We have done numerous phone and television interviews for this group, and it seems there is a common question, “Why did you write this book?”.  It’s a good question since there are hundreds of pregnancy books on the shelves and at least 100 New Releases on Amazon for Pregnancy (we are ranked #16).

The main reason for writing the book is that we felt there was a gap in the database for pregnant patients.  Some of the books out there are confusing in their information and some of them really don’t address patient concerns.  So, we wanted to write something that would be fun to read an at the same time give the reader a wealth of hard to find information.  We also wanted to write something that could be added to in the future.  As we sat down to look at ideas, there was a consistent theme that we felt the best way to go about things was to answer patient questions that we discuss almost daily in the clinic.  Many of these patient questions also seemed to be based on either some sort of fear or a misleading piece of information given to them by a family member, friend, or even complete strangers.  With the concept of pregnancy myths and our load of patient questions we set out to write the book.  There are some pregnancy myths regarding fetal gender that almost everyone has heard of, but we are receiving more and more daily from people that are asking questions about things friends and family have told them.  ”My grandmother told me that I shouldn’t reach for the dishes because if I reach above my head the baby’s cord will get wrapped around its neck.”  Needless to say this causes anxiety and has a patient standing on her head to try and wash her hair for fear of putting her hands above her head.  You can see where this would cause an educated person to think twice and we were hoping that we could help disseminate truthful information and present it in a manner that will benefit the most women.  

So the book is more of a companion guide to some the books already out there.  It is not made to replace any particular book, but it can fit nicely onto your shelf amongst your other pregnancy books or it can be given as a gift to your friend that is pregnant.  We are hoping that women will come to the website and talk about there pregnancy myths and superstitions from infertility to postpartum.  In sharing your questions you are helping to disseminate knowledge to those women that have questions.  You might think you are crazy for even asking, but we have found that there are many other women out there with the same questions.  There is security in truth and knowledge.  Help s spread the word and get your copy today.

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So much mysticism and mythology surrounds the pregnancy due date.  Much of the mysticism is held by physicians who hold on to the old ways of  determining when a pregnant woman will deliver.  Believe me, most physicians would love a way to determine the due date so we could plan our lives around the deliveries of our patients, but the truth is only 1-2% of women will actually deliver on their due date.  So what determines a due date, and what is the difference between EDC (estimated date of confinement) and EDD (estimated date of delivery) and what the heck is Naegele’s Rule.  This post will help show the origins of the due date and how we are currently using a system that is about 250 years old.

Franz Karl Naegele (1778-1851) was the German obstetrician who initially came up with the rule to determine a woman’s due date based on her last menstrual period (LMP).  There are many ways to calculate Naegele’s Rule.  I use the system where you take the LMP, add 7 days, and subtract three months.  So if your LMP was April 1, 2009 then your due date would be January 8, 2010.  You can impress your friends at parties with this maneuver.  There are problems with Naegele’s Rule and many people have pointed out that this 250 year old method is no longer appropriate for our advanced age.  What are some of the potential errors with calculating the EDC in this method?

• It assumes that you are having a regular period and that you ovulate on day 14 of your cycle.  I am a gynecologist and there are many women out there that have irregular cycles that ovulate on day 20, 25, 12, 15….you get my point.  This obviously would add potential error to the EDC determination and could change things by days to weeks.
• There is another assumption that the routine pregnancy is 280 days long and that is based on our current calendar system.  The problem with this is that there are many months that contain 30 days or 31 days and what happens in a leap year, or if you are not pregnant over the shorter month of February.  The point is that there is a movement out there that is trying to say that the number should be 288 days and that we are inducing women that have premature babies.  A study done in 1990 stated that the proper method for determining a due date was to take the LMP, count back three months and add fifteen days for a primiparous (first pregnancy) woman or 10 days for a multiparous (subsequent births) woman.  This was published in the journal Obstetrics and Gynecology.
• There are many that argue this method of calculating the EDC is as archaic as the term EDC itself.  Lending to the agrarian societies from whence it came, the EDC literally came from the fact that a woman was confined to her bed for the last part of her pregnancy to prevent preterm labor.  While we still prescribe bedrest today as a possible therapy for preterm labor it does seem odd that the medical establishment uses terminology from the 1700′s.

