My Understanding Of Prenatal Care

A few weeks ago, I was listening to Maryn Green’s livestream on Facebook where she talked about prenatal care. She concluded her video by asking what prenatal care means to you, the expecting mother. This is my second pregnancy and I am past 40 weeks right now. Last pregnancy, I was in Michigan and I had two midwives whom I saw regularly. Their prenatal care consisted mostly of just chitchatting about how I felt, if I had any concerns, questions, and they offered me different assessments I could take at certain stages as the pregnancy progressed. I did a few blood tests at the very beginning of pregnancy to check for blood count, whether I was Rh positive, iron levels, and Hepatitis B I think. These were all blood tests that I decided to do from the list my midwife read out and explained to me. I could have done more or less. In addition, we listened to baby’s heartbeat both with a fetoscope and a doppler throughout the pregnancy when it was possible to do so, and I had a GBS test done later in pregnancy which I tested positive for. No scans and nothing else.

This second time around, I happened to be living in Istanbul. It took me a while to settle with one care provider. Most care provıders in Turkey, no matter how ‘natural’ leaning, seemed to be adamant on me having at least a few scans which I did not want to do. While I was still looking for someone, my mom convinced me to have the baby in Cyprus where my family is because I’d be getting a lot more help postpartum IF the one obgyn a few of my friends had their babies with would be OK with me not having a scan and if I liked her. So I accepted to meet this doctor. Anyway, long story short the first meeting with her was short and pleasant. She seemed chill and didn’t care about me not having a scan. She asked for a lot of blood tests, if I agreed, weighed me and took my blood pressure and sent me off. It was a rushed appointment though, to say the least. The feeling I got was that she didn’t even care to see me throughout the pregnancy unless I wanted to which I was totally fine with because I lived abroad and felt healthy really and didn’t see much benefit in going in to check my blood pressure and weigh, pay about 200 Turkish liras and walk out. She didn’t say anything about having a scan later in pregnancy and from her attitude I assumed she wouldn’t ask for one. Fast forward, I made an appointment at 36 weeks because I wanted to at least pop in to say hi and make sure that when I called her during labor, she would at least have a clue on whom I was. So I thought this appointment would be very similar to my first and last one back at 10 weeks pregnancy. I was also planning on telling her a few wishes I had in regards to labor and after labor. I tried to limit my list to four things, two during and two after labor so I wouldn’t sound like a control freak and so that she wouldn’t end up, rightfully, telling me to go find another caregiver if I didn’t want to go by her rules. During the appointment, I didn’t even finish telling her exactly what I wanted. I didn’t feel comfortable or confident. I ended up having to do a scan because it seemed very important to her. She wanted to check the position of the placenta to rule out placenta previa, and obviously the position of the baby. She had me take an appointment for 10 days later for a cervical check, and I walked out the clinic wanting to cry. Later I called and canceled the appointment for the cervical check.
I should mention that in Istanbul, I saw one other obgyn for an actual prenatal rather than to meet her – she was respectful of the fact that I wanted to avoid scans. She checked for positioning with her hands, we listened to baby’s heartbeat and we did the usual body weight and blood pressure. She said she wanted to see me again before I left to Cyprus and asked for a few blood tests. She didn’t feel happy about my skin color which is very pale and gives off the feeling that I have very low iron although I have never suffered from major symptoms of anemia, pregnant or not, and my blood tests have always come out borderline to low iron levels but never alarmingly low. I had already done all the tests she wanted me to take. I was planning on taking them again anyway because frankly, I was just hoping she’d give me an OK note for traveling in case they asked at the airport at 35 weeks pregnancy. I was too tired and busy to get the blood tests done and schedule another appointment so I never did, and no one asked anything at the airport.
