Given how many trends have changed since my mother and grandmother gave birth, I like to fantasize that it doesn’t matter what I do because the recommendations will change in another few years anyway. My mother wasn’t supposed to eat fish because of mercury; now you’re supposed to eat fish because of omega-3 (but only certain ones) but avoid rice because of arsenic (except not really?).
But despite the dizzying changes in recommendations, I do actually try to find out what the evidence shows. PubMed and the Cochrane Collaboration have become my best friends. If you have any questions about anything related to health, I recommend them as a starting point. (I admit to only reading the summaries, but many of these are meta-reviews rather than individual studies so I hope any methodological problems have already been caught by the authors.)
I also highly recommend Scott’s Biodeterminist’s Guide to Parenting.
And now for some things I didn’t know before starting this adventure:
- Popular herbal remedies probably don’t help during pregnancy, and some of them are harmful. Ginger for nausea is the only one that looks good.
- Cocoa butter does not prevent stretch marks.
- Is it worth it to do pelvic floor exercises during pregnancy? It seems to make a difference in the first six months after birth, but not after that.
- There’s a big debate about whether epidurals are the best thing to ever happen to women or an evil meddling by the medical industrial complex. (Interestingly, access to more drugs in labor was considered a feminist issue in the early 20th century, whereas now you’re viewed with suspicion if you don’t Trust Your Body enough to do birth without assistance from an anesthesiologist.) This Cochrane overview concludes that epidurals usually help with pain and don’t produce a lot of differences in terms of health outcomes (for example, they do not change your chance of having a cesarean). And yet maternal satisfaction is unchanged. I’m guessing this is because people don’t like pain, but they also don’t like being hooked to lots of monitors and being unable to use their legs properly.
- Perineal stretching seems to work for reducing tearing.
- Self-hypnosis during labor doesn’t have much evidence for it. Various drugs, immersion in water, relaxation, massage, and acupuncture look better as pain relief methods.
- You would probably like to have a doula if you can afford one. Better yet, insurance should cover them. “Women who received continuous labour support were more likely to give birth ‘spontaneously’ . . . . were less likely to use pain medications, were more likely to be satisfied, and had slightly shorter labours. Their babies were less likely to have low five-minute Apgar scores. No adverse effects were identified.”
- The lying-on-your-back-with-legs-in-the-air position that’s standard for hospital births does not seem to make a lot of sense. Throughout the pregnancy, they tell you not to lie on your back because it cuts off blood flow, and then they have you do it for 12 hours during birth? It makes it easier for other people to see what’s going on, but it means gravity is not helping you. I thought it was pretty clear that upright positions are better, but the evidence is more mixed than I thought.
- If you’re going to breastfeed, you should keep taking fish oil after birth.
Founts of knowledge:
Assorted other links:
- A due date calculator that tells you your odds of going into labor by a particular date. Note that it’s based on normal distribution, not an actual data sampling. I did find it helpful for planning activities, though.
- The motherlode of pregnancy-related Wikipedia articles.
- I love these images.