The due date is as individual as the pregnant mother.  While the EDC is currently calculated by Naegele’s Rule this does seem a bit archaic and inefficient; especially if we are using this dating method to determine inductions and postdatism.  There have been other methods with increased accuracy but they require a woman to measure body temperatures and be move involved in her own self-care.  Many reading this article are very involved with birth and feel as though self-care is very important, but there are many women out there that simply choose not to be observant of their own cycle.  So, what do we “do” with the “due”.  Unfortunately, I think we will keep going with the current system and back it up with ultrasounds which are accurate within 5 days if done in the first trimester.

Approximately 3% of so-called term births (occuring after 37 weeks) are completed with fetal lung immaturity and this could be because the baby may have been between 35-37 weeks and not term.

Are we too involved in the birthing process?  Are there better ways to determine the pregnant due date or should we not worry wbout and just let man/woman  be born in his own time.  The latin word natura gives rise to the word natural and means “to be born”.  Maybe we should just leave well enough alone.

There are more couples that do not have a birthing plan when they arrive to labor and delivery than couple with an established plan.  I think there is a question out there a to whether or not a birth plan needs to be established.  There are many out there that feel like you need to be protected from your doctor and the hospital and a birth plan is the best approach.  I suppose, if you felt like you needed to be protected from your physician and hospital then you should do everything in your power to not deliver with them.

There are many sites out there for you to make your own birth plan and I would say it is a good idea to visit one of these sites and plug in your information so you can see some of the issues that might arise when you go into labor.  You may need to confront issues like, pitocin, epidural, pain meds, episiotomy, internal fetal monitors, cesarean section, and things of that nature.  It would be nice for you to have a potential feeling one way or the other on these interventions so they are not foreign.

Discuss your birthing plan with your provider and make them aware of what you would like to happen in your pregnancy.  The power of intention being laid may make a difference in the outcome of your delivery process and it doesn’t hurt to have the providers intentions set as well.  In a few instances, some couples will present and act like the birth plan is their shield and that the hospital is out to get them.

Let me share a story.

I was on call for  another group of physicians and a patient presented from their office into labor.  She was very adamant about her birth plan and was very direct in her statements towards the provider, hospital, and the nurses.  I could feel the anger in her words by the tone of the letter and I wondered why she was delivering in the hospital when she obviously felt very strongly that the hospital had policies and procedures in place that she was very opposed to; there is a midwifery birthing center her in Tucson.  I found out that her insurnace would not cover her birth at the “birth center” and so she was stuck with us and our ways and she felt the need to be defensive.  What is truly sad here is that her insurnace company would not cover her birth where she wanted to birth, and this needs to change.  The second thing that struck me as that she felt the need to protect herself from us.  Add on top of this that she did not know me because I was covering for her doctor and you had a patient that was very leery of the system.

She progressed through labor well and I visited with her  a couple of times as she labored.  She was surprised when I told her that she could do what she wanted and I was only there to help her if she needed me.  This is truly my policy.  I did ask for her to be flexible and that if I had information for her that I would present it and she could decide what to do.  She delivered in a squat position on the floor and it was the first birth where I delivered a baby like this, practically laying on the floor.  She was very appreciative at my flexibility and the joke was that may muscles were so sore from squatting with her, I don’t think I am very flexible.  She had a second degree laceration and I informed her that it was not bleeding very much and asked if she wanted sutures which she did not, and I did not put them in.

You see, we can work together, and the birth plan can be a road map for your successful birth process.

Thank to Laurie Puhn at Expecting Words for allowing us to be guest authors on her website.  We wrote an article on 5 pregnancy myths you need to know.  Obviously there are many more in our book, but we put 5 of them out there that you might not have heard of or didn’t know the answers.  Click on the link to read our article 5 Pregnancy Myths You Need to Know