So Maryn made so much sense during her live session and talked about how prenatal care should really revolve around what the mother considers prenatal care to be. What she feels like she needs whether that’s physically or emotionally or spiritually. For example, I always felt like a regular massage during pregnancy would be such a bliss but I never placed it in the category of prenatal care. I had the blessing of knowing a professional massage therapist in Michigan who offered her services inside your own home. Personally I would be making use of that opportunity if I were to have access to it throughout my pregnancy, more so than a frequent trip to an obgyn’s or midwife’s office for a weight and blood pressure check which can really be done at home. If you can only afford or have access to very limited massage therapy, you can make sure you practice some self-massage with sesame oil before a shower, followed by a relaxing 2-minute facial gua sha.
In addition, I saw an osteopath on three different occasions during my current pregnancy and felt relief each time from some hip issues I was experiencing. Some expecting mothers frequent osteopaths and chiropractors on a regular basis. Another practice that moms can benefit from is prenatal yoga, either at home or in a group setting. I had established a routine habit of practicing yoga in the mornings especially during Ramadhan and it was a great start to the day. Eating mindfully and taking regular walks is another essential part of maintaining a healthy pregnancy. Despite how constipation is seen as a normal and expected part of pregnancy, I never seemed to have an issue with it in relation to pregnancy but rather I realized that tension during my day and an inability to relax and take a break for at least 15-20 minutes with deep breathing is what causes me trouble. I need to put my mind to it. I like to include an essential oil into the breathing session too, sweet marjoram being my personal favorite. You can intend for the deep breathing to relax & benefit your womb and prepare you for the upcoming labor too. It’s a good habit and needs to be practiced prior to labor, if you are planning on using breathing techniques during labor. I tend to experience restless leg syndrome some nights especially if I’m going to bed late (which is best avoided!) so a 10-minute soak in a small bucket of warm water with epsom salt does wonders and is a great treat. Massage your feet with raw Shea butter or olive oil after drying them with a towel.
As other women, I’m guilty of sometimes feeling like pampering myself is selfish. I’m still young and maybe don’t experience the aches and pains and the struggles of life that older women do, I feel, but I need to remind myself that I am a full-time mom, wife and homemaker. I need to acknowledge that I do work hard; I’m trying my best to keep up and sometimes I have very high expectations of myself. If I expect myself to function as a sane humanbeing and avoid going out of my mind from exhaustion so that I could continue doing what I have to do, my body and emotions need to be taken care of. And so do yours.
So these are some things that I consider to be essential parts of prenatal care for me i.e. what a pregnant woman needs and really, what a non-pregnant woman needs. Another mom could feel that she needs that extra blood test and frequent blood pressure and weight check, as well as the many other routine checks that modern obstetrics and some midwives have to offer. Others might have things to add to the list of practices I mentioned. Maybe a warm cup of herbal tea or milk with honey before bed or while reading a book, meditation… I’d love to hear comments from other moms!purplepansy

