I have never been pregnant (for this long) before. But I have spent months preparing for the big event before. So, I am choosing to treat labour and birth as an endurance event. Think training, race strategies, and, of course, support crew.
I may not know exactly what to expect (just like any new race, really), but I do know that a great support crew can make or break your race.
Here’s my round-up of peeps.
MEDICAL CARE This is often the default circle of care for pregnant women. You get pregnant, you schedule a prenatal appointment, you get a bunch of forms, and a referral for your first ultrasound. At some point, you (hopefully) go into labour and end up at a hospital to deliver (only about 10% of moms in Canada choose to give birth at home). The most typical path for care is from family doctor to OB/GYN, although some choose a midwife.
Family Doctor I finally (finally!) have a family doctor I really like. He listens, and asks follow-up questions. I do not feel rushed in this office. That's a big deal! My prenatal care started in his office with routine blood work, and ultrasound referrals. This tends to be a pretty typical path for care for most pregnant women. Later in the pregnancy, you can opt for either an OB/GYN or a midwife. I ended up going through both.
OB/GYN After my family doctor got some abnormal test results (which turned out to be nothing to worry about), he referred me to an OB/GYN early, so I kind of skipped out on choosing between OB/GYN and a midwife. Boo. But, my OB/GYN was awesome, and I liked her. Although her office was super busy, and the visits were rushed. After performing the routine checks, it was not unusual for her to stand up, and hold on to the door handle, as I hurried up to look up the few questions I had for her in my notebook. And... few months in, I learned that she was also pregnant, and going to give birth few weeks before me. I'd need another OB/GYN. This presented a perfect opportunity to switch care to a midwife!
Midwife Lucky me - a local midwifery clinic was able to take me on as a client very late into the pregnancy. I would not get a chance to develop as close of a relationships with the midwives (they work in teams of three), as is the case typically, but I was happy, nevertheless, as midwife care was what I had in mind all along. While gynecologists provide care to pregnant women, they also oversee a wide variety of conditions, related to reproductive system. For a healthy pregnancy, seeing a specialist seemed like an overkill. Midwives do pregnant women, and uncomplicated births. Besides, midwives provide care to women AND newborns, while OB/GYNs would only see women after birth, and you'd have to take your infant to see a family doctor or a pediatrician for postnatal care. I wanted less appointments, not more. And, I'd have an opportunity to use the brand spanking new midwifery unit at the hospital - the first of its kind in the country. And did I mention that midwives come visit you at home after birth? Yes, please. Shut up and take my money (or, in this case, my taxpayer's contribution).
BODY MAGIC Whether it's a massage therapist, or a chiropractor, many of my previously pregnant friends report seeing at least one of these magical people during their pregnancy - especially, in the last few months, when the body working extra hard on the finishing touches, making that BABY.
Strength Coach Few months into my pregnancy, managing both my changing body, and my changing capacity for certain exercises, as well as an ongoing shoulder injury became too much, so I decided what any coach would do - get a coach. :) It made a huge difference both in how my shoulder feels and how I feel overall. Six months ago, I could not take off my own sports bra without pain. This week, I was able to do some (very light) strict press and overhead work pain free. Perhaps, the biggest impact though was the increased consistency of workouts, due to increased accountability. My coach would program a month worth of workouts, then we would meet in person to go over the movements, and adjust as necessary, and then I would check in over email once a week, reporting on how specific workouts feel, and continuing to adjust. As a result, I have been able to work out four to six days a week throughout this pregnancy. Ok, "work out" is a big word here, especially lately, but... I am at the gym, doing stuff. I'll take it!
Acupuncturist I have started getting acupuncture few months after my miscarriage, as we were trying to conceive (again). Fertility treatments were a possibility that we'd be willing to explore down the road, but until then, acupuncture seemed to be a less invasive first step. I loved my experience (she also has background in massage), and continued getting treatments throughout pregnancy. Acupuncture is also sometimes used to bring on labour. Hey, whatever will help me avoid castor oil.
Pelvic Floor Physiotherapist When I started experiencing pelvic pain around midpoint of my pregnancy (my thinking here was: Are you freaking kidding me? It hurts to walk NOW, and I still have twenty weeks to go?!), a friend recommended a pelvic physio, and I made an appointment. Working with female clients for the last five years, I have been lucky to know about this profession beforehand. Yet, I still did not know what to expect from the appointment itself. Spoiler: pelvic floor physiotherapy usually includes internal examination. Think, a gynecological exam, but more involved, and without those awful plastic (and sometimes metal) speculum. The physiotherapist can assess the tone of your pelvic floor, and show you how to do the breathing exercises, including Kegels properly. (Clench as hard as you can, while holding your breath, is not it.) She has also been helping me adjust and modify any exercises in my strength program which were not ideal - e.g. causing coning in the stomach, and thus, possibly aggravating diastasis recti. Italian attended one of the appointments with me too, where she demonstrated some ways he can be helpful during labour - different positions, etc., WHILE working around my shoulder injury. And, if you have never done squats, WHILE someone has their hand inside you... let me tell you, that's a novel experience.
