby.”
In the end, giving birth is a miracle that has been repeating itself over and over and over, Redpath says, and most women just need to find their way of accepting that truth.
More than any special technique or trick, the silver bullet is building a mind-body acceptance and trust in the natural process and refining the mind and body to a relaxed and organic state.
“There is a practice called hypno-birthing,” Redpath says, “which is getting as close as you might come to a ‘magic trick’.”  
But in the end, whether trained through hypno-birthing or other relaxation and visualization tactics, Redpath says, the key to a relaxed and comfortable pregnancy and labor is to learn how to be relaxed and comfortable.

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