Week One of Ramadan 2017

We are already on day 8 of this year’s Islamic lunar month of Ramadan. Before I get to the real purpose of my post which is sharing how my experience has been fasting while pregnant for the first time, I would like to write a little about what Ramadan is about. Even if you’re not a Muslim, you have likely heard of this holy month that is welcomed by most Muslims with much joy. The month of Ramadan is when the first verses of the Qur’an were revealed to the final Prophet of Islam, Muhammad ﷺ. During Ramadan, Muslims observe the fast incumbent upon every Muslim who has reached the age of accountability, and who is physically able to do so. The fast begins at what they call true dawn which is the Fajr prayer time, before sunrise, and ends at sunset (Maghrib prayer time). There are two other prayer times in-between Fajr and Maghrib. The fast excludes all liquids and solids, including water. Obviously the days are shorter in colder seasons and the fasts tend to be easier and vice versa during the warmer seasons.

Instead of arguing about whether fasting is a wise choice for Muslim women during pregnancy or not, I’m going to direct you to this link because again, my purpose is not that. I think the wisest choice is for a woman to listen to her body, whether that tells her to fast or not. I find fear mongering pregnant/nursing women that their baby will be harmed if they chose to fast is just as bad as making a woman feel like they must fast while pregnant/nursing.

Last year during Ramadan I knew I wasn’t even going to try fasting because the weather was very hot and I was nursing on demand a 2 month old who didn’t receive any nourishment other than my milk. I asked some friends who tried fasting while nursing older babies (one 6 month old and one 10 month old) and they also told me they tried but had a very hard time. This year as we approached Ramadan, I was still nursing my one year old a few times a day and I happened to be pregnant. So initially I didn’t give it much thought and told myself I was not going to fast. However one day a doula/midwife sister on a Facebook group dedicated to Muslim pregnant ladies asked us what our plans were for this Ramadan. One of the pregnant ladies said she would be fasting while nursing 20 month old twins 2-3 times a day and at 8 months pregnant. She showed so much enthusiasm and even shared her little tip (drinking the juice of half a watermelon every night which she did back when she was fasting last year while nursing the twins at around 8 months old). Others said they would try and fast as many days as possible. So at that point I thought I really should at least intend to try fasting and see how it went and if my body told me I couldn’t handle it, I would stop. Before Ramadan came, I weaned my daughter. So now I was left with the pregnancy and the uncertainty of what fasting would be like while chasing and caring for a mini human. Just a note, I am currently 17 weeks pregnant and therefore in my second trimester.

So the first day of Ramadan turned out wonderful and much easier than I anticipated. It was very encouraging so I decided I would continue. I didn’t have any dizziness during the day. I slept a couple of hours before suhoor the night before (suhoor is the meal that we have just before dawn to prepare us for the day ahead) and woke up about 40 minutes before dawn. My husband and I had a light breakfast style meal. We waited for dawn, prayed, and then I went to bed again until my daughter woke up. In the morning I did the usual and actually a little more than I typically feel like I have time for. I fed her breakfast, organized the kitchen if it needed any organizing, did some yoga, did the laundry, read some Qur’an, took a short walk to the grocery store, took a nap with my daughter, prepared dinner and some walnut stuffed buttery dates for iftar as well as for our next door neighbors. We never met and I thought this was a nice occasion to greet them and congratulate them for the beginning of Ramadan. Our daughter did us a favor and slept without much hassle before sunset so I had the pleasure of sitting down to break my fast peacefully with my husband without any distractions. The moment of thoughtfully sipping on water and biting into a date after a long day of fasting, I wish everyone could experience that at least once in their lifetime. You feel the water rush through and quench your entire body.

Came day number 2, and this time my daughter didn’t sleep until after the call for the Maghrib prayer. That was super annoying and I kept thinking of how I wanted to experience that great feeling at iftar like I did the previous day. I only say this because I had a thought during these few minutes that maybe is worth mentioning. Well, first of all, I was probably easily irritated because it was a long day, I was tired and looked forward to breaking my fast. But I wanted to convince myself that this was really not that big of a deal and I should be thankful that I even have such a lovely child that I am able to put to sleep. A dear friend of mine had advised me to picture a beautiful image (of a flower, for example) and imagine that I become one with that image in moments of frustration. I found that even just imagining something beautiful, at that moment wisteria, was soothing enough because gazing at beauty gladdens the soul. The rest of the days of the first week varied, some days more challenging than others with putting the little one to sleep before sunset. We did end up keeping her up one of the days till after we broke our fast and she still took forever to fall asleep later and so that choice didn’t make things much easier. Some parents decide to flip around their kid’s schedule where they’ll have them sleep later in the night and wake up later in the day so that the parent can get enough rest as Ramadan nights tend to be lively and fasting folk may choose to rest for longer in the mornings. I did that last year even though I wasn’t fasting just to fit my husband’s schedule but I chose not to this year. Anyway. After day 3, generally speaking, the fast got even easier as the body adjusted.

As a final word, it’s important that a fasting person does not push their physical limits. I normally wouldn’t take naps with my daughter during her nap time but during Ramadan, I think the nap really helps me re-energize mid-day so it’s an important adjustment. Make sure you rest, enjoy this spiritually uplifting time, and nourish & hydrate yourself after sunset.

I hope everyone including mamas who weren’t able to fast still benefit from this blessed month and feel the spiritual benefits it brings forth.