Osteopath The truth is... I was out of massage therapy benefits, and my lower back was killing me. Osteopathy turned out to be massage therapy meets chiropractic. Perfect! When I came home after my first appointment, I thought I was flying. The doc did some intense fascial release through my calves, shins and feet, and... my back felt ten times better. See? Body magic! Weekly appointments have been helpful in the last four to six weeks of the pregnancy, when the aches and pains become especially taxing. *Note to self: I have never been more grateful to have extended health benefits!
Italian Hubby has been helping me to put my socks on. And shoes. And helping me to get up from the bed. And the couch. And helping me to get out of the car. And out of the bathtub. You get the idea. I am not exactly enjoying being this helpless/awkward/slow moving, but he is super sweet. We have also planned to BOTH stay home with the baby for the first five months postpartum, so we can tag team, AND increase the likelihood of some sort of sleep for everyone involved.
Mom(s) Friends keep promising that my nesting instinct is going to kick in any moment, but... both my mom and mother-in-law have been nesting enough for all of us. Onesies, baby socks, receiving blankets - you name it. So, I feel zero desire to do any sort of nesting myself, knowing that that particular activity is well taken care of. Lol.
Friends Advice received - both solicited an not. Some taken to heart, some ignored. :) Awful birth stories heard (whyyyy?). Baby items and furniture inherited. Batches of cookies and cinnamon buns eaten. Pedicures together - done! It is a bit like talking to friends who have previously completed the race you are embarking on. What fuel was the best? Did they need a hydration bladder? How many pairs of shoes did they pack? Did it work? What didn't work?
Doula We decided to get a doula, as I was not able to get the midwife care at first. A doula is essentially a birth coach, and being a coach, I believe strongly in getting coaches yourself! Our doula has been amazing so far - being only a text away for all the random questions and symptoms. I am also looking forward to having someone by my side during labour and birth, who 1. has done this before, 2. has assisted women through this before, and an simply say "it's normal!", and "you are doing great!". She will also be visiting few times after birth (in addition to midwife visits) to make sure everything is going well. Most doulas also offer postpartum care - whether that's during the day or over night. For example, a doula can come in late in the evening, and stay with the baby until morning, either bottle feeding, or handing the baby to mom, just to breastfeed. It's like having a super qualified infant sitter. I do not foresee needing this with both of us at home, but it's great to know that the additional support is there, just in case.
Counsellor I have not been particularly anxious about the baby arrival, but I also know that 1. I have few risk factors for postpartum depression, 2. my due date is in the late fall, just as the seasons change, and I tend to get seasonal depression in the winter, and 3. marital satisfaction tends to take a hit in the first year after the birth of a baby. With this in mind, Italian and I started seeing a therapist together. We did not want to wait until we needed the support, instead aiming to develop a therapeutic relationship with the counsellor beforehand. Italian also rightly suggested that it might be helpful for the counsellor to get a bit of a baseline of my "normal" mood before it (possibly) takes a major dip in the winter. Phew.
It really does take a village.
Just like with race prep, I try to anticipate as many problems as possible, and brainstorm solutions ahead of time. Just like with race prep, I also know that it’s impossible to foresee / prepare for everything.
Want an example? While racing the inaugural Spartan Ultra Beast, I accounted for hunger, thirst, food poisoning, sunburn and more. I had band-aids with me, and hot coffee in my drop bin. I experimented with all the gear ahead of time. The biggest issue during the race? Thigh chafing. While I trained and trained and trained in the exact same pair of capris that I raced in, it never occurred to me to try running in them while soaking wet. Meanwhile, during the race, we had to waddle through chest deep water half a mile into the course.
Voila, brutal chafing. Oh, how that post-race shower hurt!
Good thing, I function well in chaos.
To be fair, I have never involved this many health care professionals into race prep before. I might just have to try it for my next big race.
Let’s see how this one goes.
If you have given birth, or done a super big athletic event, who have you involved in your support crew? Any of the above? Any that I didn’t mention? Let me know.